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Health Plans Face Under-Informed Consumers

 |  By Christopher Cheney  
   March 12, 2014

Many commercial payers are grappling with the challenge of developing direct relationships with individual customers who lack knowledge about the new health insurance exchange markets and confidence to make purchasing decisions.

It makes me nervous to think that the success of an enterprise is dependent upon changing the way people think or habitually act. Counting on a pair of commercial partners to make fundamental change can be downright panic-inducing.

With the rising profile of the consumer in the health insurance marketplace, health plan members and insurers alike face changing roles, with high costs for taking risks that end in failure.

Wanted: A Self-sufficient Consumer
Whether a person has never had health insurance or has had a policy for decades through an employer, the growing number of coverage options available makes becoming an educated consumer essential. In the case of health insurance policies with high deductibles and other out-of-pocket expenses such as the catastrophic coverage offered on the new public exchanges, consumers face high-stakes choices.

After making her presentation during the final general-audience session of last week's AHIP exchange forum, Cammie Blais, a top public exchange official in Colorado, told me one of her prime goals for the 2015 enrollment year is improved consumer "self sufficiency." The Connect for Health Colorado CFO says she is aiming to strike a balance between a fully self-sufficient consumer and the concierge model, where consumers are guided through the process of obtaining and maintaining health insurance.

Christopher Cheney is the senior clinical care​ editor at HealthLeaders.

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