Plans ready to bet on exchanges, some states dragging their feet

July 1, 2012

As the motivation for implementing health exchange increases, some states have made little progress.

NATIONAL REPORTS - As the motivation for implementing health exchanges increases, some states have made little progress. And that doesn't bode well for plans that are eager to start crafting new products.

"The smart money now would say that exchanges in one form or another will be up in each state on the current time table," says Paul Lambdin, director, Deloitte Consulting LLP, who follows health exchanges. "A bet on a delay is just that-a bet."

Even though plans are eager for exchanges to reach the market, most are trying to build their strategies with little guidance from states.

According to Birhanzel, plans that focus on a single market or a few geographical areas have the ability to tailor offerings to what the particular states are building. If plans aren't entirely sure what states are building, they can at least follow the known exchange policies and tweak as needed. Large national plans face a bigger challenge.

"They're going to face probably almost every flavor of those different [state model] options," says Birhanzel.

He says it's important for plans to think in terms of an 80/20 rule. That is, 80% of requirements are likely to be common across states. Plans can begin to build capabilities based on that 80%, knowing that the 20% could vary greatly state by state.

"The challenge is to not only show up, but to be positioned to win," says Lambdin. "The two biggest challenges will be getting to the right price point and dealing with an individual consumer effectively and efficiently."

Lambdin says that plans' readiness for exchanges applies across three pillars: