Healthcare Providers Skeptical About Approaching HIX Deadline
By Greg Bengel, contributing writer
Although most providers plan to reap the benefits of participating in an HIX, the majority is skeptical about launch date
A recent survey conducted by Edifecs at the 2013 Healthcare Mandate Summit found that 70 percent of healthcare professionals are skeptical that state and/or federal health insurance exchanges will be ready to launch by the October 1, 2013 deadline.
The survey group consisted of more than 125 senior healthcare professionals, including commercial health insurers (68 percent), healthcare providers (11 percent), government entities and agencies (9 percent), and other healthcare industry organizations (12 percent).
The survey also found that 93 percent of respondents believe state exchanges should enter into more open dialogue with health insurers. Also, 75 percent are very concerned about their ability to reconcile premium, enrollment, and payment records received from HIXs, and 88 percent are concerned about potential disruption to existing IT enrollment infrastructure.
Despite the skepticism, 95 percent of survey respondents plan to participate in an HIX, 80 percent as early as 2014. Health insurers, for one, have large incentive to do so. According to Edifecs, in 2014 alone, 12 million people are projected to purchase insurance through an HIX, paying approximately $60 billion in premiums.
For providers, this potential outweighs any lingering doubt of participating. Jamie Gier, vice president of Corporate Marketing for Edifecs is quoted in this Healthcare IT News article, saying, “The message we heard from Summit attendees is that while compliance with mandates such as Health Insurance Exchanges is no easy feat, there are considerable benefits to be gained, including increasing member enrollment.”
Still, uncertainty remains. According to Edifecs, its source is largely pessimism about the ability to make meaningful progress at the state level. “Although the ACA is a federal mandate, states are in the driver’s seat for determining exactly how their exchanges will be run,” the study points out.
Several news stories further reveal that providers have good reason to be skeptical. The Wall Street Journal reports that government officials have already missed multiple deadlines in setting up HIXs for small businesses and consumers. For example, the deadline for states to declare whether they would be starting their own HIX or adopting one from the federal government was recently postponed from November 16 to December 14, according to the Huffington Post.
The Government Accountability Office (GAO) also appears to lack confidence. “While the missed interim deadlines may not affect implementation, additional missed deadlines closer to the start of enrollment could do so,” they said in a recent report.
Amidst the uncertainty and potential roadblocks, however, the Edifecs report concludes that “for those health insurers that successfully navigate the HIX launch process … the payoff will be considerable.”