How a private benefit exchange can bend the health care cost curve

Some have compared the changes in health care to the changes that occurred in the retirement industry 30 years ago when companies switched from pension plans to 401(k) plans and put the responsibility on consumers to pick investments. But George Tzinas, chief experience officer at BenefitAlign, says it is not the same. If consumers make a mistake in their retirement planning it may not impact them for years, but if they make a mistake in benefit planning, they will feel the impact as soon as they need to see a doctor or fill a prescription, he says. He believes an exchange solution has to be about educating consumers to make the best choices for their life situation and then offering them options to purchase products that fit that choice

What is the structure of your exchange? What makes it different?

Our exchange platform is part of a broader suite of health care solutions that stretches product management to shopping and through post enrollment. Our exchange solution offers a plan and rate repository to store product and rate data, generate quotes and proposals and a robust but [easy]-to-use shop, compare and enroll front end. It was built to support both broker-led and direct sales channels. On the back end, we can integrate with existing legacy systems or act as a standalone solution with its own CRM to manage broker leads.

How do you recruit clients?

We use many of the existing marketing channels, but our most effective channel is events — private benefit exchange technology forums — where we can provide live demos of our solutions. Advertising and white papers are fine, but we sell on demos. Because we have a modular product suite we also can upsell existing clients with additional products such as advanced analytics/reporting and commission management.

Also see: Why a private exchange needs a bit of everything

What is your relationship with brokers?

We believe our solutions are a broker’s best friend. We allow brokers to cost effectively scale their businesses and reduce the sales cycle, particularly for group sales. We understand the pressures on brokers to do more with less as commissions are reduced, new sales channels offer more competition, and changing regulations impact product design. We aim to not only provide the tools to improve broker sales and retention, but also to provide them with guidance so they can act as trusted advisers to their clients.

We believe the market has been focused on exchange solutions for large employers, such as Aon, Mercer and Bloom Health, and for employers, such as Benefitfocus. We support both those market segments and also provide brokers the technology and guidance to support the small-group market as well.

How did 2015 open enrollment compare to 2014?

Definitely a lot more focus on private exchanges than in years past. Brokers really seem to be embracing technology a lot more. Employers are still on the fence, but they are starting to ask the right questions now. Much more attention to defined contribution models and the Cadillac tax, for instance.

Where do you see private benefit exchanges fitting in health care moving forward?

There has been a lot of discussion of the new cost models and reduced admin with a private exchange. But I think it’s important to understand that ultimately it has to impact health care costs for employers and employees. Moving to a defined contribution model may be fine for a year or two, but if medical inflation starts rising more sharply, as many expect it will, all it leads to is cost shifting to employees.

An exchange solution has to be about educating consumers to make the best choices for their life situation and then offering them options to purchase products that fit that choice — from understanding how cost sharing works through the value of wellness programs. Medical bills are the leading cause of bankruptcy in the U.S., so getting their benefits planning right is critical. Purchasing health care is a challenge for most consumers — that’s why they often use a broker or a co-worker to help them decide.

We believe that a private exchange, done with the consumer in mind, can help bend the cost curve through education and offering a variety of options for consumers. So it’s much more than just an online shopping tool with a defined benefit model — it’s a solution that enables consumers to manage their money and their health, and when that happens everyone wins.

Editor’s note: This story is part of an continuing series of one-on-one interviews with private exchange leaders and top decision-makers across the U.S. Know of an exchange expert who should be profiled? Email Brian.Kalish@sourcemedia.com.

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