Do you have an Exchange Connectivity Strategy ready?

To benefit from the multifarious opportunities that exchanges offer, insurers would need to establish secure and robust data channels between local internal IT networks and external health exchange systems. Internet as a data interchange medium is hardly reliable or secure and insurers would require help from the healthcare IT companies to establish connectivity with the exchanges.

Once the health insurance exchanges are up and running, consumers would be able to see, review and purchase health plans and other wellness services from the multitude of options available on an exchange. To provide access to consumers for increased health options, local State-based insurers would need to connect with the exchanges to be able to market their products through the exchange. Here’s where exchange integration software and healthcare IT companies can add value to the entire exchange model.

Without exchange integration software to help with seamless exchange connectivity, insurers selling insurance in multiple states would need to establish integration with local insurance exchanges one at a time. One-by-one integration would be a cumbersome and resource inefficient process that may also give rise to other process complexities such as dissimilarity and non-standardization in processes and documents across multiple states.

To aid insurers in easily connecting to multiple exchanges and maintain uniformity in processes, documents and other aspects across different states, healthcare IT companies have introduced “Exchange Connectivity” or “Exchange Integration” software. The software enables insurers to share and update plan and benefit data at different health exchanges through a single data channel. Insurers can also define preset rules and guidelines that the intuitive exchange connectivity software can use to align insurer data as per the standards and formats applicable at different states. Exchange integration software also allows interchange of financial and enrollment data between exchanges and insurer’s local systems for further processing and data logging at insurers’ central database. 

There is a dearth of exchange integration solutions available right now in the U.S. health space, even as States and the federal government continue to finalize their technology partners. A few of the healthcare IT companies such as a Reston-based healthcare It company called hCentive, Inc. are working on the exchange connectivity aspects of the exchanges. 

With the health insurance exchange implementation expected to gain momentum over the next few months, insurers ready with their exchange integration strategy are likely to gain business and market advantage over their competition that are yet to define a business strategy for connecting to health insurance exchanges.