No matter who does the survey or how many times the surveys are done, the overall response of employers to questions about moving employers to a private health exchange is: "I want to see more evidence that they work and will save us money."
A plethora of such studies has emerged in the last year — plus as more consulting firms and health insurers have launched private exchanges aimed at soaking up corporate business. The latest such survey, commissioned by the Private Exchange Evaluation Collaborative, confirms earlier study results.
It reveals that, while an increasing number of corporations think they'll be ready to make the private exchange decision down the road, currently, most remain unconvinced of their efficacy. Their interest is piqued. But, according to this survey, they have more questions about private exchange costs, operating systems and options than they did a year ago.
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This survey, in contrast to others, was done by groups that have no financial interest in any private exchange. The collaborative is composed of Employers Health Coalition, Inc. (Ohio), Midwest Business Group on Health, Northeast Business Group on Health, and the Pacific Business Group on Health — "all independent coalitions representing employer health care interests — and PwC (not an exchange provider), the collaborative is careful to point out in the release containing the survey results.
"Employers have taken a step back to assess the early implementation results and are seeking greater transparency in administrative, and consulting or broker fees to assure that employers and employees get better value," said Emma Hoo, director at the Pacific Business Group on Health.
"Many are not yet ready to relinquish control of key stewardship roles such as funding, carrier, plan design, provider network choice and even their benefits consultant."
The big picture takeaway is this: while 41 percent of respondents said they would consider moving employees to a private exchange by 2018, just 6.4 percent said they have availed themselves of private exchange services to date.
"Exchange models need to deliver results, choice and transparency. Employers were very strong in the value they placed in the following attributes of private exchanges for active employees: experience and track record (96 percent), plan design choices (87 percent) as well as carrier/network options (89 percent) and, finally, transparency of fees and rate setting (92 percent)," the study said.
The survey also found, as have other studies, that very few large employers are considering abandoning their employee health plans.
Other details of its findings include:
- Employer commitment to providing medical benefits to employees remains very high with 97 percent of respondents indicating they were very likely to offer coverage in 2016, up from 77 percent in last year's survey.
- Employers reported less interest in public exchanges as options for key workforce segments with 67 percent say they are not considering such an approach for part-time employees and 84 percent not considering for their full-time active employees.
- 98 percent of respondents said that the cost of plan options was "somewhat" or "very" important (up 5 points from last year) when it came to making a decision to switch plan designs. The level of fees was only 1 point behind at 97 percent (up 3 points from last year).
- Saving money and consumer choice were the top two reasons cited by employers who have already implemented an exchange.
- Hurdles to moving to a private exchange included employee readiness (84 percent), stability of carrier relationships (84 percent), loss of flexibility in plan design (78 percent) and loss of control or stewardship (72 percent).
- When asked to consider the importance of key elements of private exchanges for active employees, employers identified delivery and reporting capabilities such as implementation assistance (93 percent), spending account program administration (89 percent), member advocacy (85 percent) and enrollment and eligibility maintenance (85 percent) and employer specific reporting (91 percent) as somewhat or very important.
- 85 percent said reducing the administrative burden on internal resources proved to be a compelling reason to consider a private exchange.
- There were sizeable increases in the importance employers place on the shopping experience: 85 percent said tools that aid in plan selection were "very important" (vs. 70 percent in 2013) and 35 percent rated mobile device compatibility as "very important" (vs. 26 percent in 2013).
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