You could be living under a rock if you have yet to hear the criticism the Department of Health and Human Services (HHS) and CGI are getting on the rather flawed federal insurance exchange portal. The website has been crashing left and right, and many individuals have been unable to sign up for health plans as hearings continue to take place amongst HHS members and CGI contractors. The latest hearing seemed more of a grilling, as representatives from numerous states extensively questioned CGI’s work on the federally facilitated model. Many questions surfaced regarding the amount of testing that was done prior to its release, in addition to other elements.
CGI put much of the blame on HHS for problems with the system, claiming the department’s overall coordination of the project was poor. According to Cheryl Campbell, CGI senior vice president, CGI’s portion of the application worked as projected; however, HHS failed to conduct the extensive performance testing that was needed. She later highlighted the point that CGI had no say in when the system went live, and that it was essentially out of her company’s hands.
There is no question that the tight timelines surrounding the build out of these exchanges has much to do with post-launch problems. States were given very little guidance as to how the systems should look, which was largely due to the feds not knowing either, since the idea was so new. However, with the massive amount of issues the federal exchange is having compared to states that opted to build a system on their own – was the state-based model a better idea? The answer to this question will hopefully be answered soon, when the number of people enrolled in the federal exchange can be compared to the number enrolled in state-based exchanges. For now, Deltek thought it would be interesting to take a look at some of the work CGI has done in building out state-based exchanges, and their level of success.
The commonwealth of Massachusetts signed a $66 million contract in July 2012 with CGI for its next phase HIX and integrated eligibility system (IES). However, Massachusetts is no stranger to exchanges, as health care reform started in the state in 2006 with the creation of the Massachusetts HealthConnector, under Dell. Changes for Massachusetts included the end of Commonwealth Care as the state transitioned to federally qualified health insurance plans under the ACA. Reports available detailing Massachusetts’ exchange seven years ago stated that enrollment really didn’t flesh out until a full year had passed, but the mandate was a year away from the go-live date. Insurance shoppers were also heavy site utilizers, visiting the exchange roughly 20 times before making a purchase. The focus for officials in Massachusetts in 2007 wasn’t enrollment on a daily basis, but the long-term potential of an exchange system and its health benefits to the population.
The Colorado Department of Health Care Policy and Financing awarded CGI in May 2012 for the complete build out of its insurance exchange. According to Patty Fontneau, CEO of “Connect for Health Colorado,” the website has remained active and people have been able to shop and compare almost 100 percent of the time. The site also includes features that allow individuals to download information into an Excel spreadsheet to compare plans offline.
The Hawaii Health Connector awarded CGI in December 2012 to build out its exchange. The state experienced a considerable amount of issues with the website compared to other states, which delayed consumer enrollment by two full weeks. Prior to this, the site was not displaying prices and consumers were unable to compare and shop for health plans. Though the site is up, some consumers complain that the site is “confusing” and “not easily navigable.”
The Illinois Department of Insurance very recently (August 2013) awarded a $$66.5 million contract to CGI to build an insurance exchange system that would interface seamlessly with not only the federal hub, but the state’s current integrated eligibility system (IES). The initial launch of GetCoveredIllinois.com went pretty smoothly. Unlike the federal exchange, the state-based portal experienced virtually no issues. The state also recently launched a Spanish-language website to assist the needs of the Latino population.
Vermont contracted with CGI in December 2012 for its health benefits exchange (HBE), valued at approximately $51 million. The state was already in the process of architecting a new health and human services platform using Oracle technology. There have been reports of technical issues and computer system glitches with the Vermont Health Connect, with state Republicans calling for a delay in the exchange mandate. Governor Peter Shumlin has stated that performance is improving and that the number of Vermonters fully enrolled in health insurance through the exchange has grown by 75 percent in the past week. One of the major issues is not being able to pay for policies online at this time.
Although there has been talk regarding the relative success of Kentucky’s HIX over the federal exchange (as articles say they both used CGI), Kentucky’s $101.5 million HIX contract is with Deloitte, with CGI providing plan management and the billing solution. The state’s exchange, Kynect, has enrolled more than 15,000 people since October 1. The first day was not without technical problems, but state staff addressed IT needs. Governor Beshear has stated that there have been nearly 280,000 unique visitors to the site, and more than 66,000 calls to the Kynect hotline.
The higher success rates seen in these states that chose to utilize a state-based model suggest that development and implementation may have been carried out much better with the help of CGI. Perhaps these states were able to have more oversight of the project, which allowed for better planning and more testing. Vendors can expect to see states reaching out to contractors to help fix glitches in their systems as they arise.
Moreover, visible success of state-based exchanges over the federal marketplace could start the ball rolling on exchange transitions, especially given federal, vendor, and expert views of 2016 being the key date for the migration of federally-dependent states to state-based models.
Stay tuned for an extensive report on the insurance exchange market! Not a Deltek subscriber? Click here to learn more about Deltek's GovWin IQ service and gain access to a free trial.