Physician Patient

Election 2014 and The Future of Consumer-directed Health Care Financing

In an excellent overview (see the 5/9/2014 YouTube video at ), Peter Nelson, JD, Public Policy Director of the Center of the American Experiment (CAE) and MPPA Board Member explains how Obamacare presents opportunities and challenges for consumer-directed health care — through expansions of high deductible insurance products and wider use of individual self-insured insurance policies.

Minnesota’s dominant health insurers are marketing directly to individual consumers (see Jackie Crosby’s StarTribune article below). But what is for sale here? Are information on cost and access to physicians and clinics avalilable from Blue Cross and other Minnesota insurers?

Consumer-directed financing is key to competition and cost-effectiveness. MPPA knows there are a growing number of Minnesota Direct Pay medical practices which bypass health insurance rulers and restrictions (although many provide procedural codes for medical care so that patients can be paid directly for provided medical services by there insurance). Since Direct Pay practices market directly to consumers, they post their fees (payment transparency) and offer (better) patient-centered access to physicians and care teams. Patients therefore have choices and control with Direct Pay. See, for example,

So how will citizens and policymakers in Minnesota guage evidence of competition during the 2014 election season? And do they think this is important? Mppa thinks Minnesota needs a working medical markelplace. Patients and their families need power to hire (and fire) doctors and/or choose (or cancel) health care insurance based on cost and value to them. Unless there is real price and benefits transparency, this is not possible. MPPA thinks Medicaid enrollees as well should have choices and control over where (taxpayer) money goes for their care. Patients and their families are best able to select physicians and clinics which respect their culture and preferences. Since Minnesota Medicaid enrollees are arbitrarily assigned to an HMO now, they do not have choice of doctor, treatments, or their insurance coverage.

What is the future of MNsure? MPPA wants potential customers of our MN government insurance exchange to know the costs of 2015 Obamacare insurance policies soon.
Also, we encourage viable private sector alternatives to ACA run or ACA compliant (Mnsure) government insurance exchanges.

We are with Obamacare creating a two-tiered health care payment system in Minnesota.

Polish your crystal balls, send me your comments, and I’ll circulate them with your permission.

Blue Cross and Blue Shield of Minnesota to open a retail store in Edina
Article by: JACKIE CROSBY , Star Tribune Updated: August 29, 2014 – 12:21 AM
The state’s largest insurance company will deal directly with consumers in an Edina store.

1 comments resize text print buy reprintsShare12 Cross and Blue Shield of Minnesota will open a retail store in Edina, the first insurer in the state to make a direct play to consumers as health care becomes ever more competitive.

The store is scheduled to open this fall at Yorkdale Shoppes, a busy retail node near Southdale Center and Cub Foods, in space once occupied by specialty retailer Christopher & Banks. It will serve consumers shopping for individual plans and seniors eligible for Medicare.

Eagan-based Blue Cross is the state’s largest, nonprofit organization and the largest insurance company. The $9.3 billion organization is a dominant player outside of the Twin Cities area, and traditionally has relied on an active network of brokers to reach individual consumers.

But changes in health care are putting more choice in the hands of the consumers, and insurers are marketing directly to them to try to win their business.

“Everybody in health care wants to reach the masses, and retail is one way to do that,” said Tom Charland, CEO of Merchant Medicine, which tracks retailing trends in health care, particularly walk-in medical clinics.

No date has been set to open the doors, but Blue Cross officials said the store will be ready for the upcoming open enrollment period, which begins Nov. 15. More stores could follow in the coming years.

The 3,500 square-foot space will be also used for informational sessions and wellness activities, such as yoga, light fitness and healthy cooking classes.

Retail storefronts aren’t new to insurers. Nationwide, Blue Cross and Blue Shield operates about 50 retail stores in nine states. Michael Guyette, CEO of Blue Cross and Blue Shield of Minnesota since January 2013, was instrumental in opening the first of those stores, for Florida Blue, in 2006.

Minnetonka-based UnitedHealthcare, the nation’s largest insurance company, has long had a storefront presence and in recent years has opened temporary stores and kiosks in shopping malls around the country during the busy holiday season to sign up seniors for its Medicare plans.

HealthPartners also has tested a pop-up store concept at Ridgedale Center in Minnetonka.

The timing of the new venture is strategic, with the store opening just as tens of thousands of Minnesotans will be renewing policies bought under the first year of the fully implemented federal health law.

Blue Cross saw modest enrollment growth through MNsure, the state’s online insurance exchange established by the Affordable Care Act. About 23 percent of those who purchased coverage through MNsure bought a Blue Cross plan, compared with the market-leading 59 percent who went with PreferredOne.

Monica Engel, a vice president of sales at Blue Cross, said the insurer will take a “somewhat aggressive … but thoughtful” approach to opening additional retail outlets in the coming years. The stores are meant to complement, not replace, insurance agents, she said.

“Brokers are a key member of our distribution,” Engel said. “We see the store as being an extension of the services that the brokers provide to consumers today.”

But Charland said that brokers’ traditional business model is under siege, and the move is one more sign of massive changes underway in the health insurance industry.

“We see health care providers entering the insurance business, we see insurance companies entering the health care business,” he said. “And everybody’s starting to talk about ‘customers.’ The whole vocabulary is changing.”

Jackie Crosby • 612-673-7335

Comments are closed.