Health care exchanges provide an online marketplace where consumers can shop, compare and purchase plans. Exchanges must orchestrate numerous processes that communicate digital information among internal system components and between external partners, including: consumers, issuers, goverment agencies, financial institutions, developers and others.
The health care industry has long used Electronic Data Interchange (EDI) to transmit information and conduct electronic transactions with partners. Passage of the Affordable Care Act (ACA) — accompanied by arrival of public Health Benefit Exchanges (HBXs) — both realigned and extended these electronic data communication requirements. The HBXs now function as the system-of-record, collecting and distributing enrollment, plan selection and (sometimes) premium payment information.