Articles
8 February 2012

In the Bag

Utah Moves to Implement Health Exchange Portal

by Janine Creager

08 February 2012—

 Rarely has the common pleasantry, “So, how are you feeling these days?” been a more loaded question. From town halls to town brawls, the debate over health care has raised blood pressures right along with a growing awareness of the need for reform.

And while the drama has played out in public arenas nationwide, in Utah efforts are underway to relieve employers of the demands of administering health care benefits, and to give employees greater choice and flexibility in a health care plan that will best suit their needs.

Doctor’s Orders

The Utah Health Exchange, an Internet portal that offers consumers the necessary information to make informed decisions about their health care, is one initiative that in many cases will also serve as the vehicle to electronically execute those choices.

The recent debate in the Obama administration did not bring about the need for the exchange, but according to Norm Thurston, the health policy and reform initiatives coordinator for the State of Utah, the discussion has made it more urgent to get accomplish change on the state level. “[What is happening on the national level] just adds fuel to the fire,” Thurston says. “It’s a signal that we better get cracking to get things done.”

Thurston explains that addressing health care needs in the state has been a gradual process over the past five years. Local officials have watched federal initiatives that could impact local legislation and processes. But just waiting until decisions are made in Washington is not the game plan in the Beehive State.

“We are intent on getting things going now,” says Thurston.

The Utah Health Exchange is one of many efforts underway across the country. But that does not mean that all exchanges are created equal. Thurston says one concern is that every state could be required to have a specific type of exchange, explaining that Massachusetts, for example, has an exchange that is vastly different from what is being introduced in Utah. 

If, for example, government subsidized plans were required, “that would be sort of the biggest, direct change to what we’re doing here,” Thurston says. “We have our public programs and they are connected in a way that we want to connect them.”

But Washington could also make some adjustments to many antiquated, regulations that would ease things up quite a bit, Thurston says.  He hopes that the government will “allow for innovation and modify the federal regulations in a way that makes it more compatible with this system we’re trying to run.” 

The Utah Health Exchange is currently working with a test market of small businesses, about 130 companies with fewer than 50 employees. The average number of employees per company in this initial phase is 17 to18. The plan to launch the program for larger corporations is set for January 2012.

“We did that [started with smaller companies] for a couple of reasons,” says Thurston. “One was based on need. Health care benefits are a much more critical problem [for small businesses]. We said, ‘Let’s start where there is the biggest need.’ It turns out that creating this type of market for small groups is a lot easier. We wanted to see how the whole system works.” 

 

Freedom to Choose

The way it works, in simple terms, is that employers determine how much money they will assess each employee as part of their benefits package. Employers can either pass along a certain amount as pre-tax benefits, or even as a wage increase. The employee then goes to the exchange, knowing what the employer is providing, and makes decisions based on individual needs. 

As a small business owner, and vice chairman of risk adjustment board, Dave Jackson sees both sides of the issue.

“From a cost perspective, as far as the employer’s ability to make these decisions, the reality is that when inflation is running [so high, health care is] probably the second or third [largest expenditure] for them,” says Jackson. “As an employer, I’m taking this back to a fixed dollar amount and making it part of the compensation. For the employee, the appeal is choice: the network, the doctors, the insurance company.” 

Under this current launch for small businesses, employees have more than 60 options to choose from, which can be easily filtered down through the exchange portal to a more manageable three or four choices once individual needs are identified. Additionally, money can be aggregated from several sources which, as Jackson explains, means simply, “I have more money to shop with.”

Adapting to the new future of health care, and how the Utah Health Exchange fits into the picture, is certainly not without its challenges. 

“In many cases, these employers are looking for something new and hoping for the best [because there are] not a lot of new things they could try,” says Jackson. “They are excited about the concept and the approach and very hopeful that this is the answer. [Some employers say], ‘Oh, this is new, we have to communicate this to our [people].’ We have seen a little hesitancy with the change, but overall, people are very enthused.”

At the center of the Utah Health Exchange is the freedom for individuals to choose what will work best, and to be more personally responsible for their health care needs. 

“In a sense people have come to expect that if something really goes wrong, that [others will take care of them]. That does motivate people to be free-loaders and is an underlining value problem in our society,” says Thurston. “The only way you’re ever going to [regulate] cost is to get people healthier. The best way to do that is to get people squarely invested into their health care decisions. It’s all about bringing the consumer back into the marketplace.”  


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