In a day and age when you can order a ride with the touch of a smartphone, people demand technology that meets their innovation needs, even when it comes to health care, says Jeff Yaniga, chief revenue officer of Maestro Health. The Chicago-based company, which also owns a medical TPA, runs a private exchange, maestroEdge. Read as Yaniga shares why some private exchanges are not meeting their mark.

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

Our platform meets our clients where they are. As I sit in my office, and we are in a transportation  center, so out my window I can watch people order an Uber. I can watch them get in a taxi. I can watch them walk or get on a train. It’s a good analogy for our platform. We have clients today that want to build their benefits solution purely online. We have customers that want a hybrid — online and with telephonic support. And we have some that have all three, they want paper as well.

We are probably one of the few, if not the only, technology provider that owns a medical TPA. Within our suite of service, we have the ability to build a self-funded plan and service it completely. Though, we are agnostic to funding, we service fully-insured customers as well.

How do you recruit clients?

Primarily through our sales staff. Our average sales person has 20-years of experience in the business and our staff has a lot of diverse experience, as well. We have TPA expertise. We have carrier expertise coming from some of the large carriers; and we have technology expertise, myself coming from a company like Connecture. Our sales staff is our primary recruiting agent. Then our marketing staff is young, fun, active and very brand oriented. They invest enormous amounts of time making a unique and interesting brand, in an attempt to stimulate conversation in the market.

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What is your relationship with brokers?

We love brokers. Brokers are without question a trusted adviser and personally I think they are more important than ever. We are seeing brokers starting to trend two camps. Some brokers are looking to use technology to build a moat around the business that they have and protect themselves against some of the new entrants. Others are taking the exact opposite approach; they are using technology to go out and be conquerors and go out and secure new business with new consultative elements, like technology. Our relationships are strong with brokers; our company is built off of them for sure.

How did 2015 open enrollment compare to 2014?

We were funded about 2.5 years ago but we acquired a company that has been in the exchange business for 13 years, one of the original proprietors of New York HealthPass. We don’t report exact numbers but it is trending from tens of thousands to hundreds of thousands. We will be excited and make a pretty large splash when we cross the million threshold. We think that will happen pretty soon based on the pipeline that we have active today.

Where do you see private exchange’s fitting in the health care game moving forward?

There are a few trends I’m tracking pretty closely. Number one is consolidation and beyond the consolidation that we can’t help see in the news, with United, Anthem, Aetna, Cigna and others. I think there is consolidation happening with private exchange technology providers as well. At one point the count was over 180 companies that think of themselves as a private exchange provider of some sort. What we are seeing is some of them are starting to fail on their promises. When that happens, there are companies full of very talented people that are looking to join companies that are succeeding.

The other big trend is it’s a simple fact; there is still a literacy crisis in health care insurance. There was a report the National Bureau of Economic Research did that looked at the impact of poor decisions. Poor decisions rooted in the fact that most people simply don’t know about premiums, deductibles, co-pays, etc. While that acumen is relatively low today and that literacy is low today, we know it is going to improve as people understand the impact of choosing a narrow network instantly when they go to the doctor they’ve had for 20 years and he or she doesn’t accept their insurance. Literacy will improve and we think that for all of us in the private exchange market, as literacy improves and people become more sophisticated, they are going to demand technology that meets their innovation just like transportation today is as easy as pressing a button and dialing an Uber.

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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