AHIP: Attendees Think Change Is Really Coming. Finally.

Tension has been in the air in Salt Lake City, but so has change. Tension has been in the air in Salt Lake City, but so has change.

The attendees who crowded into the America's Health Insurance Plans (AHIP) annual meeting in Salt Lake City this week were fidgeting with their mobile devices, loading and reloading pages that might give them clues as to what the U.S. Supreme Court will do about the Patient Protection and Affordable Care Act (PPACA).

But, whatever the court does about PPACA, and whatever Congress does about PPACA, the sweeping changes that health insurers and others in the health insurance community have been expecting since the mid-1990s are probably here, according to Lindsay Resnick, chief marketing officer for health services at KBM Group, Richardson, Texas, a data analysis firm.

Karen Ignagni, president of AHIP, Washington, told attendees at a general session to expect change, regardless of what the court does, and many attendees forwarded that prediction to Twitter and other social media channels.

Ignagni has been warning health insurance executives to expect major changes since the 1990s. So far, the other shoe hasn't dropped all the way down. Preferred provider organization (PPO) plans outsold the health maintenance organization (HMO) plans. Health savings account programs and other health account programs have clawed out a growing niche for themselves. Consumers buy some of their health coverage through the Web. But private companies still generate billions of dollars in annual revenue, health insurance agents and brokers still exit, and many of the exhibitors who appeared at the AHIP meeting this year are the same exhibitors that appeared at health insurance company and managed care company meetings in the 1990s.

Resnick gave a session at the meeting that covered what health insurers will have to do to appeal to individual consumers who are choosing their own coverage, and possibly paying for their own coverage, through exchanges, and what insurers can do to track current customers and use information about the customers to improve wellness and condition management outreach efforts.

If the Supreme Court declares PPACA to be unconstitutional, will that affect health insurers' interest in reaching out to individual consumers?

Resnick said in an interview that he doesn't think the decision will have much of an effect on outreach efforts.

"That train's left the station," Resnick said.

Resnick noted that many health policy specialists expect at least 12 states to go ahead with efforts to set up PPACA-influenced health insurance exchanges, or Web-based health insurance supermarkets, no matter what happens to PPACA.

Many other states already have private heath insurance exchanges, and companies such as eHealth Inc., Mountain View, Calif. (Nasdaq:EHTH), already sell health insurance through the Web.

At the meeting, Resnick said, some of the most common topics discussed have been "PPACA or no PPACA" matters such as personalizing wellness programs to improvement performance, data analysis, use of advanced technology to increase the efficiency of health care, and improving care management for people with serious health problems and for the low-income people who are eligible for both Medicare and for Medicaid.

AHIP itself has been trying to promote the concept that policymakers should think carefully about the consequences when designing health system change proposals. AHIP officials have argued that the 8 major state reform efforts proposed in the 1990s failed, partly because of the lack of a requirement that individuals own health coverage, and they are trying to attract attention to commentaries on the history of reform efforts in Kentucky and in Washington state.

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