Consumers would benefit from transparency tools on exchange websites

Marketplace websites could be doing significantly more to help consumers make informed choices about their health plans, according to a new study.

The study, Supporting Informed Decision-Making in the Health Insurance Marketplace: A Progress Report, found that while some marketplace websites are using highly effective tools to help consumers choose the plans that best meet their families’ healthcare needs and financial circumstances, those tools are not yet available to all consumers shopping for plans in the marketplace.

“To make informed decisions about their health coverage and care, consumers need access to transparent information on both the price and quality of available services, providers, and facilities,” says Lauren Birchfield Kennedy, director of health policy or the National Partnership for Women & Families, who commissioned the report. “Access to information on price and quality will enable consumers to identify high-quality, high-value providers and to factor that information in when making decisions about their care.

“Consumers purchasing health plans through the marketplace are willing to pay for value and we are convinced they will demonstrate this willingness as the marketplace continues to mature,” Kennedy adds.

As consumers continue to enroll in and renew marketplace coverage, issuers will need to differentiate not only on price, but also on quality, benefits, and customer experience. “Maximizing the marketplace’s potential to improve the quality of healthcare services and reduce healthcare costs, however, requires providing consumers with easy access to information on quality ratings and to survey information about health plan quality, value, and consumer satisfaction,” Kennedy says. “Additionally, as consumers are confronted with plans offering narrower provider networks, being able to determine how a plan performs with respect to quality and consumer satisfaction is increasingly important.”

According to the report, there are four features of marketplace websites that are key to helping consumers make informed decisions:

• Enhanced anonymous browsing;

• Direct access to key plan features;

• Useful plan display and availability of consumer tools;

• Easy website navigation and links for assistance.

“Tools that enhance transparency and support informed decision-making should become standard practice,” Kennedy says. “We must make it as easy as possible for consumers to compare coverage options and identify the plan that best meets their families’ needs. As the marketplace continues to evolve, it is essential to identify and build on promising practices. Marketplace administrators should continuously review and improve how they help consumers analyze and select plans.”

The new report recommends that all marketplace websites should, as part of their anonymous browsing features:

• Facilitate consistent and direct consumer access to information on key plan features, including provider directories, prescription drug formularies, and deductibles as well as other cost-sharing information;

• Display, as soon as possible, comprehensive information on quality ratings and enrollee satisfaction;

• Display plans in an order that takes into account multiple factors, including eligibility for cost-sharing reductions, total out-of-pocket costs, and provider preferences;

• Conduct regular usability analyses;

• Support robust consumer feedback loops.

The report was based, in part, on in-depth interviews with academics, foundation staff, consumer advocates and representatives of patient groups. Its researchers then conducted a high-level review of all 15 marketplace websites (HealthCare.gov and those run by 14 states), as well as a more in-depth analysis of HealthCare.gov and the marketplaces run by California, Colorado, Connecticut, New York and Washington state, to assess their performance on those features.

Manatt Health conducted the analysis, reviewing marketplace websites from November 15 to December 23, 2014. Their reviews looked only at plan data and plan choice tools available to the general public as part of a website’s anonymous browsing feature, and therefore did not assess the shopping experience of consumers after they have created accounts on a marketplace. The study also did not verify the data displayed by marketplace websites, such as the accuracy of plans’ provider directories.