Connector Board Meeting Report 10/9/14
(Note: we're a bit behind in our blogging, but as the Massachusetts health care blog of record, we want to catch up with a few items. Also see our previous item, Why the Mass Health Connector Website Will Work.)
Last Thursday, Oct. 9, the Health Connector Board met to discuss:
- Small Business Service Bureau Contract Extension
- Outreach and Communications Plans for Open Enrollment
- HIX (Health Insurance Exchange) Project Update
Materials from the meeting are available at www.mahealthconnector.org (Go to Policy Center - Leadership - Board Meetings), with the main presentations available to downoad here on outreach and education activities and the HIX update. Keep on clicking on for our full report.
Before diving into the agenda, Executive Director Jean Yang announced the new actuary representative on the Board - John Bertko (state release with bio here). Bertko is an independent actuarial consultant, currently serving as the Chief Actuary for Covered California (CA’s state-based marketplace). He replaces Ian Duncan on the Board.
Yang also announced that George Gonser, the health insurance broker representative on the Board, was recently reappointed to this position by Governor Patrick.
Small Business Service Bureau
Small Business Service Bureau (SBSB) has been providing back end operations and customer service since the launch of the Connector’s small business program in 2009. Due to last year’s IT system failure, the Connector had decided to maintain SBSB’s services to offer a stable shopping experiences for small businesses. As the Connector moves forward with its new IT system for the non-group market, they propose extending SBSB’s contract through August 2016, with the option to terminate the contract or reduce its scope should they launch a new small business IT platform sooner. One of the possibilities is to integrate the small business market into the hCentive platform. The Board voted to approve this contract extension.
Board member Jon Gruber asked if there was a timeline to implement the employee choice program - which allows businesses to offer a variety of plans to its employees - and whether there are lessons to learn from other states about implementing this program. Connector General Counsel Ed DeAngelo responded that Massachusetts received approval from the federal government to defer employee choice as a requirement in 2015, but the Commonwealth will need to implement it in 2016. John Bertko commented that many states are struggling with how to implement the employee choice program, so there are not many models to follow in this regard.
2015 Open Enrollment Outreach & Education Plans
The Health Connector and MassHealth, along with partner organizations in the community, are embarking on an extensive outreach and education campaign to ensure over 400,000 Massachusetts residents who need to act in order to stay covered do so.
Outreach and communications strategies include:
- Language support: Offering outreach materials and customer service support in a number of languages
- Direct member contact: Mailings to notify temporary MassHealth and Commonwealth Care members of coverage extensions and to alert them that they need to submit a new application to stay covered in 2015; outbound calling campaign
- Direct member support: Ability to pay premiums online through bank transfer
- Enrollment assistance & community outreach: Health Care For All will embark on a door-to-door canvassing campaign, provide enrollment assistance at Connector enrollment events, develop materials for an ethnic and local media campaign, and call HelpLine clients who need to submit a new application during open enrollment
- Navigators: Navigators are beginning to be trained on the new system and are working with the Connector on a press tour
- Public education events targeting areas where navigators are not present
- Enrollment events: Held in Boston, Springfield, Worcester and New Bedford - opportunity for people to come to a public place to get assistance filling out an application
- Media: Press events, television, online, print and radio ads
- Administration & corporate support: Spreading the word about open enrollment to state agencies and corporate entities
- Reporting: Connector and MassHealth will track members to see where they are in the process and provide support and contact as necessary to get them through the process
In addition, the Connector and MassHealth are providing trainings on the new system and policies to certified application counselors (CACs) and navigators, who provide enrollment assistance to residents at community health centers, hospitals, and community organizations.
HIX Project Update
Maydad Cohen, special assistant to Governor Patrick for project delivery, began his presentation with a prepared statement to give context to the work that has been done to ensure the hCentive IT system is functional for the beginning of open enrollment on November 15th. See our previous blog post for a link to his statement.
What hCentive can do today:
- Display a Massachusetts-specific “look and feel”
- Offer single streamlined application for Connector and MassHealth coverage, including the Health Safety Net (HSN) and Children’s Medical Security Plan (CMSP)
- Integrate with the Federal Data Services Hub and “ping” information to verify eligibility
- Make Qualified Health Plan (QHP), ConnectorCare, and MassHealth program determinations (MassHealth determinations are for 24 aid categories)
- Display 2015 plans with the appropriate rates and benefits
- Automatically transfer information to Dell to complete insurance enrollment and billing
- Allow customer service representatives (CSRs) to fill out an application “on behalf of” an applicant
Essentially, the hCentive system will allow consumers to complete eligibility, plan selection and enrollment process - an end-to-end experience:
To ensure that the system works properly for the expected amount of traffic during open enrollment, the hCentive system is undergoing rigorous testing, including:
- Functional testing: ensures the system works the way it was designed
- Integration testing: ensures that individual systems work interactively to provide a seamless user experience
- Performance testing: ensures the system functions with many concurrent users
- Defect remediation: identifies and fixes defects (a top priority at this stage in the project)
Overall, the system is delivering a 91% accuracy rate for Health Connector coverage and a 95% pass rate for MassHealth. Optum and hCentive are working to ensure that the IT system is secure and can protect the privacy of residents who use it. The Commonwealth is on track to meet two critical milestones to go live: the Authority to Connect and IRS approval to use Federal Tax Information.
With the IT development complete and testing underway, the Connector and MassHealth are focusing on staffing up to support the hundreds of thousands of residents who need to submit a new application during open enrollment. As such, the Commonwealth will have 680 customer service staff - 430 more than last year.
The Commonwealth has also undergone contingency planning and put into place an IT backstop that allows the system to go live with core functionality only and an operational backstop to enable the state to use manual workarounds through the call center and “back office.”
The Board was presented with the current budget for the IT build:
The Commonwealth also finalized its contract with Optum on September 30th - the agreement totals $93.8 million for IT costs and $8.6 million for member transition. The contract is a pay-on-delivery, at-risk contract and is included in the total of the $254 million project cost.
306,000 residents are now enrolled in temporary MassHealth coverage. The state has paid $182 million on a gross basis for this coverage for the first three months of Fiscal Year 2015 (July-September 2014). Secretary Shor has made a commitment to continue to monitor this program and provide monthly reports on its costs.
The next Connector Board meeting is scheduled for Thursday, November 13th at 9am, One Ashburton Place, 21st floor.
- Suzanne Curry