On January 1, 2014 the Health Insurance Exchange (HIX) Marketplace will be operational and it is becoming increasingly clear that most state exchanges in 2014 will have risk pools with sicker, older members than expected or prepared for. Reasons include:
- Lower enrollment in most state exchanges due to continuing website enrollment technical issues
- Lower federal tax disincentives in the first year in comparison to future years
- Higher premiums in many states for younger would-be enrollees ( the ‘young invincibles’)
The HIX Marketplace is a showcase for accelerated Darwinism for Qualified Health Plans (QHPs).
How can insurer’s best be equipped with these realities? The answer lies within the data, and from that risk score accuracy will be more important than ever.