While information has been trickling out on the various state exchanges, Missouri has continued to stay quiet right up to the launch. As the state lawmakers, and then voters, voted rejected a state-run exchange, Missouri is among the many states that chose to leave it to the federal government to handle.

While efforts to publicize the exchange have faced strong opposition, there have been some initiatives put in place to help increase the public’s knowledge on the exchange.

•    Private organizations and individuals are conducting FAQ and Question & Answer Sessions on the exchange for individuals. For instance, FOX 2 recently aired a Q&A session that consisted of top industry experts and served as a platform for helping people clear their doubts about ACA. This one-hour special helped people learn more about the health reform that is going to impact their lives. Similarly, through the face of private organizations and nonprofit associations, the state will receive the required information.

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With health insurance marketplace deadline approaching fast, Alaska is relying on the federal government. As one of the 27 states that will be utilizing the Federally Facilitated Marketplace, Alaska needs to concentrate on educating residents about the marketplace and promoting general knowledge about the program.

The state is relying on the health exchange navigator role. Health insurance marketplace navigators platform are a group of trained individuals who will be responsible for guiding residents on enrollment and selecting plans within the exchange. The United Way of Anchorage and Alaska Native Tribal Health Consortium will each receive a $300,000 federal grant for the hiring and training of navigators.

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The big day for health insurance marketplaces, October 1, is coming and Michiganians are looking forward to it. The view is that the exchange will bring better coverage, affordable health insurance and greater benefits. Expectations are running high and Michigan organizations are gearing up for the big day. So, how’s the preparation going? Let’s take a look.

The first, crucial step is to establish a marketplace with top insurance carriers who can provide affordable health insurance and a wide range of benefits. Fourteen health insurers submitted their plans and offerings, totaling approximately 170 plans, to the Michigan government for approval. The approval process is still underway and results are expected before the second week of September.

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As the deadline for health insurance marketplace implementation edges closer, states are planning contingency measures to tackle last minute hassles and challenges. Although each state’s plan of action differs, there is common theme– states want to know the primary concerns of residents, and how to address them in a cohesive and comprehensive way. In fact, the state of Massachusetts has conducted a statewide poll capturing popular concerns of residents.

The poll, conducted by the Massachusetts Medical Society, randomly chose 417 adults from different areas of Massachusetts and conducted a telephone-based survey. The more prominent themes from the survey are listed below.

•    Most residents are worried about rising healthcare costs. Nearly 75 percent of the respondents felt that the expected rise in healthcare costs is the single most important issue facing healthcare in Massachusetts. In western and central Massachusetts, this number was a little lower at 67 percent. These regions saw the focus move a little toward access and quality of healthcare.

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Insurers are still trying to decipher which end of the consumer spectrum will yield greater and sustained profitability. General wisdom says that the medium- and high-income consumers will drive profits in the health insurance marketplace but the reality might be very different! This post puts forth a slightly different spin on the general perception.

Health Status vs Income Levels
Profitability in the post-exchange market is more likely to be linked to health status rather than income levels. This excludes people in and around the poverty index since they are predominantly covered by Medicaid. However, lower-income people who may or may not be healthier than their higher-income equals could constitute the bigger buying section in late 2013 and 2014.

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NYU professor Thomas Nagel is most well known for his 1974 essay “What is it Like to Be a Bat?” That is an exciting read for anyone, but especially for people in consulting and sales/marketing, who are always trained to think from the perspective of our target audience. That is the reason, that we can frequently see our own sales organization negotiating sometimes on what our product/solution should do, and sometimes on what we should charge for it. That is also the reason that we make sales.

To be able to think like your customer is an important skill for anyone to have – whether we consider a nurse delivering a flu vaccination to a child, or a hotel cleaner preparing the room for the arrival of a guest, or a solutions architect preparing to deliver a piece of software.

So then, what does a CEO or a CIO at a carrier organization think about?

Well, there are always tactical decisions to make. This is typically the “how” of the business. Things such as vendor selection, team structure, review of operations, etc. Most of the CEO’s team is charged with owning, planning and executing those tactical, repeating decisions.

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Brokers have played a significant role in how health insurance is sold and bought in the U.S. However, with the arrival of the health insurance exchanges, brokers can expect their traditional role to undergo a major change.

Getting Started: Exchanges Create Navigator & Assister Roles for Brokers
The ACA seeks to address a traditional problem that has plagued consumers when buying health insurance plans—understanding what they are purchasing. This is why the ACA mandated a comprehensive SBC (Summary of Benefits and Coverage) for every health plan. This ensures that consumers have access to comprehensive information about every aspect of the proposed coverage. However, consumers often need personalized guidance to understand the intricacies of health coverage. Traditionally producers, i.e. agents and brokers, handled such concerns. The ACA wanted to replicate the producers’ role, albeit make it more accountable and exhaustive. Further, considering that the exchanges will offer a totally new buying experience, first-time consumers are likely to need more assistance. This is why federal mandates insist that state health care exchanges train and recruit customer assistance specialists in the form of Navigators & Assisters.

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This is the second part of a discussion about how healthcare leaders should perceive the emerging Exchange marketplace and get ready to ensure survival and profitability in this fast changing domain.

Healthcare leaders shouldn’t think they need to drastically reform their business model to survive in the reformed market. The better approach is to perceive the situation as rebooting their operations, armed with better technologies and greater business intelligence. To ensure that their business is positioned for success, senior decision-makers across healthcare organizations need emphasize upon:

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The year 2012 proved to be an eventful period for the U.S. health insurance industry. The Affordable Care Act (ACA) continued to charge ahead amid widespread controversies—including a ruling by the Supreme Court—and became infused with a fresh lease of life when President Obama won a second term in office. With last year witnessing the rise of private health exchanges, payer-provider mergers, Accountable Care Organizations, 2013 is now poised to see some important developments and new trends in the U.S. healthcare sector. Some of the landmark changes that are sure to gain prominence in 2013 include:

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