Access Health CT
This week, Hartford Courant business columnist Dan Haar talks about what’s going on with Access Health CT, the state’s health care exchange website.
Below is Haar’s column on the topic from Tuesday’s edition of the Courant.
Access Health CT, tired of seeing its Connecticut Obamacare exchange held hostage by the balky federal system, is taking bids this week from outside contractors that would verify customers’ identities — a key function within the federal system that caused two nationwide shutdowns last week.
The move by Access Health CT, operator of the state marketplace for health plans, shows that the agency does not have faith in a glitch-free federal system going forward.
“What we’re looking for is a stronger contingency plan,” said Jim Wadleigh, chief information officer at Access Health CT. “Our hope is to do this as quickly as possible.”
Wadleigh said the cost of the private outsourcing, not yet determined, will be part of the $45 million systems budget the federal government gave Connecticut to build its own system. So the feds are paying for a fix to go around their own questionable system.
Access Health CT is taking other steps as well, making itself less dependent on a federal IT system that was assembled by some 55 contractors. Connecticut’s system has scored high marks for reliability but when the federal exchange is down, no one in Connecticut can enroll.
In a separate move related to the federal glitches, Aetna CEO Mark T. Bertolini advised top administration officials to shut down the system rather than try to fix it on the fly.
“Pushing the pause button right now would be a good thing,” Bertolini told an audience in Farmington Thursday at an event of the Tunxis Community College Foundation. “If you do it right now, five to 10 years from now nobody’s going to remember this.”
Bertolini has taken that message to Washington, D.C., where he’s been in touch with Jeffrey Zients, President Obama’s point man on the systems fix, along with top Obama officials including White House Chief of Staff Denis McDonough and Health and Human Services Secretary Kathleen Sebelius.
Aetna is one of only two “alpha testing sites” for the exchange system, and the Hartford-based health insurer participates in Obamacare plans in 10 states and parts of seven more — though it has been critical of regulations and pulled out of Connecticut’s exchange.
“When you get into this kind of situation with technology, you just don’t have a short-term solution,” Bertolini said. “Turn off the stuff that isn’t working.”
The idea should be to “freeze the scope,” meaning stop trying to make upgrades to the system and instead isolate the problems, said Bertolini, who has often said he considers Aetna to be a technology management firm in health care, as much as it is a risk management firm.
Wadleigh said he agrees with the idea of freezing the scope of the system but would not have advised pausing it altogether. “I don’t agree with it,” he said of Bertolini’s idea. “I think that any business that’s trying to roll out a startup organization is going to have some bumps and I’m sure there was some politics in his decision to recommend that they shut it down.”
By “politics,” he could mean Aetna’s overall criticism of the system. Bertolini, in the same speech, said Aetna is working on its own private health exchange, which he promised would be more efficient than the federal one.
“He’s not alone, there have been a lot of people out there that have been saying the exact same thing,” Wadleigh said.
It’s all part of a massive scramble including some of the nation’s top tech firms to right the system. Wadleigh says it’s unfair to compare the IT challenge of Amazon, for example, to Obamacare because the federal health exchange had to wait for states to declare whether they were in or out, and had other last-minute changes.
“Amazon and Facebook and all these others have had five to 10 years to be able to grow and expand,” Wadleigh said. “What’s killing the federal marketplace right now is a late decision to pull comparison shopping.”
That’s a reference to the feds’ forcing people to sign into the system before checking the prices of different plans for them — something Connecticut doesn’t require.
As for Aetna’s participation in the Connecticut exchange, “We’re hoping to get them back,” Wadleigh said. “They’re an integral member and a national player.”
But that’s all in the future. For now, Obama’s signature social reform rests on the success of the rollout of the health exchange system. The 33 states that rely on the federal system must hope for the best. But for Connecticut and the 16 other states operating their own exchanges, workarounds are the new byword.
And Access Health CT appears to be among the most aggressive players. Under the original design, there were 14 functions that the federal “hub” had to perform for the states in order to enroll a new person in Obamacare.
“We’ve reduced that to seven,” said Kevin Counihan, CEO of Access Health CT. “We were able to do the other seven in-house.”
That includes such things as arranging for billing, which the Connecticut system has pushed over to the insurance carriers rather than coordinating it with state and federal officials.
Moreover, Connecticut has worked its system to ask the feds to perform the seven functions in a batch, rather than one at a time — adding more efficiency.
There have been no new unplanned shutdowns since last week, Wadleigh said, but the system was down for maintenance in the wee hours over the weekend. But with the Connecticut exchange posting decent if not outstanding enrollment numbers for the first month of Obamacare, the idea is to add to the momentum without new disruptions.
Counihan said the Connecticut exchange’s communications with the federal hub have not been angry. “They’ve got a real issue, that they’re balancing the politics with the people that need to be served,” he said. “I’ve got to trust that they’re doing the right thing.”
Besides, he said, “I don’t know that we’ll reach a point where we’ll be 100 percent self-sufficient.”
Read The Haar Report at http://www.courant.com/haar