Latest / Becker’s Payer Issues Podcast / Redefining Employer Coverage: Centene’s Alan Silver on the Future of ICHRA

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Redefining Employer Coverage: Centene’s Alan Silver on the Future of ICHRA · Becker’s Payer Issues Podcast

• 0:00
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  Hello, Hello, everyone. This is Jacob Emerson with
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  the Becker's Payer Issues podcast.
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  Thrilled today to be joined by Alan Silver,
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  who's the president of Centene's Ambetter Health Solutions
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  business. That's the part of the company that
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  focuses on ICRA.
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  Alan, thank you so much for taking the
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  time to be with me on the podcast
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  today.
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  Appreciate it, Jacob. I I really appreciate the
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  time. Yeah. And we're glad you're here with
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  us. Before we dive into everything we wanna
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  talk with you about, can you tell us
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  a little bit more about yourself, your background
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  in health care, and what it is that
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  you're doing today at Centene?
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  Yeah. Jacob, thank you so much for the
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  time today as I mentioned. As you stated,
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  my name is Alan Silver. I'm the president
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  of Ambetter Health Solutions,
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  which is the brand of Centene Corporation that's
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  focused on ICRA.
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  I'm sure most of your audience knows, but
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  for those that don't, ICRA stands for individual
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  coverage health reimbursement arrangement,
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  which is a new type of employer sponsored
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  health benefits plan with a focus on flexibility
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  customization
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  using the individual market.
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  Prior to, joining this role, I spent
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  more than twenty years at, consultant brokerage house
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  called, Willis Towers Watson, where I led retiree
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  and ICRA initiatives. And I'm just really excited
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  to be in this role. I I think
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  that the reality is I spent a lot
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  of time working with employers and and many,
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  many employers at the current moment in time
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  are seeing the status quo of their group
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  health plan hasn't been working well for them
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  and and
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  really wanna focus on the innovation that ICRA
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  provides as an alternative to that status quo
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  approach.
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  Absolutely. And, you know, Alan, we're hearing so
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  much about ICRA more and more as time
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  goes on both in the private sector and
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  and at the government level. So
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  talk to us about why did Centene wanna
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  create this position? Why are you the first
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  president of ICRA at the company?
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  Yeah. I I think,
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  it's some of it is based in the
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  kind of tradition of what Ambetter Health is.
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  Ambetter Health is the largest individual market,
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  carrier in the market. It's been
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  creating
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  tailored health care plans to millions over the
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  past decade, and
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  there's an understanding
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  that we have a responsibility
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  if there is an individual market solution
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  such as ICRA that we need to be
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  championing and championing and leading that effort,
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  to keep pace with an evolving landscape and
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  bringing in somebody
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  that has the experience
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  of traditional group health plans and trying to
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  understand
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  how we might innovate in the individual market
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  realm to meet the needs of employers. So
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  I think it's been
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  really important for Centene to have somebody
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  at the head of this strategy, which represents
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  a great opportunity
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  for Centene in particular and the market as
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  at large.
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  Absolutely. It makes complete sense. So there's market
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  demand for this. Employers are asking for this
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  kind of new model, Alan. Yeah.
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  If we're backing up for a second for
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  our audience, just to level set here,
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  what does the ICRA landscape look like right
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  now? How many enrollees are out there, and
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  and who are some of the employers that
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  are actually interested in this model?
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  Yeah. I think it's a fair question, Jacob.
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  I think that the
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  the current environment
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  is is one of constant evolution.
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  From the HRA council data that we have
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  and some other data points that we have
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  out there, we right now can see somewhere
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  between 500,000
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  and a million people eligible for an ICRA
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  and some 250,000
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  to 750,000
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  people actually enrolling.
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  The
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  the point in time nature of those estimates
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  makes it a very wide range, but it
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  started to become a a significant
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  kind of portion of the employer sponsored landscape.
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  The leaders in this space have been small
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  group employers, and the reason why is because
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  the direct comparison
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  between small group rates on insurance and individual
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  market rates has been something that, a lot
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  of small group employers have have taken the
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  opportunity to seize
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  the the more efficient way of providing benefits.
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  Interestingly enough, though, 83%
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  of them
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  hadn't provided insurance before. So this provides a
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  significant opportunity for them to provide a benefit
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  that they haven't provided in the past.
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  The last thing that I'll say about the
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  the number of lives and and the growth
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  that's out there is just this concept of
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  the greatest growth sector segment of the market
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  is actually in employers with 200 and more
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  lives.
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  So larger midsize midsize and larger employers are
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  really coming into this space because they understand
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  the promise of what ICRA can do for
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  them
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  and understand there may be a different way
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  given the population that they're covering.
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  Sure. That's a really interesting last point that
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  you just made there, Alan, that you are
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  seeing a lot of large employers
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  interested in this. But at the same time,
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  you're also seeing a lot of, small employers
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  offering this kind of model, offering insurance for
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  the first time to their employees through this.
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  So it's that's a really interesting, dichotomy there.
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  But
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  I wonder you know, we're hearing so much
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  now about,
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  ICRA changes at the federal level.
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  How how do you see this market continuing
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  to evolve, let's say, over the next five
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  years or so?
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  Yeah. So I think the next eighteen to
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  twenty four months are crucial to the growth
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  of ICRA.
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  It's growing year over year. But the reality
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  of the situation is,
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  I wanna take a little bit of a
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  a a look at what employer group sponsored
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  coverage is is doing these days. And the
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  the issue that we have is a multigenerational
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  workforce, four generations of people working within
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  the workforce today, and that can include the
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  young professional that's relatively healthy, the family of
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  four with, two kids under three,
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  somebody managing a chronic condition,
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  people on benefits to kind of bridge the
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  gap in their retirement to Medicare.
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  Those are just four examples
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  of people that need very different things from
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  their health care.
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  So
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  the growth in ICRA is going to come
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  from this concept of kind of a direct
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  to consumer
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  type of approach to health care. We
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  anticipate this model becoming more and more streamlined
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  in the next few years,
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  but we absolutely
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  need, some some technology enhancements, some some education,
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  some decision support tools to come out to
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  make that view and vision of that multigeneration
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  generational
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  use,
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  workforce
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  become a reality in the ICRA space.
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  Sure. No. That makes complete sense. And it
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  really sounds like, at the end of the
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  day, what this what this model offers is
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  flexibility
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  to employers.
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  I wonder then what what you would say
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  are some of the biggest challenges you're seeing
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  facing AMCA. And when you're when you're talking
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  about to employers, when you're promoting this new
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  model, what are some of the top challenges
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  you're hearing hearing there?
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  Yeah. I I think it's it's
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  basically mostly about education. If if I had
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  to drive one point home, it's education, and
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  it's education for
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  employers themselves. It's education
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  for,
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  brokers, both on a group and the individual
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  basis. But it's also education for health systems
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  and education,
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  for payers
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  just to get to a place where we
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  all understand
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  what the future of this could look like.
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  It's a new category
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  growing at speed, and it's gonna face some
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  challenges. I think beyond the education,
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  two or one or two other things could
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  be just the concept of
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  the technology
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  really needing to embrace
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  the world of, you know, frankly, consumers making
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  their own choice on health insurance.
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  So we need to get to a place
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  of decision support where pipes are connected between
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  carrier and broker and employer
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  and ICRA administrator altogether to make this a
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  fundamentally
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  good experience.
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  And then we bear responsibility at places like
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  Ambetter for us to meet the needs for
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  individuals and what they want for their health
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  insurance.
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  That talks about us building networks,
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  building,
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  designs, having good relationships at the local level
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  with health systems, with providers
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  to ensure that people actually want to produce
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  want to purchase
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  our health insurance coverage that we are providing
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  to them.
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  Absolutely. So really just getting more information about
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  this new model out there sounds very key,
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  to more growth in this market. What do
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  you what do you think other insurers should
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  know, Alan? I mean, should most insurers be
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  considering entering this market at this point?
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  Jacob, the the words I wanna use here
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  are I think other insurers will need to
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  have a very intentional strategy
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  around
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  entering the ICRA space. It's kind of an
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  obvious play for us at Ambetter because we
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  don't have
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  a group business for us to sit there
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  and say, oh my gosh. We're taking things
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  from the group business to the individual. For
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  us, we are pushing an individual solution, and
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  that's why we see ourselves
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  as a leader in this space. For other
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  carriers, that may not be the case, but
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  I think they're going to wanna either make
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  a determination that they are in with us
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  in this kind of building of a direct
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  to consumer world or maybe it's just not
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  for them. It's going to be very important
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  for us to all understand
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  that you can't really do this off the
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  side of your desk. You actually need to
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  commit to meet the needs of the employee
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  population.
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  Absolutely. So a strong strategy here. It's it's
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  gonna be different for every company. That makes
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  sense.
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  Before we go, Alan, you've got the ears
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  of a lot of other health plan leaders
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  from all over the country right now. What
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  else do you wanna tell them about this
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  market?
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  Anything else we we really need to hit
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  home on today? Yeah. Jacob, I think you
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  could hear it in my voice. I am
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  very, very passionate about this. I am very
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  much looking forward to the challenge of building
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  ICRA
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  in this country. It comes from a couple
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  different places, but the biggest place that it
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  comes from is I think, that employer sponsored
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  insurance was built for a different time,
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  a time when
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  everybody came into the office or the store
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  or the factory, and employers only had to
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  worry about people that lived close to where
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  they worked. So it's really easy for employers
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  to understand
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  what the health kind of construct was in
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  the markets where they had people.
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  Well, as I mentioned earlier, with a multigenerational
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  workforce, if we add on
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  the concept of remote and hybrid work,
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  all of a sudden, you have employees that
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  are working
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  nowhere close
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  to an office or, in some cases, very
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  far away from the people that they're associated
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  with. And as a result of that, employers
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  have to make a choice. And the choice
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  is, do I now go out and try
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  to learn
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  what's different about the health systems where all
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  of my people are,
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  or do I rely on someone
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  to help deliver deliver a solution at the
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  local level
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  through ICRA? I I think that's a fair
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  choice, and employers need to be intentional about
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  that choice. What I'll just say coming out
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  of that conversation is, at Ambetter,
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  our focus is improving the lives of the
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  people we serve
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  at the local level in the communities we
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  serve them.
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  So we are well positioned and you will
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  see us commit to the ICRA strategy at
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  a very local level, which will be a
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  great option for many, many employers.
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  Fantastic. Well, I think that's a great place
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  to leave things. Alan, I wanna thank you
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  for taking the time to sit down with
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  us and for sharing your insights with our
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  listeners. We really appreciate it. Jacob, appreciate the
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  time. Thank you so much. And to our
• 12:04
  listeners, if you'd like to listen to more
• 12:06
  podcasts from Becker's Healthcare, you can visit beckershospitalreview.com.