Story updated March 9, 2pm ET

Despite predictions that private exchange enrollment will hit 30 million in 2017, employers remain cautious about them, including those early adopters who say they had little choice but to move to one.

At the largest health care staffing search company in the United States, it was scary coming into 2015 and not knowing what is ahead with the Affordable Care Act, says Lisa Larson, AMN Healthcare’s senior director of HR Operations.

“Everything is changing. Not just year-over-year — daily things are changing,” she said at a National Business Group on Health summit in Washington last week. AMN wanted to navigate how they were going to do everything, including counteracting rising health care costs.

It was a similar story at software company Convergys. Dennis Hicks, the company’s VP of compensation and benefits, said back in late 2012 his company was looking for an answer to solve the issues of: rising costs, low participation in medical plans, too many employees enrolled in mini-med plans, a lack of plan value and administrative burdens.

Also see: Why Hilton Worldwide moved to a private exchange

In 2013, 36% of Convergys’ population was enrolled in medical plans and 22% of those were in mini-med plans. “We gave people six plans and bad communication,” Hicks said. While that was before he came onboard at the company, an early analysis gave the company the options of paying a penalty, restructuring the workforce or moving to the public exchange, which were all not ideal, he explained.

With their old medical plans, carriers were adding an undue risk premium to shift people somewhere else, Hicks believes. “That was our take,” he added. “It made it more difficult to truly deliver on choice.”

As a result of these issues, Convergys moved to Towers Watson’s OneExchange and AMN Healthcare to Buck’s, a Xerox company.

Lessons learned

Overall, both said moving to an exchange was a good move for their companies, but there were some lessons learned.

For example, they wish they started the process earlier. At Convergys, they made the decision to move to an exchange June 27 and kickoff started in July. “Don’t do what we did,” Hicks said. “It was crazy to go that fast in the first year.”

Also see: Employers share private exchange successes

He also said communication was key, but at first the company stumbled with new hire information as well as a provider lookup.

At AMN, Larson said keeping the company’s brand name was crucial. “Our team members don’t know that we are on an exchange platform,” she said. “They see AMN Healthcare logos, they see our branding, [and] call center staff say ‘AMN.’”

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