Jacon C. Lee and Ken R. Steele: 14 Questions to Assess Your Organization's Readiness for Health Exchanges

1. Is your organization out-of-network for the plans offered in your market's exchanges?
2. Have you outlined a process to accurately register exchange plan members?
3. Do your contracts specify how exchange plan members will be identified?
4. What is the patient's out-of-pocket liability?
5. How much of patient out-of-pocket expenses can providers expect to collect from patients insured through the exchanges?
6. What is the yield or margin related to the contracts for exchange-offered plans?
7. Are you prepared to track and monitor the exchange plans like your other contracts?
8. Did the health exchange patient end up in the right insurance plan-code bucket?
9. Will your bad debt policies differ for these products?
10. Will the increased revenue outweigh the bad debt losses?
11. Is your state expanding Medicaid?
12. Does your state offer a Basic Health Plan to help span the gap for people in the 75-200 percent of federal poverty level range?
13. What steps is your organization taking to improve understanding about health exchanges in your community?
14. Are consumers aware of the available plans and which plans you participate in?

Source: Becker's Hospital Review, September 9, 2013
Source URL: http://www.beckershospitalreview.com/hospital-management-adm...

Printer-friendly versionSend to friendmore...