Econometrica produced a literature review and diagnosed key challenges in each State to help CMS better serve its customers in State Insurance Marketplaces
What are State Exchanges and why are they important?
In order to increase affordability of health insurance options for individuals and small businesses, the Affordable Care Act made private health insurance available through new competitive private markets (Marketplaces or Exchanges) on January 1, 2014. Marketplaces provide qualified small businesses and individuals with a diverse selection of private plans, and include pertinent information for consumer comparison of plan options. The Exchanges allow individuals, families, and small businesses to shop for health insurance in these Marketplaces. They are available in every State through websites, call centers, and in-person sessions. The Exchanges are essential in helping people find and enroll in affordable health insurance plans with quality medical coverage.
What was the purpose of Econometrica’s Post-Reform State Marketplace Market Dynamics project?
The Centers for Medicare & Medicaid Services (CMS) and the Center for Consumer Information and Insurance Oversight (CCIIO) needed to understand the landscape of the new Marketplaces to better serve the people using them to find coverage. The Econometrica Team was awarded the contract Post-Reform Consumer Landscape Market Analytics and Implementation to analyze market dynamics, which would help accomplish this goal as well as highlight key challenges in each State.
What did we do on the project?
Specifically, we executed projections of the supply, demand, and pricing of health insurance from 2014 to 2016. We also monitored and reported on individual premium rate changes in the State-based Marketplaces from 2013 to 2014. For each challenge we identified, we also evaluated possible solutions and reviewed them with the States.
Our technical work consisted of a literature review, which had several goals:
- Identify existing models of insurance market assessment.
- Recognize gaps in the modeling.
- Fill in those gaps with additional modeling.
- Integrate existing models with the additional models.
- Identify and quantify the impact of the challenges to the Marketplace operations.
- Develop strategies to address the challenges.
- Lead working groups with the State Marketplaces to discuss challenges and resolutions.
- Support the Exchange State teams.
- Update and expand upon analyses of possible solutions to challenges.
The States involved in the working groups included Illinois, Delaware, West Virginia, Arkansas, Minnesota, California, Colorado, New Hampshire, District of Columbia, Oregon, Washington, Idaho, Nevada, and New York. We also led interviews of key stakeholders in State-based Marketplaces and State Partnership Marketplace to better understand their experiences. These results were presented through Microsoft PowerPoint.
What did we gain from the project?
Ultimately, this work allowed CCIIO to manage enrollment and premium expectations for States receiving grant funding. Its impact also provided State Marketplaces with a clearer picture of the sociodemographic composition of their enrollees and identified the enrollees that could be most effectively targeted for outreach. The Econometrica Team produced high-quality products to inform CCIIO and the States, allowing them to better serve their consumers. This was our first foray into the State Exchanges and laid the groundwork for many future projects on them.
Founded in 1998, Econometrica is a research and management organization in Bethesda, MD, established to provide public- and private-sector clients with customized program support services. Econometrica works with multiple agencies to provide high-quality, cost-effective analyses, modeling, and economic evaluations. The company consistently receives exceptional scores from its clients and believes in three principles: technical capabilities, happy customers and business development.
The Econometrica Team was awarded the contract Post-Reform Consumer Landscape Market Analytics and Implementation to analyze market dynamics, which would help accomplish this goal as well as highlight key challenges in each State.
Read GAO’s study about CMS’ efforts to establish federally facilitated health insurance exchanges.
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