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In Healthcare, Access Matters, As Does the Consumer Experience

February 16, 2016

This week, Covered California announced that it selected VSP Vision Care to offer a path to vision coverage through the health insurance exchange, ensuring greater access to eye care for adults. This is a great development for adults purchasing healthcare through Covered California, as there was previously no access point for vision care because the Affordable Care Act did not deem it an "essential benefit" like it did for children.

Just as a child needs healthy vision to succeed in the classroom and beyond, adults too depend on good vision in all aspects of life, from their home to the office and everywhere in between. People are more likely to get an annual comprehensive eye exam than a routine physical, and that matters: Your eye doctor can detect early signs of  diabetes, high cholesterol, and other chronic diseases, improving your well-being and reducing healthcare costs.

This decision by Covered California helps close the gap in access to eye care for millions of residents. However, the gap in access still exists in many states throughout the country and VSP will continue pushing to include it in those state exchanges.

Love it or hate it, there's no shortage of opinions about Affordable Care Act. If nothing else, we can agree that the healthcare law drove a tremendous conversation around the importance of expanding access to care. But there is plenty of room for improvement. For the program to work, young Americans need to sign up, but a significant number of uninsured Americans are choosing to pay a penalty rather than get covered.

One study found that just 60 percent of the uninsured understand key insurance concepts like deductibles, premiums, co-pays, going in and out of network, etc. With numbers like that, it’s not surprising people are confused. More can and should be done to educate the target customer – Americans who have never had health insurance, don’t have an internal HR business partner to assist them through the process, and are in unfamiliar territory.

While big strides have been made to improve glitches, those administering the law could benefit from looking at their challenges through a business perspective. Who is the customer? What matters to them? What are their pain points when trying to buy healthcare for their family?

I’d love to hear from you. There is no silver bullet solution, but what ideas do you have to make the Affordable Care Act work better for Americans?

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