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Posted by on May 22, 2015 in Uncategorized | 0 comments

HIX Participation and Network Utilization

HIX Participation and Network Utilization

We are beginning to see a glimpse of what the public health insurance exchange market will look like in 2016. Assurant is leaving the HIX market and the health insurance business altogether. UnitedHealthcare, like in 2015, is expanding into additional states. Start-up Oscar is looking to expand into California and Texas. Wellmark still won’t participate in Iowa but the state will see a dramatic change in the HIX competitive landscape with seven payors applying to offer coverage in 2016.

In 2015 there were more carriers participating on the exchanges and more provider networks utilized for exchange plans than in 2014. It appears 2016 will see a continuation of the change in the healthcare landscape, but before we get ahead of ourselves, let’s take a look at how the landscape changed from 2014 to 2015.

61 new entrants offered public health insurance exchange products in 2015 that did not participate in 2014; 21 percent of the 2015 participating carriers were new entrants in the public exchange market. 219 networks were utilized for exchange plans in 2015 that were not offered in 2014; 36 percent of the 2015 networks were new offerings in the public exchange market.

With payors expanding to additional states and so many new network options, it will be important to keep an eye on how the landscape is changing – Who is competing? What networks are being utilized for competitive products? Which providers are in exchange networks? Our Strenuus Insights team has put together a brief that takes a look at how the public exchange competitive landscape changed from 2014 to 2015.

Check out the brief now, HIX Competitive Landscape, and gain a better understanding of the exchange market.

Make sure to register for our upcoming free webinar, Unlocking the Mystery of Narrow Networks, where the Strenuus Insights team will dive into what makes a network narrow.

Many of the new exchange networks have been called “narrow,” “limited,” or “high-performance” networks, but there is no comprehensive explanation of what this really means – What defines a narrow network? Attempts at answering this question have focused mainly on the hospital portion of a provider network, which is more manageable to analyze. Strenuus Insights is taking a different approach to defining what constitutes a “narrow network.” In our upcoming webinar, we will dive into methods for how to more accurately analyze networks. As you prepare for 2016, make sure you have the information you need to understand the competitive landscape.

Register for the free webinar on Wednesday, June 17th at 12:00 CDT now: https://attendee.gotowebinar.com/register/4116146390042389249

About Strenuus

Strenuus has a range of software and data solutions centered on the management of healthcare provider data. This expertise has made it the go-to resource for a variety of industry stakeholders who need actionable information about provider networks. In addition to Strenuus’ role supporting network optimization efforts for payors, it has become the backbone for integrated search solutions for exchanges and online directories.

Learn more at www.strenuus.com.

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