1. What is Avenue H?
Avenue H is an internet-based information portal. It connects consumers to vital information they need to make an informed choice, and in many cases, allow them to execute that choice electronically.
2. Why do we need a consumer-based system?
One of the cornerstones of Utah's approach to health system reform is to move our health care system toward a consumer-based system where individuals have greater control over their health, health care, and health care financing. A major step in that direction is the development of a workable defined contribution system. Avenue H is a critical component in moving towards a consumer-based system. For example, in order for a defined contribution system to function efficiently, consumers need a single shopping point where they can evaluate their options and execute an informed purchasing decision. For a consumer-based market to succeed, brokers, agents, employers, and individuals must have access to reliable information to allow consumers to make side-by-side comparisons of their options.
3. What is the overall goal of Avenue H?
The overall goal of Avenue H is to serve as the technology backbone to enable the implementation of a consumer-based marketplace to shop for healthcare coverage.
4. How does Avenue H accomplish that goal?
To accomplish this goal, Avenue H has three core functions:
- Provide consumers with helpful information about their health care and health care financing
- Provide a mechanism for consumers to compare and choose a health insurance policy that meets their families' needs
- Provide a standardized electronic application and enrollment system
5. Isn't this information already available in the private sector?
While it could be argued that the information that a consumer needs exists in the present system, Avenue H provides two key elements missing in the current system:
- A standardized format for critical information
- A single point for comparison and purchase.
6. Why did Utah choose to go with a consumer-based model?
Utah's approach to health system reform relies on the fundamental principles of personal responsibility, private markets, and competition. To promote competition in the health care system, consumers need three things - accurate and relevant information, real choice, and the opportunity to benefit from making good choices. The insurance marketplace model enhances private competition in the health care system by providing all three elements of increased competition.
In addition to the benefits to the consumer, the insurance marketplace model also offers relief to employers who will no longer need to bear the full burden of running a health plan for their employees.
7. What is unique about Utah's approach?
Utah's approach to developing a portal is unique in that it builds on existing technology instead of starting from scratch. This allows the state to incorporate and build on private solutions. Utah's approach is also designed to support the existing roles of entities in the health system, including insurers, brokers/agents, and health care providers.
8. What will Avenue H actually do?
Avenue H will provide a technological interface between employers, brokers/agents, insurers, and employees. The end result is that employees have the necessary information and purchasing power to make an informed health insurance choice. Employers benefit due to the defined contribution nature of the system and the ease of implementation. Insurers receive all enrollment information electronically in a standard format.
In addition to supporting the defined contribution market, Avenue H also supports consumer choice in the traditional individual and small group markets.
9. Where will Avenue H take us in the future?
It is important to remember that a robust marketplace will be more than just a place to "apply for health insurance". While the initial focus of setting up an on-line marketplace is to establish a stable defined contribution market, this is just the first stepping stone in the process toward a consumer-oriented system.
In order to facilitate consumer choice in the long run, it is clear that Avenue H must provide information relevant to not only health care financing but also quality and transparency of the health care system. Avenue H will also evolve into a tool for patients to make better decisions about their health and health care by providing access to information about cost and quality and health and wellness.
The value of Avenue H is the sum of all its parts and each "part" is essential to the long term success of the portal and to the success of Health System Reform.
As part of Utah's approach to health system reform, we are increasing consumer information, choice, and power in the health insurance market by creating defined contribution arrangements.