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Breaking: Massachusetts Granted Permission To Operate State-Based Health Exchange

Breaking: Massachusetts Granted Permission To Operate State-Based Health Exchange

August 8, 2014

This great news just in from the state. We're very pleased, because it means Massachusetts can proceed with its own affordability assistance and other state programs that will meet the needs of our consumers:

Commonwealth of Massachusetts
Press Release

Decision means Massachusetts will remain a State-based Marketplace, FFM no longer needed as a contingency plan

BOSTON – Friday, August 8, 2014 – Maydad Cohen, Special Assistant to the Governor for Project Delivery, today announced that the Patrick Administration has decided, with support from the Centers for Medicare and Medicaid Services (CMS), to use hCentive the state’s Health Insurance Exchange (HIX).

By proving hCentive’s IT readiness for Fall 2014 Open Enrollment, the Commonwealth can remain a state-based Marketplace, stop its contingency planning to join the Federally Facilitated Marketplace (FFM) and focus exclusively on expanding access to affordable, quality health insurance through hCentive.

“This decision means that the unique policies and programs that make us a national leader on access and affordability will continue and it provides the market the certainty it needs about our path forward,” said Cohen. “Our team, Connector, MassHealth, ITD, Optum, hCentive and Dell, moved mountains to get here and CMS has been an indispensable partner. I am grateful for all of the hard work but know some of the biggest lifts – especially around consumer outreach and member transition – are in front of us. We will need the coalition of insurers, providers and consumer advocates who helped us come this far to continue contributing their best thinking and efforts to the project.”

The Commonwealth front-loaded core technology into early releases of the hCentive software in order to demonstrate key functionality to CMS and to be in a position to conduct rigorous system testing in advance of go-live on November 15, 2014. As a result, the state is poised to offer consumers a streamlined, single-point-of-entry shopping experience this fall and a solution that meets – and in some instances exceeds – current FFM Exchange capabilities.

Unlike the FFM, hCentive now supports State Wrap, the unique Massachusetts program that offers additional state premium assistance to help make health insurance more affordable for thousands of residents. The State Wrap program is one of the main drivers behind the Commonwealth’s nation-leading 97% rate of insurance.

Additionally, hCentive has automated its interface with Dell, the Health Connector’s billing and enrollment vendor responsible for conducting transactions between insurers and consumers. Health plans and consumer advocates cited this connection and State Wrap as their top concerns with migrating to the FFM. The project’s IT team needed to create and implement new systems to modify the hCentive software to support these Massachusetts-specific consumer affordability and back-office functions.

“Today is an important milestone for the Massachusetts Connector and we are pleased to continue to work with them to ensure that consumers have access to affordable, quality health care,” said Andrew Dreyfus, Blue Cross Blue Shield of Massachusetts President and CEO.

“We are pleased with today's decision as we have believed that a state-based solution offers the best approach for Massachusetts residents given the unique offerings to supplement coverage, such as the State Wrap, that are available only in our state and would not be possible through the FFM,” said Lora Pellegrini, President & CEO of the Massachusetts Association of Health Plans. “We appreciate the collaborative and transparent process the Administration and Connector have undertaken with us and we commend them for the significant progress that has enabled the Commonwealth to reach today's decision.”

"Health Care For All thanks and congratulates the leaders and team members whose hard work we celebrate today including Sarah Iselin, Maydad Cohen, Kristin Thorn and Jean Yang who have worked tirelessly to preserve the Massachusetts state-based Exchange,” said Amy Whitcomb Slemmer, Executive Director of Health Care for All, “We are excited to be working on a single track. Reports of hCentive’s capabilities are very encouraging and it will be a pleasure to turn our attention to making sure that the upcoming Open Enrollment period is a success.”

Following the Administration’s May 5, 2014 dual track plan announcement, the Health Connector began to hold twice-weekly briefings with executive and IT health plan leadership. The group has met 48 times since May, increasing collaboration and giving insurers a direct sightline into dual track implementation and immediate access to leadership from the Commonwealth and project vendors Optum, hCentive and Dell.

People currently in extended or temporary coverage through the Health Connector and MassHealth, along with those in Qualified Health Plans through the Health Connector, will need to complete new applications this fall in order to transition into ACA plans starting in 2015. In order to prepare for the significant task of reaching hundreds of thousands of people these consumers, Cohen will use the insurer meeting model for consumer advocates and state and vendor leadership. Now that the project has moved to a single track, consumer outreach and member transition will take center stage as the Health Connector and MassHealth seek to implement successful strategies to encourage existing members to submit new applications and attract the remaining uninsured to sign-up during the upcoming Open Enrollment period.

“We at Ecu-Health Care are thrilled with the news that the hCentive platform will be ready to be implemented for the upcoming Open Enrollment period,” said Charles Joffe-Halpern, the Executive Director of Ecu-Care Health, Inc., in North Adams, one of the Health Connector’s Navigator organizations that supports enrollment in local communities. “We are certainly aware the state has dedicated itself to the task of ensuring that this Open Enrollment period is successful, along with the enrollment process going forward afterwards. It is a pleasure to partner with the Patrick Administration to make health reform successful in western Massachusetts and throughout the Commonwealth.” 

“We look forward to continuing to help all Massachusetts residents obtain high-quality, affordable health care coverage,” said John Santelli, Chief Information Officer, Optum.

“We could not be more pleased with the confidence CMS and the state have in our solution. We understand that the goal is to provide health insurance coverage to as many residents of the Commonwealth as possible and we are confident, that come this fall, our solution will help the state meet that goal,” said Sanjay Singh, CEO of hCentive.

The Health Connector Board of Directors meets next Thursday, August 14, 2014 (9:00 AM, One Ashburton Place, 21st Floor, Boston), where a demo of hCentive’s new functionality will be presented.