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Evolving Expectations of Consumers on the ACA's Exchanges


Consumers on the Affordable Care Act's public exchanges have shown a willingness to shop around for coverage that heath plans can tap into.

More than 11 million Americans were enrolled in health insurance coverage through the Affordable Care Act’s exchanges as of March 31, 2016. A new report from Deloitte has found the behaviors, attitudes, and perceptions of enrollees on the public exchanges can vary vastly from those of individuals enrolled through employer coverage.

The 2016 Survey of US Health Care Consumers sought to understand exchange consumers’ satisfaction with coverage, knowledge of costs, use of online services, and more. Preliminary findings of the survey were first released in May.

“For many organizations, success in these new markets may largely depend on their understanding and approach to consumer engagement,” according to the report.

The report found that exchange consumers are as likely to say they are satisfied (53%) with their coverage as those with employer coverage (54%). Reasons for dissatisfaction between the 2 groups differ. Exchange consumers were most likely to say their premiums were too high (50%) compared with their employer-sponsored counterparts (42%). However, fewer exchange respondents said they were having difficulty paying out-of-pocket costs (70% vs 75% of employer respondents).

The survey found that exchange consumers have shown a willingness to shop around for coverage and evaluate the total costs before they make a decision, even if they end up staying in the same plan.

“Exchange consumers’ focus on factors beyond cost and their demand for tools and technologies to support their shopping experience emphasize how important it can be for health plans to review consumer engagement techniques to enhance touchpoints,” according to the report.

Deloitte suggested that health plans make the following changes in their strategies to best meet evolving consumer demands:

  • Understand the drivers behind consumers’ decisions: cost is not the sole driver and returning consumers are less likely to accept network tradeoffs for lower payments than newer enrollees
  • Build tools that enhance transparency and help consumers understand costs, benefits, and networks: exchange consumers are paying attention to premiums and out-of-pockets costs at the enrollment and re-enrollment stage and online tools let them make more informed decisions.
  • Meet consumers where they are: a willingness to switch plans or companies means health plans should consider providing an adaptive, seamless, and compelling consumer experience.
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