Three things MCOs must consider as the uninsured rate drops

August 25, 2015

The drop in the number of uninsured may seem like a good thing, but managed care executives need to be on guard in three areas.

The number of uninsured Americans under age 65 has decreased by more than one-third due to the Affordable Care Act (ACA), shows a recent survey from the Centers for Disease Control and Prevention (CDC).

For the report, analysts examined data from the National Health Interview Survey, which was collected through household interviews by the Census Bureau.

Among those under age 65, the percentage with private coverage through the health insurance marketplace or state-based exchanges rose from 2.5% (6.7 million) in the last three months of 2014 to 3.6% (9.7 million) in the first three months of 2015.

The number of total number of uninsured in the U.S. also decreased. In the first three months of 2015, 29 million people of all ages (9.2%) were uninsured at the time of interview, 7 million fewer persons than in 2014, according to the CDC.

The drop in uninsured Americans will yield a significant influx of newly insured patients to the healthcare system, according to Drew Boyd, author, innovation expert, and a 17-year Johnson & Johnson veteran.

“That may seem like a good thing, but managed care executives need to be on guard in three areas,” Boyd tells Managed Healthcare Executive.

Next: Three things to consider

 

 

#1. They need to track their revenue mix carefully to make sure they’re not just trading out high-revenue patients for low revenue patients. “They need to track this by age group to see where changes in spending and coverage occur,” he says. 

#2.  Managed care programs have a new opportunity to build customer loyalty and brand equity. “These newly insured patients will expect high levels of customer service, and their satisfaction levels will be surveyed along with existing patients,” Boyd says. “Low satisfaction levels could put the plan at risk during contract renewal.”

#3. They need to become more innovative, especially in process innovation and seeking non-traditional sources of income. “The influx of newly insured patients gives them access to more people,” he says. “They need to find ways to monetize these new relationships beyond their current insurance model."