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Topics of interest to both consumers and agents related to Covered California and the ACA biased in favor of the successful implementation of the Exchange and deliberately apolitical.


Consumers Want to See Quality Ratings in Year One

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Covered California previously said they would implement a new quality rating system for health insurers this fall, two years earlier than required by the ACA. Now it looks like that may slip by a year. According to Peter Lee, currently available insurer data are out of date and only cover plans that differ significantly from those that will be offered through the Exchange. Covered California instead is determining strategies for quickly collecting performance data during the first year of the exchange and creating its own ratings.

The Exchange may have underestimated the demand for a rating system. You only have to look at how Generations “X” and “Y” use ubiquitous online rating applications like Yelp to help make decisions about where to eat and what to buy. While definitely not part of Gen-x or Gen-y, I generally look for some objective comparative data to make purchasing decisions.

Beth Capell of Health Access made a good point “it’s important for consumers to have information on quality in year one, even if it’s not everything we want…If for five bucks more a month I can get a 4-star plan instead of a 2-star plan, I should have that information.”

Better-performing insurance companies under currently available quality data are all HMOs. Kaiser Permanente, Sharp Health Plan and Western Health Advantage jointly wrote that the exchange should prominently display quality ratings. They argued that officials should label plans as “not yet rated” if data are not useful for certain insurers, rather than withholding ratings for all insurers. That would certainly be to their advantage, so insurers who sell PPOs should be looking for ways to help Covered California quickly gather performance data so that they can compete on a level playing field in the ratings game.

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