How exchange plans compete

Avalere Health says health insurers look first at deductibles when trying to attract customers through the new public exchange system.

Avalere came to that conclusion by reviewing plan design information for the silver plans that insurers offer through the exchanges run by the U.S. Department of Health and Human Services (HHS).

The firm found that 74 percent of the insurers in the silver plan market cut the deductible offered by the standard silver plan, according to a slide deck prepared for the Michigan Association of Health Plans. About one-third changed the level of cost-sharing for access to primary care doctors. One-quarter cut the out-of-pocket cost of seeing specialists or using relatively low-cost drugs.

Fewer than 15 percent appealed to consumers by reducing out-of-pocket costs for the kinds of expensive, brand-name specialty drugs that patients take to control conditions such as AIDS, hemophilia and hepatitis C.