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Under HIX, Quality Ratings May Be 'Market Movers'

Margaret Dick Tocknell, for HealthLeaders Media, June 16, 2011

Health insurance exchanges will transform the way customers think about health insurance and the way they compare products. To respond to this challenge Health plans need to become more engaged with their existing and potential customers. That was the message delivered Wednesday during a session at the America's Health Insurance Plans conference in San Francisco.

"This book of business will act differently," explained Patrick Howard, a principal at Deloitte Consulting LLP. "We don't know if the HIX will have the same familiar ratios. Will 20% of the customers still consume 80% of the healthcare resources?

"Where will health plans find their customers for an exchange? They may need to develop new navigators to identify potential markets," said Howard. "Maybe the YMCA or fitness clubs will become a community partner and a source of customers."

The Affordable Care Act requires states to create health insurance exchanges by 2014. The HIX will be designed to allow individuals and small businesses with fewer than 100 employees to buy coverage at competitive rates from policies offered through the exchange, which may be run by either the state or a private company.