America’s Health Insurance Plans

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Presentation transcript:

America’s Health Insurance Plans Health Plan Initiatives and Regulatory Agenda for Consumer Driven Healthcare Tom Wilder America’s Health Insurance Plans September 27, 2007

Outline Consumer Driven Care is Alive and Well and Growing Value Proposition for Consumers Operational and Policy Challenges

Growth of HSA/HDHP Enrollment from March 2005 to January 2007 4,532,000 3,168,000 1,031,000 Source: AHIP Census March 2005, January 2006, January 2007

Average Annual Premium HSA/HRA Compared to Non-HSA Plans Group Market Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2007.

HSAs Quickly Emerging as Valued Coverage Option Individual Market Source: AHIP Census January 2007

HSAs Quickly Emerging as Valued Coverage Option Small Group Market Source: AHIP Census January 2006

Disease Management Benefits Offered by HSA/HDHPs, 2007 Source: AHIP Census, January 2007

Consumer Decision-Support Tools Available to HSA/HDHP Enrollees, 2007 Percent of Companies Offering Available Online Patient access to HSA information 93% Health education information 99% 95% Hospital-specific quality data 86% 85% Physician-specific quality data 50% 49% Other physician-specific information 97% Provider cost information 88% Personal health records 72% Other* 52% *e.g. clinical or Rx information, health plan comparison resources Source: AHIP Census, January 2007

Operational Challenges Make the transaction seamless - link financial and insurance data and enable real-time transactions Consumer decision tools Consumer, employer, and provider education

Legal/Regulatory Challenges Finalize HSA guidance and comparable contribution and Sec. 125 Rules. Allow high deductible health plans to cover Rx “first dollar” Allow use of HSA dollars to purchase insurance coverage (including Medicaid supplement coverage). Permit higher contributions for individuals with chronic conditions. Allow embedded deductibles for individual coverage in a family policy. Permit better coordination of coverage between HRAs, FSAs, and HSAs.