Exchange competition to expand in second year

FROM THE SOURCE: Margaret ‘Meg’ Curran, chairwoman of the R.I. Health Benefits Exchange Advisory Board, left, and Lt. Gov. Elizabeth H. Roberts. / PBN PHOTO/RICHARD ASINOF
FROM THE SOURCE: Margaret ‘Meg’ Curran, chairwoman of the R.I. Health Benefits Exchange Advisory Board, left, and Lt. Gov. Elizabeth H. Roberts. / PBN PHOTO/RICHARD ASINOF

When HealthSourceRI, the state’s newly renamed health-benefits exchange, opens for business on Oct. 1, it will offer 28 different health insurance plans – 12 for individuals and 16 for small businesses with fewer than 50 employees.
That’s a remarkable achievement in itself, according to Christine Ferguson, executive director of HealthSourceRI. There’s really no precedent, she says, for government to be selling products and to be doing a startup of this magnitude.
The first year, however, will not be the best indicator for how competition for market share will play out between health insurers on the new marketplace, according to Ferguson.
“We don’t know what the take-up rates are going to be,” she told Providence Business News. “We’re making assumptions about people’s willingness to buy. I think that those kinds of projections from a market-share perspective are really tough.”
Ferguson is already looking ahead to the new marketplace’s second year of operation, when the HealthSourceRI’s new slogan, “Your Health, Your Way,” will reflect more options and innovations.
Actual plan coverage begins on Jan. 1, 2014 for enrollees with Blue Cross & Blue Shield of Rhode Island, UnitedHealthcare and Neighborhood Health Plan. A year later, Tufts Health Plan is due to join them.
“When we negotiated this year with health plans, the magnitude of systems change and the importance of the employee-choice model were really at the top of the list,” Ferguson said. “We got those. For next year, which we will start negotiating in November of this year, the focus will be on [innovative plans by a combination of hospitals, medical groups and health insurers] offering limited, tiered networks.”
Many of the plans in the first year of HealthSourceRI’s operation will still have a range of high deductibles, Ferguson continued, something she said she doesn’t like. “We have spent the last 15 or 20 years designing what’s available in health plans based on copayments and high deductibles,” she said. “Once employees can make their own choice about health plans, the ability to use networks will increase, and that’s what we hope to do next year.”
The opening of the new consumer call center on July 15 at 70 Royal Little Drive in Providence, just down the road from AAA Southern New England headquarters and Edesia’s manufacturing plant, marked the beginning of a public outreach and marketing campaign that will visit every one of Rhode Island’s 39 cities and towns. The first stop on the tour was on July 17 at Heritage Restoration, at 122 Manton Ave. in Providence. The call center will be run by Connextions, an Orlando, Fla., firm owned by Optum, a division of UnitedHealth Group, Inc., the parent company of UnitedHealthcare, under a recently signed contract worth about $24 million for services through 2016. About 150 Rhode Islanders will be hired to work at the call center, which will be fully operational on Sept. 1.
In addition, an advertising media campaign will kick in toward the end of August, promoting HealthSourceRI, according to spokesman Ian Lang.
At the July 15 news conference, public officials were beaming like proud parents of a newborn.
“I do feel like a proud momma,” Lt. Gov. Elizabeth H. Roberts told PBN. “But … it takes a village,” she said, praising the team that includes former R.I. Health Insurance Commissioner Christopher F. Koller, Gov. Lincoln D. Chafee and Ferguson.
Richard Licht, director of the R.I. Department of Administration, and Steven Costantino, secretary of the Executive Office of Health and Human Services, also played roles and credited Chafee for signing an executive order to create the new insurance marketplace.
From the podium, Rep. David Cicilline, D-R.I., praised the state’s national leadership in creating a “thoughtful, transparent” health marketplace with an emphasis on affordability, calling Washington, D.C., an “alternative universe” where the Republicans were still fixated on trying to repeal health care reform.
“This is a big step forward for Rhode Island,” said Sen. Sheldon Whitehouse, D-R.I., in an interview. Whitehouse said Rhode Islanders who already have insurance, and who get their insurance through their work, and who intend to stay with that company forever, might not understand the significance of HealthSourceRI.
In terms of the state’s planned expansion of Medicaid, Costantino told PBN that out of the 100,000 who will be potentially eligible, “The first year’s uptake will be 27,000 – and that is an estimate.”
The key to success, Costantino continued, is to create a system that is user friendly, enhancing the seamless capability of HealthSourceRI to accommodate customers. “Whether it’s Medicaid, whether it’s small businesses, it doesn’t matter,” he said. “The system should be blind to that.” •

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