PRESENTATION OF THE QUICK COST AND PLAN FINDER TOOL. For the Connect for Health Colorado Policy Commi4ee July 24, 2017

Transcription

1 PRESENTATION OF THE QUICK COST AND PLAN FINDER TOOL For the Connect for Health Colorado Policy Commi4ee July 24, 2017

2 Agenda Purpose of the Quick Cost and Plan Finder Tool Summary of Enhancements & New Project Methodology & Timeline Data sources Preview of the Tool & of Logic 2

3 Present new enhancements and of the Quick Cost & Plan Finder tool. Reminder: The tool is a work in progress, and much of the copy will be updated before we go live 3

4 Purpose of the Quick Cost and Plan Finder Tool Quick Cost and Plan Finder is customer-decision support tool funded primarily through the Colorado Health FoundaGon. The tool is designed to: Allow the customer to quickly see if they qualify for financial assistance and preview plans before to fill out an Educate the customer about factors, beyond the premium, they should consider when plans, including: o Total out-of-pocket costs o Preferred doctors o Preferred medications o Cost impacts of health usage Give customers an es@mate of their TOTAL out-of-pocket costs based on health usage and medica@on costs, including APTC and CSR, specific to each plan. Provide an es@mate. It is not an eligibility tool. Note: Each year, we will con>nue to iden>fy enhancements that will further assist the customer in making a smart buying decision. 4

5 Enhancements & New Inclusion of costs into out-of-pocket costs of number of screens by 50% Regionalizing the data that informs out-of-pocket costs Significant increase in claims data used to calculate the out-of-pocket costs Improving health insurance literacy Improvements to the usability of the tool ADA/508 Compliance improvements 5

6 Project Methodology & Timeline Methodology TEAM COMPOSITION Project Owner - Marke@ng Socware Development Project Manager UI Designer Development Team Test Team Subject Ma4er Experts: Plan Data Expert, Customer Service Manager DEVELOPMENT METHODOLOGY Includes: Performance* Security* Integra@on* Regression* System** Data** Includes: User Tes@ng Includes: Unit Test* Includes: Data Regression End-to-End UAT Itera@on Planning 6

7 Project Methodology & Timeline Methodology con>nued USER/USABILITY TESTING Goals ü usability issues RESULTS ü Understand how the tool is to the users ü Gain on how to modify/improve the tool Used an outside firm with 10 paid Testers Test is video taped Provided Testers with a script/scenarios to follow Through watching the videos we iden@fied one area which needed redesign 7

8 Project Methodology & Timeline Timeline April Scope We are here October 2018 Plan Data in UI Design Development Test Development Test August Enhancements & New in Throughout the project: Demos to stakeholders Product Roadmap/Backlog maintenance 8

9 Data Sources & Data Loads DATA SOURCES 1. CIVHC 2. NaGonal Library of Medicine (NLM) 3. Carrier SERFF Templates 4. 3M / Provider Directory DATA LOAD FREQUENCY 1. CIVHC (Annual) 2. 3M / Provider directory (Monthly) 3. Prescrip@ons from NLM (Annual) 4. Carrier SERFF Templates o New plans/ SERRF Templates (Annual) o RX from providers (Quarterly + 4 in between updates) Other Data Updates FPL (Annual Feb/March) Average Tax Credit (Annual) 9

10 Data Sources - CIVHC CIVHC DATA (health usage and medicagon average costs) Date Range 1/1/2015-5/31/2016; 17 months of data Lines of Business Commercial (not Medicaid or CHP+) Claim Types Inpa@ent, Outpa@ent, Professional, Pharmacy Geographic Groupings 3 digit zip codes Age/Gender StraGficaGon 0-5, 6-17, 18-34, 35-44, 45-54, PAYERS INCLUDED (each Payer may have mul@ple plans): 1. Aetna 2. Cigna 3. Humana 4. Rocky Mountain Health Plan 5. United Health Care 6. Wellpoint 7. Denver Health COUNTS DescripGon Count Total Members for included Medical plans 818,309 Total Claims for included Medical plans 5,187,036 Total Count of Members U@lizing Medical Benefits for included plans 531,309 Total Members for included Rx plans 812,745 Total Claims for included Rx plans 4,514,423 Total count of Members U@lizing Rx benefits for included plans 380,158 10

11 Preview of the Tool & of Logic Enhanced Screen Flow Quick Cost and Plan Finder Screen Flow Revised on: June, 2017 What you should know ELIMINATED SCREENS REUSED SCREENS NEW SCREENS Basic InformaCon EsCmate Tax Credit Tax Credit Summary (to print) Good News! Tax Credit result Choose path (HC needs vs skip to plans) Filter on Docs, Meds, Hospitals? Healthcare Usage Welcome Select Hospital Select Doctor SelecCon Summary (for print) Select MedicaCon What you should know Found xx plans for you Plan Results Plan Details/ Compare Plans Next Steps Basic Info & Savings EsCmate Existing flow Redesigned flow Reduced from 17 to 9 Screens New Screens: 1. Consolida@on of data capture screens 2. Next Steps op@ons 11

12 Screen Shots from the Quick Cost and Plan Finder Tool PLEASE NOTE This tool is in development, but what is shown here is a close representa@on of what will be launched this fall. 12

13 Welcome Page 13

14 Basic 14

15 Savings Es>mated Eligibility Results and Tax Credits 15

16 Health Usage 16

17 Select Preferences Doctor(s) 17

18 Select Preferences Medica>on(s) 18

19 Compare Plans 19

20 Compare up to 3 Plans 20

21 Next Steps 21

22 Logic Explained Available Plans & Yearly Cost Es>mate Available Plans Plans are displayed to the customer based upon their: Zip Code Selected Doctors Selected The plans are by default sorted by Yearly Cost Low to High. The user can sort the plans based on Monthly Premium or Annual Yearly Cost EsGmate The Yearly Cost = Monthly Premium x 12 Tax Credit + Other Es@mated Expenses (based upon Health Usage and Medica@ons) Cost Sharing ReducGons (CSR) CSR are incorporated into the plans and costs shown to the customer, and are highlighted as such. 22

23 Logic Explained Medica>on and Health Usage Costs MedicaGon and Health Usage Cost EsGmates The tool s reference data includes an average cost for each of the following: o Visit with a Doctor o Outpatient visit By age group and 3-digit zip code o Day in Hospital o Medication Based upon customer s selec@ons when using the tool, the average costs are applied to each health insurance plan tailored to the customer s selec@ons o copays, coinsurance, and deductibles are accounted for in the calculation o in calculating estimated costs the appropriate Medication Tier is used to apply the accurate copay/coinsurance Addi@onal Medica@on Logic If a Medica@on isn t covered by any available plan, the full cost of the medica@on will be shown as out-of-pocket 23