By Katie Kerwin McCrimmon
When Kevin Patterson saw Colorado’s health exchange board floundering earlier this month as their only CEO finalist backed out and the search for a new leader was failing, he decided he might be able to provide some answers.
“I think they’re exhausted … fragile is the right word,” Patterson said of the board that is facing extensive IT and financial woes.
“They don’t have six months to go through another search.”
Patterson said friends outside Colorado first suggested he consider taking the helm at Connect for Health Colorado and he warmed to the idea. He said his boss, Gov. John Hickenlooper, never suggested the move. Rather, Patterson decided he might relish the challenge and spoke with his former colleagues at the exchange. Patterson had been a non-voting board member and Hickenlooper’s representative at the exchange board in 2013 and 2014.
“Look, if this helps you guys figure out a way that we can focus on the issues that we have to solve, I think this is the right way,” Patterson said.
Currently Hickenlooper’s chief administrative officer, Patterson will wrap up that job and take over as interim CEO at the exchange on May 8.
He’s clear on his mission.
“It’s a turnaround. We’ve got to make sure we’re going in the right direction,” Patterson said. “We can do this, but it’s going to be hard work.”
Patterson has experience working on complex government IT systems when they’ve been in trouble. He cites the mess he encountered with Colorado’s notoriously problematic IT system that provides food stamps and aid to the poor. The Colorado Benefits Management System (CBMS) had tripped up three governors as it failed to work over 12 years, leading to lawsuits against the state of Colorado.
In that case, Colorado had spent $300 million on faulty IT systems that were only working about 65 percent of the time.
Patterson took a decidedly low-tech approach at first.
“We started out with stick figures on a paper to figure out where the pinch points were,” he said.
Previously, he said multiple government officials who were using CBMS at the state and county level kept prioritizing different fixes. It was vital to get everyone unified on the highest priorities, then work on fixes one by one.
“When we began to solve what seemed like simple problems … and have the technology do more work than the people, it began to snowball. We’ve moved from 65 percent timeliness, according to the court order, to about 90, 95 (percent),” Patterson said.
Now he wants the challenge of trying to do the same with the exchange.
There are certainly parallels. Colorado has received nearly $200 million in federal tax dollars to set up the exchange, along with several million more in leftover cash from the state’s now defunct high-risk insurance pool.
Still, the system is not working seamlessly and exchange managers have had to spend millions on IT fixes while the exchange’s call center keeps blowing its budget.
Complicating matters is that Colorado lawmakers set up the exchange as an independent agency outside of state government, but it must work closely with state Medicaid managers. They oversaw the creation of a shared IT system that was supposed to make it simple for customers to qualify for Medicaid or get rejected and buy private insurance through the exchange.
But far from being simple, that shared system instead created problems this year for thousands of customers.
Patterson said his highest priority out of the chutes will be fixing the customer experience.
“The reason I’m going over there is that I think I have something I can offer in terms of helping build relationships both with the state partners and the feds,” Patterson said.
“It’s really important for us that we’re working from one playbook. Usually when people are working really, really hard and not getting the results they want, it’s a problem of alignment.”
Asked about how he’ll solve the exchange’s financial woes or whether he knows exactly how to make the problematic shared sign-in system work better, Patterson readily conceded that he doesn’t have all the answers yet.
He plans to quickly hire a chief financial officer and a chief operating officer. Both of those jobs have been vacant since last fall when the team of leaders who set up the exchange left just before a raft of new problems emerged during the second open enrollment period.
“You’ve got to have enough tools in the toolbox to get the job done,” Patterson said.
As he helps prepare for the third open enrollment in November, Patterson plans to keep in mind concerns from people in the business community who have shared their frustrations that Colorado’s exchange is not working better.
And he’ll keep tapping some valuable advice from his great grandmother, Bessie Calhoun, of Corsicana, Texas.
“She always said you have two ears and one mouth for a reason. You’re supposed to listen more than you talk,” Patterson said.
“We need to listen to where people are having problems,” Patterson said.