Deloitte came up big again in the health insurance exchange (HIX) market, recently winning a $105 million contract for Rhode Island’s Unified Health Infrastructure Project. The project encompasses the state-based HIX and integrated eligibility for Medicaid and other human services programs. Neighbor-state Connecticut previously contracted with Deloitte for both its exchange and eligibility system, with a contract valued at $42.5 million.

Rhode Island estimates that nearly 200,000 new and existing Medicaid customers will use the exchange to sign up for insurance. The eligibility engine will ultimately replace the current eligibility-determination system that supports Medicaid, the Children’s Health Insurance Program (CHIP), the Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF), child care, general public assistance, and state supplemental payments. Like most eligibility revamps across the states, Rhode Island will split the project into two phases, with the human services aspect migrated over by December 31, 2015.

Look in February for a new report from our analysts on the HIX market. In the meantime, Deltek’s Health Insurance Exchange Vertical Profile Application provides expanded market coverage, giving vendors a competitive edge by extensively tracking states’ progress in HIX implementation. Non-subscribers can gain access with a GovWin IQ free trial. As always, be sure to follow Deltek’s Health Care and Social Services Team on Twitter @GovWin_HHS, or connect with us through LinkedIN.

December was a relatively quiet end to a rather noisy 2012, which saw the Supreme Court ruling on the Affordable Care Act and the reelection of President Barack Obama, solidifying health reform. The individual mandate was ruled constitutional, while Medicaid expansion was left to the states to decide their fate. As states begin to conduct analysis on the fiscal impact of expansion, few states are unexpectedly finding Medicaid expansion will keep them in the black, not the red. Two of these states are Arkansas and Oklahoma. Arkansas estimates Medicaid expansion could save the state $372 million from state fiscal year (SFY) 2014-2021, or about $53 million annually. Oklahoma estimates expansion could save the state nearly $48 million annually.

In terms of health insurance exchange (HIX) development (recently rebranded as “health insurance marketplaces”), states were given until December 14, 2012, to submit their blueprint to the federal government. The deadline for a decision to partner with the feds is due in February. To date, the federal government has spent $2.2 billion to help states establish their health insurance exchanges. Progress was also made in 2012 in the area of interoperability, as integrated eligibility systems took off, syncing health and human services IT systems.

Procurement activity in December included:

·         The Kentucky Cabinet for Health and Family Services (CHFS) released a request for information (RFI) for quality health information (QHI) framework. The focus of the RFI is the assessment of recommendations for technology standards and approaches for the development of an interoperable, scalable and easily adaptable cross-sector technology framework.

·         The Colorado Department of Human Services, Office of Long Term Care, Division of Regional Center Operations (DRCO), in cooperation with the Governor's Office of Information Technology, released an RFI on December 7, for electronic health record, clinical, and accounting system services.

·         The Tennessee Department of Labor and Workforce Development released a request for proposals (RFP) for the Southeast Consortium to design, develop and implement a multi-state unemployment insurance benefits system for Tennessee, North Carolina, South Carolina and Georgia.

·         The Connecticut Health Insurance Exchange released an RFP for a small business health options program (SHOP) on December 17. Proposals are due by 5 p.m. EST on January 22, 2013.

·         The Kentucky Finance and Administration Cabinet, on behalf of the Department for Income Support/Child Support Enforcement (DIS/CSE), released an RFP for child support new hire and employer data.

·         The Washington Department of Early Learning released an RFP on December 19, for project management, analysis and requirements for child care subsidy electronic attendance record tracking and payment system services.

·         The Mississippi Information Technology Services released an RFP a for patient information management system. Proposals are due January 24 by 3 p.m. CST.

·         The South Carolina Department of Health and Human Services awarded its member management technology framework to IBM on December 27, in the amount of $22,779,268.

·         The District of Columbia Department of Human Services awarded its access system (DCAS) to Infosys Public. The contract will develop the district’s HIX and is valued at $49,465,158.

Since the health insurance marketplace will continue to be a hot topic as we move into 2013, be sure to brush up on your knowledge with Deltek’s Health Insurance Exchange Vertical Profile Application. The expanded coverage gives vendors a competitive edge by extensively tracking states’ progress in HIX implementation. Non-subscribers can gain access with a GovWin IQ free trial.

As always, be sure to follow Deltek’s Health Care and Social Services Team on Twitter @GovWin_HHS, or connect with us through LinkedIN.

The District of Columbia awarded a contract to Infosys Public Services at the end of December for the design, development, and implementation of its health benefit exchange (HBX). The contract, valued at $49.5 million, ensures the Department of Health Care Finance an interoperable framework that will be scalable in the future for planned connectivity with the national health insurance exchange (HIX) and other health information exchange (HIE) networks. The award runs for one year, and could be worth up to $86 million if options are exercised. Dell, HCL Technologies, and Deloitte all submitted bids as well for the project.

D.C. has received nearly $80 million in federal funding so far for the development of its HBX. The district is also working with Accenture on the design of the HBX system. A call center is next on the list of procurements. The HBX call center will assist in eligibility, enrollment, financial management, appeals, technical support, and the small business health options (SHOP).

Look in February for a new report from our analysts on the HIX market. In the meantime, Deltek’s Health Insurance Exchange Vertical Profile Application provides expanded market coverage, giving vendors a competitive edge by extensively tracking states’ progress in HIX implementation. Non-subscribers can gain access with a GovWin IQ free trial. As always, be sure to follow Deltek’s Health Care and Social Services Team on Twitter @GovWin_HHS, or connect with us through LinkedIN.

Last week, the state of Vermont signed a $36 million contract with CGI to design, develop, and implement its health insurance exchange (HIX), Vermont Health Connect. The Vermont Health Connect is one of the many major health and human services’ IT projects underway in the state. These projects include the replacement of Vermont’s Medicaid management information system and a new integrated eligibility system. CGI is also the vendor tasked with developing the federal HIX, expected to go live in October 2013. Vermont hopes to leverage other states’ development experiences, as CGI holds state exchange contracts in Hawaii, Colorado, and Massachusetts. The state has claimed that it tried to contract with a different vendor before choosing CGI, but that the first vendor would not accept the level of liability written into the contract (the state has had three or four major IT projects go belly-up in the past few years).

Vermont did not use the standard request for proposals (RFP) route when choosing CGI, however. Under guidance from the feds, the state decided to use a transitive procurement process (or piggy-back contract), meaning it analyzed existing contracts and bids in other states to find a vendor. Nearby-neighbor Connecticut also ditched the traditional procurement process for its HIX, instead issuing a sole-source contract to Deloitte for both the development of its exchange and its new integrated eligibility system. The contract is worth a total of $42.6 million, and will run until 2014. The state had already engaged with Deloitte in the past, and utilized previous work history as one of the reasons for utilizing its services.

With quick decisions and rapid procurements to hit the looming 2014 deadline, it will be interesting to watch which states will be able to switch on and which systems might keep citizens waiting to connect. Only time will tell if rushing to implement a state-based exchange will be worth it, as states can make the switch from a federal exchange in the future. States like Vermont, which are redoing their entire health and human delivery systems, could either be the innovative success stories later mimicked across the country, or be splashed across newspaper headlines with delayed system implementation or overrun costs.

Be sure to also check out Deltek’s brand new Health Insurance Exchange Vertical Profile Application. The expanded coverage gives vendors a competitive edge by extensively tracking states’ progress in HIX implementation. As always, be sure to follow Deltek’s Health Care and Social Services Team on Twitter @GovWin_HHS, or connect with us through LinkedIN.

The Vermont Agency of Human Services (AHS) released a request for proposals (RFP) today for its new integrated eligibility system (IES), one part of Vermont’s Health Information Technology Plan (VHITP) aimed at modernizing the state’s health technology and business processes. AHS submitted an Implementation Advanced Planning Document (IAPD) in April, calling the document the “first of its kind,” as it serves as an umbrella Advanced Planning Document that covers the common IT shared services and tools, including the health benefit exchange, eligibility and enrollment systems, financial management systems, public health information, health data, health surveillance technologies, and Medicaid enterprise solution architecture.

Medicaid Information Technology Architecture (MITA) standards are a big part of the project, as the state requested enhanced federal funding to retool its health enterprise. Vermont plans to utilize service-oriented architecture (SOA) as much as possible, and is looking to implement an enterprise master person index (EMPI) to “clean” patient records down to a single, holistic view of a person/family and its needs.

The state estimates the total value of all projects to near $375 million, with the new Medicaid system costing $125 million, the eligibility and enrollment system costing $22 million, and the HIX totaling $20 million. Deltek has long written about the need for states to break down their IT silos, but as Vermont pointed out, this may be the first instance that a state has broken down its APD silos. This project rewires the network of Vermont’s health systems and gets as close to real-time information management as possible. This project will require immense coordination and communication, as it runs the gamut of departments (both state and federal) and programs. It will be interesting to see if other states adopt this new APD method when attempting to create true health and human services delivery systems.

“The law is the law, whether you like it or not. It doesn’t matter if you like it. It’s the damn law.” 

Many governors and insurance department heads awoke this morning with Mississippi Insurance Commissioner Mike Chaney’s words ringing true after last night’s reelection of President Obama. States holding out for a change in federal leadership on health reform now have fast decisions to make. The numbers are staggering for Mississippi: one in five people lack health insurance; it leads the “States of Misery” in health, poverty, and crime statistics; and has the highest level of obesity in the country at 34.9 percent. Despite Governor Phil Bryant calling for a stall on Obamacare, Chaney is creating a health insurance exchange (HIX) under his own authority, and with an Obama victory, plans to file a blueprint on November 16, unless he receives a court order from “some idiot out there trying to stop me.” Though his words could be considered somewhat crude, the logic behind them is solid: State’s ignoring the law does not mean the law disappears, and these words come from someone against Obamacare.

Exit polls from last night showed that roughly a third of voters listed health care as an important factor in their vote. Despite Obama being reelected, several states had voter efforts approved to limit Obamacare, including Missouri, Alabama, Wyoming, Florida, and Montana. Although some states were opposed to health care reform from the beginning, those that started the exchange planning process are finding that they have run out of time, and will likely adopt the federal exchange until a state-based exchange can be built.

With a scramble to hit the 2014 deadline, procurement strategies may be expedited, like Connecticut’s sole-source award to Deloitte for both its HIX and its integrated eligibility system. Expect to see even the early innovators relying heavily on federal hub resources for the first enrollment period. As Chaney pointed out, there is no more waiting; the Affordable Care Act is the law. Deltek will be watching as blueprints are submitted to the Center for Consumer Information and Insurance Oversight by November 16, 2012, and how federal-state relationships play out as the nation addresses health care reform.

As always, be sure to follow Deltek’s Health Care and Social Services Team on Twitter @GovWin_HHS, or connect with us through LinkedIN. Stay tuned for more information around a new Health Insurance Exchange Vertical Profile addition in the near future!