People enrolling in public health insurance exchanges are more willing to switch plans, placing pressure on insurers to continually win over shoppers based on price, product and service, according to a new report by Deloitte.
Among those who had exchange coverage in 2014 and renewed for 2015, 45 percent switched to a new plan, according to the report.
This included 29 percent who chose a new option within the same company and 16 percent who went with a new carrier.
Seventy-six percent of exchange enrollees cited the cost of premiums, deductibles and copays, as the biggest factor when choosing a plan. In addition, 34 percent of respondents covered in 2014 expressed difficulty paying these fees.
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The report shows insurers can attract new customers and reduce turnover by focusing on benefit-price tradeoffs and tailoring products to consumers' differing coverage preferences.
"Loyalty is not locked in like it is in other industries – there could be a significant opportunity for traditional players and new entrants to seize market share by listening to what consumers say about product, price and service," said Paul Lambdin, director, Deloitte Consulting LLP.
The report showed only 30 percent of exchange respondents are satisfied with their current product, compared to 42 percent for those on an employer plan and 58 percent for those on Medicare.
Exchange enrollees better understand their benefits and costs and are more likely to compare providers and services on price and, to some extent, quality, according the the report "Public Health Exchanges – Opening the Door for a New Generation of Engaged Health Care Consumers, " by the Deloitte Center for Health Solutions.
Exchange customers may be especially receptive to benefit structures that incorporate incentives and tools for pursuing healthier lifestyles and chronic care management.
Exchanges and plans should also consider using both online and personal methods for engaging consumers, as a substantial number still value phone and face-to-face conversations in picking a plan.
"I think for year three of open enrollment we'll see carriers get more personalized and creative in how they appeal to targeted segments of consumers who show signs of becoming discriminating shoppers," Lambdin said. "Insurers in the last two years have been building up their capability to think and act more like a retailer, so we will likely see more tangible examples of execution in the marketplace."
Exchanges are pushing consumers into the new healthcare model based on value, transparency and population health, said Deloitte principal Greg Scott.
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"One way to bend the cost and quality curves is to shift the health system to more of a wellness model versus waiting to treat people after something bad happens," Scott said.
The report found that 51 percent of the exchange individuals surveyed used an online tool to compare and negotiate prices among doctors and hospitals, versus 45 percent for those with employer-based coverage and 36 percent for those on Medicare. Similarly, 63 percent of respondents used an online tool to determine how much their plan would pay for services, versus 53 and 51 percent for the employer and Medicare respondents, respectively.
The report also found that consumers don't have strong trust in any one source of help in finding a plan, but that the exchanges rated about as well any of the 11 sources measured by the survey, including family and friends, providers and consumer organizations.
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Exchanges seem to be improving access and making inroads into preventative care. Nearly two-thirds of respondents said they used their plans to seek services and purchase medication, and nearly 75 percent of those said they may not have been able to afford it without their coverage.
Seventy-six percent said they have a primary care provider – twice the rate of the uninsured – and nearly 60 percent report visiting a doctor for a well visit in the past year, similar to people covered by their employers.
Money concerns led 16 percent to skip seeing a doctor when sick or injured, slightly higher than for those with employer plans and double the rate reported by the Medicare enrollees, according to the report.
Twitter: @SusanMorseHFN