A recently published survey from industry consultant HTMS, an Emdeon company, and the Managed Care Executives Group (MCEG) showed that only 4 percent of small and mid-sized health plans consider health reform to be a threat to their business.
Detailed in the whitepaper "Moving Forward with Reform: The Health Plan Pulse for 2012 and Beyond" one-in-three health plan executives saw nothing but opportunity in health reform, while the vast majority – 60.9 percent – considered it both a threat and an opportunity for their businesses.
The yearly survey, the third conducted by MCEG and HTMS, is designed to get a feel for what issues are being faced by regional and small and mid-sized payers across the country. Authors of the report, Nancy Wise, vice president of planning and strategy for HTMS, and Ferris Taylor, president of Armored Health & Strategy and an advisor to MCEG said it is important to get the voice of these health plans heard in the larger healthcare debate – a debate that is often dominated by the largest for-profit insurers.
"What we are trying to do with the survey is get a broader perspective on where the industry is," Wise said. "In this case, many of the MCEG members are small-, mid-sized or regional health plans. In many cases, the voice you hear from the survey isn't the voice that you hear from some of the larger plans in the marketplace. So one of the goals for MCEG has been to make sure the thoughts and goals and priorities of smaller plans is also a part of the national dialog."
As part of that dialog, HTMS and MCEG will hold a webinar to delve durther into the results of the October survey at 12:00 pm Central time, in a forum that will also allow significant participation from attendees.
"People are well aware of waht they are doing, but to see themselves in the context of what others are doing can be quite helpful," said Wise.
The survey and subsequent follow up with respondents indicated that many health plans see 2012 as a tactical year, a time that needs to be spent meeting many of the regulatory mandates from HIPAA 5010 to ICD-10, meeting health reform's MLR requirement and also preparing for the advent of the state health insurance exchanges.
"Many of the respondents we spoke to said they aren't ready for all of these changes," Wise added. "So 2012 is a tactical year since many plans are focused on making the investment in technology and systems."
Other survey findings include:
- The majority of insurance executives surveyed said they expect their memberships will increase in the coming years.
- 75 percent siad they were planning to particiapte in a health insurance exchange (HIX) in some capacity
- 53 percent said they anticipated participation in an HIX would increase membership.
- 47 percent are actively planning to particiapte in ACOs; the same number are still trying to figure out how ACOs will fit within their organizations
- 5.7 percent said they have no plans to particiapte in an ACO.
While much of the activity of the repsondents focus on meeting federal mandates and preparing for changes as a reuslt of health reform, Taylor noted that comments submitted in response to some survey questions also indicate that the smaller and mid-sized plans represented are today focused on finding ways to reduce costs, regardless of other factors.
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AR-SA">"Since I first got in to healthcare, the annual increase in cost and the premium increases have been unsustainable," said Ferris. "These things override the individual mandate and the Supreme Court and the elections."