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Exchanges fear churn and burn

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Public exchange managers are thinking about issues that could cause headaches even after enrollment and administration systems work properly.

One recurring issue is “churn,” or movement between one coverage state and another.

The board of Connect for Health Colorado looked at the issue this week at a meeting.

Churn could include moves between public and private coverage; between group and individual coverage; or between having coverage and not, according to a presentation prepared by Jessica Dunbar, the exchange eligibility director.

Drafters of the Patient Protection and Affordable Care Act tried to expand access to coverage, but they didn’t guarantee enrollees right to stay in the same plan for an extended period.

Some fear, for example, that workers with erratic schedules could end up bouncing between group coverage and individual exchange coverage at least annually.

Even if the consumers affected by churn still have coverage, they might face new deductibles and disruptive provider network changes, Dunbar says.

The Colorado exchange is thinking about trying to manage churn by analyzing churn-related data better; making any systems for helping consumers shift between plans and state health programs as smooth as possible; and reaching out to churn-prone employers to try to ease the effects of churn on the employees.

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