Dash says the SHOP exchanges have the potential to help the country achieve a value-based healthcare system. "The idea is you aggregate the purchasing power of your individuals and your small businesses," she said. "Big businesses can drive value-based initiatives. They can kind of drive the marketplace more [than smaller players]… The idea behind the marketplaces is as an aggregator and setter of standards. That's the promise as far as the value-based delivery system is concerned."
Rhode Island on a Roll
While the Commonwealth Fund study does not gauge SHOP exchange performance, it does indicate "which ones are working and which ones aren't working," Dash said, noting the states are leading the charge.
"The states that did move forward with establishing their own SHOPs really tried to make this a value-add for small businesses," she said. "Federally run SHOPs just don't have the level of choice. Employers in those states don't have the options that are available in other states."
Several states offer health insurance policies on their SHOP exchanges that exceeded federal standards, according to Dash. She says seven states, including Rhode Island, offer the fullest possible range of plans.
"Our SHOP exchange is one of the only SHOP exchanges in the nation that has been up and running since October 1," HealthSource RI officials said in a statement released Monday. "We've been pleased with the interest we've seen from Rhode Island's small employers, particularly around our unique Full Employee Choice model, which lets the employer select a base or reference plan at a designated contribution level and then gives employees the flexibility to choose from any of the 16 plans offered on our SHOP exchange. Employers appreciate having predictability in cost while still having the flexibility to let their employees choose what's best for them."