“Ross Weiler, a principal analyst at Day Health Strategies, says that providing high-performance networks and implementing programs to address chronic diseases could position ACA-compliant small group plans as a market standard.
“Payers could add value through high-performing, tiered networks or perhaps through more robust clinical programs and a combination of value-added services to members,” Weiler said. “Payers would [additionally] benefit by developing, implementing and effectively deploying programs to engage chronic or high-risk members to manage their health earlier before a disease or an illness occurs.”
He added that an AHP or other low-cost competitors may not have the capabilities to provide high-quality plan benefits, which can be used as a major marketing point for small business plans under SHOP.”
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