4 Emerging Health Plan Innovations In The Connecticut Insurance Market

One of the new trends that have emerged as a result of the Affordable Care Act (ACA) is the strategic option for employers to define their contribution and provide employees with significantly more choices in the insurance products they may want to buy for themselves and their families.  The platform to do this is known as a Private Exchange, and there are many options available, as I outlined in my last post: Choices on Top of Choices: Deciphering the Private Marketplace Landscape with 7 Essential Components.

As many are aware, OneDigital Hartford has been hosting bi-weekly seminars on our own Private Exchange, the OneDigital Marketplace (DBM).  These seminars explore the concept of how the rise of the consumer will transform the future of employer-sponsored benefit plans. Each of the seminars has included an opportunity to see a test drive of the marketplace from the employer’s perspective.

In addition to this exciting new macro trend in healthcare, employers sponsoring a health plan in Connecticut should be aware of the three recent emerging options:Healthy CT, Harvard Pilgrim HealthCare and ProHealth Physicians Accountable Care Organization (ACO).

A brief overview of each follows:

Healthy CT

HealthyCT is a non-profit, Consumer Operated and Oriented Plan (COOP), whose development was encouraged by healthcare reform law and funded by the federal government.  Their model is based upon the concept of a Patient Centered Medical Home (PCMH) relying heavily on the Primary Care systems to help improve quality of care while lowering costs. Their provider network development is ongoing.

HealthyCT has been writing individual and small business coverage since January 1, 2014 and has recently begun targeting larger groups (50 employees or more) with very aggressive pricing. To learn more, visit www.healthyct.org.

Harvard Pilgrim HealthCare (HPHC)

Harvard Pilgrim HealthCare, also a non-profit, has been around for 35 years primarily serving members in Massachusetts, but they have their sights set on Connecticut with a tentative roll out of July 2014. For 10 years, HPHC has been recognized as America’s number one health plan.  HPHC has been using the services of Mickey Hebert, whose background in the Connecticut marketplace should accelerate HPHC’s acclimation to the state.  To learn more visit www.harvardpilgrimhealth.org.

ProHealth Physicians Accountable Care Organization (ACO)

ProHealth Physicians was formed in 1997 with a mission to empower Primary Care physicians through improved care processes and patient outcomes. One of the health system models encouraged by health care reform is the concept of an Accountable Care Organization (ACO). ProHealth has formed an ACO and are in the process of developing a direct-to-employer solution to improve quality of care and reduce cost. ProHealth believes their approach to population health management and provider reimbursements will improve the system for all constituents. To learn more visit https://www.prohealthmd.com/.

These innovative insurance options are a direct result of the emerging healthcare marketplace. Each represents a potential option for employers who offer a health plan in the state of Connecticut. The genesis and practical application of these options, plus the OneDigital Marketplace, will be discussed in Ovation’s spring Chief Executive Series event, “Emerging Market Forces in the New World of Connecticut Health Plans" on May 21^st, 2014 at The Society Room in Hartford, Connecticut.

For more information or to register, contact Lisa Hathaway at [email protected].