This post originally appeared in NASHCO’s newsletter, News from NASHCO, on July 17, 2015. To read the full newsletter, please click here.
Two years have come and gone since several New Jersey executives crafted a business plan which would eventually become New Jersey’s first and only healthcare CO-OP, Health Republic Insurance of New Jersey (HRINJ). The dream was big; the road not taken paved with high ideals. After all, they were entering an arena with health insurance giants to their left and right, in a state that had seen no new player in the insurance industry for many years. But the mission was clear. Take the intent and purpose of the Affordable Care Act (ACA) and make it resonate for New Jersey residents who did not have healthcare insurance, and those who could not previously get affordable healthcare coverage.
The result was better than most could have anticipated. After the second enrollment period, the membership numbers were impressive – a climb from 4,000 to almost 60,000 members. But there was a secret formula that was unmistakably put in place by the CO-OP’s leadership to make that happen.
Listening is the Key
Knowing clearly that innovation would take center stage of every decision, listening to members became a top priority. Because living the mission of a CO-OP was so important to HRINJ, understanding member needs defined the decisions that were made. Competitive rates, more coverage options (now 21 plans), and a multi-state provider network were requested. HRINJ responded in earnest, giving members what they needed and adding open access so no members would ever need referrals to see specialists.
The company also built relationships with many external groups, including Federally Qualified Health Centers, or FQHCs. These health centers throughout the state serve many people who are uninsured, but also those who have private insurance. Two years ago, HRINJ started cultivating this relationship knowing that the health centers were trying to expand access to a broader spectrum of people under the ACA. Now, the company is contracted with most of NJ’s FQHCs through its network partner, QualCare. It has a good, solid working relationship with these community-based centers that now serve many of HRINJ’s enrollees.
Good Health is the Outcome
Since HRINJ endeavors to promote a culture of wellness, the CO-OP rolled out several new and innovative programs this year. HRINJ was the first health insurer in the state of New Jersey to offer its members telemedicine. Through its partner Teladoc, HRINJ delivers around-the-clock access to healthcare providers via telephone and web at no additional cost to the member. No longer would members be without a provider in the late-night hours or on weekends, or left having to deal with the considerable cost and inconvenience of the local emergency room. Simply Smoke-Less™, HRINJ’s smoking cessation/harm reduction program, seeks to help smokers not only quit smoking through consultations with physicians and no-cost medications, but also to give members the resources they need to cut down gradually at their own pace. The expansion of this benefit to address tobacco harm reduction is not only comprehensive, but grants members multiple avenues for smoking cessation.
This program is also offered at zero out-of-pocket cost to members.
Making it Easy for Members
Recognizing that health insurance is still a labyrinth for many to navigate, HRINJ initiated Member Orientation events throughout the state as part of its robust outreach and education program so each member could have the opportunity to ask questions in person and come away with a greater understanding of the plan they chose. Simply making the sale and leaving members to fend off the Minotaur on their own is not an option for the CO-OP. Also, in an effort to give members a quick, easy and convenient way to access doctors and other healthcare providers in the network, HRINJ has introduced a completely redesigned provider search tool. This decision support tool offers users a clean and modern interface, plus directions to any doctor, and the ability to do side-by-side comparison of providers in just a few clicks.
Members who visit CVS/pharmacy also have a number of convenient perks. Each HRINJ member receives 20 percent savings on thousands of CVS/pharmacy brand health products. And, starting later this year members will have the ability to pay their HRINJ premiums right at any register at their local CVS/pharmacy.
CVS/pharmacy and hundreds of other pharmacies offer HRINJ members a variety of common vaccinations at no cost. Members can walk into participating pharmacies with no appointment, present their ID card and receive important vaccinations – like the flu shot – for no out-of-pocket cost.
HRINJ’s strong growth in its second year signaled a bright start for the young CO-OP. Listening to the voice of its membership, and ensuring members have an understanding of their benefits while encouraging them to stay well will continue to be HRINJ’s differentiators in the marketplace.