More than a year later and the impact of health care reform continues to be debated. Some features have been implemented and the regulatory definitions continue even with the uncertainty of potential legislative changes. It's murky at best. One thing is clear: The broker world is changing and a consulting-oriented approach seems the best course. Now is a great time for brokers to expand their assistance to employer groups and provide expertise and technology on health care cost transparency - with the ultimate benefit being the reduction of health care spend.

Health care reform will most likely increase access to insurance but it is still not clear how it will affect the cost of health care, if at all. In any event, account-based plans, whether purchased directly by consumers through exchanges or through employers, will continue to grow. Patients (consumers and employees) will be expected to pay a growing portion of their health care expense out of pocket.

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