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Understand who will buy health insurance on the new exchanges

Understand who will buy health insurance on the new exchanges

by Frank Tiedemann on April 15, 2013


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The Center for Medicare Services (CMS) has just released their own study of the population expected to buy health insurance on the new exchanges beginning October 1, 2013. Surprisingly the expected 48 million people can be segmented into just six groups. The three largest of those groups comprise 92% of the total.

48% of total purchasers or approximately 23,000,000 individuals comprise the largest group labeled “Healthy and Young.” These individuals take their good health for granted, are tech savvy, and shun traditional media. Sadly, they have low motivation to purchase health insurance on the exchanges.

Another 29% or 13.9 million individuals are represented in the segment “Sick, Active and Worried.” This segment is comprised of Gen X and Baby Boomers who actively seek healthcare information. Many have pre-existing health conditions and are concerned about the cost of care and the cost of health insurance.

The third segment, “Passive and Unengaged”, represents 15% of the total or 7.2 million individuals. Healthcare is not a pressing issue for this group. Though they are likely to be age 49 and older they are not interested enough or likely to take the time to sort out the health insurance options.

Hospitals and healthcare systems would do well to study the details in this CMS report to better understand the 48 million people who will shortly be accessing healthcare services having purchased a health plan on the insurance exchange.

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