Is the HIX the Right Fix?

Rene Letourneau, for HealthLeaders Media , August 13, 2013
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This article appears in the July/August issue of HealthLeaders magazine.

Editor's note: This piece is adapted from René Letourneau's July 1 online column, "Providers May Be Hit by Health Insurance Exchanges." To read her weekly Armchair Finance columns, visit

There are different pieces to the uncertainty around health insurance exchanges. One is timeliness: The U.S. Government Accountability Office recently released two reports that cast doubt on whether the HIX established under the Patient Protection and Affordable Care Act will be up and running in time for the Oct. 1, 2013, enrollment period. And just last month, the Obama administration announced that it would delay until January 1, 2015, a key provision of PPACA that requires midsize and large employers to provide health insurance for their workers or pay a fine, which could have implications for the exchanges.

But perhaps the bigger uncertainty surrounding the exchanges—both state- and federally operated—is whether they will benefit hospitals and health systems financially. With more people having coverage through the insurance they can purchase from the exchanges, it would appear on the surface that the new marketplace will be good for providers. Yet I've spoken recently with two CFOs from very different healthcare providers who are unconvinced that the exchanges will be a net positive for their organizations, regardless of the exact date of implementation.

Mark Bogen, senior vice president and CFO at South Nassau Communities Hospital, a 435-bed not-for-profit teaching hospital in Oceanside, N.Y., expects the New York state–run exchange to be online by Oct. 1, with lots of participation from payers and providers because of the political support the program is receiving from the governor's office.

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