Listen in: My comments to NPR on the first days of the ACA plans

Guest host Barbara Bogaev leads “The Brave New World of Obamacare”

Listen to or download the Jan 2 podcast of “The Brave New World of Obamacare” on To The Point with Warren Olney.

I joined a panel of experts on exchanges, health care reform and insurance to give insights on ACA plans going into effect. To The Point tweeted key comments from each of us, including:

• Bryce Williams, Towers Watson, @brycewatch:
  The ACA could be major boost to entrepreneurship
• Sarah Kliff, Washington Post, @sarahkliff:
  36 hrs into Obamacare, vast majority can signon & signup w/in an hr
• Susan Shargel, Shargel and Company
  
• David Nather. Politico, @DavidNather
• Gerald Kominski: UCLA Center for Health Policy Research, @UCLAFSPH

In the full podcast, you’ll hear comments on these points and more:

The New Year brought with it medical coverage for millions of Americans under the Affordable Care Act. On Jan 1, about two million people began to receive private health coverage through the state health exchanges or the federal website.

With one of the nation’s most sweeping changes to social policy in decades, no longer can insurers deny coverage to people with pre-existing conditions, or charge them more for their coverage than other customers. It’s also the first time they can’t legally charge women higher premiums for the same coverage as men, and the first time they can’t set a specific limit on the amount they spend on “essential health benefits” for individual policyholders.

But there are a lot of “if’s” in the implementation of Obamacare:

• Will people be able to find a doctor who accepts their new plan?
• Are the nation’s healthcare providers ready for the change in policy?
• How will Obamacare shape the political climate this election year?

Sharing Team Pride: Healthcare’s Hottest & Industry Innovator

I’m proud to share some recognition in the fields of health care business and consumerism.

Modern Healthcare: 2013 Healthcare’s Hottest Companies
The Exchange Solutions segment of Towers Watson, launched with the acquisition of Extend Health, was recognized by Modern Healthcare for being one of the fastest growing health care companies in the U.S. – named 4th among a great group of companies.

Institute for HealthCare Consumerism: 2013 Innovator > See pg 63
I’m honored to be named among some very esteemed industry figures by the Institute for HealthCare Consumerism. See page 63 to learn a little about the early days of Extend Health and what’s it’s meant to my team at work and at home to be in the leading wave of health insurance exchanges in our nation.

Get a Closer Look at Towers Watson’s Liazon Acquisition

I spoke with several journals about what the Liazon acquisition means for Towers Watson and the exchange space. This coverage pulls in opinions from across the industry as well as my highlights.

Private Health-Exchange Market Consolidates, David McCann
My highlight: “Towers Watson has plenty of good reasons for buying Liazon….The market is moving so rapidly, and there’s a sense that a tipping point is being achieved…It’s as if the music just stopped and we grabbed the last chair.”

Towers Watson expands private exchanges with $215M Liazon purchase, Jerry Geisel
My highlight: “Liazon has “the most sophisticated insurance platform by a mile in this market.”

Towers Watson’s private exchange division leader details advantages of Liazon purchase, Kathleen Koster
My highlight: “We want to be the leading player in private exchanges….A year and a half ago, they [Towers Watson] bought the leading retiree exchange in Extend Health. Today, they’re buying the leading active exchange technology company, Liazon….The acquisition gives Towers Watson the ability to hit the market very quickly with all the most sophisticated exchange technology out there.”

More on the acquisition

• Towers Watson’s announcement
• Reuters
• Wall Street Journal
• Huffington Post Business
• Bloomberg BusinessWeek
• Daily Finance, Motley Fool
• Insurance Networking News
• Employee Benefit Advisor
• LifeHealthPro
• Plan Sponsor

A closer look at Liazon

• New York Times, The Landscape of Small-Business Health Insurance
• FastCompany, This Buffalo Startup Built the Amazon of Health Care Buying

Towers Watson Acquires Liazon to Expand Private Benefit Exchange Offerings Through Multiple Channels

Transaction complements Towers Watson’s OneExchange with scalable, flexible solution

NEW YORK, November 22, 2013 — Towers Watson (NYSE, NASDAQ: TW), a global professional services company, announced today that it has acquired Liazon Corporation, a leader in developing and delivering private benefit exchanges for active employees. The acquisition, which follows the purchase of Extend Health in June 2012, solidifies Towers Watson’s strength in the private exchange market through its OneExchange solution. Going forward, Towers Watson will continue to enhance Liazon’s award-winning private exchange solution and serve the needs of Liazon’s leading broker, consultant and carrier partners, some of which offer the Liazon product under their own brands.

Read the full announcement.

Transparency crucial to empowering health care consumers

Knowledge is power — the power to think, to act, to buy, or even to not do any of the above. Our nation’s health insurers and health care providers need to figure out how to put power back into the hands of consumers. Consumers today have too many constraints when it comes to accessing decision-critical information about the cost of health care. That’s a hard pill to swallow when there’s so much at stake.

A recent post on The Health Care Blog featured a fascinating yet not unsurprising finding: The cost for appendectomies can vary by more than $100,000 between health plans and hospitals.

Dr. Renee Hsia of UCSF was asked what appendectomies cost by a friend who had to pony up over $50,000 in co-pays for one. Dr. Hsia’s research, which looked at pricing variability across the state of California and was published in the Archives of Internal Medicine,  found that an appendectomy could run from $1,529 to $182,955 — varying as much as $7,504 to $171,696 within one hospital.

The question of where to begin is starting to be answered by sites like FAIR Health’s Consumer Cost Lookup. It uses continually updated claims data from insurers and third-party administrators for 126 million people to benchmark costs. Visitors to the site can find typical rates for certain services in their area as well as what Medicare pays.

Fourteen other states have or are setting up searchable databases to help compare health care prices and quality.

The savings that can be realized are impactful not only for consumers but for health insurers themselves. Because half its members had no idea when they were being referred to out-of-network providers, Aetna launched a service to let members know if their outpatient surgery could be done by an in-network provider. In many cases, the surgery could be done less expensively, in-network reducing out-of-pocket costs for Aetna members, not to mention for Aetna.

More and more insurers are trying to help people locate services and compare costs, like UnitedHealthcare’s postcard campaign, which lists costs for common lab services at in-network and out-of-network facilities in members’ local areas and its online tool for estimating the costs of over 100 common treatments.So what’s central to all of these stories? Information.

In the California appendectomy story the information was too hard to get: too many sources, too many different plans. And, technically Aetna didn’t offer consumers (and network doctors) anything they didn’t already have access to. The information was just too hard to piece together and act on.

What these stories show us is that health care consumers today need access to information, plus tools and services to make sense of it all. Like Aetna, United Healthcare and other insurers who have developed cost-comparison tools for consumers, the insurance side of health care has been making cost information more available to aid consumer decision-making. We look to healthcare providers and hospitals to start doing the same.

Bringing transparency to the costs of services and products can supercharge consumer decision-making, forcing healthcare providers and hospitals to be more upfront with price information and to work on getting a better handle on costs for “incidents of care.”

Extend Health Medicare Exchange Interface

The Extend Health exchange platform is a great example of transparency in an insurance shopping site. It delivers information on thousands of private Medicare plans to our customers — and it does it in an easy-to-understand way. Our system supports benefit and cost transparencyby allowing customers to compare plans side-by-side and estimate their prescription drug costs for the year. These tools, along with the opportunity to speak with a benefit adviser if they wish to, help ensure that our customers find the plan or plans that meet their health needs and the needs of their budget.

Massachusetts and Utah already offer the ability to buy health insurance online through their state exchanges. The upcoming Supreme Court decision on the Patient Protection and Affordable Care Act will determine if citizens in every state will have the same opportunity. If all or part of the ACA is struck down, health insurance exchanges — a forum whose effectiveness is based on transparency in costs, benefits, services and products (such as drugs) — could be in jeopardy.

Related articles

• A 14-month effort to answer one question: Can shopping for insurance be easy?
• Paper Cuts: Reducing Health Care Administrative Costs
• HHS site tracks government data on health system indicators, such as access to care and costs
• Attributes of a Health Literate Organization
• Data trove may shed light on health-care uncertainties

For regular commentary on developments and trends in health care, insurance, and health IT, follow @brycewatch and @ExtendHealth on Twitter and check out Extend Health online.