Startups Create Online Tools To Help Consumers Find Exchange Plans

December 24, 2014 in News

Startup companies are developing online tools designed to help U.S. residents shopping for plans through the Affordable Care Act’s health insurance exchanges, Modern Healthcare reports.

Background

According to a Robert Wood Johnson Foundation investigation, the ACA’s exchanges can be complicated for consumers. Researchers noted that HealthCare.gov and some state-run exchanges do not:

  • Estimate the costs of different plans for individuals; or
  • Provide integrated tools that allow individuals to search for providers in a plan’s network.

Meanwhile, a Commonwealth Fund survey conducted from April to June found that almost 40% of individuals who purchased exchange plans did not know what providers were in their networks.

Online Tools Details

To ease the enrollment process, companies are creating online tools that can help consumers shop for exchange plans. For example, Stride Health is working on a recommendation engine for individuals that will suggest different health plans based on consumers’ answers to key questions. Specifically, the engine aggregates health plan data, including:

  • Claims history;
  • Physician networks;
  • Prescription drug formularies;
  • Real-time medication pricing data; and
  • Self-reported consumer data.

The engine then uses the data to recommend a plan for consumers based on their personal information, including:

  • Current medications;
  • Estimated costs; and
  • Medical conditions.

According to Modern Healthcare, Stride is marketing the product directly to consumers and has partnered with various companies to push its product.

Meanwhile, a website created by health IT startup Gravie allows employees of small and midsize businesses to manage their health plans through its exchange. For example, individuals with high-deductible plans can use the site to manage their health spending accounts and seek options for telehealth services. Gravie also will help individuals handle denied claims and other issues.

In addition, the site offers an application, called “Is it covered?,” that allows individuals to ask whether particular procedures or providers are covered under certain health plans. The app also can recommend alternative health plans if the services being searched for are not covered by an individual’s plan (Tahir, Modern Healthcare, 12/22).

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