Modern Healthcare interviewed Manatt’s Joel Ario, a managing director with Manatt Health, for an article discussing why some insurers have succeeded in the health exchanges while others have floundered.
Ario said both regulatory changes and improved operations by insurers are needed. On the regulatory side, the federal government and the states have to offer insurers adequate reinsurance mechanisms to protect them against unforeseeable costs associated with sicker members. On the plan side, more insurers need to tighten their networks, lower their costs, and make primary care more accessible and affordable by taking those basic services out from under the deductible.
“You have to do both,” said Ario. “The government should honor promises around the risk corridors. But it's also important to look at why some plans are succeeding and what other plans can learn from them.”
Read the article here.