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Health Plans Ramp up for Healthcare Reform

Margaret Dick Tocknell, for HealthLeaders Media, May 2, 2012

Paternoster says the HIX number surprised him because early in the healthcare reform process health plans seemed more interested in HIX than ACOs. He says payer organizations devoted planning and development resources to product design and data exchange to be used as part of HIX.

Of course, politics may have played a role in the softening in interest. The exchanges have been stuck in a quagmire as some states refused all federal overtures, including big bucks, to help establish state-run HIX.

Paternoster says he sees signs that interest in HIX is rebounding as payers look to form their own commercial exchanges. Even if the Supreme Court throws out the ACA legislation, he says payers still see huge potential in the individual market and view HIX as a viable way to bring insurance to the uninsured.

Meanwhile, payer interest in ACOs seems to be cruising along, as insurers such as Aetna developcommercial ACO and ACO-like relationships to shift traditional payer-provider relationship from rate-based to value-added-based. The company expects to have at least 20 ACOs under contract by the end of 2012.

With all the talk about the vaunted triple aim of healthcare: better care, better health, and lower cost, it shouldn't come as a huge surprise that health plans tapped improving the customer experience as their top priority for 2012.

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