What health insurance consumers will expect in 2023
Understanding your consumers’ motivations and mindsets is key to paving the way for a seamless experience. Nearly every shopper seeks to quickly find plan details, costs, the list of providers, and essential health benefits and value adds, so offering quick and transparent information will elevate the overall consumer experience, ultimately leading to increased enrollment and retention.
Clearly display coverage and plan type
While consumers have been enrolling in the Affordable Care Act (ACA) for over a decade, a new group of eligible consumers are entering the market now, shopping and seeking information on the types of plans and what is covered. However, existing members still peruse the marketplace annually in search of more affordable plans. As you help navigate shoppers to your plan options, keep in mind that navigating them to the right place—with minimal clicks—will lead to swifter selection of a plan that suits their life. HMO, EPO, and PPO are still among the most common types of health plans available and ones that consumers still seek education on. Adding a comparison chart or helpful graphic can quickly communicate the plans, differences in plans, and benefits that best fit their needs.
Make provider networks easily accessible
Provider networks, specific physicians, and care specialists continue to be top-of-mind for those shopping. Consumers want to stay with the doctor or doctor's office they know and avoid the hassle of making provider changes. In addition to making this information easily accessible on your owned channels—such as your website, email, blog, or social posts—it’s also important to note that earned media (mentions, reposts, shares) and paid media (digital ads, retargeting, sponsorships) can also aid in educating members and prospects.
The importance of price transparency
Price transparency will almost always be paramount to the consumer experience. During the 2022 open enrollment period, many consumers benefitted from the enhanced tax credits based on the American Rescue Plan Act (ARPA) that Congress passed as temporary pandemic relief. As a result, a record 14.5 million people signed up for marketplace plans, with 13 million receiving a subsidy in 2022. By the end of this year, the majority of those 13 million people will see their premium payments rise if the ARPA subsidies expire as planned. Moving consumers to review plan options with transparent costs and comparisons will help them quickly reach a decision. Additionally, a subsidy tool should be factored in, giving consumers a more accurate view of premiums and out-of-pocket expenses for the 2023 plan year.
With pending legislative efforts and an increased consumer expectation of accessibility and transparency, preparing for 2023 requires keeping health insurance consumer trends and motivations front of mind.
Fast facts: Three Congressional impacts to Plan Year 2023
- Impending expiration of the America Rescue Plan Act (ARPA) and subsidies, enacted to give Americans temporary COVID-19 pandemic relief, could impact millions of consumers. Congress is considering an extension of the expanded subsidies as a permanent decision. However, if Congress does not extend the subsidies, premiums for the subsidized could rise by 53%.
- Shopping experience will be simplified on Healthcare.gov due to President Biden’s Executive Order 14036. Issuers will be required to offer standardized plan options at every network type and tier level. Plans will be displayed differently than they have in past years, which will allow consumers to compare costs, plan attributes, and quality ratings.
- New Network Adequacy Requirements will be implemented. The intent of the rule is to help ensure that patients will have access to the right provider in an accessible location by requiring Qualified Health Plans to provide care within required parameters, including distance.
- Value of coverage for consumers is expected to increase. The Centers for Medicare & Medicaid Services (CMS) will update the allowable range in coverage levels, which will likely require some plans to increase coverage by making plans more comprehensive with lower costs. Consumers will find it easier to compare plans and distinguish between offerings.
- Increase in Essential Community Provider (ECP) threshold. CMS will increase the threshold of available ECPs in each plan service area to participate in the plans’ provider network. Consumers who are low-income or medically underserved will have increased access to a variety of providers.
