Should PreferredOne Been Booted Off MNsure ?

The news that low-cost provider PreferredOne was pulling itself out of the MNsure exchange has caused some degree of concern for some shoppers.

But should it ?

Think of PreferredOne as you would think of other consumer products … after all, that’s what they are … they just provide a “menu” of services that are covered and allow “off-menu” items if you go outside the network.

So, how do you react when the word is that Little Caesars or Domino’s is closing up their local pizzeria in the neighborhood strip mall ?
The reaction for many is … that’s too bad for the workers, but there is still Pizza Hut, Papa John’s and of course that “family-owned” pizza shop that every community has.
Heck, some will say, that’s okay because they really didn’t like the quality of the pizza or the service.
Yeah, it may have seemed cheaper but if given a preference you may have chosen something else.

Well, look at Preferred One in the same way … there is still BlueCrossBlueShield, Medica, and Health Partners.
Besides most Minnesotans don’t participate in MNsure (just like everybody does not buy Little Caesers). By now you have heard that the average premium increase for companies continuing to offer policies on MNsure next year will be 4.5 percent higher. What you may not have heard is

According to an annual survey released August 13, 2014 by the National Business Group on Health, a non-profit association of nearly 400 large U.S. employers, employers project their health care benefits costs will increase by an average of 6.5% in 2015. That is slightly lower than the 7.0% increase employers would have experienced this year had they made no changes to their plan design. However, employers expect to keep increases to 5% next year after making changes to their plans, such as increasing cost-sharing provisions

So based on price, the projected rate of increase for the average Mnsure client is increasing less than what employers are projected to see. Of course, BlueCrossBlueShield, Medica, and Health Partners each may have different rates of changes … and for example, the Strib reports that Medica policies may go up 1.8% while BCBS may go up 17%.
But here’s the great aspect of ObamaCare, you can shop around … if you do not like the plan (price and quality) offered by one insurer, you can move to another — AND NOT BE DENIED based on pre-existing conditions.

Yes, price is one consideration but what about service and service offerings ?

That may be a little hard to compare … fortunately, there is NCQA which has ranked health plans since 2005.
For the 2014-2015 rankings, NCQA studied almost 1,400 health plans and ranked more than 1,000 of them based on clinical performance, member satisfaction and results from NCQA Accreditation surveys.
Minnesota companies ranked in the survey :
#26 HealthPartners
#90 Medica
#102 BlueCross Blue Shield
#215 Preferred One

The surveys are based on categories and subsets …
for example, based on a five point scale with #5 as the highest rating

Customer Satisfaction
#4 HealthPartners
#3 Medica
#4 BlueCross Blue Shield
#2 Preferred One

Getting care
#4 HealthPartners
#3 Medica
#4 BlueCross Blue Shield
#3 Preferred One

Satisfaction with physicians
#4 HealthPartners
#4 Medica
#3 BlueCross Blue Shield
#3 Preferred One

Satisfactions with health plan services
#3 HealthPartners
#4 Medica
#4 BlueCross Blue Shield
#3 Preferred One

Prevention
#4 HealthPartners
#4 Medica
#4 BlueCross Blue Shield
#2 Preferred One

Treatment
#5 HealthPartners
#5 Medica
#4 BlueCross Blue Shield
#5 Preferred One

Hmmm … good supply management practices would say that PreferredOne has been identified as the weakest supplier … and even though they may offer what appears to be the best price, the value may not be there. Many procurement managers would look at PreferredOne and boot them off their approved supplier list.

Voters also should be reviewing federal elected officials … determining which is the weakest … which ones are being honest … and which ones are fighting for you.

Case in point … Minnesota’s Second District
John Kline : “Because of ObamaCare, my constituents are seeing their rates skyrocket or are losing their health insurance altogether and being forced into government run health care where they can no longer keep their doctor, clinic, or hospital. As Congress continues to rightfully scrutinize this misguided law, I will continue to fight for Minnesotans by pressing the Administration to do the right thing and either scrap this law or delay it for all Americans before it does further harm to middle-class families and our entire economy.”

Mike Obermueller : “The 2015 MNsure premium rates reflect an insurance marketplace at work. While we have seen a significant improvement in the cost of health insurance as a result of the Affordable Care Act, the fact remains that the cost of health care is still increasing, and those costs are reflected in the premiums people pay. This is true for both plans obtained through the MNsure exchange and through private or employer plans.
“That is why it is so critical that Congress focuses its attention on improving the ACA, rather than continuing to fight the four-year old battle over repeal of this law. To reduce the cost of health care, we need to provide greater incentives to doctors to help people stay healthy, rather than just treat them when they are sick, and we need to have an serious discussion about allowing Medicare to negotiate for drug prices.
“While those who still seek the repeal of the ACA are sure to view the rates as cause for political cheer, the thousands of Minnesota families who are benefiting from the ACA deserve better than that. Because of the ACA, thousands of Minnesotans now have access to affordable and reliable health insurance. They can’t be excluded from coverage because of pre-existing conditions, and they can’t be kicked off their insurance because they were ‘too sick.’ It’s time to elect representatives who will actually work to improve healthcare costs rather than continue to undermine access to affordable care with political stunts like last year’s 16-day government shutdown.
“Even considering the newly published rates, Minnesota will still have the lowest premiums in the nation. More importantly, these rates make healthcare affordable for thousands of Minnesotans that couldn’t afford it before the ACA took effect.”

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