A Healthy Blog

Massachusetts health care — wonky, with a healthy dose of reality

Testimony From Last Week's Connector Enrollment Systems Hearing (UPDATED)

Testimony From Last Week's Connector Enrollment Systems Hearing (UPDATED)

April 22, 2014

Last week the legislature's Committee on Health Care Financing held a public hearing on the issues stemming from the problems with the enrollment and eligibility systems built for the Health Connector and MassHealth.

The testimony from the administrative was offered by Secretaries John Polanowicz (Health and Human Services) and Glen Shor, (Administration and Finance); the Connector Website czar (formal title: Special Assistant to the Governor for Project Delivery) Sarah Iselin; Health Connector Executive Director Jean Yang; and MassHealth Director Kristin Thorn.

The hearing was covered by the State House New Service (link to their story from the Springfield Republican's mass.live site), and the AP (their story on Boston.com). For the record (as they say), here's the prepared testimony from each of the officials (all pdf):

1. Joint Testimony of Secretary John Polanowicz, Executive Office of Health and Human Services and Secretary Glen Shor, Executive Office for Administration and Finance

Highlight: In Massachusetts, since the ACA took full effect in January, over 230,000 more people have signed up for subsidized coverage. Working in concert with our partner agencies like the Health Connector and with thefederal Centers for Medicare and Medicaid Services, MassHealth stepped in to create our current transitional coverage solution for residents who applied for assistance with health coverage but whose applications have not yet been able to beprocessed.  We have extended this Transitional Coverage program to nearly 160,00 people.
As we continue to work toward a long-term solution that moves these individuals intotheir final ACA-compliant coverage, these 160,000 individuals can visit the doctor, gneeded prescriptions and know that they are covered in the event of a serious illness or accident.  Another 85,000 people have newly enrolled in permanent MassHealth coverage and likewise have full access to needed care.
Separately, people insured through Commonwealth Care prior to January 1 have hatheir coverage protected.  Approximately 110,000 Commonwealth Care members moved to permanent MassHealth coverage, and the Health Connector continues to keep Commonwealth Care open for the remainder under waiver extension authority secured by MassHealth.  Moreover, about 30,000 people have purchased unsubsidized, ACA-compliant plans through our Health Connector.  The Health Connector is also offering dental policies for the first time, with over 2,500 plans purchased to date by individual shoppers.

2. Testimony of Sarah Iselin, Special Assistant to the Governor for Project Delivery

Highlight: By the end of this week, Optum will finish an exhaustive assessment of the two long-term options we have been talking about with all of you, the Health Connector Board, CMS and the public for some time now: The first being to partner with a new vendor to rebuild key components of our system; or, option two, to leverage functionality – in whole or in part – of another state’s Exchange or the federal Exchange.
Optum’s deep dive into these two options will use specific evaluation criteria including: risks, costs, timeline, consumer experience, member management tools, state and federal-specific requirements and relative size and complexity of the options. Weighing the pros and cons associated with each will allow us to settle on a plan that ensures we can transition people into permanent ACA-compliant coverage as soon as possible and stand up a functional HIX by the fall, in time for the next ACA open enrollment period on November 15.  
... My colleagues and I will be traveling to Washington, D.C. in two weeks to discuss our assessment of our two long-term options. We will incorporate the feedback we receive into the path forward recommendations that will be presented to the Connector Board of Directors at the next meeting, May 8.

3. Testimony of Jean Yang, Executive Director of the Massachusetts Health Connector

Highlight: Another big topic that was discussed last time was people’s frustration with our call center, where wait time was long and people couldn’t reliably get the help they needed. To tackle the issue, we nearly quadrupled the number of customer service representatives answering phones for the Health Connector – starting with 65 customer service representatives on October 1, and reaching 239 by March 31. During Open Enrollment, we received more than half a million calls to our call center, and on March 31st alone we received more than 10,000 calls. Even with unprecedented volume, we were able to dramatically improve our wait time, from a peak average of 16 minutes in November to less than two minutes in March. To strengthen our service quality, we also increased call center staff retraining and developed better access to systems that allow call center staff to check enrollment and application status more easily.


4. Testimony of Kristin Thorn, Director of Massachusetts Medicaid

Highlight: We have significantly improved the process to move people more quickly and smoothly into this coverage. We successfully eliminated the 72,000 application backlog with the assistance of additional resources from Optum. We have also kept pace processing new applications, averaging around 1,400 paper applications per day. A new data entry tool has increased data entry productivity by more than 300%; it now takes less than 27 minutes to enter an application, down from 120 minutes. As a result, we have been able to enroll people into transitional coverage on a daily basis so that most applicants no longer have to wait long periods of time not knowing whether coverage is available to them. 

(Updated to include Sarah Iselin testimony left out originally.)