Healthcare

Healthcare Providers

Health Benefit Marketplaces

The Affordable Care Act (ACA) proposes to transform the U.S. health care system as we know it today. A significant component of this change is the development of State Health Benefits Marketplaces (formerly known as Exchanges). Each state has flexibility in the design, governance, policies and implementation of their Marketplace. In its simplest form, a Marketplace is a web portal that will facilitate the process of comparing and purchasing health insurance by certain individuals and small businesses. The ACA calls for each state Marketplace portal to:

  • Offer a choice of health plans
  • Provide consumer assistance with the evaluation of options
  • Support a governance structure with strict rules regarding product offerings and pricing structures

The planning, implementation, program integration and business operations of Marketplaces require expertise in many different areas. We bring a highly experienced team with decades of healthcare consulting experience spanning the full spectrum of healthcare services. Navigant’s healthcare practice is a nationwide network of nearly 500 dedicated consultants with proven experience in Medicaid and other state programs, insurance marketplace development, managed care and provider strategies, commercial insurance and IT system development and integration.

  • State Health Benefits Exchange Services

  • Health Benefit Exchanges: Preparation for Hospitals

 

Proven Track Record

Navigant continues to work at the forefront of healthcare reform – providing assistance to state governments, health insurers, hospitals and physician practices as they implement changes to comply with the ACA.  We have worked with the Massachusetts Connector Authority on the assessment of its CommonwealthCare program and we continue to work with Pennsylvania as it designs its Marketplace.  Navigant professionals recently led Connecticut through the resolution of many Marketplace planning, implementation and sustainability strategy issues.  We have hosted collaborative stakeholder groups including state agencies and community stakeholders, assessed existing information systems infrastructure to identify current system gaps and have evaluated states’ and commercial payers’ benefit marketplaces.

We assist state governments, providers and commercial payers in developing options to meet population and insurance marketplace needs, as well as project Marketplace impact.  Navigant delivers the support and creative solutions necessary to design, develop, implement and operate sustainable Health Benefits Marketplaces.

Click here to read our insights on the healthcare industry.

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