Of the many changes trending in the past year, deductible-free health insurance plans are among the most appealing to consumers. A growing number of insurers are attempting to use these member-targeted plans to draw in more enrollees. But other insurers may be wondering how this decision may or may not affect their profitability. What are the cases for and against this type of plan?
Drawbacks to No-Deductible Health Plans
Deductibles have notoriously led members to rethink their need to seek care in the face of both minor and major health concerns. So it’s likely that removing these upfront expenses could cause a sharp spike in service utilization and, therefore, overall health care spending that would need to be balanced with carefully configured monthly premiums.
Advantages of Removing Deductibles
The desirability of no-deductible health plans is understandably high, which is likely to cause a rise in enrollment from members looking to change plans. Workplaces are also seeing the attraction of these plans and may seek them out in an effort to cut health care costs for their employees.
It’s also a possibility that members with these plans who also have chronic conditions will see an improvement in health outcomes. This hasn’t been formally confirmed, but some research shows that adults living with diabetes who are enrolled in high-deductible health plans experienced more severe disease complications than their counterparts enrolled in lower or no-deductible plans. Therefore, it stands to reason that health outcomes may actually improve with the removal of high upfront expenses.
Some experts also posit that the removal of deductibles won’t have a major effect on health insurer profits. They believe that, with associated premium adjustments, any cost increases or decreases will actually cancel each other out.
Regardless, there are a few points all health plans should keep in mind before removing plan deductibles:
- Ensure representatives and customer service staff are prepared for enrollment surges that may result from member attraction to these plans. Since their workload may be lessening, it may be possible to recruit claims agents for this purpose.
- Make a plan to help members with chronic diseases utilize services wisely. Offer patient education about the levels of care, signs that may warrant seeking help for their condition, and what services are available at each type of facility.
- Encourage a value-based insurance model by further incentivizing the use of screenings and primary care services in lieu of costly emergency department visits.
- Plan to use potential savings from administrative costs to support new members and aim to bolster satisfaction ratings from the start.
- Consult with TOG Network Solutions to build a smart network intelligence strategy to ensure your market ROI before making major changes to your health care provider network delivery structure or entering a new market with a deductible-free plan.