HealthCare Exchange Solutions

July/August 2014

Exchange Hypergrowth Hits Private Exchange World

What’s Next for Private Exchanges The Inevitable Shift to Defined Contribution Single-Carrier Model on the Rise

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INSIDE

FEATURE 13 Growing Pains for Private Health Insurance Exchanges Private health insurance exchanges are experiencing hyper-growth. There is enthusiasm and adoption among many employers, consumers and carriers alike. Accenture predicts that private health insurance exchange participation will approach public exchange enrollments by 2017—if not sooner, as enrollment figures indicate an earlier-than-expected growth spurt.

Accenture estimates there were more than three million individuals that enrolled in private exchanges during the 2014 benefit year. While rapid growth is encouraging to exchange sponsors, it’s important to consider how exchanges can sustain this positive trajectory. Now that the first material open enrollment period has concluded, exchange sponsors have the opportunity to reflect on what has worked and what hasn’t.

By Rich Birhanzel, Scott Brown and Joshua Tauber, Accenture

7 Private Exchange Profile How the ACA and Exchanges Are Driving a New “Whole Workforce” Strategy The benefits business is changing more rapidly than it ever has, spurred on by public debates and private progress. As we approach the second open enrollment of the public marketplaces, and as we see rapid growth of health care consumerism through an increasingly sophisticated private exchange market, it’s clear that while we may see things settle down a bit from last year’s momentous milestones, the proverbial dust of health care reform won’t settle for many years to come.

By Shandon Fowler, Director of Product Management, Marketplaces, Benefitfocus

9 Private Exchange Trends Health Plan Exchanges Begin to Take Off With open enrollment just around the corner, the private exchange market is beginning to heat up. Preparing for a big season in which enrollment figures are expected to jump significantly, we’ve witnessed a number of emerging trends over the first summer months, including an increase in

individual exchanges for non-eligible employees, the accelerated adoption of defined contribution funding and the rise of single-carrier exchanges.

By Jonathan Field, Managing Editor, The Institute for HealthCare Consumerism

10 Defined Contribution The Inevitable Shift to Defined Contribution

DEPARTMENTS 12 Stats & Data Survey Results Support Projections for Explosive Growth in Private Exchanges Recently, Array Health released its second annual Health Check survey report on private insurance exchanges.

The report provides insight into the industry’s expectations and approach for creating and operating private exchanges. The 2014 survey shows that momentum toward private exchanges continues. It is no longer a question of if private exchanges will become popular sales channels, but rather, when. The Health Check survey findings bolster recent studies, such as an Accenture report, that claim faster than expected adoption of private exchanges.

The health care industry has been through the biggest change in history, with an impact some say is even greater than ERISA, Medicare and Medicaid. The current trends in the business and regulatory environment are leading to more creative ways to continue offering employee benefits.

One of those methods has taken the industry by storm with the reinvention of the defined contribution plan.

By Frank B. Mengert, Partner and Director of Exchange Technology, ebenefit Marketplace

4 Publisher’s Letter CEO/Publisher Doug Field covers the latest trends in private exchanges and shares what’s happening at The Institute for HealthCare Consumerism around exchanges.

By Lance Hood, Senior Director of Marketing, Array Health

5

Briefs & Innovations Keeping you up-to-date with the latest news, research and innovation in defined contribution and health insurance exchanges.

HealthCare Exchange Solutions™ I www.TheIHCC.com I July/August 2014

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PUBLISHER

Exchange www.theihcc.com VOLUME 10 NO. 4 | JULy/AUgUst 2014

Private Exchange Industry on the Verge of Big Open Enrollment Season

Published by FieldMedia LLC 292 south Main street, suite 400 Alpharetta, gA 30009 Fax: 770.663.4409 CEO

Doug Field @ theihcc.com MANAgiNg DirECtOr

Brent Macy

To say that there is considerable hype and excitement building in the private exchange market would be would be an huge understatement. In the Accenture article that anchors this

MANAgiNg EDitOr

Jonathan Field

issue, the authors describe the current exchange market as experiencing a “hyper-growth”

sENiOr EDitOr

stage, and the oft-cited Accenture enrollment projections forecast as many as six million new

Heather Loveridge hloveridge@theihcc.com

enrollments this fall. With the high number of new enrollees projected each year throughout

ACCOUNt MANAgEr

the remainder of the decade, there’s no sign of slowing down.

Joni Lipson

MArkEtiNg COMMUNiCAtiONs MANAgEr

Throughout the rest of issue, contributors address the other moving pieces in the private exchange world. Shandon Fowler, Benefitfocus, dives into the “whole workforce” exchange solution and the reasons why it benefits employers, brokers and employees. Led by Mercer, Benefitfocus, GetInsured and bswift, this trend has emerged within the last year to cover noneligible employees through a comprehensive exchange solutions.

Frank Mengert, ebenefit Marketplace, looks at the rise in defined contribution funding strategies and the inevitability of its continued growth. Lance Hood, Array Health, reveals a number of key points from a recently released private exchange survey. And Managing Editor Jonathan Field analyzes the growth of single-carrier exchanges for both regional and national health insurers.

Finally, I want to remind readers of the upcoming FORUM West conference in Las Vegas and of the private exchange content that will be available at the show. We will be reprising the

Lana Perry

Art DirECtOr

Kellie Frissell

grAPhiC DEsigN

Patrick Washington DirECtOr OF EDUCAtiON sErViCEs AND PrOgrAMs

Dusty Rhodes ChAirMAN OF ihC ADVisOry BOArD

Ronald E. Bachman, CEO, healthcare Visions EDitOriAL ADVisOry BOArD

kim Adler, Allstate; Diana Andersen, Zions Bancorporation; Bill Bennett; Doug Bulleit, DCs health; Jon Comola, Wye river group; John hickman, Alston+Bird LLP; tony holmes, sanders McConnell, tsys healthcare; roy ramthun, hsA Consulting services LLC; John young, Consumerdriven LLC WEBMAstErs

pre-conference private exchange workshop with experts from PricewaterhouseCoopers, and

Kevin Carnegie

leading consultant John Young will be leading a private exchange general session with Jeff

Tom Becher

Yaniga, Connecture; Mike Smith, Lockton; and more. More speakers and information will be announced later this month. With $99 rates available until September 8, I hope to see you

AssOCiAtE WEB ADMiNistrAtOr

Tim Hemendinger

there.

DirECtOr OF CONFErENCE sPONsOrshiP/ COrPOrAtE MEMBErshiP/rEPriNts

Rogers Beasley

Sincerely,

BUsiNEss MANAgEr

Karen Raudabaugh

Doug Field CEO/Publisher dfield@fieldmedia.com

™ Volume 10 issue 4 Copyright ©2014 by FieldMedia LLC. All rights reserved.

™ is a trademark of FieldMedia LLC. ™ is published eight times yearly by FieldMedia LLC., 292 south Main street, suite 400, Alpharetta, gA 30009. Periodical postage

tO sUBsCriBE: Make checks and money orders payable to ™ magazine 292 s. Main street, suite 400, Alpharetta, gA following rates: single copy $7.50; $75.00/yr in the U.s., $105/yr in Canada and $170/yr international. Please contact FieldMedia at 404.671.9551 or PriNtED iN thE U.s.A. ™ is designed to provide both accurate and authoritative information with regard to the understanding that the publisher

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July/August 2014 I www.TheIHCC.com I HealthCare Exchange Solutions™

NEWS BRIEFS & INNOVATIONS

NEWS BRIEFS Blue Cross Blue Shield of Arizona Selects Array Spectrum™ Private Health Exchange Technology Array Health announced that Blue Cross Blue Shield of Arizona has selected the Array Spectrum™ Private Exchange solution for managing employers’ enrollment and benefits plan choices.

Multiple funding arrangements for groups will also be available. The platform will be BCBSAZ branded and made available later this year for plans effective after March 1, 2015. The exchange will launch with core medical, dental and vision plans with additional ancillary products to be included in the future. BCBSAZ will offer the new exchange to groups of all sizes (large, medium and small) as well as brokers that work closely with Arizona employers.

Three Million U.S. Employees Enrolled in Private Exchanges, According to Accenture An estimated three million people currently receive employer health benefits through a private exchange, according to new report by Accenture released at the annual America’s Health Insurance Plans Institute in Seattle. Accenture’s analysis shows three times as many people enrolled in private exchanges for 2014 benefits as the company originally forecast last year. Accenture expects this trend to continue, projecting total enrollment in private exchanges will ultimately surpass state and federal exchanges, reaching 40 million by 2018.

Bloom Health Greatly Expands Specialty Offerings on its Private Exchange Platform® Bloom Health announced the expansion of specialty products and carrier options for their Private Exchange Platform® solution.

These additional options, paired with Bloom’s existing industryleading private exchange technology and consumer experience, further strengthen the platform’s value to brokers, employers and consumers. The broad choice enjoyed by employees on Bloom’s platform results in more appropriate benefit selections that better fit each employee’s unique personal and family needs.

mobile format. The app allows consumers to browse anonymously, determine potential eligibility for financial assistance and view plan information, including all of the plan details and documents that are available on the website.

Fifty Employers Become Repeat Customers of Towers Watson’s OneExchange Towers Watson announced that 50 major U.S. employers that previously transitioned retirees to the company’s OneExchange solution for Medicare-eligible retirees are now making the exchange available to new groups of retirees, becoming repeat customers.

While many employers transition all of their Medicare-eligible retirees at the same time, some transition them in waves. Reasons for a phased approach include differing timelines for union contract negotiations, the desire to test-drive an exchange with a portion of a population and the opportunity to streamline benefits administration by providing consistent benefits to retirees of newly acquired companies if appropriate.

bswift and GetInsured Announce Private Exchange Partnership bswift has announced a partnership with GetInsured. GetInsured will provide employers who use the bswift Springboard Marketplace, a cloud-based private health and benefits exchange, with access to individual health insurance plans for employees who do not qualify for sponsored plans, including part-time workers, pre-65 retirees and those who are COBRA-eligible. The GetInsured exchange seamlessly integrates with the bswift Springboard Marketplace, allowing employers to instantly offer those employees who are ineligible for group plans access to a broad array of ACA-compliant health insurance options as well as the ability to claim tax credits. GetInsured is certified by the federal government to enroll Americans in subsidized health insurance, appointed with more than 275 insurance carriers and fully licensed to advise consumers in 50 states.

BCBSNC Launches Private Exchange for Employers

The Mahoney Group announces a private marketplace platform that gives employers an unprecedented range of administrative flexibility and employee health benefit options. The Mahoney Group is pleased to offer this flexible insurance plan customization to small, middle and large market employer groups. In collaboration with a leading employee benefits outsourcing partner, Businessolver, this private exchange allows employers to maintain a competitive advantage by offering best-in-industry benefits while removing the heavy lifting of benefits administration.

Blue Cross and Blue Shield of North Carolina introduces the BlueBenefits Center, a private exchange to help employers stabilize the amount they spend each year on health care, while offering employees more choices for personalized health insurance.

This new tool will be available to groups of 51 employees or more with plan effective dates beginning September 1. Currently, most employers choose to offer only one or two health insurance plans for the entire company. Their choice of plans is based on the overall health and health care usage of the employee population. This leaves employees few options for co-payment amounts, deductible limits and other out-of-pocket expenses.

Access Health CT Launches First State Health Exchange Mobile App

Lockton and GetInsured Partner to Offer Employers Individual Exchange Solutions

Access Health CT has launched the nation’s first mobile application for a state health exchange, providing consumers with a new, easy way to compare health care coverage options access information and enroll in quality, affordable plans. The free application offers nearly all the functionality of the website in an easy-to-use

Lockton will offer GetInsured’s cloud-based exchange platform as part of its Lockton Marketplace solution, making it easy for employers to offer health insurance to part-time employees, early retirees and COBRA-eligible individuals via the public exchanges.

The Mahoney Group Launches Private Exchange

HealthCare Exchange Solutions™ I www.TheIHCC.com I July/August 2014

5

already moved their employee population into a private exchange, or are planning to in the highest adoption rates, according to recent research published by Alegeus technologies.

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PRIVATE EXCHANGE PROFILE

How the ACA and Exchanges Are Driving a New “Whole Workforce” Strategy

BY SHANDON FOWLER » DIRECTOR OF PRODUCT MANAGEMENT, MARKETPLACES » BENEFITFOCUS

The benefits business is changing more rapidly than it ever has, spurred on by public debates and private progress. As we approach the second open enrollment of the public marketplaces – and as we see rapid growth of health care consumerism through an increasingly sophisticated private exchange market — it’s clear that while we may see things settle down a bit from last year’s momentous milestones, the proverbial dust of health care reform won’t settle for many years to come.

Rethinking Eligibility and Group-Based Coverage The past 18 months have seen a flurry of activity from companies seeking to stay compliant with new coverage thresholds and tracking requirements. But thanks to delays in the enforcement of the ACA’s employer mandate, they’ve also had time to think about what works best for the company and employees, both financially and strategically.

And what are those strategic thoughts? One of the more prevalent and potentially game-changing perspectives is what we at Benefitfocus refer to as “benefits for the whole workforce.” This concept breaks down the traditional barriers between “eligible vs. ineligible” that has driven group-based coverage for decades and instead aligns strategies based on a broader, more inclusive consideration of benefits eligibility.

Here’s how it works: Full-time employees are still the most valuable to employers and up to 30 percent of their total compensation comes in the form of benefits; “variable” workers, whose eligibility can vary from year to year based on average hours worked, can be full-time or part-time, and there are a great deal of administrative needs to keep tabs on their eligiblity; part-time workers have not traditionally been eligible for core company benefits, but they may now be qualified for government subsidies on qualified health plans through public marketplace channels; and retirees may change based on whether they’re pre- or post-65 for Medicare eligibility.

It’s an incredible — and incredibly complex — challenge to address the needs of each type of employee. But new technology and connectivity options through private and public marketplaces are making it possible to not only meet the needs of a company’s whole workforce, it’s making it easy to thrive as a broker and as a consumer in this new world order.

What’s in it for…

and private marketplaces, a company and/or its broker would want to start adding part-time workers, to which employers have no benefits obligations, to their benefits plans. The answer is two-fold: 1.

2.

3.

It’s the right financial decision for employees. Millions of Americans are considered hourly employees and don’t currently have health coverage, which impacts their ability to do their jobs. More than 70 percent of all consumers who got coverage on public marketplaces in 2013-14 received a subsidy. Connecting the dots on behalf of employees costs companies very little — given the right communication technology — and may help their employees become more stable.

Companies can open up lateral revenue/personnel strategies.

A 2007 report by the U.S. Chamber of Commerce notes that companies that aid employees to track down various forms of public assistance (such as food stamps and Headstart programs) may see increased employee retention and loyalty.

The study predates the ACA by several years but provides lessons that are easily transferable.

It’s the right financial decision for brokers. Medicare Advantage, which predates the ACA by a decade, blazed the way for the public-private hybrid offerings, and brokers may ultimately see enrolling part-time workers in subsidized public marketplace coverage is good for their bottom line.

Eligibility for Everyone!

There are many challenges ahead as we enter the second major year of the ACA. Some of these challenges will take all we have to address them. But as we look out onto the horizon, let’s keep our eyes on where things might go next. Where that is may change somewhat, but the two certainties are that consumers will be continually empowered to make the best decisions for them and those who do the empowerment will become the consumer’s favorite.

The question may arise as to why, in the face of an already seemingly insurmountable burden of complexity and compliance with public

HealthCare Exchange Solutions™ I www.TheIHCC.com I July/August 2014

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PRIVATE EXCHANGE TRENDS

BY JONATHAN FIELD MANAGING EDITOR THE INSTITUTE FOR HEALTHCARE CONSUMERISM

W

Health Plan Exchanges Begin to Take Off

ith open enrollment just around the corner, the private exchange market is beginning to heat up. Preparing for a big season in which enrollment figures are expected to jump significantly, the industry has witnessed a number of emerging trends over the summer months, including an increase in individual exchanges for non-eligible employees and the accelerated adoption of defined contribution funding.

But perhaps the rise of single-carrier, health plan-run exchanges has been the most important trend to watch. Above all, this trend possibly reveals a glimpse of the strong future for private health insurance exchanges. If the subject matter and discussion of this year’s AHIP conference is any indication (and it almost certainly is), America’s health plans are really buying-in to the private exchange trend.

Does a single-carrier model in fact still qualify as an exchange or marketplace? As naysayers (perhaps rightfully) continue to question the legitimacy of the single-carrier model to be called an “exchange” or “marketplace”, this model has still shown strong growth this year; and perhaps — with many of the nation’s largest health insurers still planning their private exchange launch — may be the biggest winner in this fall’s open enrollment season.

The Blues as Early Private Exchange Leaders Since the earliest days of private health exchanges, the Blues have been some of the earliest proponents of private exchanges through partnerships with technology companies like Array Health and Bloom Health. And this trend has shown no signs of slowing down over the past few months.

Blue Cross Blue Shield Michigan, an early investor in Minneapolisbased Bloom Health along with Health Care Service Corporation and WellPoint, recently announced that they have five times the number of participating employers in the GlidePath private exchange than they did in 2013. According to recently released user data, the health insurer states that 94 percent of employers that have implemented GlidePath would recommend it to other employers.

In New Jersey, Horizon Blue Cross Blue Shield of New Jersey, the state’s largest health plan, launched a private exchange — again with Bloom Health — called Horizon Select and similarly expects a spike in enrollment this year. Just north in Massachusetts, Blue Cross Blue Shield of Massachusetts recently launched the state’s first private exchange, My Blue Choices, with Liazon as its technology partner — possibly a shift in direction for the Towers Watson-owned exchange provider known for its vast broker network.

Blue Cross Blue Shield North Carolina, the state’s largest health insurer with 3.8 million customers in a state of just 9.8 million, announced its private exchange, BlueBenefits Center, in late June.

Finally, Blue Cross Blue Shield of Arizona announced in early June that it had adopted Array Health’s private exchange platform. The platform

will be BCBSAZ branded and made available later this year for plans effective after March 1, 2015.

National Health Insurers to Make an Entry But maybe the most important news from around the single-carrier private exchange space is yet to come. Earlier this year, Cigna made headlines by launching its proprietary retail exchange. Initially offered in only four metro areas (Atlanta, Dallas-Ft. Worth, the Bay Area and D.C.), the company just recently expanded its private exchange offering nationwide. In order to bolster its private exchange leadership team, Cigna recently announced the hiring of Patty Fontneau, former head to Colorado’s state-run exchange, to helm private exchange business.

Another one of the big five U.S. health insurers, Aetna, is also poised to make an entry into the private exchange space. First reported by Beth Fitzgerald, a health care and business reporter for NJBIZ, the Aetna Marketplace will soon be a reality. In the article, Aetna spokeswoman Susan Millerick said that in addition to offering its products on many third-party private exchanges, the company will soon be offering its own exchange. Although Aetna has not “officially” made an announcement of the Aetna Marketplace launch, they have confirmed that more information will be coming later this summer.

Looking Ahead In June of this year, Array Health, the Seattle-based technology company known for being one of the earliest proponents of the singlecarrier exchange model, released the results of a survey of 88 leaders from across health insurance industry, including health plans, brokers, TPAs and others. The company found that 42 percent of health insurers will offer a private exchange by the end of 2015. Seventy-five percent indicated they would be implementing an exchange by the end of the following year. This aligns closely with survey data released by Wells Fargo Insurance in May. In the Wells Fargo survey, which included 70 health insurers nationwide, 47 percent said they will launch their own proprietary private exchange by 2015.

Looking forward a few years, most projections — including the oftcited Accenture analysis — expect private exchange enrollment to outpace enrollment numbers on the federal and state-based marketplaces. While last year’s open enrollment period saw most of the nation’s leading health plans jump into the government-run exchanges (late hold-out UnitedHealthcare enthusiastically joined-in this summer), this year’s open enrollment period — and next year’s and the year after’s — will likely hold witness to a huge increase in health plan enrollment via private exchanges.

Health plans are now realizing that they simply cannot afford to ignore this new distribution channel. While many already have medical and supplemental products included in broker/consultant-run exchanges nationwide, what’s better than a “marketplace” with only your products?

HealthCare Exchange Solutions™ I www.TheIHCC.com I July/August 2014

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DEFINED CONTRIBUTION

BY FRANK B. MENGERT PARTNER AND DIRECTOR OF PRIVATE EXCHANGE TECHNOLOGY EBENEFIT MARKETPLACE

The Inevitable Shift to Defined Contribution

T

Option C has been what I have seen most employer groups he health care industry has been through the biggest change in history, with an impact some say is even greater than trending towards. This way, if an employee chooses not to enroll in a ERISA, Medicare and Medicaid. The current trends in the particular plan, the funds go back to the employer. If the benefits being business and regulatory environment are leading to more creative offered exceed the defined contribution amount or if the employee ways to continue offering employee benefits. One of those methods exhausts the money being allocated, the remaining money would come has taken the industry by storm with the reinvention of the defined via a payroll deduction on a pre- or post-tax basis.

Going back to my point about data being skewed in polls on contribution plan.

Depending on what you are reading, the interest in defined defined contribution, I think it is important for anyone reading this contribution varies greatly. What really is skewing these polls is the article to take into consideration why this may be well-suited for them. industry and sizes of the employer groups responding to the survey. The In many cases, I see this being utilized when an employer is at the point adoption rates for a defined contribution strategy are going to differ quite where they can no longer sustain the double-digit increases in their benefit offering. Most employers that offer coverage do so because they a bit in the 2-99 market, 100-1000 market and the 1000+ markets. care about their employees, and they need For the scope of this article, to retain and attract the best talent they I am speaking purely about a defined Most employers that offer can in what has become an extremely contribution within a group setting which coverage do so because they competitive job market. Unfortunately, enables an employer to set a fixed-dollar care about their employees, scaling back those rich benefits and amount to their employee benefits budget contributions they have provided for all and allow their employees to pick the plans and they need to retain and these years creates a problem for their that best fit their needs. The employer that attract the best talent they can in benefit budget. has traditionally taken the “parental” role what has become an extremely Adopting a defined contribution of picking the plan they think best fits their strategy involves some education, employees’ needs is beginning to take a competitive job market. planning and some powerful technology backseat to providing the employee with to handle both the flexibility of the defined a choice. contribution delivery and plan offerings.

This can be done in a variety of ways depending on how crafty the employer wants to get in their delivery. Employers that have previously given employees choice in their In most instances, defined contribution is being brought on with the benefit offering experience good success in a transition such as this. implementation of a private exchange. This allows an employer to Those that have taken that “parental” role in picking the plan for their provide a comprehensive suite of products including several medical employees will require a bit more education for their organization in plan choices, CDHP options, life, disability, voluntary and non- order to have a smooth migration.

When thinking about this strategy, it is important to remember that traditional offerings like pet insurance, identity theft and more. this is not the silver bullet in controlling costs. Employers will still need There are three typical strategies for a defined contribution: to plan on adjusting their future benefits budget, assuming it is based A. Provide employees with a lump sum of money and allow on the Consumer Price index, which may go up 3 percent in a year. But them to shop for the plans how they choose. For example: what if health care costs increase 5 percent in a year? This will mean $500 a month to spend how they wish. the employee will bear more of the cost of the plan which will in turn B. Provide employees with a lump sum of money and allocate cause employees to look to a lower premium, high-deductible plan that a fixed dollar amount to health and allow them to use the gives them fewer benefits and more out-of-pocket expenses. rest how they choose. For example: $500 a month with In any event, the shift toward defined contribution is happening. $400 allocated towards health insurance and $100 for other Without having to cite any national polls, I predict that in the next five benefits offered. years private exchanges delivering defined contribution with employee C. Provide employees with a lump sum of money and earmark choice will be the norm, taking over the one-option health plan and funds for each benefit being offered. For example: $500 for defined benefit philosophy of today. health, $25 toward an HSA, $25 for dental, $10 for life, $10 for LTD, $10 for STD, $10 for accidents or critical illness and $10 for things such as pet insurance or identity theft.

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July/August 2014 I www.TheIHCC.com I HealthCare Exchange Solutions™

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STATS & DATA

BY LANCE HOOD SENIOR DIRECTOR OF MARKETING ARRAY HEALTH

Survey Results Supports Projected Explosive Growth in Private Exchanges

R

ecently, Array Health released its second annual Health Check Survey Report on private insurance exchanges. The report provides insight into the industry’s expectations and approach for creating and operating private exchanges. The 2014 survey shows that momentum toward private exchanges continues.

It is no longer a question of if private exchanges will become popular sales channels, but rather, when.

The Health Check survey findings bolster recent studies, such as an Accenture report that claim faster than expected adoption of private exchanges. The Accenture report estimates that three million U.S. employees were enrolled for their 2014 benefits using private exchanges. The consulting firm projects total enrollment in private exchanges will reach 40 million by 2018. Defined contribution models are one of the major drivers behind expected growth in use of private exchanges. The Health Check survey shows expected adoption of this model by employers remains very consistent in the 2013 and 2014 surveys. The majority of respondents believe defined contribution models will be more common than defined benefit approaches within five years. One-third of respondents now believe that will occur within just three years. Survey respondents believe that awareness of private exchanges has increased over the past year. This is not surprising given the national attention surrounding rollouts of public exchanges.

Perceived awareness among consumers jumped from 31 percent to 45 percent in the past year (with the percentage of those who are “very aware” increasing four times).

Employer awareness is seen as almost complete with 99 percent being “somewhat” or “very aware” of private exchanges. Increasing awareness and understanding of private exchanges is key to supporting broader adoption and use by employers and employees. Private exchanges encompass both multiinsurer solutions that sell insurance products from different carriers and exchanges operated by single insurers that support sale of their own 12

July/August 2014 I www.TheIHCC.com I HealthCare Exchange Solutions™

products. The survey revealed that single-insurer solutions are being adopted faster than multi-insurer exchanges. More than half of the insurer respondents say they will use a private single-insurer exchange as a sales channel for their products by the end of 2014, while about one-third plan to participate in multi-insurer exchanges.

As we anticipate increased momentum in private exchange adoption, single-insurer exchanges are expected to be used to sell to all market segments. Respondents expressed strong support for use in large and small groups, as well as for individual insurance. Small group is the most common segment to be addressed, although nearly 30 percent of respondents support use for large groups.

The survey results are a snap shot of industry expectations for private exchanges. Eighty-eight industry leaders responded to the survey, which was conducted in May 2014. The full survey and analysis can be obtained on the Array Health web site.

GROWING PAINS FOR PRIVATE HEALTH INSURANCE EXCHANGES How to balance promises and priorities to sustain hyper-growth

BY RICH BIRHANZEL » SCOTT BROWN » JOSHUA TAUBER » ACCENTURE

Accenture predicts that private health insurance exchange participation will approach public exchange enrollments by 2017, if not sooner, as enrollment figures indicate an earlier-than-expected growth spurt.

HealthCare Exchange Solutions™ I www.TheIHCC.com I July/August 2014

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Growing Pains for Private Health Insurance Exchanges

P

rivate health insurance exchanges are experiencing hyper-growth. there is enthusiasm and adoption among many employers, consumers and carriers alike. Accenture predicts that private health insurance exchange participation will approach public exchange enrollments by 2017, if not sooner, as enrollment growth spurt. Accenture estimates there were more than 3 million individuals that enrolled in private exchanges during the While rapid growth is encouraging to exchange sponsors, it’s important to consider how exchanges can sustain this material open enrollment period has concluded, exchange sponsors have the have the core promises of private health insurance exchanges been met?

Are these exchanges delivering the retail-like, front-end experience that consumers expect? Are employers feeling a reduced administrative burden?

Employer expectations, and corresponding service levels and capability maturities, will vary widely across exchange models (see Figure 1). however, no matter how “premium” or “simple” the exchange, there are fundamentals that all private health insurance exchanges should consider as key factors to help sustain their growth.

Potential pain points 2) will emerge as a likely culprit restricting some exchanges’ growth exchanges.

sets of their workforce. While for smaller companies this tends to be often vary based on workforce elements such as full-time vs part-time, differences in what products are offered and how much is subsidized by the employer. Although exchanges are working hard to standardize product offerings, they should offer solutions to manage these complexities. contribution strategies that may have a variety of permutations across these employee groupings. Further adding to the complexity of managing enrollment is the abundance of changes to an employee population that existing employees get promoted, move across states, take a leave of absence or quit/are terminated. Each of these situations could result

not new concepts for seasoned administrators, but leading exchanges

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May/June 2014 I www.TheIHCC.com I HealthCare Exchange Solutions™

will build automation to help reduce manual costs and minimize errors.

Furthermore, these rules and processes should seamlessly integrate into an intuitive front-end consumer shopping experience. Exchanges that do not streamline and automate enrollment and eligibility processing for their employer partners will likely fail to deliver on a core promise of reduced administrative burden.

As exchanges allow employers to offer an expanded set of products across multiple carriers, the amount and complexity of data being managed also grows. While some employers previously offered only a few plan options (typically less than three) for medical insurance, often

and carriers for dental, vision, life and other types of voluntary or

EXCHANGE SOLUTION PROVIDER MEMBER PROFILES

HSA/HRA/FSA TECHNOLOGY: ADMINISTRATION & MANAGEMENT

TSYS HEALTHCARE TSYS Healthcare® provides end-toend strategic payment solutions for 706.649.5080 consumer directed healthcare. We www.tsys.com/healthcare partner with benefits administrators, healthcare@tsys.com financial institutions, health plans, and software providers to navigate all aspects of HSAs, HRAs, FSAs, transportation accounts, cash reimbursements, and lines of credit. TSYS Healthcare cards offer participants the security they expect along with the ability to conveniently access funds from multiple accounts and manage their benefits payments with simplified single-card access. Clients and partners benefit from simplified processes, reduced paperwork and cost savings that can contribute to improved return on investment.

“We built the TSYS Healthcare platform to meet the market demand for reliable, configurable and intelligent solutions. Understanding the dynamic U.S. healthcare market, our customers rely on our option-driven system to prepare them for the future.”

— Trey Jinks, Group Executive, TSYS Healthcare HSA/HRA/FSA TECHNOLOGY: ADMINISTRATION & MANAGEMENT

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The InsureXSolutions® private exchange offers employers a simplified role in the new health insurance marketplace. Employers with part-time workers or retirees, as well as small businesses can utilize this exchange to empower their employees to choose the health and dental insurance that best fits their personal and family needs. Employers can reduce costs and administrative tasks, while employees receive interactive support tools and personal guidance from our licensed insurance professionals. Available in select markets, InsureXSolutions is exclusively offered and operated

by Flexible Benefit Service Corporation (Flex). Contact your broker or consultant, call us directly at 855-563-6993, or visit www.insurexsolutions.com to learn more.

BENEFIT ADMINISTRATION/PRIVATE EXCHANGES

Since 1988, CieloStar (formerly OutsourceOne) CIELOSTAR has helped brokers, employers and employees 530 U.S. Trust Building navigate the ever-changing world of benefits.

730 Second Avenue South Now, with the dawn of “Defined Contribution Minneapolis, MN 55402 Health Care” we are again on the leading edge.

With a team of industry thought leaders, CieloStar 612.436.2706 makes navigating healthand benefits choices john.reynolds@cielostar.com easy for employers and employees by offering comprehensive benefits administration solutions with a high-touch, high technology model—most recently launching a proprietary private health insurance exchange.

“Fueled by the far-reaching impact and complexities of health care reform taking effect in 2013 and 2014, employers and employees increasingly find themselves in a ‘farmer’s market’ of benefits choices. Cielostar is uniquely positioned with enabling technology that helps purchasers and consumers make the best possible decisions and create a best-in-class benefits administration process. Our unique comprehensive approach to benefits offers everything from back room technology for enrollment, data, billing and call centers to complete solutions for COBRA, CDHP and health insurance exchanges.”

— John Reynolds, CEO, Cielostar HSA / HRA / FSA ADMINISTRATION AND FINANCE

Evolution1 and our Partners serve more EVOLUTION1, INC. than 9 million consumers, making us 952.908.9056 the nation’s largest electronic payment, www.evolution1.com on-premise and cloud computing sales@evolution1.com healthcare solution that administers reimbursement accounts, including HSAs, HRAs, FSAs, VEBAs, Wellness and Transit Plans. It is the only solution that offers a single end-to-end user experience, provides innovative auto-substantiation technologies, and automates workflow for Partners, employers, and consumers. It does all this on one technology platform comprised of 1Cloud™, 1Direct™, 1Pay™, 1View™, 1Plan™, and 1Mobile™. Evolution1 and our Partners are dedicated to delivering value, reducing costs and simplifying the business of healthcare.

“The combination of our innovative products will further our leadership position in a rapidly changing healthcare market. Together with our Partners we are committed to reducing costs and simplifying the business of healthcare.”

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HealthCare Exchange Solutions™ I www.TheIHCC.com I July/August 2014

15

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VOLUNTARY BENEFITS

Keep Your Cool by Planning for Open Enrollment Today

A

mericans throughout the nation are experiencing maximum summer — the time of year when it’s so hot that everything moves in suspended motion..

Feeling the lethargy? Well, snap out of it! For those involved with

professionals and human resources managers, it’s time to gear up for open enrollment.

Sure, employees’ open enrollment decisions are months away. But

employers made voluntary plans available.

Make decisions today for success later With that in mind, action-oriented employers are already meeting with insurance agents and brokers to determine what changes they’ll make

and why, it begins now — long before it’s too late to make changes that Workers themselves have health care

options should consider that coverage helps workers cope with challenges such as rising medical and coverage costs, increasing deductibles and copayments,

current coverage. A recent survey revealed that 82 percent are concerned about paying for expenses no longer covered by their health plans.1 , which found that high medical costs affected the credit scores of 10 percent of participants and 13 percent had been contacted by a credit agency about unpaid medical bills.2 It’s no wonder, considering that health care premiums have increased 80 percent since 2003, nearly three 3

Workers say voluntary insurance matters

result of health care reform.

What’s more, by providing access to voluntary insurance, companies will be more appealing to current employees and new applicants alike: top-tier organizations offer their workers a wide

have three things in common: recession. small amount of buck.

important to employees, so they operate on the principle that health today’s employees are voluntary insurance policies. makers should consider that these types of policies are a win-win for employees and their organizations: Companies can offer voluntary insurance with no direct effect on their bottom lines because premiums are paid by workers who apply for coverage.

Employees can assess the unique needs of their families and apply for the type of voluntary coverage that meets those needs and works within their budgets.

offerings today. By doing so, they’ll help ensure that open enrollment is a no-sweat event for all concerned.

menus because they don’t believe workers are interested, but research consider voluntary insurance an important part of a comprehensive HealthCare Consumerism Solutions™ I www.TheIHCC.com I July/August 2014

33

HEALTH ACCOUNTS

BY JOE JACKSON CHIEF EXECUTIVE OFFICER WAGEWORKS

Consumer-Directed Benefits Important Consideration During Open Enrollment

C

ompanies and their employees are increasingly choosing consumer-

Why? the answer is easy: it saves both of them money. It also provides an opportunity to engage consumers in their health care purchasing decisions.

families.

Flexible spending accounts and health savings accounts are great to their tax-advantaged status to employees and employers alike.

For employees and their families who need to keep more of their hard-earned money, ensure funds are available for healthrelated expenses when needed, and build for a healthy future, CDBs are a great tool to help them achieve these goals. CDBs allow them to save money on income taxes, thereby reducing their health care expenses, and also enables them to easily set aside funds for critical expenses to take care of their families.

Beyond the cost-savings, CDBs put the power of choice back into the consumer’s hands; providing them with more options for managing their money. the proof is in the number of consumers taking advantage of these tax vehicles to manage their health care expenses proactively. Adoption is likely to increase, as the ever-rising costs of health care force Americans to look for savings

of up to $500. In a 2014 study by WageWorks and VISA, 53 percent of employers plan to offer the new carryover option to their employees, citing their employees as the top reasons behind their decision. this is a fundamental shift for FSAs that is expected to alleviate a common barrier to employee participation in FSAs. For many, enrolling in an FSA now means saving money on anything from glasses to prescriptions to co-pays, without the fear of losing their money if they don’t use up their entire contribution by the end of the plan year.

34 July/August 2014 * XXX 5IF*)$$ DPN * HealthCare Consumerism Solutions™

With an FSA, an employee who makes $60,000 a year — assuming a 30 percent tax rate and $2,500 in annual health care expenses — would save an average of $750 a year on their taxes. In this situation, an if the participant has not exceeded the social security FICA limit. that’s because the employee’s gross taxable pay is reduced by $2,500 annually and typically the employer would pay about 7.65 percent on payroll taxes.

For an employer that has 100 enrolled employees, the savings can really add up. For an employer with 1,000 enrolled employees, the savings can be huge.

America’s health Insurance Plans, highdeductible health plans coupled with an hSA are now providing coverage to 17.4 million people. that’s two million more than 2013 — or a growth rate of about 12 percent.

Like an FSA, employees set aside pre-tax money for eligible health care expenses.

Unlike an FSA, hSAs allow employees to save and invest their contributions.

When disbursing funds from an hSA, that money is non-taxable as long as it is used for approved health care expenses. And employees can keep hSA funds even if they change employers. hSAs have the potential of making a huge difference as a valuable supplement to standard retirement savings. by comparing hSAs to a 401(k), except for health care. Using the same calculations we did with the FSA, an individual who elects an amount of $3,300 with their hSA can save $990 a year. In this situation, an employer would save about $252 per enrolled employee. Again, the more employees take advantage of an hSA, the more an employer can save on payroll taxes. the upside to CDBs applies to employers as well. For those that need rising health care costs and help control expenses through corporate tax savings, these pre-tax CDBs provide corporate tax advantages and help recruit and retain happy, healthy and productive employees.

In the end, what makes CDBs so attractive is their tax-advantaged nature, which helps both employees and employers make health care expenses more affordable. And we all like paying fewer taxes!

Going the Distance: Domestic Medical Travel Steerage Programs

BY LAURA CARABELLO » FOUNDER AND PRINCIPAL, CPR, AND PUBLISHER » MEDICAL TRAVEL TODAY AND U.S. DOMESTIC MEDICAL TRAVEL™

The fast-growth phenomenon of U.S. domestic medical travel – inter-state to centers of excellence throughout the country – is capturing the attention of employers, payers, third party administrators, insurance companies and other intermediaries throughout the country. With the influence of health care reform, the significant shift toward cost-containment and patient-centric care, employers now put enormous stock in preventive health care programs and options that offer quality, transparency and value.

orthopedic and cardiac care. retail giants Wal-Mart Stores Inc., Boeing, Lowe’s and PepsiCo — to name a few — offer domestic medical programs for a number of reasons: Baby Boomers are aging, raising the necessity for knee, hip, spine and heart-related surgeries Surgery costs account for a substantial percent of total health care spend Complex, high-cost surgeries are infrequent, but consume disproportionately high resources COEs have demonstrated promising results in avoiding unnecessary procedures this last point is especially important given that as much as one-third of surgeries may be medically questionable or unnecessary, according to a Consumers Medical resource study. this includes surgical procedures for seven complicated and serious medical diseases such as breast cancer, heart disease and prostate cancer.

Benefits of Domestic Medical Travel the success of domestic medical travel programs relies upon transparent pricing and quality measures, which can vary widely across prices that are generally 20 to 50 percent below rates charged through traditional insurance plans. this savings enable them to a) waive co-pays or offer cash incentives, b) cover the full cost of travel for the patient and caregiver and c) still save on procedure costs.

Providing access to COEs helps employers reverse a costly trend in HealthCare Consumerism Solutions™ I www.TheIHCC.com I July/August 2014 35

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which plan members typically make decisions about surgery guided solely by their physician.

Studies show that when patients engage with diagnosis, prognosis and treatment options, they make informed medical decisions that lead to healthier, and more personally satisfying, outcomes. given the ability to understand their options and actively participate in surgical decisions, plan members can play a role in cutting the costs of surgery.

Shifting high-cost procedures to COEs can also help plan members avoid unnecessary risk associated with overtreatment, while enabling

" CSJFG IJTUPSZ PG EPNFTUJD NFEJDBM USBWFM BEPQUJPO 2010: Lowe’s offers its full-time employees and covered dependents heart surgery at the Cleveland Clinic for no out-of-pocket costs. 2011: PepsiCo domestic employees and their dependents are given the option to seek treatment at Johns Hopkins Medicine for cardiac and complex joint replacement surgeries.

2012: Boeing offers its 83,000 non-union employees, retirees and their dependents the option to travel to the Cleveland Clinic for complex heart procedures or surgery.

2013: Wal-Mart partners with six U.S. health care organizations to expand its COE program to certain heart and spine surgeries in addition to transplants at Mayo Clinic.

2014: Lowe’s adds to its domestic medical program, offering employees no-cost hip and knee replacements at one of four designated COEs located in Baltimore, Md; Seattle, Wa.; Springfield, Mo.; and Irvine, Calif.

Steerage Programs at lower cost. avoiding costs related to complications. For years, hospitals have been rewarded for medical complications with the ability to bill for the additional services provided — while employers have paid a high price for mediocre outcomes. One study shows that the average surgical complication generates an additional $13,000 in revenue for the hospital. medical travel, companies may encounter reluctance from executives and plan members. therefore, it’s important to develop steerage programs to inform them about strategies for leveraging the domestic medical travel opportunity.

Factors that impact the success of a COE program include employee willingness to travel, the role of incentives, ease of travel, waived co-pays and deductibles, and coverage of all travel costs. Steerage programs can be implemented to: help employees fully understand all of the Establish top-down commitment to the Share the experience of other employers of similar size that have introduced the Arrange programs for spouses/traveling companions the use of incentives is key, and many employers arrange complementary programs for spouses/traveling companions, eliminating

co-pays and deductibles, and going the extra to cover the cost of meals, gas, tolls and other expenses. the purpose of a steerage program is to spread the word that travel to COEs is in the employee’s best interest — and dispel any negative perceptions or confusion. Emphasis should be placed on a commitment to highquality care, less cost for employees and access to alternative sites for surgery. COE programs are of special value to those living in rural communities with limited access to high-quality care.

A steerage program also addresses obstacles. For example, when Lowe’s asked its beners to determine the best hospitals for cost and quality, the insurer dragged its feet for years, and Lowe’s ended up doing the research.

-BT 7FHBT 8FMMOFTT %FTUJOBUJPO After a hospital stay, many patients and companions choose to remain in the host city for a period of time before going home. An extended stay represents additional tourism revenues to

for the COE, hotels, restaurants, shopping malls, museums, local attractions or points of interest, entertainment venues, sports events, airports and transportation services. making a huge play in the domestic medical travel arena. the Las Vegas Convention and Visitors Authority has taken a multi-faceted approach by focusing on hosting health care meetings and medical meetings, such as bio-skills training and continuing medical education for doctors, nurses and other health care professionals.

In November, LVCVA will feature its hotels, spas, accommodations and specialized

accommodations for corporate medical travelers and others interested in Las Vegas as a medical/ wellness destination at the City healthcare Consumerism™ FOrUM West. their goal is to promote the concept that Las Vegas is a medical and wellness travel destination. top reasons to choose Las Vegas for medical travel include: 16 hospitals, nearly 3,500 patient beds and access to a world-class collection of renowned medical experts.

Medical providers who excel in unique specialties such as brain health, executive physicals, age management medicine, reproductive/fertility medicine, cosmetic surgery, bariatric surgery, and dental treatments and cosmetic dentistry.

A variety of services designed for executive business

travelers, as well as their guests, including comprehensive executive physicals, age management services, dental treatments and cosmetic dentistry services.

An array of unique medical laboratory meeting facilities for hands-on bio-skills labs and surgical training, as well as a clinical simulation center and specialized continuing medical and dental education training facilities.

Diverse community of dedicated physicians, dentists and other practitioners representing numerous ethnicities, cultures and religions, representing exceptional training from institutions around the country and the world.

Acute-care hospitals in Southern Nevada are accredited by the Joint Commission. technology infrastruc-

HealthCare Consumerism Solutions™ I www.TheIHCC.com I July/August 2014

37

ture has reached nearly $1 billion on construcsions and renovations, allowing hospitals to offer the latest state-of-the-art surgical care in the areas of cardiology, orthopedics, and emergency and trauma services. $19.6 million grant to construct and operate a statewide broadband network for the purpose of improving patient care by eliminating technology disparities between rural and urban areas through telemedicine and health information exchange. generates $281 million in value output, employs 654 people and creates $58 million in household income, with new biotechnology research being conducted to address the use of proteins to regenerate blood vessels, skin and other tissues.

World’s top global spa trends, including culturally diverse treatments and services (Japanese stone beds, turkish hammams, Shio salt rooms and Ayurvedic treatments, acupuncture and Moroccan rhassoul); healthy foot treatments and gait analysis; ice and cold therapies (arctic ice room, cedar wood saunas, laconium rooms, and postnatal massage).

More accessible guest rooms than any other city in the country, with hotels offering rooms with roll-in showers, transfer showers, tubs with built-in or portable seats and lifts for swimming pools. and nonstop services from 120+ U.S. cities, with McCarran International Airport conveniently Averages 320 days of sunshine of precipitation annually, which is particularly Nevada physicians must pass stringent licensing requirements and comprehensive investigation programs.

Academic institutions of higher education providing medical, nursing, dental and pharmacology education to ensure that the future of medicine remains stable.

More than 150,000 rooms, averaging nightly room rates of $107.

Dining: World-class chefs offering great food for every culinary taste, including vegan, superfood and farm-to-table choices.

More than 50 of the world’s treatments.

38 July/August 2014 * XXX 5IF*)$$ DPN * HealthCare Consumerism Solutions™

Close proximity of Las Vegas hotels, in many cases, eliminating the need for transportation as visitors can walk to many destinations, or use car rentals, buses, taxis, shutyear-round sunshine allows for year-round swimming.

In collaboration with the multi-disciplinary, Las Vegas hEALS, the City of Las Vegas plans to span its economic developing agencies, medical schools and the University of Las Vegas for the development of a strategic plan for the community to look at the development of medical tourism in the community. Part of this involves price transparency and packaged pricing, and bundling of medical services.

Some health care providers in Las Vegas are already on board and offer package programs with transparent pricing. Others are still in the development process. A number of hotels have taken the lead as well, and have begun incorporating wellness technologies and amenities into their rooms: the Stay Well room Product at MgM has worked with the Cleveland Clinic and a company called Delos Living to integrate wellness technology.

M resort has a new room called the Experience room, which is basically a room that comes with wellness amenities. they also offer a Vitamin C-infused shower head and other types of aroma therapy and enhancements that create more of a wellness environment. the hilton grand Vacations has a new medical traveler’s discount program. trump International hotel resorts and Spas in Las Vegas offers trump Wellness, which includes everything from an early morning boot camp for organized workouts to complete spa treatments — all designed around a wellness and preventative health experience.

Las Vegas’ city-wide effort is designed to target the traditional medical surgical traveler and the wellness preventative traveler, serving as a pioneer in what is likely to become a boom industry as more employers and their employees recognize and embrace the substantial advantages of domestic medical travel.

The End Result Many companies have watched the big retailers begin offering domestic medical travel

employers adopt domestic medical travel, they will be motivated more by cost control, while moving toward paying for quality care - rather than simply paying per service.

Domestic medical travel can play a critical role in mitigating the high cost of unnecessary surgery. Utilizing robust health data, employers can identify plan members who are on the path learning more about the surgery, as well as less invasive but equally effective options.

As an innovative approach to health care, risk for employer organizations of all sizes, while a relationship with a COE empowers them to anticipate costs and take positive, proactive action. Steerage programs are critical for getting a domestic medical travel program off the ground. they should be designed to inform and enlighten a company from the top down, with a focus on keeping employees healthy and productive for the company’s long-term sustainability.

Control your healthcare costs by empowering your employees With HealthSparq’s cloud-based healthcare transparency solutions, your employees can shop online for healthcare services—with accurate costs for providers, treatments, facilities and more.

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In partnership with your health plan, your employees can access industry-leading tools that enable them to make informed decisions on treatment and provider options based on cost, quality, convenience, social content and other information.

Every employer is different so we’ll work with you to engage your employees in healthcare services shopping by delivering additional solutions and services that motivate them to make smart, cost-saving decisions.

Single Search: Allows employees to easily research all their healthcare needs.

Real Prices: Shows how much an employee pays for care, based on their health plan’s contracts, benefits and coverage.

Patient Ratings & Reviews: Offers insights into patients’ actual experiences with providers.

Health & Wellness Community: Provides support, information and encouragement via online interactions with other consumers and health industry experts.

• Proactive Campaigns: Offers cost-saving opportunities through email alerts and personalized dashboards, plus rewards and incentives that recognize positive shopping behaviors.

• Conveniences: Delivers services that make it easier to shop and save, such as a phone concierge, Telehealth virtual doctor appointments and online appointment scheduling.

• Engagement Services: Keeps shopping for healthcare top of mind and leverages advanced analytics to identify savings opportunities and recommend targeted interventions to drive behavior change.

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HealthSparq.com | 855-SPARQ-IT (855-772-7748)

The Rebirth of

L

ong linked to the wealthy, concierge medicine is being reinvented. gone are the days of only those with deep pockets being able to afford personalized heath care. Instead, concierge

retainer-based medicine and more. describe it as ‘concierge-style service without the

you should be able to receive personalized care across the board — no matter how many zeros As the health care landscape continues to change thanks to the Affordable Care Act — among other things — consumers are of health care. In fact, according to and , executives and celebrities account for less than 4 percent of those seeking personalized care. the reality is, more than 50 percent of concierge medicine patients make a combined household income of less than $100,000 per year. responsible for the rapid growth of concierge

40 July/August 2014 * XXX 5IF*)$$ DPN * HealthCare Consumerism Solutions™

BY HEATHER LOVERIDGE Âť SENIOR EDITOR Âť

“With direct primary care, we can now offer a similar service to the small businesses in the community.�

gross founded Epiphany health as a direct result of clients seeking cost savings through personalized care. approached my partner and asked about saving money by contracting directly with us to care for his 10 employees, then changing his policy over to a catastrophic policy. With the money he would save, even if he paid for his employees’ deduct-

and co-founder and senior vice president up to the realization that they want to make individualized health choices and are seeking those opportunities. Physicians are waking up to the same. Also, while more and more care is being relegated to mid-level providers/physician assistants, many patients want the option to actually see a physician. In many systems, that is only guaranteed by a concierge relationship.

Affordable Care Act allows a direct primary around insurance product to avoid tax penalties.

Washington state with a wrap around Ambetter insurance product. In 2014, this combination was about 40 percent cheaper than the next most expensive option, without any out-ofpocket expenses for routine care under the DPC

need to be so complicated? What we provide is cheap. Basic health care can also be cheap if very basics that one needs, like labs and imaging

A concierge doctor, instead of seeing 25003000 patients a year, typically cares for 400600 patients, charging a set fee per visit or a yearly retainer. medicine — some practices are saying ‘you know what — I don’t need to be paid $3,500 for you to see me, you don’t even have to insurance to see age or risk and may charge $45 a month, $50 a As the concept has gained popularity, distinct offerings have emerged.

Concierge Care THE INSTITUTE FOR HEALTHCARE CONSUMERISM

HealthCare Consumerism Solutions™ I www.TheIHCC.com I July/August 2014

41

Growing Pains for Private Exchanges, cont’d from Exchange Solutions page 14 ancillary insurance. With such a large volume of information, issues arise around how to pass data back and forth across organizations, or how to handle exception processes and reconciliation. Exchange operators will be expected to address these increased complexities, often managed by

or one across the marketplace? how do these increased complexities impact legacy carrier systems and processes for employer and member setup? how does the exchange integrate with employer payroll systems to contribution impact pre- and post-tax earnings? successful exchanges will develop thoughtful approaches to data management that can help simplify their employer and payer partners’ data complexities.

When employers transition from receiving 5 bills per month to having 15, they are not feeling administrative ease. Exchanges must from multiple carriers. Many exchanges are deferring billing functionality are the products your employees purchased, and here is how much to take out of employees’ paychecks.” Furthermore, some exchanges fail to provide reconciliation. Employers must trust that the exchange and carrier systems are in sync in a complex environment ripe for errors and that offers little visibility into the source of truth. Mature exchanges will help emulate the ideal experience: an employer pays one bill (consolidated billing) across all carriers and products with assurance that the balance matches employee elections on the health insurance exchange (reconciliation).

Fine-tuning the front end Advancing the “front-end” consumer marketplace will also distinguish leading exchanges (see Figure 3). Consumers expect the retaillike, personalized and data-driven experience that they get in other parts of their lives. these are some areas in which exchanges are improving the front-end experience.

When exchanges enable a retail-like experience, consumers will see recommended product bundles that are pulled from a fuller library of health and ancillary products. Ultimately, the overall shopping experience

Front-end integration with health care savings and spending accounts makes it easier for users to manage current and future contributions/ balances. this information could also feed into the decision support tools mentioned previously, better enabling consumers to forecast the longer

Stretching to sustain growth According to an Accenture survey of 2,000 U.s. consumers, 87 levels” as an important feature, with 58 percent identifying it a very important or critical feature. Personalized decision support tools better product recommendations. Advanced analytics may also help with product recommendations by leveraging claims data to forecast expected out-ofpocket costs and showing products that “people like me” may have bought.

Most exchanges today link to carrier tools so that a consumer can manually determine which products cover which doctors. integrating these tools will make it more convenient for consumers to understand this critical factor in the decision-making process.

42

July/August 2014 I www.TheIHCC.com I HealthCare Exchange Solutions™

the private health insurance exchanges that make the right moves in the next 18-24 months will be the ones who are better positioned to achieve sustainable growth as this robust market matures. getting the front end right will draw in customers, and getting the back end right will retain them.

WWW.THEIHCC.COM

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— Liz Frayer, RHU, Intrepid

PROFESSIONAL DEVELOPMENT

Health Insurance 101: An Orientation is a new, flexible online course offered by AHIP. It is designed to teach health insurance basics to those new to health care or individuals who wish to review the fundamentals.

The course is formatted in short modules; you learn at your own pace and on your own time, moving through the materials as you choose. Plus, AHIP will customize the course to fit your organization’s specific learning requirements.

AMERICA’S HEALTH INSURANCE PLANS 601 Pennsylvania Ave., NW South Building, Suite 500 Washington, D.C. 20004 Lindsey Miranda Canaley Tel: 800.509.4422 Fax: 202.861.6354 lmirandacanaley@ahip.org www.ahip.org/courses

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HEALTH DECISION SUPPORT TOOLS

Castlight Health enables employers, their CASTLIGHT HEALTH 85 Market Street, Suite 300 employees, and health plans to take San Francisco, CA 94105 control of health care costs and improve care. Named #1 on The Wall Street 415.829.1400 Journal’s list of “The Top 50 Venturewww.castlighthealth.com Backed Companies” for 2011 and one of Dow Jones’ 50 Most Investment-Worthy Technology Start-Ups, Castlight Health helps the country’s self-insured employers and health plans empower consumers to shop for health care. Castlight Health is headquartered in San Francisco and backed by prominent investors including Allen & Company, Cleveland Clinic, Maverick Capital, Morgan Stanley Investment Management, Oak Investment Partners, Redmile Group, T. Rowe Price, U.S. Venture Partners, Venrock, Wellcome Trust and two unnamed mutual funds.

— Giovanni Colella, M.D. CEO and Co-Founder, Castlight Health HSA/HRA/FSA TECHNOLOGY: ADMINISTRATION & MANAGEMENT

A PRIVATE EXCHANGE THAT SIMPLIFIES HEALTH INSURANCE

INSUREXSOLUTIONS

10275 W. Higgins Road, Suite 500 Rosemont, IL 60018 855-563-6993 info@insurexsolutions.com www.insurexsolutions.com

The InsureXSolutions® private exchange offers employers a simplified role in the new health insurance marketplace. Employers with part-time workers or retirees, as well as small businesses can utilize this exchange to empower their employees to choose the health and dental insurance that best fits their personal and family needs. Employers can reduce costs and administrative tasks, while employees receive interactive support tools and personal guidance from our licensed insurance professionals. Available in select markets, InsureXSolutions is exclusively offered and operated

by Flexible Benefit Service Corporation (Flex). Contact your broker or consultant, call us directly at 855-563-6993, or visit www.insurexsolutions.com to learn more.

HealthCare Consumerism Solutions™ I www.TheIHCC.com I July/August 2014

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SOLUTION PROVIDER MEMBER PROFILES

HSA/HRA/FSA TECHNOLOGY: ADMINISTRATION & MANAGEMENT

MasterCard (NYSE: MA), is a global payments and technology company.

MASTERCARD WORLDWIDE 2000 Purchase St. Purchase, NY 10577-2509

It operates the world’s fastest payments processing network, connecting consumers, financial institutions, merchants, governments and businesses in more than 210 countries and territories. MasterCard’s products and solutions make everyday commerce activities—such as shopping, traveling, running a business and managing finances—easier, more secure and more efficient for everyone.

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HEALTH ACCESS ALTERNATIVES

Carena provides 24/7, on-demand access to CARENA, INC. health care by phone, webcam, and house 1525 4th Avenue, Suite 300 call. Seattle-based Carena is committed to Seattle, WA 98101 delivering the best health care experience 800.572.2103 possible. Its technology-enabled care delivery www.CarenaMD.com model provides on-demand access to health James.Taylor@CarenaMD.com care 24/7, via phone, secure video, and house call. Carena provides health care solutions to patients through employers, health systems and through its consumer service, CareSimple.

“People are paying more out of pocket for care than ever—through higher co-pays and deductibles, reduced benefits, and in the rising costs of goods and services. Taken together, health care has become more expensive and less accessible. Our goal is to make health care more affordable by providing the right care at the right time for the right cost; to help people live healthier lives by removing the barriers to people taking control of their health care.”

— Ralph C. Derrickson, President & CEO, Carena

TOTAL POPULATION HEALTH MANAGEMENT

Orriant helps businesses produce a better, more profitable product by creating a workforce that is healthier, more productive, and less expensive to insure.

ORRIANT

9980 South 300 West Ste. 100 Sandy, Utah 84070 801.574.2306 www.orriant.com suzanne.viehweg@orriant.com

Orriant’s proven strategy is to hold people accountable for improving their health as an integral part of your benefit strategy in a way that is fair and compassionate to all.

“Employers can fight back to control rising health care costs.

Orriant’s strategies have helped major employers from almost every industry cut the cost of health care, improve the health and productivity of their workforce, and push hundreds of thousands of dollars to their bottom lines.”

— Darrell Moon, CEO, Orrian

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FSA/HRA/HSA/TRANSIT/COBRA: ADMINISTRATION & MANAGEMENT

July/August 2014 I www.TheIHCC.com I HealthCare Consumerism Solutions™

eflexgroup (eflex) is a nationwide eflexgroup administrator of pre-tax benefits 2740 Ski Lane and COBRA. Committed to providing Madison, WI 53713 fast answers, fast claims, and web 877.933.3539 ext 300 self-service, we set the industry www.eflexgroup.com standards for service. With a efgsales@eflexgroup.com customer focus and Lean Six Sigma methodology, we don’t talk about service, we prove it. See our metrics at eflexgroup.com.

“eflexgroup’s customer service department should be a model for ALL customer service departments. The courtesy, professionalism and knowledge surpass ANY customer service department I’ve encountered! I feel the outstanding, exemplary customer service of eflexgroup is simply the best!”

— Kimberly Adams, Southeast Energy Assistance [testimonial]

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HSA/HRA/FSA TECHNOLOGY: ADMINISTRATION & MANAGEMENT

TSYS Healthcare® provides end-toTSYS HEALTHCARE end strategic payment solutions for 706.649.5080 consumer directed healthcare. We www.tsys.com/healthcare partner with benefits administrators, healthcare@tsys.com financial institutions, health plans, and software providers to navigate all aspects of HSAs, HRAs, FSAs, transportation accounts, cash reimbursements, and lines of credit. TSYS Healthcare cards offer participants the security they expect along with the ability to conveniently access funds from multiple accounts and manage their benefits payments with simplified single-card access. Clients and partners benefit from simplified processes, reduced paperwork and cost savings that can contribute to improved return on investment.

“We built the TSYS Healthcare platform to meet the market demand for reliable, configurable and intelligent solutions. Understanding the dynamic U.S. healthcare market, our customers rely on our option-driven system to prepare them for the future.”

— Trey Jinks, Group Executive, TSYS Healthcare HSA / HRA / FSA ADMINISTRATION AND FINANCE

WageWorks helps employers support consumer directed pre-tax benefit programs, including health care (FSA, HSA, HRA), wellness programs, commuting and

WAGEWORKS 1100 Park Place, 4th Floor San Mateo, California 94403 United States of America 888-9905099 www.wageworks.com

child and elder care. Wage Works also offers retiree health care and COBRA Services.

More than 100 of America’s Fortune 500 employers and millions of their employees use WageWorks.

SOLUTION PROVIDER MEMBER PROFILES

HSA ADMINISTRATION & FINANCE

At HSA Bank, we’ve been helping businesses HSA BANK optimize their health care spending for over 605 N. 8th Street Suite 320 15 years. We offer unmatched service and Sheboygan, Wisconsin 53081 expertise when it comes to health-based United States of America savings accounts. You can count on our 800.357.6246 dedicated business relations team for turnkey www.hsabank.com solutions and ongoing support that help your business and workforce save for a healthy future. To connect with your regional representative, call 866.357.5232 or visit hsabank.com.

“When implementing one of the first Medical Savings Account programs in the country, I had a belief that health care could be fixed with free-market principles. I still do. By adopting flexible and transparent practices that manifest core attributes of consumerism such as private exchanges, defined contributions, and self-funding; we will reform health care in our nation.”

— Kirk Hoewisch, Co-Founder and President, HSA Bank, a division of Webster Bank, N.A. HSA / HRA / FSA ADMINISTRATION AND FINANCE

Evolution1 and our Partners serve more EVOLUTION1, INC. than 9 million consumers, making us 952.908.9056 the nation’s largest electronic payment, www.evolution1.com on-premise and cloud computing sales@evolution1.com healthcare solution that administers reimbursement accounts, including HSAs, HRAs, FSAs, VEBAs, Wellness and Transit Plans. It is the only solution that offers a single end-to-end user experience, provides innovative auto-substantiation technologies, and automates workflow for Partners, employers, and consumers. It does all this on one technology platform comprised of 1Cloud™, 1Direct™, 1Pay™, 1View™, 1Plan™, and 1Mobile™. Evolution1 and our Partners are dedicated to delivering value, reducing costs and simplifying the business of healthcare.

“The combination of our innovative products will further our leadership position in a rapidly changing healthcare market. Together with our Partners we are committed to reducing costs and simplifying the business of healthcare.”

— Jeff Young Chairman and CEO, Evolution1

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SOLUTION PROVIDER MEMBER PROFILES

EMPLOYEE ENGAGEMENT TOOLS

Millions of consumers via benefits, health CODEBABY plan, and healthcare providers depend on 111 S. Tejon St. Suite 107 CodeBaby customer engagement solutions Colorado Springs, CO 80903 to make personalized and informed 877.334.3465 healthcare decisions. These major healthcare codebaby.com/online-solutions organizations experience overwhelming info@codebaby.com engagement, accuracy, and form completion results by using CodeBaby virtual assistant and engagement technology. t 5IF #FOFmUT "EWJTPS TPMVUJPO HVJEFT DPOTVNFST UP NBLF GVMMZ JOGPSNFE JOTVSBODF BOE CFOFmUT DPWFSBHF EFDJTJPOT t 5IF )FBMUI "EWJTPS TPMVUJPO ESJWFT CFUUFS IFBMUI CFIBWJPST CZ FOHBHJOH QBUJFOUT PO XFCTJUFT 1)3T BOE DBSF NBOBHFNFOU QMBUGPSNT

“CodeBaby is focused on creating solutions that communicate, educate, and elevate the entire healthcare consumerism experience throughout the consumer lifecycle. Our solutions provide organizations innovative ways to optimize their current platform while meeting the demand for an enhanced online experience.� — Dennis McGuire, CEO, Codebaby BENEFIT ENROLLMENT AND ELIGIBILITY

Totem Solutions is a boutique benefits TOTEM SOLUTIONS consulting and administration firm offering highly 11330 Lakefield Drive specialized services and products. We serve Bldg 1, Ste 150 benefit management and HR professionals as an Duluth, GA 30097 extension of their team, allowing them to focus on key initiatives and core strengths. Our services 770-295-1600 include Employee Benefits Consulting, Benefits Toll-free 866-481-4917 Administration, Enrollment, & Communication, www.totemsolutions.com Health Care Reform Education, Enrollment, Reporting & Compliance, Leave and Disability Management Administration.

“We are hands-on benefits advisors for public and private sector companies throughout the country. Totem delivers employer-centric service that simplifies benefits administration and enrollment in order to facilitate employee understanding and ensure the best possible employee experience. Our goal is also our great passion and commitment: to offer organizations clear and accurate counsel accompanied by services and solutions that are easy to access, seamlessly implemented and custom fit, while providing a worry-free outsourcing solution.� — Debbie Schultz, President, CEO, Totem Solutions

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July/August 2014 I www.TheIHCC.com I HealthCare Consumerism Solutions™

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HEALTH DECISION SUPPORT AND COST-SAVING TOOLS

WiserTogether Inc., helps patients choose the right care at the time. It

WISER TOGETHER Praveen Mooganur

offers an innovative online treatment

202.276.3074

selection & shared decision support

www.wisertogether.com praveen.mooganur@wisertogether.com

platform that helps patients make evidence-based, cost effective

treatment decisions across musculoskeletal, cardiovascular, mental health, diabetes, pregnancy and respiratory illnesses saving payers money. Currently 1.5 million members have access to the platform through employers and health plans in the country.

WiserTogether was founded in 2008 and is based in Washington, DC. — Praveen Mooganur, COO, WiserTogether SUPPLEMENTAL HEALTH

Delta Dental leads the DELTA DENTAL industry in designing 1130 Sanctuary Pkwy, Suite 600 Alpharetta, GA 30009 innovative dental coverage programs that keep costs 770-641-5196 down and deliver quality care. Our diverse client list includes everyone from Fortune 100 companies to public agencies to individuals and families. Our customer’s satisfaction is based on our expansive dentist network, cost-saving mechanisms and superior customer service. We are part of the Delta Dental Plans Association that provides dental coverage to more than 56 million people in the US.

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HSA/HRA/FSA TECHNOLOGY: ADMINISTRATION & MANAGEMENT

HEALTHCARE ACCESS

HealthPerx is a health and wellness marketing company specializing in creative non-insurance benefit solutions that reduce absenteeism, increase productivity and decrease healthcare costs.

Consultants: These benefits differentiate you from competitors.

HEALTHPERX Jeff Marks, CEO Jmarks@hperx.com Direct: 205 222-4062 Toll Free: 888 417-6187 www.hperx.com

Corporations: These will give you a far greater ROI than your wellness program while saving your employees thousands of dollars a year.

Differentiator: Telemedicine Services: PGGFSJOH UIF FOUJSF GBNJMZ unlimited calls with no consult fees BOZUJNF GSPN BOZXIFSF Additional Health Benefits: PGGFSJOH TJHOJmDBOU TBWJOHT GPS QIBSNBDZ EFOUBM WJTJPO NFEJDBM BEWPDBDZ USBWFM BTTJTUBODF UFMFQIPOJD DPVOTFMJOH &"1 BOE NPSF Turnkey Program: CJMMJOH BENJOJTUSBUJPO GVMmMMNFOU DBMM DFOUFS NBSLFUJOH HealthPerx benefits complement any and all existing benefit plans.

— Jeff Marks, CEO PRESCRIPTION BENEFITS MANAGEMENT

Provider of Prescription Benefits Management services to self-funded employee groups, TPA’s, Brokers, and Consultants. Phoenix also offers a prescription savings card, RxAdvantage, for individuals and groups alike.

SOLUTION PROVIDER MEMBER PROFILES

PHOENIX BENEFITS MANAGEMENT

410 Peachtree Parkway, Suite 4225 Cumming, Georgia 30041 888.532.3299 main office 678.208.6257 marketing & pr 678.208.6252 sales 678.208.6255 fax

Phoenix Benefits Management is a prescription benefit manager sales@phoenixpbm.com providing traditional PBM services marketing@phoenixpbm.com to Self-Funded companies, TPA’s, www.phoenixpbm.com Brokers, and Consultants. We also provide comprehensive 340B services as well as our very own prescription savings card known as the Phoenix RxAdvantage Prescription Savings Card. Though our approach is scalable, our solutions are individualized. It’s been our experience and it is our firm belief that prescription benefit plans are not a one-size-fits-all proposition so we create a plan that is customized to fit the unique needs of each and every one of our clients.

DataPath, Inc., is one of nation’s largest providers of CDH solutions specializing in account-based administration systems.

DATAPATH, INC.

1601 WestPark Drive, Suite 9 Little Rock, AR 72204

501.296.9990 www.dpath.com Since 1984, service providers using DataPath systems have provided administrative solutions for over 1 million participants of FSA, HRA, HSA, and COBRA. DataPath is the only solutions provider to design and deliver a full Suite of systems for handling 125, 105, 132, COBRA, HSAs, Credit and Debit Cards all delivered to account holders through a single Internet portal, myRSC.com.

“With the significant changes in healthcare today, our software solutions allow users to create custom plans for clients that benefit both the employer and employee. Not only have we created a single platform for all systems with myRSC.com, with the integration of our mySourceCard Debit Card at Wal-Mart and other retailers, our clients are able to offer a hassle-free solution with 100% compliance.” ®

HSA/HRA/FSA TECHNOLOGY: ADMINISTRATION & MANAGEMENT

LOOKING FORWARD TO A CONSUMER DRIVEN FUTURE

FLEXIBLE BENEFIT SERVICE CORPORATION (FLEX)

10275 W. Higgins Road, Suite 500 Rosemont, IL 60018 888-353-9178

fpsales@flexiblebenefit.com It has been an exciting year www.flexiblebenefit.com at Flexible Benefit Service Corporation (Flex). We celebrated our 25th anniversary along with a decade of increasingly popular HSAs. We have been a trusted benefits administrator of these consumer-driven plans since day one and also offer FSAs, HRAs, Transit and COBRA Administration. In fact, we now offer the InsureXSolutions® private exchange to employers with part-time workers or retirees, as well as small businesses. At Flex, we look towards the future and leverage our consumer-driven experience as a way to help our clients move forward in the changing marketplace.

Contact your broker or consultant, call us directly at 888-353-9178 or visit www.flexiblebenefit.com to learn more.

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SOLUTION PROVIDER MEMBER PROFILES

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BENEFIT ADMINISTRATION/PRIVATE EXCHANGES

Avoid the the Cadillac CadillacTax! Tax! Consumer’sMedical Consumer Medicalhelps Resource® your(CMR) employees helps answer your the five most important in healthcare: employees answer the fivequestions most important questions What do I have?

What I need? do I go? in healthcare: What do I do have?

WhatWhere do I need?

What will it cost?

How do I connect?

Where do I go? What will it cost? How do I connect?

CMR CMR helps helps leading leading Fortune Fortune 1,000 1,000 companies companies improve improve engagement, quality, and satisfaction engagement, quality, and satisfaction through through informed informed clinical clinical decision-making decision-making with with guaranteed guaranteed savings. savings. drive 70%70% of your “10% 10%ofofemployees employees drive of your cost. only help cost.Our Ourservices servicesnot not only help companies in in areas such companiessave savemoney money areas such as elective as reducing reducingunnecessary unnecessary elective surgeries, empower employees surgeries,but butalso also empower employees to make thethe most important makesome someofof most important decisions decisionsofoftheir theirlives.” lives.”

David J. Hines President and Founder

CMR delivers value by helping organizations take control of their healthcare costs. Find out what we can do for you. i ÞÊ7> >Vi]Ê ÀiVÌ ÀÊ vÊ >À iÌ }ÊUÊ Ü> >ViJV ÃÕ iÀà i` V> °V Ê Kelly Wallace, DiriVÌ ÀÊ vÊ >À iÌ }ÊUÊ >À iÌ }JV ÃÕ iÀ i` V> °V Ê Çn£ Çä £ÇÓÇÊUÊÜÜÜ°V ÃÕ iÀà i` V> °V Çn£ Çä £ÇÓÇÊUÊÜÜÜ°V ÃÕ iÀ i` V> °V

TOTAL POPULATION HEALTH MANAGEMENT

Steven LEVEL1DIAGNOSTICS Level1DiagnosticsDr. uses new M. Helschien Founder and CC&BW 11722 Lightfall Court tools to evaluate employees’ Columbia, MD 21044 www.level1diagnostics.com cardiovascular health

410-707-5667 ◆ doc@level1diagnostics.com Dr. Steven Helschien, Founder Heart disease is the number one killer Sales: Penny Aleo, Executive VP in the U.S. and costs millions of dollars 443.878.3087 in medical care and time lost from work. pbaleo@gmail.com Detection and prevention is the key to heart health. Level1Diagnostics is an innovative program that, unlike conventional cardiology tests, provides advanced testing and methods to detect and prevent the earliest signs of cardiovascular disease and encourage optimal health.

There is testing for the early detection of cancer and other diseases, and now we have testing for the early detection of cardiovascular disease.

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July/August 2014 I www.TheIHCC.com I HealthCare Consumerism Solutions™

Since 1988, CieloStar (formerly OutsourceOne) CIELOSTAR has helped brokers, employers and employees 530 U.S. Trust Building navigate the ever-changing world of benefits.

730 Second Avenue South Now, with the dawn of “Defined Contribution Minneapolis, MN 55402 Health Care” we are again on the leading edge.

With a team of industry thought leaders, CieloStar 612.436.2706 makes navigating healthand benefits choices john.reynolds@cielostar.com easy for employers and employees by offering comprehensive benefits administration solutions with a high-touch, high technology model—most recently launching a proprietary private health insurance exchange.

“Fueled by the far-reaching impact and complexities of health care reform taking effect in 2013 and 2014, employers and employees increasingly find themselves in a ‘farmer’s market’ of benefits choices. Cielostar is uniquely positioned with enabling technology that helps purchasers and consumers make the best possible decisions and create a best-in-class benefits administration process. Our unique comprehensive approach to benefits offers everything from back room technology for enrollment, data, billing and call centers to complete solutions for COBRA, CDHP and health insurance exchanges.”

— John Reynolds, CEO, Cielostar HEALTH DECISION SUPPORT TOOLS

Truven Health Analytics, formerly Healthcare at Thomson Reuters, delivers unbiased information, analytic tools, benchmarks, and services to the health care industry.

TRUVEN HEALTH ANALYTICS 6200 S Syracuse Way, Suite 300 Greenwood Village, CO 80111 734.913.3000

Hospitals, government agencies, employers, health plans, clinicians, and life sciences companies have relied on us for more than 30 years. We combine deep clinical, financial, and health care management expertise with innovative technology platforms and information assets to make health care better by collaborating with our customers to uncover and realize opportunities for improving quality, efficiency, and outcomes.

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HEALTH INCENTIVES

MedEncentive offers a patented, web-based incentive system that’s been independently validated

MEDENCENTIVE

Cecily Hall Executive Vice President medencentive.com chall@medencentive.com

to control healthcare costs. Doctors and patients earn financial rewards for declaring adherence to best practices and healthy behaviors, provided they agree to be accountable to the other party for doing so. Easy to implement and

EMPLOYEE COMMUNICATION AND EDUCATION

ExperienceLab has created a breakthrough, CDHCENTRIC patented communication program that saves 507 S. 8th Ave. Bozeman, employers money by increasing adoption and Montana 59715 usage of consumer directed health (CDH) 617.224.6223 insurance plans among their employees. www.experiencelab.com CDHCentric, sold on a subscription basis, rtravis@experiencelab.com delivers regular, multi-media communications that are tailored based on seven unique attitudinal segments developed from proprietary research.

Traditional health plans protect employees from having to learn the basic skills for making cost-effective healthcare decisions. Our segmentation research, which is based on 20 years of behavioral marketing, found 7 unique personality types, and each makes healthcare decisions differently. The result is that, when employee messages are correctly tailored to their personalities, employees become health care consumers!

— Roger Travis, President

embraced by users.

SUPPLEMENTAL HEALTH

Transitions Optical, Inc. is the maker of Transitions® lenses, the #1-eyecare professional recommended photochromic lenses worldwide.

SOLUTION PROVIDER MEMBER PROFILES

TRANSITIONS OPTICAL 9251 Belcher Road Pinellas Park, FL 33782

800.533.2081 ext. 2262 www.healthysightworkingforyou.org

Transitions Healthy Sight Working for You® is an education initiative that helps HR professionals and benefits professionals communicate the value of the vision benefit to employees. More information and complimentary education tools are available at HealthySightWorkingForYou.org.

“Don’t overlook your employees’ healthy sight when thinking about your business goals. A vision benefit that includes an eye exam and sight-optimizing eyewear helps ensure that employees see their best, so they can do their best work, directly affecting your business.”

HEALTH ACCESS ALTERNATIVES

WeCare TLC is a medical risk management company that leverages onsite primary care clinics to provide solutions to rising healthcare costs while improving patient health and wellness.

WE CARE TLC

120 Crown Oak Centre Dr Longwood, FL 32750 800.941.0644 www.wecaretlc.com raegan.garber@wecaretlc.com

Our holistic approach to care empowers the clinic staff to act as patient advocates, which increases compliance and decreases unnecessary expensive services.

“Healthcare is now a right and employers are faced with the challenge of truly managing their healthcare costs. We have created a unique medical home clinic model that properly addresses quality of care and cost. This requires constant, aggressive, creative, and directed attention to accomplish but it can be done.”

— Lynn Jennings, CEO, WeCare TLC

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RESOURCE GUIDE

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Download on itunes or google Play Join the conversation by tweeting or emailing your questions to us in advance, during or after each show: twitter: @the_IhC Email: dfield@theihcc.com

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ADVERTISING CONTACTS 404.671.9551 CEO/PublIshEr

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Rogers Beasley rbeasley@theihcc.com

AHIP ...................................................... 43

IHC Radio.........................................HCX 8

Alegeus Technologies ......................HCX 2

IHC FORUM West 2014 ....................11-13

Allstate .................................................... 5

IHC FORUMS 2015 Save the Date ..........16

Best Buy ........................Inside Back Cover

insurexsolutions .......................HCX 15, 43

Carena ................................................... 44

Intrepid .................................................. 43

Castlight Health ..................................... 43

Level1Diagnostics .................................. 48

CDHCentric ............................................ 49

MasterCard ............................................ 44

CieloStar..................................HCX 15, 48

MedEncentive ........................................ 49

CodeBaby............................................... 46

Orriant ................................................... 44

Consumer Medical ................................. 48

Phoenix Benefits Management................ 47

DataPath ................................................ 47

PrivateHealthCareExchanges.com ..........HCX 6

Delta Dental ........................................... 46

Totem Solutions ..................................... 46

eFlex Group............................................ 44

Transitions ............................................. 49

Evolution1................................HCX 15, 45

Truven Health Analytics ......................... 48

Flexible Benefit Service Corporation........ 47

TSYS Healthcare ..................7, HCX 15, 45

Fresh Benies ..................................HCX 16

UnitedHealthCare ..................... Back Cover

HealthPERX ............................................ 47

WageWorks ........................................... 45

HealthStat ......................Inside Front Cover

WeCare TLC ........................................... 49

HSA Bank ..................................HCX 8, 45

Wiser Together ...................................... 46

IHC Certification .............................HCX 11 50

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GIFT CARD INCENTIVES As powerful incentives, Best Buy gift cards energize your health and wellness program by motivating people with the things they want most, from TVs to tablets to smart phones. They’re hard to resist and easy to redeem online or in store. For instant e-mail delivery and easy personalization, choose our popular e-gift cards. Make your wellness program even more rewarding.

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3TEPPING UP

to empower your employees with award-winning health resources

At UnitedHealthcare, we offer innovative tools that put members in touch with their information.

We’ve made it easier for your employees to find the right information at the right time (even on the go). s MY(EALTHCARE #OST %STIMATOR provides relevant information on care and estimated costs. s MY#LAIMS -ANAGER helps members understand, track and pay their medical bills online. s 5NITED(EALTHCARE (EALTH -E4- is an award-winning* mobile app that provides instant access to a family’s important health information. s MYUHC COMŽ is a resource for members, providing easy access to personal health care benefit information – whenever they need it.

Empower your employees. It’s good for their health – and the health of your business. &OR MORE INFORMATION VISIT WELCOMETOMYUHC COM OR CALL

*Produced by MediaPost Communications, a media, advertising and marketing news and events publishing company based in New York, the annual Appy Awards’ aim is to acknowledge extraordinary Applications, whether they be mobile, social, or Web-based. The Appys don’t discriminate by format, platform or device; instead, they focus on simply honoring the best Apps in all imaginable categories: http://appyawards.net/.

All UnitedHealthcare members can access a cost estimator online tool at myuhc.com. Depending on your specific benefit plan and the ZIP code that is entered, either the myHealthcare Cost Estimator or the Treatment Cost Estimator will be available. A mobile version of myHealthcare Cost Estimator is available in the Health4Me mobile app, and additional ZIP codes and procedures will be added soon. This tool is not intended to be a guarantee of your costs or benefits. Your actual costs and/or benefits may vary. When accessing the tool, please refer to the Terms and Conditions of Use and Why Your Costs May Vary sections for further information regarding cost estimates. Refer to your health plan coverage document for information regarding your specific benefits. Š2014 United HealthCare Services, Inc. Insurance coverage provided by or through UnitedHealthcare Insurance Company or its affiliates. Administrative services provided by United HealthCare Services, Inc. or their affiliates. Health Plan coverage provided by or through a UnitedHealthcare company. UHCEW686242-000