KTP Advisors Launches PHIX Market Map

traditionalKTP Advisors™ has launched the first comprehensive, unbiased and completely independent Market Map and comparative data service of private healthcare insurance exchanges (PHIX) and marketplaces for employers, trade associations, and insurance brokers who don’t have the time to shop through different private exchange solutions.

The company, which has no exchange nor is it affiliated with one, has created a very robust set of criteria, along with site visits, to evaluate each exchange. In addition, KTP has created a “market map” which outlines the more than 170 distinct PHIXs currently available. The research presented on this map includes a partial list of the almost 150 comparative data points KTP has researched and gathering on these exchanges and marketplaces.  In addition to complex comparative analyses, KTP can run competitive, national Request for Proposals (RFPs) and negotiate contract terms as well for organizations seeking to partner with a private exchange.

In addition to basic operational, product and pricing factors, there are even more complex considerations that KTP assesses before employers sign onto an exchange, said Mike Martocci, KTP’s private healthcare exchange strategy leader. “The back-end technology, which powers the different exchanges, can be incredibly intricate. The software platform is a part that an employer and employees never see, yet exchange owners as well as corporate human resource departments and insurance brokers and carriers will have to deal with every day.“

Another standard that demands close scrutiny is on who owns the exchange and how the exchange is compensated. “Many large, traditional human resource consulting firms have launched their own private exchanges, which are generating significant commissions for the advisors as well as administrative fees,” explained Mark Whitcher, KTP’s president and CEO. “Evaluating private exchanges and all of the options in a brand new market is extremely difficult and it’s essential to know the right questions to ask. There are multiple hidden revenue sources in the exchange market, which make an objective appraisal of the possible solutions difficult, if not impossible, when one of those exchanges under consideration is your own.  There are legal and fiduciary concerns for employers as well.”

Deb Jacobson, a PHIX senior consultant at KTP and former Board Chair at Blue Cross Blue Shield of RI, added, “Offering independent insight into technically sophisticated health benefit issues is at the core of KTP’s expertise, and our private exchange services are no different.” We believe our PHIX performance standards and data metrics will establish the benchmark for the industry.”

For a more in-depth analysis of the exchanges including, financial information, service information, product information, consumer decision support tools, exchange strategy, sales and marketing techniques, data and security obligations, etc., please contact Nicole Allen at nallen@ktpadvisors.com.

KTP Advisors Opens West Coast Office


KTP Advisors Opens West Coast Office

Newport BeachNewport, RI – October 22, 2014 – KTP Advisors, a specialty advisory firm in retiree health benefits, private exchange comparisons and pharmacy benefits for active employees, has opened a West Coast office in Newport Beach, California. This new office allows the firm to more effectively provide services to its clients located in the western states.

“We look forward to expanding our presence to the West Coast. Having an office there will enable us to better serve and support our clients in the region.” said Mark Whitcher, KTP’s President & CEO.

KTP’s new office is located at:  4350 Von Karman Avenue, Suite 100, Newport Beach, CA 92660.


KTP Advisors Interviewed on HealthCare Consumerism Radio

imagesTwo senior consultants of KTP Advisors, Deb Jacobson and Mike Martocci, were recently interviewed by Brent Macy and Doug Field of The Institute for HealthCare Consumerism, on America’s Web Radio: HealthCare Consumerism. In this episode, Deb and Mike discuss KTP’s new private healthcare exchange advisory service.

In the interview, KTP’s consultants acknowledged that there are approximately 170 different private healthcare exchanges available in the United States today. The private healthcare exchange market is very complex and each exchange or marketplace is different. KTP Advisors is constantly performing extensive research to provide a completely unbiased and independent evaluation of the private healthcare exchanges and marketplaces that have emerged. KTP does not have their own exchange and is not affiliated with any.

Deb and Mike outline three specific take away points from their interview:

  • KTP Advisors is going to evaluate exchanges in an absolutely objective and unbiased way. They take a customized approach to evaluating the exchanges, by looking at exchanges from the customer’s perspective in order to prioritize the client’s goals.
  • KTP Advisors is independent and objective of any brokers, carriers, or exchange providers.
  • KTP Advisors believes that private healthcare exchanges can become important levers for addressing the effectiveness and cost of health benefits for employees.

For the full interview on HealthCare Consumerism Radio, please click here.


Walmart Enters the HealthCare Marketplace

Walmart signBack in September 2013, Steve Kraus, vice president of Bessemer Venture Partners, which has an undisclosed stake in private-exchange operator Liazon, made a prediction about  the future of private exchanges. “I actually don’t rule out a surprise entry” into the private-exchange business, Kraus said in an interview with CNBC. He said “Companies that already sell ‘books, electronics, food on-line,’ could view private exchange insurance as big potential opportunity that would leverage their existing skills of offering customers products with competing price points in an attractive, easy-to-navigate Web platform.”

One year later, and Kraus’ predictions were right, at least for one company! Walmart, the Arkansas-based retailer, has teamed up with DirectHealth.com to launch what they are calling Healthcare Begins Here – “an in-store program designed to educate customers on health insurance options.” The partnership was said to be an easy one for both parties, as they each promote themselves as companies that “help people save money and live better.” As a result of this partnership, Walmart shoppers will be able to compare and shop for health plans with a licensed sales agent both in-store and over the phone. Customers may also utilize DirectHealth.com to compare and shop for plans without assistance.

Walmart said DirectHealth will offer access to more than 1,700 plans for customers over the age of 65, from carriers including Aetna, Cigna, Humana, UnitedHealthcare and certain Blue Cross and Blue Shield companies. For non-Medicare customers, it will offer access to “thousands of health exchange plans from more than 300 carriers.”

Private healthcare exchanges and marketplaces are growing in number. Every day there is an announcement for a new exchange or marketplace for employers and individuals to choose from.  So, what company will be next to enter the healthcare marketplace?

Please check back to KTP’s website for updates as much more information, including a comprehensive market map of the current private exchanges and marketplaces, will be released in the coming weeks.

Evaluating Private Healthcare Exchanges

due_diligence_2Since the passage of the Affordable Care Act, interest in private healthcare exchanges has exploded, and so have their numbers.  As of October 2014 there are at least 150 different private healthcare exchanges in the United States. The private healthcare exchange market is very complex and each exchange or marketplace is different. In fact, many employers remain largely unaware of the variety of solutions available today under the “private exchange” label.  So, how do employers properly evaluate all these exchanges?

Private exchanges vary from the most basic level through to more complex differences. Does the exchange target Medicare retirees, non-Medicare retirees or active employees? Is the exchange single-carrier or multi carrier? What carriers and products are available? What decision support tools are available to help consumers make decisions?

Here at KTP, we have found that while these characteristics are important and worth evaluating, there are even more complex considerations employers need to address before signing onto an exchange. For example, how does the exchange get compensated? What does the ownership of the exchange look like? How does the exchange negotiate contracts with carriers?

Another set of questions employers should address involve the technology itself that powers the different exchanges. A recent article from Employee Benefit News, “Buyer Beware: Can Your Private Exchange Deliver on the Back-End?” raises important concerns regarding the back ends of the technology system. “Benefit exchanges are incredibly complex on the back end. There are medical, dental, life and disability insurance carriers. There are reimbursement account administrators. There are payroll and HRIS platforms. There are pharmacy benefit managers. There are wellness providers. That’s the part the employee never sees, but that exchange owners — corporate HR departments, and insurance brokers or carriers — will have to deal with every day.” When evaluating exchanges, employers need to consider more than just their employees.

With the market this fragmented it is inevitable that some players will get gobbled up in the consolidation. Others will simply fade to black. Will the exchange you choose be around for the long haul? Will it be acquired by a buyer whose long term strategy and commitment are contrary to your own?

When vetting and evaluating private exchanges, employers need to be sure to cover all of their bases. To properly evaluate all the players in the private healthcare exchange market, it is important to get an independent perspective and know the right questions to ask.

KTP Advisors is constantly performing extensive research to provide a completely unbiased and independent evaluation of the private healthcare exchanges and marketplaces that have emerged. KTP does not have their own exchange and is not affiliated with any.

For the full EBN article, please click here.