The rocky implementation of the Affordable Care Act is mostly behind the industry, and all signs point to reform sticking around. Its just begun, J.D. Kleinke, a medical economist, author, health care business strategist, and entrepreneur who provides business, product and technology strategy services to insurers and other health organizations. During Sun Life Financials Wake Up Summit last week Kleinke said the industry is currently in the "version 1.0" state of health care reform. Its going to take a lot of iterations, but at the end of the day, the insurance industry is not running from this," he said. "The insurance industry has embraced it; they want those 10-30 million new customers.
Harvard Pilgrim is one insurer that has embraced reform. Doing most of its business in Massachusetts and having 98 percent of that market share, Harvard Pilgrim was fairly advanced in its health reform efforts. As Harvard Pilgrims sales and customer service leader, Vincent Capozzi, SVP, has been a part of the health insurers changes, including introducing a set of service standards that guide Harvard Pilgrims relationships with employer customers and developing and implementing the New Partnership Model, which engages employers and Harvard Pilgrim in a way that ensures the value of a health plan is maximized. Capozzi joined Kleinke on a panel at the event to talk about how the implementation has set the scene for Harvard Pilgrim. A fair amount of health insurance exchange enrollees are currently not paying premiums and 70-75 percent of enrollees already had health insurance, so we didnt solve the problem of the uninsured, at least with the first rollout, theres a lot up in the air, Capozzi said. Strategically, health reform made sense, but the implementation wasnt well managed. Its been challenging. In our case, having to change products, implement new systems and IT integration that frankly doesnt hook up well has been a mess. I cant imagine how many hours our staff has spent trying to [make it all work].
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