2016 pricing trends
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Transcript of 2016 pricing trends
2016 exchange market remains in flux:Pricing trends
OVERALL
MARKET VIEWPrices at county level
CONSUMER VIEW2
Prices weighted by QHP-eligible population
% SEEING INCREASE IN PLANS BY METAL TIER
Median rate increases across re-filed plans are higher than last year. Premiums of lowest-price silver plans have increased as well.
Median change in gross premium across all re-filed plans1
Percent of consumers who will see change in net premium of the lowest-price silver plan4
Despite higher increases in lowest-price silver plan gross premiums this year, a greater share of consumers seeing less expensive lowest-price silver net premiums this year than last year.
CATASTROPHIC BRONZE SILVER GOLD PLATINUM
10% 12% 15%
7% 8% 11%
7%10% 13%
KEY: 2014-2015
2015-2016
2014-2015 2015-2016
Median change in gross premium across lowest-price silver plans
YEARS:2014-’15
YEARS2015-’16
4.4% increase
13.2% increase
Findings across 50 states and DC
As of 11.04.2015
18%
46%
27%
9%
28%
38%
9%
25%
4%
KEY: Over 10% decrease
Within 10% decrease
Within 10% increase
Over 10% increase
McKinsey Center for U.S. Health System Reform
2016 exchange market remains in flux: Evolution of carriers and offerings I Page 1 of 4
Median change in gross premium across all re-filed plans1
2016 exchange market remains in flux:Pricing trends continued
BY GEOGRAPHY
MARKET & CONSUMER VIEW
QHP-eligible weighted average change in lowest-price silver plans' net premium
In many states, this year's lowest-price silver net premium changes are much different than last year’s.
KEY: 2014-2015
2015-2016
16% 15%
20%
4%
AK AL AR AZ CA CO CT DC DE FL GA HI IA
3%5%8%
4%
14%
6%
12%9%
25%
4%2% 1%
-3%
6%2%
-11%
18%
-10%
3%
12%9%
6%
RI SC SD TN TX UT VA VT WA WI WV WY
22%
4% 4%7%
0%
10% 10%6% 4%
11%11%
-1%
0%2%
-5%
4%
-5%
9%
-1%
13%
2%4%
7%8%
Prices at county level
McKinsey Center for U.S. Health System Reform
2016 exchange market remains in flux: Evolution of carriers and offerings I Page 2 of 4
ID IL IN KS KY LA MA MD ME MI MN MO MS
0%
10%
16%
5%1%0%
9%
2%3%
-7%
7% 8%
-1%
0%0%5%
-6%
18%
2%5% 6%
2%
18%
11%
16%
-1%
MT NC ND NE NH NJ NM NV NY OH OK OR PA
10%12%
1%0%2%1%
9%
26%
-3%
1%
6%
-4%
11%
4%
-2%
22%
6%4%
-12% -14%
1%3%
9%7%
12% 9%
PRICE CHANGES BY CARRIER TYPE
There is considerable price fluctuation in rate changes by carrier type. MARKET VIEWPrices at county level
Median change in lowest-price silver plans’ gross premiums by carrier type
CONSUMER VIEW2
Price leadership weighted by QHP-eligible population3
Percentage of consumers seeing given carrier type offering lowest-price silver plan in their county
Provider and Medicaid plans are gaining silver price leadership across eligible consumers.
BLUE
45%26% 24%
REGIONAL/LOCAL
17%10% 10%
PROVIDER
10% 13% 17%
NATIONAL
20% 24% 18%
CO-OP
5%15%
2%
MEDICAID
3%12%
29%
KEY: 2014 2015 2016
REGIONAL/LOCAL
3.4%
11.0%
PROVIDER
1.6%
6.4%
NATIONAL
6.7%
12.6%
CO-OP
-8.8%
18.5%
MEDICAID
-11.8%
-0.5%
BLUE
6.2%
11.9%
KEY: 2014-2015
2015-2016
McKinsey Center for U.S. Health System Reform
2016 exchange market remains in flux: Evolution of carriers and offerings I Page 3 of 4
2016 exchange market remains in flux:Pricing trends continued
There is considerable price fluctuation in rate changes by carrier type. MARKET VIEWPrices at county level
CONSUMER VIEW2
Price leadership weighted by QHP-eligible population3
Provider and Medicaid plans are gaining silver price leadership across eligible consumers.
MEDICAID
-11.8%
-0.5%
McKinsey Center for U.S. Health System Reform
QHP-eligible weighted average change in lowest-price silver plans' net premium
PRICE CHANGES BY CARRIER TYPE continued
Percentage of QHP-eligible consumers seeing new price leader in 2016
58% silver
51% platinum
49% bronze
55% gold
39% catastrophic
Many consumers will see new price leaders in 2016 and may have to switch plans if they are seeking the lowest-price option.
McKinsey Center for U.S. Health System Reform
2016 exchange market remains in flux: Evolution of carriers and offerings I Page 4 of 4
1. Plan is defined as a health insurance offering in which an individual can enroll, offered by a carrier
2. Consumer defined as all individuals eligible to purchase qualified health plans (QHP)
3. Price leader defined as carrier offering the lowest-price plan
4. Net premium takes subsidy into account based on consumers' geography, family size, age and income; we assume that these factors remain constant in 2016, since consumers have not yet supplied current income information during the open enrollment process
METHODOLOGYThe above findings are based on publicly available, approved 2016 individual market exchange rates as displayed on exchanges for all states and DC, compiled within the McKinsey Exchange Offering Database.
healthcare.mkinsey.com/reform
McKinsey Center for U.S. Health System Reform
2016 exchange market remains in flux:Pricing trends continued