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Health Plans Talk Strategy in 3Q Earnings Calls

Margaret Dick Tocknell, for HealthLeaders Media, November 6, 2013

Senior health plan executives sound upbeat about health insurance exchanges, Medicare Advantage plans, and collaborative risk-sharing agreements with providers.

Despite the well-publicized enrollment issues of healthcare.gov, senior executives at major health insurers were upbeat about the opportunities presented by public health insurance exchanges during their third-quarter earnings calls in October and November.

"We continue to believe that these emerging retail marketplaces can be successful over the long term," stated Mark Bertolini, Aetna's chair, CEO, and president. HIX—both public and private—as well as Medicare Advantage and payer-provider relationships were among the topics covered during the third-quarter earnings calls. Here are the highlights:

Public health insurance exchanges
Senior health plan executives say they were prepared for the difficult start of the HIX program and have their own resources in place to provide full-time exchange support. Still, payers are counting the days until Dec. 15, which is the last day to enroll in a plan that takes effect on Jan. 1.

They are worried that the time it will take to make the necessary repairs to the HIX system won't leave enough time for enrollees to be processed. They are also keeping a wary eye on Congress, which seems determined to intercede, perhaps in the form of extending open enrollment or delaying the individual mandate. Neither move is popular among health plan executives, who maintain that the program must cast a wide net to calibrate for adverse selection.

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