Reprinted from HEALTH PLAN WEEK, the most reliable source of
objective business, financial and regulatory news of the health insurance
industry.
July 11, 2016 Volume 26 Issue 25
You see them everywhere — head down, earbuds secured, a smart
phone clutched in one hand and a latte in the other. They’re young, they’re
healthy, they’re uninsured and they see little reason to slice off part of
their paycheck for something they can’t use until they first spend thousands of
dollars to meet an annual deductible.
As of April 2016, 69.2 million voting-age U.S. citizens fell into
the millennial category (adults ages 18-35), according to an analysis from the
Pew Research Center. That number is close to the 69.7 million baby boomers
(ages 52-70). And about 53 million millennials are in the workforce, accounting
for about one-third of all U.S. workers.
As a group, millennials are rarely sick enough to seek medical
care and typically don’t want to make long-term commitments, Jon Hager,
director of planning and performance at Reno, Nev.-based Hometown Health, tells
AIS Health. “So how do you get a person who doesn’t want to be committed, to
make ongoing payments for something they don’t feel they need, from someone
they don’t trust?” he asks. Ironically, millennials typically don’t trust the
advice of strangers, but often will trust the advice of 50 strangers giving an
Uber driver a 4.5 star rating. Insurers that can garner the support of their
members in Yelp! and CMS star ratings “might gain a leg up on their competition,”
he adds. Hager is the former executive director of Nevada’s public insurance
exchange.
While rarely sick enough to need a doctor, young adults end up in
the ER more often than any other age group outside of the elderly. And more
than half of young adults who have a significant amount of debt point to
medical expenses as the main reason, says Erin Hemlin, director of training and
consumer education at Young Invincibles, an advocacy group founded by
Georgetown University students in 2009. She says carriers should emphasize the
cost of care without coverage. Uninsured care for a broken arm, for example,
will cost $7,000, she says.
Among young exchange participants, there is a willingness to
accept limited provider choice for a lower price point. While that’s true among
all age groups, it is striking among young adults (age 18 to 34), with 43%
willing to consider a network without their current primary care provider for a
lower premium, according to a recent survey conducted by the Deloitte Center
for Health Solutions. That could give local insurers and provider-sponsored
health plans an edge over bigger competitors. By contrast, just 27% of people
between 35 and 54 would be willing to make the same trade-off. According to the
survey, 30% of surveyed young adults selected their plan based solely on
premium after starting with insurance companies they knew. For the next cohort
(35-54), it dropped to 20% looking solely at premium to drive selection.
Value Accompanies Price in Importance
But getting uninsured millennials to buy health insurance is just
part of the battle. Carriers also must demonstrate their product has enough
value that members stay enrolled and re-enroll, says Paul Lambdin, a managing
director at Deloitte Consulting LLP.
In 2014, BlueCross BlueShield of Western New York, a unit of
HealthNow New York, Inc., launched an enrollment site designed to attract more
members of the coveted 18-34 age demographic through the state-run New York
State of Health insurance exchange. The website was designed by a millennial,
27-year-old Patrick Finan, and his branding and strategy agency, Block Club.
Many 26- to 34-year-olds have never had their own health insurance
coverage and don’t understand it. Along with explaining the components of
coverage and how it works, carriers also need to show that health insurance has
value beyond paying for medical expenses, says Dave Busch, the insurer’s senior
vice president and chief sales officer. The insurer, he says, actively reaches
out to new members via email or phone to explain their new plan.
In March, the Blues plan announced a nutrition program dubbed
HealthyLifeRewards, which offers up to $500 in annual cash-back rewards for
members who buy healthy foods at participating grocery stores. Food items are
scored based on their nutritional value and an average score for each shopping
trip is calculated. At any time, individuals can deposit their rewards into
their checking account or redeem them as cash, according to the Blues plan. The
program was piloted last fall by the Blues plan’s employees. In the first four
months of the pilot, 44% of the insurer’s eligible employees engaged in the
program and collectively logged more than 720 shopping trips, one-third of
which were eligible for rewards.
The Blues plan has built some products around tiered provider
networks that offer a variety of cost-share options based on the provider
selected, and has worked with urgent care facilities to focus on affordability,
Busch says. In the fall, the Blues plan will launch a “provider finder” tool
that will offer detailed information and allow members to post reviews, à la
Yelp!
Busch notes that young people who have launched a business face
even bigger challenges. In addition to buying coverage for themselves, they must
decide how to cover their employees. Through a private exchange platform dubbed
BlueConnect, small employers are able to determine how much they want to
contribute toward health coverage. Employees then select their coverage through
a custom enrollment portal.
Carriers Must Also Go Beyond Just Coverage
Here’s a look at seven strategies to help attract and retain young
members:
(1) Explain what their premium dollar buys: The Affordable Care Act [ACA] requires
that qualified health plans (QHPs) include an annual preventive care visit.
Hemlin says that in focus groups, young participants often don’t know what the
term “preventive” means, so they ignore it. “When we walk them through it, and
explain that it includes check-ups, free immunizations, health screenings and
birth control…then they see real value. We also explain that an actual
preventive care visit costs about $200, and the insurance company pays for it
…even if you haven’t met your deductible.”
(2) Offer something outside of the deductible: Some small start-ups offer value outside
of the annual deductible. Canopy Health’s products, for example, include two
office visits — in addition to the annual preventive visit —with no copayment,
coinsurance or deductible. The company also offers access to urgent care
centers for a low copay. And products across all metal levels include low-cost
or free generic drugs. Likewise, the Western New York Blues plan covers some
preventive prescription drugs outside of the deductible. It also offers a $250
“Wellness Debit Card” that can be used to pay for gym memberships, fitness
classes and personal training, as well as nutritional supplements, acupuncture
treatments, massages, road races and fun walks. “You don’t want an enrollee to
make it to the end of the year and determine they got nothing in return for
their premiums,” says Lambdin.
(3) Ensure provider networks highlight retail
clinics and urgent care: Compared with older adults, millennials are much less likely
to choose a health plan based on the providers included in the network, says
Robin Gelburd, president of FAIR Health, Inc., a New York-based independent
data firm. FAIR Health researchers have seen a notable uptick in claims from
retail clinics and urgent care facility, she says. Telehealth also is gaining traction
among millennials. “They appear to be more interested in cost and
convenience…and are not prioritizing the need to see the same doctor each
time,” she adds.
(4) Get onboard the social media train: Knowing that millennials are strongly
influenced by social media could help carriers stay connected to those members.
According to Deloitte’s survey, millennials have higher levels of trust in all
sources of influence compared to older populations, according to Deloitte.
(5) Keep surprises to a minimum: People who don’t understand their coverage
might be surprised to discover a medical expense isn’t covered. About 17% of
young adults said they were surprised when a doctor or hospital visit wasn’t
covered, but just 7% of those aged 35-54 were similarly surprised, according to
Deloitte’s survey. “The insurance companies, if they want to keep these
members, need to make sure the young consumer understands how the policy works
or a surprise may lead to a lapse,” says Lambdin.
(6) Focus on experience rather than ownership: Millennials prefer experiences over
ownership, according to Hager, who points to venture capital-backed health
insurance startups Oscar, Bright Health, Zoom+, Canopy and Clover Health that
are focused on improving the enrollment experience. “They work with companies
such as Softheon or hire large numbers of tech-savvy individuals to streamline
their websites, plan selection processes and provider directory and formulary
search engines to make the insurance experience much more enjoyable,” he says.
(7) Make sure shoppers understand the impact
subsidies can have on premiums: Affordability is the top concern for young people when it
comes to coverage, says Hemlin. Young adults just starting out in the workforce
typically have low incomes and might qualify for large tax credits to reduce
their monthly premiums. Carriers also need to be sure that people understand
how to use their coverage once they buy it.
https://aishealth.com/archive/nhpw071116-04?utm_source=Real%20Magnet&utm_medium=email&utm_campaign=114150342
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