Evaluating Your Organization’s Operational Readiness for Health Exchange Marketplaces


HFMA: Maine Chapter Newsletter

As the first new major federal healthcare program implemented since the introduction of Medicare and Medicaid in 1965, health exchange marketplaces promise to bring numerous strategic and operational challenges for even the savviest providers. Although some providers have modeled the potential implications of health exchange product contracts, few organizations have thought through the operational realities of accepting new health exchange patients and payment rates. This article explores the four general categories of readiness requirements aimed at preparing providers for the changes caused by health exchange marketplaces – financial impact, organizational operations, clinical operations, and educational opportunities. By surveying the issues specific to your market, you can minimize the potential stumbling blocks and ensure that the health exchange marketplace rollout goes smoothly for your organization.

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