By Katie Kerwin McCrimmon
Dogged by technology failures last year that snagged at least 10 percent of customers, Colorado health exchange managers promised Monday that they’ll have a new streamlined IT system ready by Oct. 18, just two weeks before the Nov. 1 launch of the next open enrollment season.
In order to get the sign-up system for individuals finished by mid-October, exchange managers revealed Monday that they are delaying any fixes for a poorly performing small business portal until at least February.
The news that the system for individuals won’t be ready until October prompted concerns from consumer advocates at a hearing of the health exchange board on Monday.
“We continue to be very concerned about that timing,” said Deb Judy, policy director for the Colorado Consumer Health Initiative.
For the past two years, exchange and Colorado Medicaid and IT managers have made similar claims that they would be ready for sign-up season and that the IT systems would function well for customers. Each time, the systems have had major failings. The exchange, Connect for Health Colorado, has a new interim CEO and several new board members. Former Chief Technology Officer Proteus Duxbury stayed at the exchange just over a year and left this spring to take another job. But many of the same IT vendors and IT managers who have failed to produce simple systems in the past are trying to make fixes now.
Adele Work, formerly a consultant who was the project manager for the exchange and now the exchange’s chief information officer, said she’s aiming for a better experience for customers this year. But she warned that some customers still will have trouble.
“Flawless is a goal that we will never attain,” Work told board members.
Easy sign-ups are critical for the long-term success of Colorado’s health exchange. The exchange is banking on a big bump in sign-ups for 2016 — about 215,000 compared to about 140,000 during open enrollment this year.
Without attracting more customers, the exchange can’t bring in enough cash to survive. A legislative oversight panel has been meeting to decide whether to keep a state-based exchange in Colorado and the state auditor is conducting a broad audit after a narrow review last year found extensive problems and questionable spending.
Work said there’s never enough time to do adequate testing with a system as large and complex as the “Shared Eligibility System,” a combined IT portal for the exchange and Colorado’s Medicaid system. Colorado’s exchange is an independent public entity outside of state government. But customers who want tax subsidies to help pay for health insurance premiums must first show they don’t qualify for Colorado’s Medicaid program. So the exchange and Medicaid systems must work together.
In many states, the state government runs the health exchange. In Colorado, managers for the entities bickered for years. On Monday, managers for the state exchange, Office of Information Technology and the state Medicaid programs attended the exchange board meeting to try to show a unified front. The new interim CEO for the exchange, Kevin Patterson, is Gov. John Hickenlooper’s former chief administrative officer. Board members hope that Patterson can foster better cooperation among the separate entities and score millions in support for the exchange from Medicaid.
Work told board members that “there are a number of risks” to the timeline, so she’s trying to focus on the most critical fixes.
- Automatically renewing people for the same plan they had the previous year if they don’t take any action. Last year, hundreds of people who browsed for new plans, but didn’t select one automatically lost coverage instead of keeping their old plans.
- Preventing the system from randomly increasing a person’s income. Some customers found that each time they logged in, their income had inexplicably doubled or tripled.
- Improving the call center operations and allowing customers with problems to check their status through an online system, rather than requiring them to wait on hold to see if their problem has been solved.
- Making it easier for people to learn if they’ll qualify for Medicaid or can shop for private plans with subsidies.
Patterson said it was important to delay fixes for the small business system, which has attracted very few customers, in order to make sure the main system is working well.
“We are trying to control how much technology we are changing,” Patterson said. He and other top managers nonetheless promised to increase the number of people using the small business system since that will also help bring in more cash.
Work said testing on the new individual sign-up system will begin in late September.
“We can’t really say how well open enrollment is going to go until we (do key testing) about one month from now,” Work said.
She also warned board members that capacity problems are likely to surface and could require contingency spending since most customers are likely to wait until the last minute to sign up.
The open enrollment season begins on Nov. 1 and ends on Jan. 31.
Work said she expects customers won’t begin signing up in earnest until after Thanksgiving and the exchange will have to brace for as many as 10,000 sign-ups a day during the crunch period just before the enrollment deadline.
When they do shop and buy, she hopes exchange users will be happier.
“It’s all about the customer experience,” Work said. “I believe we weren’t ready to handle the kind of issues that came out of the woodwork (last year).”
Since the exchange has new board members, the board elected new officers and reorganized committees, vowing that the committees would meet more often to try to do a better job of strategic planning.
Sharon O’Hara, vice president of the Colorado-Wyoming chapter of the National Multiple Sclerosis Society, will remain board chair.
Steve ErkenBrack, a veteran of the board since its inception and president of Rocky Mountain Health Plans, will become vice chair.
Eric Grossman, president of NextHealth Technologies and another board veteran, will take over the key board committee that oversees finance and operations.
Newer board members, Adela Flores-Brennan, a consumer advocate; Marc Reece of Aetna; and Jay Norris, an insurance broker, will work on a policy committee with Colorado’s Insurance Commissioner, Marguerite Salazar.
Correction: An earlier version of this story said that open enrollment for 2016 would end on Dec. 15. That’s incorrect. Open enrollment begins on Nov. 1 and ends on Jan. 31.