Private Health Insurance Exchanges

While the new state health information exchanges are projected to provide health insurance to about 30 million people by 2017 according to the Congressional Budget Office ( a projection which is starting to look wildly optimistic), private health exchanges have begun to make a rapid penetration into the employer market and Accenture projects that at least as many people will be obtaining coverage through these private exchanges as via the official state ones.   (Accenture Survey)   The Company notes that this trend interacts with and facilitates the employer move to defined contribution models, while offering employees more choice and the ability to tailor coverage to their needs.  About one-fourth of employers currently say they are looking at using a private exchange and almost all the larger benefit consultants offer the infrastructure for employers to create them, as well as many health plans and some independent vendors.  Employees are generally less aware of exchanges, with 83% saying they are unfamiliar with the concept.  While exchanges give employers yet another option to control health spending growth, for consumers they may be a mixed blessing.  Many consumers feel unable to cope with the decision-making involved with more choices.  Exchanges will need to provide very robust tools, lots of information and lots of guidance for consumers to maximize their utility and get appropriate coverage.  It appears that the latest evolution in employee health benefits will certainly involve more defined contribution and more use of private exchanges.