By Katie Kerwin McCrimmon
Colorado’s 2.0 “Kentucky-style” system that is supposed to simplify the way people get health insurance won’t be ready until days before the Nov. 15 open enrollment starts.
And as Colorado’s health exchange enters its busy season, a third “chief” has announced she’s leaving Connect for Health Colorado. Chief Executive Patty Fontneau departed in August. Chief Financial Officer Cammie Blais left two weeks ago. And Chief Operating Officer Lindy Hinman announced her resignation and plans to leave next month after open enrollment begins.
The exchange board hired a search firm to hunt for a new CEO, and board members hope to select a candidate by early December.
Interim CEO Gary Drews said he’s not worried about the loss of Connect for Health’s three top executives.
“I really want to allay any concerns you may have regarding the departures. These things are to be expected,” Drews said. “Searches are underway for these positions.”
Along with the staffing news, board members received a readiness update during their Monday board meeting. A new shared system between Colorado’s exchange and the state’s Medicaid system is slated to go live on Nov. 9. Open enrollment will begin days later on Nov. 15.
That tight timeline has some board members worried.
“I’m concerned,” board chair Sharon O’Hara said during a break in the meeting. “Even if we launched it this week, it’s a complex (system).”
Drews acknowledged the system is weeks late and Connect for Health spokesman Luke Clarke said in “a perfect world” the system would have been up sooner. Exchange managers and state officials have been promising a better system since last fall when people trying to buy private health insurance first had to answer a long, clunky list of income and asset questions before they could get a Medicaid denial and shop for insurance. In some cases, getting the Medicaid denial took nearly 45 days and slowed those trying to buy on the exchange.
“We already know it’s not what we hoped for,” O’Hara said of the completion of the new streamlined system. “We’re not going to be able to launch it until early November. This is a pretty complex, complicated issue to work out. Hopefully we’ve given ourselves enough breathing room that we can work it out.”
Board member Steve ErkenBrack seconded O’Hara’s concerns.
He acknowledged that building a simpler system is surprisingly complex.
“It is understandable (that it won’t be ready until Nov. 9) and it is a concern,” ErkenBrack said. “Would I have preferred a longer testing period? Absolutely.”
Kentucky last fall managed to build a relatively simple sign-in system that sent customers either to Medicaid or private insurance options. Since that time, Colorado managers pledged to follow Kentucky’s lead. Doing so here is a bigger challenge because Colorado’s exchange is an independent public entity outside of state government. And last year, conflicts between state and exchange officials and their dueling consultants escalated to the point that a mediator came in to help.
Sue Birch, head of Colorado’s Medicaid agency, insisted that testing is going very well and the complexity of the new system “is not keeping me up at all.”
“I’m eager for it to debut so people can see it themselves. If I’m wrong (about it working well) we will be on it,” Birch said.
“It’s a much better version of our first launch and we’re really proud of it. We’re going to be totally ready,” Birch said. “It’s very intuitive. You only get asked the questions you need to be asked. It’s quick and very user-friendly.”
Drews, the interim CEO, said he was pleased that the shared enrollment system will “eliminate last year’s two-step process.”
“It’s been an immense amount of work,” Drews said, noting that building the architecture and testing it has involved staff from the Colorado Office of Information Technology and the Department of Health Care Policy and Financing, who manage Medicaid, along with exchange managers and technology contractors at both Deloitte and CGI.
Along with launching the shared sign-in system, exchange managers are trying to get current customers to renew their plans online. That system debuted on Monday. With renewing customers and new prospects, technology and customer service specialists could get slammed.
“This is a hugely complex system that we have under operation here and we’re adding a lot of new functionality, and in doing that, we’re bound to have some hiccups. I know these things will happen and we will have bugs to fix,” Drews said.
The small business exchange also attracted far fewer customers than expected for this year. Exchange managers acknowledged that the system was not intuitive, was difficult for brokers to use, asked for too much information for a simple quote and that response time was too slow.
For 2014, exchange managers had hoped to attract 1,000 employers and about 8,000 employees. Instead, only 304 employers used the system to cover 2,519 people.
“We fell short of those expectations,” said Marcia Benshoof, the exchange’s new chief strategy and sales officer.
Along with attempting to improve the IT interface for 2015 sign-ups, Benshoof said she’s trying novel approaches like holding events where small business owners can get help signing up employees for insurance while also getting professional photos taken.
The exchange is also planning to partner with the National Federation of Independent Business. The group fought the Affordable Care Act nationally, but supported the creation of Colorado’s health exchange.
Benshoof said the exchange will try again this year to get 1,000 businesses to sign up.
“We want to use this year as the stabilizer,” she said.
Kevin Patterson, Gov. John Hickenlooper’s deputy chief of staff and a non-voting member of the exchange board, said it’s critical to improve the system if Connect for Health expects business owners to use it.
“If it’s harder to get insurance through this path, we can’t expect better results,” Patterson said.
Board member Steve ErkenBrack, who is also president of Rocky Mountain Health Plans, urged exchange officials to find a way to help small businesses get affordable insurance.
“These folks are really, really hurting and have been for years,” he said.
Board chair Sharon O’Hara said she used the small business exchange to cover her employees at the Colorado chapter of the National Multiple Sclerosis Society. While it’s great to have a lot of choices, she said many employees were confused. She said most sought help from an insurance broker and asked for the most similar plan to the one they had had the year before.
“Choice…can be overwhelming for employees,” she said.
Board member Ellen Daehnick said she tried, but was unable to buy insurance for employees at her small caramel-making business through the exchange.
The newest member of the board, Davis Fansler of Telluride, urged exchange managers to keep trying to entice small business owners to the exchange.
“I think it’s a great opportunity,” Fansler said, noting that the vast majority of businesses with two to 50 employees probably don’t offer insurance and might do so if it were easy and they knew about tax benefits.
“We’ve got to make the path less cluttered to get to the marketplace…and make it as simple as possible.”