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Level 1 Exchange Establishment Grants Released

Hot off the press is the news of $185 million awarded to 13 states and the District of Columbia today under Level 1 Exchange Establishment grant funding. These grants are part of an ongoing series under the Affordable Care Act (ACA) to assist states in designing and implementing health insurance exchanges. Previously, 49 states and Washington, D.C. received planning grants and seven states received nearly $241 million in early innovator funding (Kansas and Oklahoma eventually rejected the funds). California received the most ($39.4 million), while other states include Connecticut, DC, Illinois, Kentucky, Maryland, Minnesota, Mississippi, Missouri, Nevada, New York, North Carolina, Oregon, and Washington. The chart below shows the breakdown in funding:


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*Indiana, Rhode Island, and Washington were awarded grants on May 23, 2011

Several sessions of the Medicaid management information system (MMIS) conference last week were devoted to health insurance exchanges, and it seems some states successfully grasp how to tackle the large hurdles imposed by the ACA between now and 2014, while others are waiting on a miracle. This new round of funding is crucial since state planning documents so far have projected exchange implementation costs from $20 million to $50 million. Most states are near the end of their planning studies, so vendors need to be able to showcase modular, and in some cases, transferable solutions as we enter the exchange IT core infrastructure phase. Systems should be up and running by summer 2013 to comply with the mandated deadline, which doesn't leave much time considering exchanges need to be linked with integrated eligibility systems and Medicaid IT structures (if not more systems). Although early innovators are developing exchanges that could be adopted by other states, one has to keep in mind that not all states have technology currently in place to even handle or interact with these transferred exchanges. Much work still needs to be done, and in this uncharted territory, vendors with innovative and flexible solutions are in high demand

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