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Reading: Good riddance: United finally gives up on ACA marketplaces
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Health Works Collective > News > Good riddance: United finally gives up on ACA marketplaces
NewsPolicy & Law

Good riddance: United finally gives up on ACA marketplaces

DavidEWilliams
Last updated: 2016/04/28 at 2:38 PM
DavidEWilliams
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ID-100146585

United we hardly knew ye

ID-100146585

United we hardly knew ye

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United Healthcare announced that it’s exiting most of the Obamacare insurance marketplaces (aka exchanges) next year. Sound like a familiar story? In fact all the recent news coverage is just a rehash of last November’s announcement that United was probably going to exit.

As I wrote at the time (United pulls out of ACA exchanges: Should we care?), United’s exit is not a huge deal. The company specializes in selling high-priced plans to corporate accounts. In the price-sensitive world of the exchanges that’s a losing proposition. No surprise — United wasn’t getting traction.

In January (Like I said: United’s ACA exchange departure is no big deal) I reported on a study that showed that the name brand, high-priced commercial players like United were losing out to insurers with a Medicaid managed care background and to mission-oriented Blues plans. United’s departure represents the failure of United, not the failure of the marketplaces. If United says otherwise, it’s a sore loser.

Health plans thinking of competing in the marketplaces should say this to themselves a few times before diving in: “Exchange business is price sensitive business. If we can’t compete on price we might as well stay home.”

Now, if United were a little more clever and capable it actually could make a play for the exchange business, in a way that would boost its success in the commercial market as well. In particular, there are opportunities to better manage the way specialty care is delivered and paid for, by emulating the approaches used by the most efficient and innovative specialists. This would drive down the overall cost of insurance and improve care for patients. Some astute players in the bundled payments space are starting to figure it out. Somehow I don’t think United will be the one to make it happen.

Image courtesy of Stuart Miles at FreeDigitalPhotos.net

—

By healthcare business consultant David E. Williams, president of Health Business Group.

 

TAGGED: health insurance, obamacare, United Healthcare

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DavidEWilliams April 28, 2016
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Previous Article Diagnosing Illnesses with Advanced Technology
Next Article The ACA has put patients at the center of healthcare services. A patient-centric healthcare approach in this digital era means a revised definition of quality in the physician-patient relationship. When it comes to healthcare services, patients shell out a hefty amount from their pocket and want nothing less than the best. The services in healthcare are no longer limited to just cost as consumers now evaluate quality and experience in the same equation. Research highlights from the 2015 Healthcare Consumer Trends by National Research Corporation states that reputation in healthcare matters more to consumers when choosing a brand than any other industry, e.g. hospitality, retail, airline, etc. The new generation of quality measurements in healthcare require a different mind-set and a different 'toolbox' to handle the hurdles. It’s the need of the hour for healthcare providers and others across the healthcare value chain to adopt the patient-centric approach for surviving in the vast competitive ocean of healthcare services. Patient-centric care is an approach that develops through effective communication, empathy and a positive physician-patient relationship. The primary purpose is to improve patient care outcomes and satisfaction and to reduce patient symptoms and unnecessary costs. It’s a win-win situation for both physicians and patients. While healthcare providers are able to support their patients in becoming more compliant with treatment and management of their conditions/diseases, patients feel more satisfied with the care that they are receiving. PwC’s Health Research Institute’s annual report 2016 states that health systems should keep an eye on the consumer experience as they expand and extend. More partnerships and more caregivers could mean confusion for patients and poor customer experiences. To differentiate their practice among competitors, patient satisfaction can be used as a competitive distinguishing factor. Although patient satisfaction cannot really provide tangible benefits, but an experience that exceeds patient expectations for what a practice/hospital can provide is very important as it creates loyal patients who return for future health needs and refer their family and friends. Happy and satisfied patients are a secret marketing weapon for healthcare providers, whether they are physicians, dentists, physiotherapists or hospitals. Your patients are the new-age digital health decision-makers. In this era of Internet and social media, they now have multichannel access to information related to health. Needless to mention, they have gained new power to make their decisions; whether it’s choosing a healthcare provider or referring a physician to family and friends. By converting your satisfied patients to be your brand advocates, you can capitalize and use their voice as an effective marketing strategy to reach out to many other potential patients. To strive and thrive, in the U.S. many healthcare organizations are applying patient-centric approaches to healthcare. It’s all about what matters to patients, so it makes a lot of sense for the healthcare industry to place patients' healthcare experience at the center of their policies and procedures. The best deliverables are a combination of great communication for a positive physician-patient relationship, disciplined measurement and analysis of patient feedback and commitment to technology innovation – the formula for improving patient engagement and care. The Link Between Patient Satisfaction and Long-Lasting Relationships

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