On May 2, 1961, President John Kennedy set an astonishing challenge for the United States, declaring that by the end of the decade, the U.S. would send a man to the moon. In many ways, the Affordable Care Act is the health insurance industry's own space race, with the goal of insuring every citizen taking the place of, well, going to the moon.
And, like the moon mission, we are seeing evidence of a growing innovative spirit as a consequence of this enormous goal.
Specifically, our product development and implementation teams, working with a number of state-based marketplaces and CO-OPs around the country, are seeing first-hand how the following ACA-driven factors are spurring innovation:
Fearlessness in the face of uncertainty: Innovation requires a comfort with uncertainty and the ACA – a "moon shot" – has certainly brought its fair share of that to the health insurance market.
The ACA forced issuers working with public marketplaces to start development based on little more than their own expectations of the interaction. These are organizations that thrive on actuarial charts; they do not typically undertake projects without knowing each and every requirement and milestone ahead of time. But in the world of the ACA, new information continues to come out every day, even now.
Being comfortable with this level of uncertainty doesn't guarantee that things will go smoothly. However, instead of worrying about what might happen next, acceptance of this new way of doing things is causing organizations to adapt and change their processes to meet the new challenges, something that wouldn't happen without embracing the unknown.
Shift to direct-to-consumer communications: Marketplaces not only shift the responsibility to consumers, they also shift the burden of information gathering to consumers. And as consumers are engaged, they expect purchasing healthcare to be similar to other purchases in their life, such as buying books on Amazon or airplane tickets on Orbitz.
Because they need to be given the tools for better decision making, the ACA compels issuers to come up with new ways to communicate critical healthcare information. This forces them to analyze and improve how they communicate information, and as information becomes increasingly clear and easy to understand, we will see improved outcomes and more affordable healthcare over time.
Demand for modularized infrastructure: Constantly changing data requirements from both federal and state marketplaces – for actions such as individual and group enrollment and payments – require flexible technology platforms that can allow for changes to be made in very short windows of time.
This means that the old technology approach of monolithic "set it and forget it" solutions is, at last, dead. In the age of the ACA, payers are being forced to make changes – large and small – in a limited period of time, and in turn they are demanding that system vendors offer modular technologies that can be modified quickly, easily and at a lower cost. By breaking large solutions into smaller parts, it becomes easier for innovations to occur, and for innovative new players to step in to handle particular specialties.
Given reports of marketplace difficulties at both the state and federal level, it may be difficult to view this period as one where innovation soared. In a few years, however, as we look back on where we started, it will become clear that the healthcare space race brought new ideas and greater healthcare for the entire country.
Darin K. LeGrange is the president and CEO at Aldera, a provider of core administrative systems, private portals and informatics for the health insurance industry.