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November/December 2012 St@teside

Research Demonstrates Lessons Learned from Massachusetts' Small-Employer Program in its Health Insurance Exchange

Changes in Health Care Financing and Organization (HCFO), an initiative of the Robert Wood Johnson Foundation, released a report by grantee Mark Hall, J.D., in October, titled “Employers’ Use of Health Insurance Exchanges: Lessons from Massachusetts.” The report examines the experience of employers in Massachusetts who participated in the state’s health insurance exchange (the Connector) to purchase insurance. Mr. Hall conducted his research using qualitative methods, predominantly via document review and in-depth interviews with 37 individuals with close ties to the Connector.
The report highlights difficulties the state has had making its small-employer program financially successful, and discusses possible factors contributing to those difficulties. The factors range from issues around pricing, benefit standardization, and the increased operational complexity of the group market compared to the individual market, among others. Mr. Hall also describes the impressions and views of the Connector’s small-employer program held by employers, insurers, and brokers. He concludes the report by sharing lessons learned from the Massachusetts experience that can apply to states as they implement Small Business Health Options Program (SHOP) exchanges as part of the Affordable Care Act.
In December 2012, HCFO released a Study Snapshot of Mr. Hall’s work. This one-page document highlights the central research question of the report, the evidence uncovered during Mr. Hall’s qualitative research, and the implications of the research for other states working to design and implement SHOP exchanges.