The Patient Protection and Affordable Care Act regulations are changing the healthcare business, requiring guaranteed issue, medical loss ratio (MLR) requirements and qualified health plans (QHPs). State and national health insurance exchanges are expected to attract more of the currently uninsured population with the metallic plan offerings. While health plans have traditionally struggled with administration and profitability of individual products, this will be further stressed by the expected transition of small group business to individuals.
The creation of health insurance exchanges (HIXs) will force health plans to consider who owns and manages the customer relationship and how relationships can be preserved with the HIX acting as the initial interaction point. New, on demand communications like Summary of Benefits and Coverage will require that health plans provide accurate information quickly. Capgemini can help you meet these challenges while managing growth and profitability.