Following a scathing report, Massachusetts is altering course as it attempts to deal with its health insurance website.
The commonwealth has tapped Sarah Iselin, a top executive with Blue Cross Blue Shield of Massachusetts, to be the point person in fixing what has been a rocky start for the state’s health insurance exchange website. Governor Deval Patrick has also contracted the technology firm Optum to serve as an advisor as the Bay State continues work to fix the Massachusetts Health Connector website. The state will not immediately cut ties with its primary website vendor, CGI Group, but has transferred the handling of its contract with the company to the Executive Office of Administration and Finance, therein relieving the UMass Medical School of its duties. Iselin is taking on the role for the next four months.
“When you are doing a project this big and one that gets off track, you really need a single point of accountability,” said Iselin.
The shakeup is a result of recommendations from the MITRE Corporation. In January, the state brought in the non-profit research group to conduct an independent review of the Connector and the website. A four-day assessment found a lack of organization, communication and leadership among the commonwealth’s team and CGI. MITRE’s findings also show CGI did not adequately apply resources and indicated “it had taken on more work than it could accomplish within the timeframe available.” The governor says ending things with CGI crossed his mind, but Iselin says it was decided the firm was needed for the time being.
“Cutting off a relationship with a vendor who is providing such incredibly technical services is significant,” Iselin said. “So we are going to take this one day at a time, one week at a week and we’re really holding their feet to the fire.”
While most other states had the task of enrolling thousands if not millions of people in Affordable Care Act plans, Massachusetts’ primary focus was moving 300,000 people already covered under long-standing state insurance to federal plans. Patrick says on January 1st the Connector smoothly transitioned 130,000 of those people. But, due to a lack of total website functionality, the Connector set up manual workaround methods like mailing out applications and tripling staffing at call centers to get 30,000 new applicants temporarily covered. Iselin says the most challenging part was that the state’s previous website, set up under its groundbreaking 2006 law, allowed people who weren’t getting government subsidized plans to shop, but the national law expands coverage to more people.
“Those were folks who might be self-employed or for other reasons buying coverage on their own,” Iselin explained. “That’s really the community of people that our old website was designed to serve. We’re now, under the requirements of national reform, creating a website that actually is able to support eligibility determination for subsidies across the entire population. It’s just a completely different system requirement. So we had to start over.”
So far, Massachusetts has paid $15 million of its $69 million deliverable-based contract with CGI, a company that was also a contractor for the problem-plagued federal website. Jean Yang heads the state’s Health Connector.
“We are not going to be making additional payments until key milestones are delivered,” said Yang.
Iselin says Optum will stay on while the state continues to assess its plans moving forward. She says potential payment sources include federal and state funds as well as money remaining from the CGI contract. The state faces a March 31 deadline to fully transition the 97 percent of its citizens covered under its health-care law to the federal Affordable Care Act. A recent Boston Globe article reports state health officials knew of potential website problems in July, citing a memo from UMass Medical School. Representatives from UMass Medical and CGI were not available in time for broadcast.