What’s New in the Health Insurance Exchange (HIX) Market?

Published: May 01, 2017

Health CareHealth Information TechnologyHealth Insurance ExchangeHealth ITHealth ServicesInformation TechnologyProfessional Services

An overview of recent state health insurance exchange (HIX) procurement activity.

Following passage of the Affordable Care Act in 2010, states contracted with vendors for the design, development and implementation of new health insurance exchanges (HIX). Deltek has not seen any states re-bid their HIX contracts except in states that initially had trouble with their vendor, like Oregon and Maryland, or states that switched their type of exchange model. For example, several states have transitioned from a State-Based Marketplace (SBM) to a Federally-Facilitated Marketplace (FFM), or a State-based Marketplace using the Federal Platform (SBM-FP). However, some states are tweaking their HIX systems to facilitate application processing and improve the consumer experience. Over the past few years, states have submitted solicitations for expanded call center services and customer service centers, premium rate review services, enrollment assistance, marketing and outreach services, as well as smaller technology upgrades like implementation of a provider directory or consumer support tools.

Below are some examples of recent solicitation activity in the HIX market:

1. In late 2015, Washington state issued two Request for Proposals (RFPs) to improve the Washington Health Benefit Exchange (HBE). The Exchange issued a solicitation for a Financial System Replacement for the Health Benefit Exchange with the goal of increasing accountability and transparency and facilitating reporting requirements to the state and federal government. The State also sought a new Web Content Management System to improve website performance, increase abilities to add new webpages, optimize search engines, and provide marketing analytics and social media integration.

2. In 2016, the Minnesota Health Insurance Exchange (MNsure) released a Request for Information (RFI) on tools for its Consumer Shopping, System of Record, Enrollment Decision Support, and Small Business Health Options Program (SHOP). MNsure was seeking information on tools that are accessed from the MNsure website and/or would be integrated into Minnesota Eligibility Technology System (METS), enhancing shopping experiences for consumers and small business, and the support technology for its enrollment system of record and enrollment decision support system, in a cost-effective manner.

3. In May 2016, the California Health Benefit Exchange, Covered California, released an RFI for an Enrollment Assistance Program solution (EAP) to serve as the common platform to facilitate document submission and processing by way of workflow automation that will support multiple needs for internal and external stakeholders.

4. The Massachusetts Office of Information Technology (MassIT) released an RFI for Hosting Services for the Massachusetts Health Insurance Exchange/Integrated Eligibility Services (MA HIX/IES). Services are currently provided by OptumInsight, and the state is considering releasing a future solicitation to conduct Phase II of the HIX/IES project.

These are just a few examples of recent HIX solicitation activity. For more information, check out the GovWin IQ database for detailed project information and upcoming opportunities.