Path to Success Presented to Maryland Health Benefit Exchange Board of Trustees Rebecca Pearce Executive Director A service of Maryland Health Benefit Exchange
Data Overview Tremendous interest – Over 400,000 unique website visitors – Over 54,000 phone calls to our call center – Over 50,000 accounts created with verified identity – Over 30,000 applicants have had their eligibility determined 2
Status Many Marylanders have been able to use website; but many have been frustrated by technical challenges We have made a number of changes – Addressed user experience issues such as phone number and zip code formats – Updated overall capacity to support the volume of users – Created easier access to plan browsing for account holders – Improved eligibility for special populations (i.e. non-parent caretakers) – Improved plan shopping and check the cost of plans experiences However, we are not satisfied with website or with pace of improvement 3
Path to Success New resources on project We have worked to define path to greatest improvement and service to Marylanders over the next 6 months Key goals: – Continue to improve user experience and functionality of the system – Assurance of eligibility determinations – Support enrollment transactions to & from carriers (834 file) and managed care organizations (8001 file) 4
Focus: User Experience Additional resources now focused on addressing additional performance and software gaps in the system Examples of areas to be addressed include: – Slow speeds during of peak usage – Difficulty for some users to see health plans – Consistent end-to-end experience for all supported browsers 5
Focus: Assuring Eligibility When we launched, we gave all users examples of certain scenarios that might not be accurate. We have completed significant testing of existing eligibility determinations with a high level of confidence. Regular reviews, additional upgrades to the software, and other steps underway 6
Focus: Support enrollment transactions An 834 file gets passed to carriers to confirm enrollment into a qualified health plan, and an 8001 file is passed to confirm enrollment into Medicaid. With support from carrier community modified 834 file format to be in line with CMS version 1.6 (Released September 2013) File to be sent to carriers mid-November 7
Path to Success To maximize our chances of success, we need to focus on these three issues. This means that we need to look at everything else in the project and find the right time frame for implementation. Principles for this review: – Alternatives available to Marylanders – Impact on Marylanders – Ways we can support Marylanders in advance of a fully IT solution 8
SHOP Background • Small group market strong in MD • Same prices inside and outside SHOP • SHOP Exchange expected to start slow and grow slowly: Less than 10K enrollees expected Support / Considerations • Waiting until 4/1 would allow MHBE to properly test solution internally and externally • Would allow TPAs time to build their solution to work with MHBE • Feedback from Broker Advisory Committee is in full support of delay to allow proper time for testing and training • Tax credits will not be lost – available for 2 years from first receipt Recommendation: Plan to launch SHOP 4/1 9
Collection of First Payment Background • Not required of exchanges • ACA requires ability for individuals to pay carrier directly • Policy decision to take first payment was made by board in 2012 to complete “sale” for individual Support / Considerations • Carriers are expecting to collect first payment from individuals so minimal impact on carriers • Removes Maryland Health Connection from transaction • Will require consumers to complete enrollment online a few days earlier Recommendation • Forego collection of first payment at this time; add when we can 10
Provider File Background • Not required of state-based exchange • Working with CRISP, we have developed a consolidated provider file to include in the plan shopping process within MHC • Due to some technical issues, not currently available on MHC • CRISP created solution outside MHC with same information on separate site Support / Considerations • Allows people to search for their current provider to confirm he/she participates in a plan • File is only as good as the information received from carriers Recommendation • Have development team continue to work to implement on MHC, but behind the work needed to complete required core functions 11
Spanish Translation Background • MHC is intended to be in both English and Spanish • Currently, site is in two components: (1) MHC Front End and (2) MHC Application • Both are in English Support / Considerations • We can launch Spanish translation of front end within a couple of weeks, allowing them to complete many pre-enrollment activities. • We can translate application once changes are made and system is stable • We can strengthen phone and in-person Spanish assistance to help Spanish speakers until the full translation is available Recommendation • Implement MHBE front end Spanish version as soon as possible • Notify users as they move from (1) to (2) that the application is in English. • Direct users to the call center (with Spanish speaking reps) or to CE’s with Spanish - speaking navigators; supplement these resources as possible 12
Next Steps We will stakeholders informed on key decisions and progress We will inform board of any major changes 13
Recommend
More recommend
