With many of the moving parts needed to establish health insurance exchanges now fitting into place, the exchanges are now directing their attention toward consumer engagement and outreach said a panel of HIX executives Wednesday at the AHIP Institute Exchange Conference in Las Vegas.
According to officials from the Nevada, Arkansas, and Colorado exchange, they have reached the final "sprint" to the Oct. 1 go-live date. Now HIXs are directing their attention to training the navigators and others who will assist consumers with enrollment while also increasing their outreach and education to consumers about how to obtain health coverage through the exchanges.
Lindy Hinman, chief operating officer, Colorado Health Benefit Exchange, which is now branded as Connect for Health Colorado, said, "I think that all of the health insurance exchanges feel right now that it's an awkward sprint to the finish line. It's so many moving pieces all at once. Huge budgets, huge political pressure. We're working hard for delivery on Oct. 1," she said.
Colorado was one of the states to enact legislation early, in 2011, "which gave us a leg up in terms of our build. We had a lot of stars aligning, a huge boon for us, for success in the early days," she said, like bipartisan support in the state.
Now Colorado is in a full-scale marketing campaign to reach out to consumers. "We're doing print, tv, radio commercials, transportation ads and grass-roots campaign to engage from the ground up to incentivize consumer groups and others to bring people to the table and get them enrolled," she said.
The Colorado exchange has moved to testing use cases with three volunteer carriers and is starting to see some of the results, which have been successful. "We won't see the whole system end-to-end for a few months, and that's a little unnerving. But we're starting to see that this is coming together now," Hinman said.
Still, exchanges will have to be prepared in the back office for processes that don't automate appropriately and will need some workarounds and staffing for that, she said.
Jon Hager, executive director of Nevada's Silver State Health Insurance Exchange, said that the exchange just started testing its Nevada Health Link web portal, and it seems to work well. But he, like other exchange executives, worry about whether the exchange components will work effectively when they go live and whether the states will be able to enroll enough of the uninsured. Another concern is having health plans that will assure coverage everywhere, even in rural areas.
"I think across the country there will be geographic areas where we'll see nothing," he said.
One of the ways that the Nevada exchange is differentiating itself is to also provide individual billing at the exchange level. "We think we will be able to do it well. It is part of our exchange fee, which falls outside of the MLR cap," he said, but still to be seen is whether the exchange's reserves and fees will be sufficient for long-term sustainability.
Arkansas is not expanding Medicaid but has received preliminary approval from the Health and Human Services Department for a waiver for a "private option" through which the state will provide subsidies for what would allow newly Medicaid-eligible individuals to obtain health insurance on the exchange.
"The consumers will enter into a high-level Silver cost-sharing plan," said Cynthia Crone, director, Health Benefit Exchange Partnership Division of the Arkansas Insurance Department, referring to a high-level health plan but one which requires that the insured share in some of the cost.
Crone added that she will travel to the Washington area for the exchange implementation review with HHS on June 19. Arkansas anticipates that its exchange can enroll 400,000.
Some of its immediate challenges are completing its qualified health plan certifications by July 31 to assure consumer choice among carriers and also that the Silver plans meet the federal cost-sharing requirements.
Although the Arkansas Health Connector will rely on the federally facilitated exchange for its marketplace, Arkansas plans its own state-based exchange in the future and will appoint a board July 1 to start planning for that, she said.
"It will be important that we work closely to align our planning with the new exchange board so that we don't duplicate even as we work toward two different ends," Crone said.
Finish line photo from Shutterstock.com.