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The health whisperer: Private exchanges are for real

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Kaveh Safavi is one of the big-name consultants who shape how the world’s health care systems work.

He has a law degree from DePaul, and a medical degree from Loyola University. He’s been the head of units at Cigna Corp. (NYSE:CI), UnitedHealth Group Inc. (NYSE:UNH), and Cisco Systems Inc. (Nasdaq:CSCO), and he’s now managing director of global health business at Accenture P.L.C. (NYSE:ACN).

In 2013, he appeared at the America’s Health Insurance Plans (AHIP) annual meeting on a panel that looked at strategies for improving the U.S. health care system. 

Kaveh Safavi

Earlier this year, his team at Accenture helped AHIP set up the AHIP Innovation Lab in Chicago. The lab will try to use tools such as a digital media studio and a satellite link to get groups of experts teaming up on strategies for tackling specific health care delivery and health care payment challenges, such as reducing fraud and abuse and improving chronic care. 

When agents and brokers sell customers health insurance products 50 years from now, there may be provisions that grew, in part, out of some idea Safavi (photo, right) put in a report decades earlier. In 2013, for example, his team issued a report that drew attention to the rise of health clinics in settings such as drug stores. 

This week, he took time out from his trip to Nashville for AHIP Institute 2015, which ended today, for an interview about how he’s seeing the meeting.

See also: AHIP meeting: Great tweets

For a look at some of what Safavi said, read on. 

Purple machinery gears

1. Safavi said he is not seeing talk about hackers, or broken risk-management programs, dominating conversations.

Attendees at the AHIP meeting may have talked some about topics such reports about the hacking of the U.S. Office of Personnel Management, and the state of the programs that are supposed to protect health insurers against unexpected fluctuation in risk resulting from the Patient Protection and Affordable Care Act (PPACA) programs and underwriting rules that came to life in 2014.

But Safavi said that, from his vantage point, he sees the AHIP meeting as one that focuses mainly on health care management and customer relationship management, not so much on financial management or data administration.

But he did say data security is becoming much more of a general concern.

“It’s a board priority,” Safavi said.

Shopping cart

2. Safavi said he’s still seeing plenty of talk about private exchange programs.

A Cigna executive who expressed optimism about the future of private exchange programs predicted at the AHIP meeting that they might take longer to take off than originally expected.

Accenture has predicted that employers with about 40 million covered lives, or about one-quarter of the U.S. group health market, could be using private exchanges by 2018.

Safavi said his company has reconfirmed that projection, and that he has seen insurers’ confidence in the importance of private exchanges increase since the 2014 AHIP meeting.

“Everybody’s explicitly focused on having a strategy for that,” Safavi said.

It’s not clear how many of the private exchanges will offer a choice of carriers and how many will simply offer workers a choice of plans from the same carrier, but “I think, in general, the concept is that people want choices,” Safavi said. 

Mountain of folders

3. Safavi sees private exchanges adding to insurers’ marketing workload.

Years ago, the pioneers in what’s now known as the private exchange movement knew that consumers wanted coverage choices.

See also: Calif. HIPC Increases Agent Comp. To Gain Market Share

Insurers hoped serving workers through private exchanges might be a way to simplify the distribution process, and possibly to free employers from responsibility for organizing and paying for health coverage.

See also: Will defined contribution health plans get to waltz?

But Safavi said Accenture found when it surveyed 2,700 workers that workers still want employers to set up health benefits plans, partly because they like getting the employer’s help with evaluating coverage, Safavi said.

In the past, Safavi said, one of insurers’ questions was whether employers would still have a role in providing health benefits.

Now, he said, insurers are seeing that, instead of getting to focus on reaching individuals, rather than employers, they may end up of having to pay more attention to consumers while continuing to court employers. 


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