Survey: Consumers Readying for ACA Exchanges

Mar 18, 2013
Applying the principles of Health Decision Science to decisions related to healthcare can help make the most of benefits from the Affordable Care Act.

While complex changes are coming to healthcare next year, a majority of Americans – including those currently uninsured – are confident in their ability to choose health coverage, according to a national survey we released this morning.

The Challenges of the New Health Exchanges

In just seven short months, approximately 30 million uninsured Americans will have access to a new marketplace of public health insurance exchanges when open enrollment begins Oct. 1. Health plans are facing dramatic changes in how healthcare will be purchased, delivered and regulated. They are tackling new market realties and changes, preparing to reach millions of individuals directly. Creating and communicating public exchanges to such a diverse audience, while complying with complex government regulatory requirements will be no simple task.

New Insights Into Consumer Perceptions

It’s for this reason Express Scripts, with an extensive knowledge of healthcare reform, sought to better understand the new public exchange consumer and the role pharmacy benefits will play in the overall selection of a health insurance plan.

To that end, we commissioned Deft Research, LLC to conduct a national Web-based survey to get the pulse of people’s attitudes and perceptions regarding the exchanges, with a particular emphasis on their expectations of pharmacy-plan coverage. We surveyed 2,765 participants, aged 18 to 64, segmented into three groups: uninsured, self-insured and employer insured. The key findings of the survey include:

  • Consumers will select a narrower pharmacy network
  • Home delivery is acceptable for most consumers
  • As subsidies neutralize premiums, pharmacy factors more heavily influence plan choice
  • Uninsured are less sensitive to drug copayments
  • Most consumers will accept a $100 drug deductible
  • High medication users have similar preferences as healthier members
  • Consumer preferences are similar across the country and among employer groups

Leveraging these insights and the solutions we’ve built, health plans can optimize their public exchange plans to attract new consumers, while managing costs and promoting healthy outcomes. Each solution incorporates Express Scripts proprietary approach called Health Decision Science – the application of behavioral sciences, clinical specialization and actionable data to improve health decisions.The solutions are also organized around helping people make better decisions that drive healthier outcomes; decisions around drug choices, pharmacy choices and health choices.

The research is clear, in the exchanges there will be no one-size-fits-all offering. However, by applying Health Decision Science to a unique suite of solutions, health plans and their public exchange consumers can better manage their clinical and financial outcomes.

Author Bio

Julie Huppert
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