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PBGH Talks Exchanges

On January 13th, our friends at the Pacific Business Group on Health (PBGH) met with leaders from the Department of Health and Human Services (HHS) in Washington, D.C. to share their insights on how HHS can best ensure that health insurance Exchanges improve coverage and quality while moderating costs.

According to PBGH’s Executive Director Bill Kramer, Exchanges must address three particular concerns:

  • First, Exchanges must be able to set high standards for participating health plans and use value-based purchasing strategies to drive improved quality, service and affordability;
  • Second, Exchanges must meet the needs of their customers by being user-friendly and developing easy-to-use decision support tools for employees and their families. This will depend on having useful and transparent information regarding cost, customer service and the quality of physicians and hospitals. The Exchanges will also need strong tools to protect themselves from adverse selection;
  • Finally, Exchanges should operate consistently across state lines to make it easier for multi-state employers to participate in the future.

These recommendations are closely in line with those developed by our Exchange Issue Workgroup. If these and other expectations are met, the Exchanges can fulfill their potential to offer affordable coverage to millions of Californians and help drive improvements in our health care system.