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Health Plans: Avoiding the $10K Deductible

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If health plans move down the road of greater personalization in benefit design, however, insurers will need to improve data collection. Berger says health plans will need systems to target, engage, and communicate with members. She adds pharmacy benefit managers are already using these programs to find what communication methods to use with each individual and when to make that contact. Health plans are working to implement those same programs, she says.

Many health plans of 2020 will not have the help of employers to connect to members. The group market has been eroding each year and Fred Karutz, general manager of health plan solutions at Silverlink, predicts most Americans will have individual health insurance by 2020.

This shift will force insurers to create benefit designs for each member, create more sophisticated branding to get their message out in retail health insurance, create multiple distribution centers to find customers, and manage lifestyle transitions for members, such as those who move from individual insurance to a Medicare product, says Karutz.

Without employers, members, in turn, will need to educate themselves on healthcare decisions and insurers will need to provide adequate tools for them to compare and learn. Berger says more Americans are taking greater responsibility in their healthcare. "There's no question that we see even our seniors today taking on more personal responsibility and asking the questions that need to be asked and making the final decisions," says Berger.

Les Masterson

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