Private Health Insurance Exchanges Solutions Primed for Robust Growth among U.S. Employers as Vendors Differentiate to Meet Evolving Consumer Expectations

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Employers increasingly embrace e-commerce tools to better manage benefits and promote healthcare consumerism, finds Frost & Sullivan's Digital Health team

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Frost & Sullivan

Apr 11, 2017, 09:48 ET

SANTA CLARA, Calif., April 11, 2017 /PRNewswire/ -- Heath insurance exchanges (HIX) are self-service online stores or marketplaces designed to help people select health plans and other benefits such as the ability to easily buy ancillary products, the ease of enrollment in insurance plans, more choice and control over the benefit selection process and, pricing transparency and decision support. While the adoption of private HIX solutions among United States (U.S.) employers has lagged initial market expectations, the need to support a robust e-commerce experience for health plan beneficiaries among active and retired employees will accelerate uptake in coming years.

The market will be mainly driven by the following factors:

The growth of consumer-directed health plans like health savings accounts (HSAs) that encourage people to be smarter and more selective with their health benefits;
Changing expectations derived from shopping experiences with online retailers such as Amazon;
Employers' growing need to reduce the costs, complexities, and back-office administrative burdens associated with managing employee health benefits.

"Over half of the U.S. population receives health benefits through their employer, but the process of benefit selection and management is rife with frustration and confusion for both employers and employees," said Frost & Sullivan Principal Digital Health Analyst Nancy Fabozzi. "Today's proactive and engaged healthcare consumers seek a more organized and transparent marketplace to facilitate their interactions with their health plans and, increasingly, to purchase and manage related insurance and financial products."

US Employer-sponsored Private Health Insurance Exchange, Forecast to 2020, new analysis from Frost & Sullivan's Digital Health Growth Partnership Service program, finds that the total market for private HIX solutions deployed by U.S. employers will grow at a compound annual growth rate of 41.9 percent between 2016 and 2020.

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Most often associated with Affordable Care Act (ACA) public or government-sponsored health plans, private HIX solutions actually predate the ACA and were initially targeted to address shortcomings with managing employer-sponsored health insurance plans. HIX encompass a robust set of features and functions designed to drive a consumer-centric experience and ongoing engagement and interaction. Common features include shopping tools, enrollment, eligibility checking, decision support with side-by-side plan comparison, price transparency, and member education. Advanced features may include real-time, multi-carrier quoting and rating, health and wellness support, telemedicine capabilities, and support for ancillary insurance products.

"Information technology solutions for the administration and management of private health insurance benefits are rapidly evolving to support retail-inspired and consumer-centered approaches," said Fabozzi. "To thrive and prosper in the growing private HIX market, platform vendors must invest in differentiating features, including smart decision support tools, ancillary insurance products, automation tools for task management, and reporting services along with mobile platform support."

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Frost & Sullivan, the Growth Partnership Company, works in collaboration with clients to leverage visionary innovation that addresses the global challenges and related growth opportunities that will make or break today's market participants. For more than 50 years, we have been developing growth strategies for the global 1000, emerging businesses, the public sector and the investment community.

Employer-sponsored Private Health Insurance Exchange, Forecast to 2020
K05B-48

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