Health insurance research trends for 2011

Here are the top health insurance market research requests seen by DSS Research during 2011:

  • Public health insurance exchanges. They are an obvious source of uncertainty and research lately.  We have conducted numerous studies with employers and consumers looking at product preferences and likelihood to drop (employers) or not purchase (consumers) coverage.  We have tested the impact of changes in penalty levels, as well as, changes in federal and employer subsidies on consumer and employer choices.  We have also looked at the impact of branding, product naming and presentation order in terms of product selection in an exchange environment.
  • Private exchanges. These are also getting some attention in terms of which employers are most likely to consider moving to a defined contribution or benefit allowance coupled with a private exchange that constrains product selection for employees.
  • Ancillary benefits. Particularly how ancillary benefits can differentiate and add value in competitive situations like exchanges has been addressed in many recent studies.
  • Risk attraction and adverse selection. This has also been a hot topic with clients either looking at identifying plan designs that attract consumers with more favorable risks or they are looking at measuring risk levels between themselves and competitors.
  • Market segmentation in general and risk-based segmentation specifically. We are conducting more market segmentation studies than in years past.  Many clients have been looking at risk-based segmentation to segment their market and/or their current members on medical risks and related health status issues.  In some cases we are looking at conducting multiple studies on a target market to create product-based and risk-based segmentation solutions that can be executed independently, as well as, looking at the cross-section of these segments for very specific target marketing.
  • Health care engagement. We have included the DSS Health Care Engagement Index (HCEI) in numerous studies related to segmentation (risk-based, behavior-based and traditional product-based segmentation).  The instrument has been useful in providing insights on members’ and prospects’ level of health care engagement, as well as,  providing benchmarks for these groups.  HCEI has been a core component in many segmentation studies looking to target less engaged, at risk members for interventions.
  • Medicare star ratings. This has been top-of-mind for many clients, but as of yet, very few are tracking results year-round rather than waiting for the annual reporting period to determine if any changes have had an effect.
  • Predictive modeling. We are using a lot more predictive modeling to score prospects lists and member databases with segment identifiers for targeted marketing.  Appended data from KBM and Acxiom has provided the data source for most of these models, along with clients’ available internal data.  We have also created models for Medicare and Commercial plans to identify potential disenrollees based on certain behaviors identifiable in claims data so that those individuals can be contacted prior to their disenrolling rather than trying to win them back after disenrollment.
  • Network restrictions. Research around network reductions and tiered networks has also been prevalent as more carriers are forced to reduce network size due to contracting problems or are looking to gain more control over network costs.


This entry was posted in Ancillary benefits, Health Care Engagement, Health insurance exchanges, Health risk, Medicare, Segmentation, Statistics. Bookmark the permalink.

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