Health Insurance Marketplaces

The skill to navigate a volatile environment.

Health insurance marketplaces are some of the most complex aspects of the Affordable Care Act (ACA). And they’re likely to stay that way, as states continue to adjust their strategies, assess the sustainability of their marketplaces and implement new functionality like the SHOP Marketplace for small businesses. Add in a contentious legislative environment and it’s clear that the challenges will likely continue in the years ahead.

We’ve been at the forefront of understanding the opportunities and challenges of healthcare marketplaces since before the ACA went into effect. Our team of experts comes from top positions in state-based marketplaces, government, health plans and other key areas. They have first-hand experience navigating the complexities of health insurance marketplaces for governments, health plans, providers and consumers. Their expertise includes:

  • Conducting state-specific studies of the uninsured and underinsured for those eligible for coverage through marketplaces
  • Modeling policy options for states
  • Driving stakeholder engagement and consumer outreach
  • Exploring marketplace implications for state Medicaid and CHIP programs
  • Developing financial sustainability models for state-operated marketplaces
  • Preparing Level 1 and Level 2 establishment grant applications
  • Evaluating state business processes and IT needs
  • Assessing options for eligibility, enrollment and customer service solutions
  • Leading states that are transitioning from state-based marketplace models to the federal marketplace
  • Helping health plans assess the implications and opportunities of offering Qualified Health Plans (QHPs) through the marketplaces and assisting with implementation

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