The consumer strikes back: ACA enrollment hits 4 million

The Los Angeles Times recently reported that ACA enrollment is picking up steam, with over 700,000 enrollments in February alone. It is unclear whether or not the Obama administration will hit its 2014 goal of 7 million enrollments given the March 31st deadline. Officials remain bullish:

 

“With individuals and families enrolling in coverage every day, we continue to see strong demand nationwide from consumers who want access to quality, affordable coverage,” Marilyn Tavenner, the head of the Medicare agency overseeing implementation of the law, wrote in a blog post Tuesday.

“Our outreach efforts are in full force with community partners and local officials participating in hundreds of events each week and enrollment assistors are helping more and more people enroll in coverage.”

 

The state-based insurance marketplaces enable individuals to compare plans and purchase insurance directly from payers without the risk of being rejected for existing conditions.   According to America's Health Insurance Plans, 19 million Americans currently purchase individual insurance. Employer-sponsored insurance has declined from covering 70% of the non-elderly population to less than 60% today. What are the implications for hospitals of having more consumer-driven market forces in healthcare? A recent article by Becker's Hospital Review sums it up best:

 

Moving forward, hospitals might leverage strong population health management skills to advertise to the consumer-driven patient. By identifying target health concerns in a population, health systems and hospitals are potentially less at risk of dropping the ball on patient care, at least on a macro-level.

"With a solid population health management program, hospitals can make a positive and significant impact on the health of the entire community while creating a stronger and more financially sound healthcare organization," says Pearson Talbert, president and CEO of Nashville, Tenn.-based hospital consulting firm Aegis Health Group.

Physicians have skin in the game too. Accountable care organizations and other integrated care models are providing physician groups financial incentives to improve patient outcomes. In the not so distant future, as many as half of a physicians' earnings may be based on quality outcomes, according to CEO of Objective Health Russ Richmond, MD. With incentives to improve long-term health of patients, primary care physicians are spending more time on preventative care.
But for patients to participate fully in preventative measures they need to be engaging and incentive-based, says Ms. Sarasohn-Kahn.

"You have to create in connected health systems incentives for patients to connect back," she says. "You want to enable patient engagement, which requires interactive tools, carrots, and when appropriate, sticks."