Health exchange under pressure to find new CEO, improve performance in year two

By Diane Carman

Patty Fontneau was all smiles Monday at her final board meeting as executive director and CEO of the state’s health exchange organization, Connect for Health Colorado.

The board met in executive session before the open meeting to discuss the process for replacing Fontneau, who is joining Cigna as president of its private exchange business. An interim director will be announced “shortly,” Board Chair Sharon O’Hara said, and negotiations are under way to contract with an executive recruitment firm to search for a more permanent replacement.

“It’s a remarkable time to hand over this organization,” said Fontneau, who listed its accomplishments as “140,000 covered lives,” “strong carrier participation” and an organization that is “very, very financially secure.”

“I’m very sad to be leaving,” she said, “and I’m very proud of this team.”

Then her team proceeded to outline a grueling schedule for readying the exchange for the coming enrollment period with every expectation from board members and the public that it will go more smoothly than the rocky rollout of the Affordable Care Act last fall.

New enrollments and plan renewals for 2015 will be offered for only 30 days from Nov. 15 to Dec. 15, 2014. Adele Work, a manager of information technology, said her team plans to have descriptions on the rates and details of plans for the coming year available on the website during a pre-enrollment period beginning Oct. 15.

From Oct. 15 through Nov. 14, customers will be able to shop for plans and put their selections in their online shopping cart, she said. Then on Nov. 15 they will be able to proceed to the checkout.

She said more than half of the 396 different plan variations available for the coming year have been loaded. The plan details are still tentative, however. They are undergoing review by the Division of Insurance.

Work said they want to make it possible for customers interested in renewing their insurance plans to do so as effortlessly as possible. Still, as with all private insurance policies, rates and provisions often change from year to year, so questions are likely to arise.

In addition, customers’ eligibility for subsidized plans or certain coverage levels may change, she said. Some customers will turn 65 and become eligible for Medicare, for example. Some will age out of eligibility for coverage under their parents’ health care plans; others will turn 30 and no longer be eligible for the cheapest catastrophic plans. Some may have incomes that change in ways that will affect their eligibility for Medicaid or subsidized plans.

While Work’s goal is that customers “don’t have to click or sign” to renew their policies, she said the team is working to train brokers and build a system to answer their questions and guide them into appropriate health care plans. Even last year’s brokers and customer service representatives will have to undergo four hours of training to do the job this year.

While the exchange has been able to reduce the percentage of uninsured Coloradans from 17 percent to 11 percent in one year, according to a recent Gallup poll, board and staff members expressed concern about the need to more effectively market health insurance to the remaining 300,000 to 400,000 people who are  uninsured, particularly the hard-to-reach Latino population.

Many uninsured Coloradans never have had insurance and struggle to understand the language of plans  with such terms as “co-payments” and “deductibles,” and rates that vary by geographic area and coverage level.

“I’m very concerned about insurance literacy,” said Vice-Chair Arnold Salazar, who said insurance is “complicated to the point of being almost incomprehensible” even for him.

The exchange spent $8.8 million last year on marketing and outreach, much of it aimed at introducing the broad audience of potential health care customers to the concept of shopping on the exchange.

Part of the 2013 ad campaign.

Part of the 2013 ad campaign.

Chief Marketing Officer Linda Kanamine said this year her team is working to develop ads and marketing tools designed to target specific populations, and has a Spanish language version of the exchange website in production.

Board member Ellen Daehnick urged her to test potential messages using focus groups before launching any expensive ad campaigns. “What was the most effective message of Year 1?” she asked.

Kanamine said at this point the evidence is only anecdotal, but the heaviest emphasis was on hammering home the message that health plans are available, affordable and required by law.

Once the customers do come to the exchange, Customer Service Director Shelley Michas said the goal is to have 80 percent of calls answered within 90 seconds, and for the duration of the calls to be reduced from the current average handling time of 12 minutes to make the system more efficient.

“We need to make major changes in cost and performance for our long-term” sustainability, said Chief Operating Officer Lindy Hinman.

Last year, Connect for Colorado spent approximately $87 million to build the exchange and to enroll 140,000 people in some form of health coverage – private plans or public plans such as Medicaid.

While the challenge is enormous, the departing CEO was optimistic.

“We have tight timeframes,” said Fontneau, “but we’re on track and hitting our goals.”




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