Massachusetts has unveiled a plan to fix problems with its health insurance website that have slowed the state's transition to the federal Affordable Care Act. The plan calls for a "dual-track" approach including purchasing new software while also connecting with the federal healthcare website.
The state will purchase hCentive, an off-the-shelf application that has powered exchanges in Colorado and Kentucky. Jean Yang is executive director of the state’s health connector.
“We actually looked at hCentive as part of the original plan,” Yang said. “But subsequently we decided not to go there in part because the system was just not mature enough particularly when it comes to customizing unique state specific needs.”
Instead the state chose CGI Group to build the website that debuted in October. The IT vendor also worked on the troubled federal website. It has been relieved of its work on HealthCare.gov, but has had success with states like Colorado, which also used hCentive. Yang says the “out of the box” applications have developed over the past year through work with other state health exchange websites.
“It’s a tested commercialized, end-to-end solution,” she said. “Whereas the system that we had been relying on CGI to build, even though it had the original vision of offering end-to-end solutions successfully, it didn’t happen. So as of today, not only is it missing key functionality, but the pieces that are deployed have serious issues in terms of the quality and its performance.”
The goal is to have a functional end-to-end exchange running by the fall. About 36,000 people have been enrolled in permanent health and dental plans since October, mostly through a dwindling stack of paper applications. Stemming from its 2006 groundbreaking healthcare law, the state has also been transitioning the 97 percent of its citizens with health insurance to plans that comply with the federal Affordable Care Act. An additional 159,000 are in transitional or temporary Medicaid coverage. With that already extended temporary plan set to expire in June, Yang says the state is working with the Centers for Medicare and Medicaid Services to continue coverage until the end of 2014 while the state pursues this $120 million dual-track plan.
“We are working extremely closely with CMS to discuss our strategy and insure that they are supportive of our path forward so that we can secure funding support from them,” Yang said. “So the hope is that the state is not going to be exposed financially in order to implement this strategy.”
The Connector will continue to use one piece of the existing website developed by a subcontractor of CGI, called the program determination rules engine, according to Yang.
“There is one piece that we will continue to work on and recover, but in terms of the full end-to end-solution the full CGI built HIX is going to be off the table for the longer term,” said Yang.
Yang says the state has paid CGI $17 million of a $69 million deliverable-based contract and is in negotiations to transition out of that agreement.
“So to what extent that we’re able to leverage the $69 million is really subject to the outcome of the negotiation, but the idea is that we are not going to be completely that contract,” Yang said. “That certainly is no longer part of the discussion.”
Despite issues with health exchanges, the Canadian-based CGI has reported a doubling of its quarterly profits because of growing business in Europe. Along with the new strategy, the website work will have new leadership. Sarah Iselin will return to her position with Blue Cross Blue Shield of Massachusetts in June. Governor Deval Patrick brought her on in February to fix the exchange, when she spoke with WAMC News.
“When you are doing a project this big and one that gets off track, you really need a single point of accountability,” said Iselin.
Maydad Cohen, Patrick’s Deputy Chief of Staff for Cabinet Affairs and Policy, will take over. The technology firm Optum, which was also brought on in February, will continue supporting the Health Connector.