Six Months to Go –– Will the
Health Insurance Exchanges Be Ready on Time? Survey: Health Plan Execs Don't
Think So
<>As the Obama administration continues its top
secret effort to build federal insurance exchanges in about 34 states while 16
states are doing it on their own, that continues to be the big
question.
HHS is using IT consulting firm CGI for much of the work on the
exchanges and the federal data hub. CGI has their plate full since they are not
only working on the federal exchange but also doing work for the state exchanges
in at least Colorado, Vermont, and Hawaii.
Earlier this month, the Senate
Finance Committee held an oversight hearing. The Obama guy in charge of exchange
development testified before them. I thought it was notable that it was the
Democrats who expressed the greatest concern, and frustration, over senators not
getting a clear idea for just where the administration is toward the goal of
launching the new health insurance exchanges on October 1.
I thought the
following Reuters quote was telling;
I am absolutely confident that every state will have
an exchange that will be functioning and ready, said Gary Cohen [HHS executive
in charge of the effort], who declined to elaborate on the number and identity
of states that could be in for difficulties."
He wouldn't elaborate
on just where there might be problems? Why? Why does the administration have to
be so secretive?
This lack of transparency has the health insurance
industry––the people the feds are going to have to connect with––very
worried.
In early February, information technology consultant Edifecs,
which provides health care software services to health plans, hospitals, and
other organizations, held a "Compliance Summit" for 125 executives from
hospitals, clearing houses, state health insurance exchanges, and health plans.
The audience included executives from 34 different health plans. I gave the
conference's opening keynote speech.
These are the industry executives that the state
and federal exchanges are working with day-to-day. So, if
you want to get the perspective from those in the trenches with the state and
federal health insurance exchanges (HIXs) on whether they'll be ready, this is a
pretty good group to ask.
Edifecs did just that using interactive software in the room
to get the audience's response to a number of questions.
The input from
the marketplace doesn't inspire confidence:
- The vast majority of those who attended are planning to participate in the
new health insurance exchanges.
- They are worried that, with the feds and states getting such a late start
in detailing requirements and with so little time left, that their own
organizations can be ready.
- They are also worried because the information they are getting from the
health insurance exchanges in order to do their share of the work is poor, to
very poor.
- They are not optimistic that the government-run exchanges will be ready on
time.
- Almost all of those surveyed are concerned that the exchanges have not
involved them as users in gaining input from the industry––traditionally a
very bad sign in system development.
- And, the executives are very concerned about being able to reconcile
billing and eligibility information from the exchanges.
From the
Edifecs survey:
