Three Key Takeaways from AHIP’s National Conference



Last week in Washington D.C. payer executives, industry leaders and government officials from across the country representing Medicare, Medicaid and Duals lines of business gathered to teach and learn from each other about the latest challenges, best practices and opportunities surrounding government lines of business. HealthEdge, as a Silver Sponsor, attended the conference to listen in on sessions and present with our customer, Neighborhood Health Plan of Rhode Island, about transformation. Below are three key takeaways from the conference.

Hurry up and Wait

While some healthcare issues, like prescription drug pricing and value-based reimbursement, have historically been non-partisan issues, AHIP’s CEO, Matt Eyles believes no new legislation will be brought forward until after the 2020 election. Outside of spending measures that must be passed to avoid another government shutdown, and some regularly scheduled voting, it’s unlikely this Fall’s Congress will bring forth any new legislation ahead of the Democratic primary, and then the presidential election.

Personalized Messaging

Medicare plans are starting to treat individuals aging into and remaining in Medicare very differently based on their age, altering messaging to the various age groups. What payers are finding is that information and education needed by 65 year old’s are different from those who are 66+  and they are taking steps to communicate differently to these members, offering different plan types, and having different guidance for them in making the right choice when enrolling or re-enrolling, depending on where they fall in age. We heard from various panelists who also reiterated the importance of simplicity within Medicare: making the system simpler for all stakeholders to enroll, participate and focus on key areas to improve instead of making broad changes.

Simplicity May Go Hand-In-Hand with Satisfaction

Health plans and other healthcare stakeholders should not be surprised to hear that people are frustrated with the U.S. healthcare system. In general, consumers are satisfied with their health plans, but Kaiser found 70% of Americans, regardless of political party affiliation want Congress to focus on lowering  prescription drug costs, making sure the Affordable Care Act’s protections for people with pre-existing conditions continue (69%), and protect people from surprise medical bills (56%). If Congress does decide to take on one or more of these issues, there will be direct impacts on payers.

These are just some of the key messages our attendees heard. The list also included things like executives believing Medicare-for-All is losing steam because of the public’s declining faith in the federal government to effectively manage its potential costs and administration; further, most consumers see their main healthcare issues as either cost or quality (depending on where they live) but to date, elected officials have not made a determination on which factor is a higher priority. HealthEdge believes a true technology partner with in-house subject matter experts is one of the key ingredients health plans will need to navigate government lines of business, especially with what potential changes coming after the 2020 election. 

Read more about how HealthEdge keeps a pulse on the Medicare market by downloading our recent survey of over 200 payer executives with Medicare and/or Medicare Advantage lines of business.


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