The HealthCare.gov Web portal will give consumers a new way to comparison shop for health coverage as soon as October. On July 1, HHS unveiled the first phase of its online portal, which allows consumers to search for public and private health coverage options in their area based on ZIP code. Through the site, called for by the health reform law, consumers also can determine if a doctor is in an insurer’s provider network. And people who might not be eligible for individual coverage due to a preexisting medical condition can find out about coverage offered through high-risk insurance pools.
A request for proposal (RFP) for the second phase of the portal — worth between $5 million and $10 million a year — was issued May 18 and had a June 17 deadline for bid submissions. The contractor will be responsible for the collection and display of pricing and benefits information of health plans at the consumer level for both individual and small-group markets. The contract period runs just one year, but includes optional extension years that extend to 2014, the year state-run insurance exchanges are scheduled to be operational. An HHS spokesperson tells HPW that the contract will likely be awarded before the end of July. HHS declined to name the bidders, comment on how many have applied or offer details about the potential dollar amount of the contract. California-based eHealth, Inc. which bid on the contract and is considered a front runner, declined to comment on its proposal.
The winning bidder will be required to gather benefit design and pricing information directly from health insurers — on behalf of HHS — and run it though software that lets consumers search for policies using a number of criteria (e.g., age, sex, smoking status and ZIP code). The contractor also will need to obtain agreements from health insurers to “obtain and display” information about their products, according to the RFP. Consumers will then be able to compare options based on level of coverage, premiums and out-of-pocket costs.
“This is a big deal.…By allowing for transparency, less-established health plans will be able to set themselves up as comparable to larger ones, without the typical marketing channels,” says James Yocum, executive vice president at DestinationRx, Inc., a California-based firm that has developed Internet-based tools that help consumers compare drug prices and health plan costs. “Once you open the transparency window, it is very hard to close it.” Yocum’s company, which submitted a proposal for the contract, already provides online comparison information to Medicare Part D and Medicare Advantage enrollees.
The winning bidder’s most significant challenge will be gathering data from health plans. And once the information has been collected, it will be extremely difficult to ensure accurate comparisons, Yocum says. “Everyone has their own underwriting logic,…and they have never had to turn over this type of information to the feds.” However, he adds, the federal government was successful in creating a comparison tool for every drug available through Medicare Part D “in spite of significant doubts about the limits of then-current technology.”
Once the contract is awarded, information about it will be available at www.fbo.gov.
Contact Yocum at jim.yocum@destinationrx.com, or visit www.healthcare.gov.