1. Exchanges: The Large Employer Perspective Purchaser Bill Kramer, Executive Director for National Health Policy Pacific Business Group on Health SHOP Webinar February 22, 2012

2. ©PBGH 20112 Key Issues Why do large employers care about Exchanges? Will large employers use the Exchanges? What factors will they use in making these decisions?

3. ©PBGH 20113 Why Do Large Employers Care about Exchanges? The Exchange can be a potential purchasing ally Opportunity to align the purchasing strategies of Exchanges with those of large employers  consistent signal to health plans and providers Employers want the Exchanges to work They may want to use the Exchanges for some or all of their employees in the future.

4. ©PBGH 20114 Will large employers use the Exchanges? 2014: many are considering use for pre-Medicare retirees and part-time workers 2017 and beyond: some may use for all employees, but...

5. ©PBGH 20115 Uncertainties  Economy/ labor market  Viability of the Exchanges  Future of the ACA

6. ©PBGH 20116 Internal Factors  Costs  HR strategy  Competition

7. ©PBGH 20117 The Bottom Line It is much too early to predict whether and how large employers will use the exchanges. What is clear, however, is that the Affordable Care Act and the planning for the exchanges have given a jolt to the thinking of many large employers. After decades of frustration with attempts to improve the quality and affordability of the health benefits offered to employees, many large employers now see the possibility of new options. This developing awareness is allowing them to rethink their basic human resources strategies and consider alternatives to traditional employee health benefits.

8. ©PBGH 20118 The Pacific Business Group on Health The Pacific Business Group on Health helps purchasers improve the quality of health care and limit health care cost increases. Our 50 members spend 12 billion dollars annually to provide health care coverage to more than three million employees, retirees and dependents in California alone.

9. ©PBGH 20119 PBGH Members

10. ©PBGH 201110 For more information please visit: Learn more about the Pacific Business Group on Health and our effort to improve the quality of health care while moderating costs at www.pbgh.orgwww.pbgh.org Learn more about the Consumer Purchaser Disclosure Project’s work to bring employers, consumers and labor organizations together to improve access to publicly reported health care performance information at www.healthcaredisclosure.org www.healthcaredisclosure.org Bill Kramer: wkramer@pbgh.orgwkramer@pbgh.org