Health care costs are the most important issue facing the country as American families navigate a lasting pandemic and very real financial challenges. As a new administration seeks to invigorate the federal workforce, there is no better time to modernize the system that federal workers use to select health care benefits. Just as consumers shop for hotel stays and rental cars by comparing price, quality and characteristics, they should be afforded the same ease and transparency as they shop for reliable and affordable health coverage.
This is not a minor inside-the-Beltway bureaucratic problem. The entire country would benefit if federal employees could confidently shop for health benefits that best fit their needs and ultimately improved their health.
The start of a new administration offers a golden moment for a significant upgrade. It would allow President Joe Biden to go a long way toward addressing a priority.
“After decades of under-investment in a modern-day workforce, the civil service is in need of repair and rebuilding,” he said in sending his first budget request to Congress in May.
Enhancing federal benefits, including by simplifying and modernizing the way employees shop for and select health coverage is an important first step.
The good news is that the solution is neither complicated nor politically polarizing. The necessary upgrades, to the Health Plan Comparison Tool on the Office of Personnel Management website, are relatively modest and easily accomplished following other health care marketplaces.
The individual exchange, Medicare Advantage and others are doing the job right — providing complete and easy-to-understand health plan details in one single place, allowing consumers to be savvy comparison shoppers. Providing access to both cost and quality information also helps arm consumers with the complete information to select the coverage that best fits their needs.
But this is not the case for almost nine million customers of the Federal Employees Health Benefits Program (FEHB), the largest employer-based health insurance program in the world.
Because they lack easy access to health plan quality information and navigating it can be cumbersome, far too few government employees and their families are enrolled in the highest quality plans. Evidence shows that high-quality health plans support the best health outcomes for consumers. Fortunately, OPM realizes the importance and value of high-quality coverage and care. That’s why they’ve set a goal to get 75% of federal employees on such plans. But that won’t happen unless the government creates a better online path for its employees.
We know that today’s sorely outdated shopping experience is producing sub-optimal enrollment because only six percent of FEHB enrollees switch plans annually, at least in part because it’s too difficult to navigate the FEHB plan comparison tool to learn what’s better and available. Plan switching is twice and four times as prevalent in Medicare Advantage and the Affordable Care Act exchanges, respectively. It’s no surprise that these markets see greater plan switching: both have state-of-the-art online shopping systems.
The current FEHB website is out of date and not user-friendly. The static site often redirects shoppers to attachments containing dense, eye-blurring summaries of available health plans. Sometimes essential information — as basic as which doctors are in-network and which prescriptions are covered — is simply not available.
The navigation tools are cumbersome and limited, too. While shoppers can rank options by cost — premiums, deductibles or out-of-pocket limits — they cannot sort by the quality of health plan. This is a must.
While cost may be the top consideration, research shows that when consumers get reliable information about the quality they avoid poorly-rated plans, pay more for average quality plans and are more likely to switch to top-rated plans. In addition, putting quality information front and center spurs competition, boosting performance across the board. And in the long run, better care reduces costs.
The Alliance of Community Health Plans has been a longtime champion for quality coverage and care. It’s time to ensure that federal employees can get the information they need to make the best health choices for themselves and their families. We recommend OPM redesign its website to add:
A prominent, sortable display of each plan’s quality ratings.
A calculator to estimate annual out-of-pocket expenses under each plan, including cost-sharing based on expected use of the health system.
A way to rank plans by total expected cost as well as quality of care.
A filter to avoid information overload and allow customers to prioritize the criteria mattering most to them.
A single platform for all enrollees, minimizing confusion and improving data sharing between OPM and FEHB plans.
More than 70 percent of federal employees indicated in the 2020 Federal Employee Benefits Survey that health benefits were an important part of their decision to take, or stay in, their federal job. This underscores the power the Federal Employee Health Benefits Program has to attract our best and brightest to government service at this critical juncture in our nation’s history. A renovation of the marketplace is easy to make. And a healthier country and more effective government will be the result. At a time marked by partisan gridlock and distrust in government, this is an easy way to score a win.
Ceci Connolly is president and CEO of the Alliance of Community Health Plans, a trade association representing nonprofit health plans in 36 states and DC.
Andrea Walsh is president and CEO for Minnesota-based HealthPartners, the largest, consumer-governed, nonprofit health care organization in the nation.