With the Patient Protection and Affordable Care Act’s (ACA’s) ninth open enrollment period (OEP) set to launch in less than a month, the ACA Marketplaces are seeing record enrollment numbers with more generous subsidies, new carrier competition, and a relatively stable rating environment. At the same time, there is uncertainty with the trajectory of the COVID-19 pandemic and medical costs trending upward as the economy recovers, albeit at an uneven pace. These trends have made for a challenging rate review process in the 47 states plus the District of Columbia (D.C.) that conduct their own ACA rate reviews of carrier-proposed rates using federal review standards. State announcements of 2022 rates have trickled out at a slower pace than in prior years, and it is likely that many states will not publish their approved rates until the beginning of open enrollment. As always, state rate results vary widely and, even within states, there often are substantial variations among carriers and across different regions in geographically diverse states. With these caveats, this expert perspective highlights some observations about the factors that are impacting rate changes this year and the kind of variations that exist among states.
How Can Insurance Exchanges Strategically Approach the Selection and Management of Qualified Health Plans?
Jon Kingsdale, Managing Director, Wakely Consulting Group Patrick Holland, Managing Director, Wakely Consulting Group
The ‘How Can Insurance Exchanges Strategically Approach the Selection and Management of Qualified Health Plans?’ took place on Thursday, February 14 at 2:00 pm ET, and was facilitated by Wakely Consulting Group. Click the blue “download” button on the left to access the slides from the webinar and click here to download the webinar recording. Wakely has also published an issue brief covering this same topic. Below is a brief write-up on the webinar:
Contracting with issuers to offer qualified health plans (QHPs) is one of the most important opportunities that Exchanges have to affect health care reform in their states. Unlike many start-up tasks, certifying, re-certifying, de-certifying and managing the relationship over time with health plans is an ongoing and evolving set of tasks. Therefore, Exchanges should take a strategic approach to these functions. This webinar looked at the many of the types of decisions that Exchanges should consider in preparing to launch a clean, effective QHP solicitation process; the standards that Exchanges can use to certify QHPs; and what are options for “negotiating” key elements of the issuers’ proposals.