The last few months of news have not been kind to the Affordable Care Act, also known as Obamacare. Implementation of the Exchange has been smooth in Washington state compared with the badly flawed rollout of healthcare.gov nationally. But, regardless of how well the ACA may be implemented in Washington state, confusion and questions from employers and consumers is one of the biggest trends we see at Premera Blue Cross.

The ACA is far from a perfect law, but it’s the reality of health care today. We’re committed to its success as we serve customers and members in the individual and small group markets across the state.

The overwhelming majority of recent stories on the ACA have been focused on changes and impacts for consumers purchasing individual plans. While attention of changes in the market are focused on the initial open enrollment period from Oct. 1 to March 31, we expect the small employer market to evolve throughout 2014 as groups renew and explore their options under the federal law.

We know from experience that as employers consider their options, costs and affordability will be top of mind. We’ve taken a number of steps in introducing products for small employers that comply with the ACA while offering some of the lowest rates across the state.

One step includes creating a network of hospitals and clinics to provide our members in the individual and small-group markets access to high quality care at a more affordable price. That network originally included the Rockwood Health System as its foundation. We’re happy to have just recently announced that Providence Health & Services, in Spokane, is part of that network now as well, providing access to two high-quality health care systems while holding our affordable, highly competitive rates steady.

Another major opportunity for small employers to save money on their employees’ health care coverage every month is participating in a voluntary wellness incentive program that is embedded into all Premera small group plans. This offering lowers health care premiums for businesses when employees participate in two simple wellness activities, a biometric screening and a health assessment—the results of which are only available to the employee, not the employer. Employers receive a 7.5 percent reduction in participating employees’ monthly premiums, while those employees receive a $100 gift card.

These examples of provider networks in the era of the ACA and the creation of a first-of-its-kind small employer wellness program showcases how the world of health care is changing for everyone. 

Consumers are more engaged in the cost of coverage and its drivers. There is a new focus in how health care is delivered and paid for that is focused on controlling costs and paying for quality instead of relying on an inefficient fee-for-service system. Employers are exploring their options, including new plan designs, and even private exchanges. And all stakeholders in health care—hospitals, doctors, nurses, health plans, regulators, employers, and consumers—are affected in some way.

Our view at Premera is that while the ACA has accelerated some of the changes occurring in the health care system, the jury is still out on the success of the law.

Its impacts will take time to assess, including after the initial open enrollment period for individual customers. The ultimate success of the federal exchange is a huge issue nationally, while locally the issue is more how to make our state’s comparatively effective exchange better, without creating unintended consequences that are a constant consideration with complex government programs.

All of this is happening in an election year, where the ACA will likely be a hot topic in a number of congressional and state legislative races. That’s a reality we have to deal with, but the outcomes are unpredictable, so our focus remains on implementing the ACA as smoothly as possible for our customers in a time of tremendous change for everyone in the health care system.

Bill Akers is vice president for health care delivery systems and general manager for Eastern Washington at Premera Blue Cross.