Certifi nabs Utah HIX business
"Exchanges are going to come in all shapes and sizes," Jay Belschner, managing partner of the Minnesota-based consulting, software and compliance firm Certifi told the Minneapolis Star Tribune.
"They're going to be public, they're going to be private. They're going to be profit, they're going to be not for profit. They're going to be owned by banks and they're going to be owned by health plans."
HIXs in many shapes and sizes means there's unlikely to be any one-size-fits-all accounting software for those exchanges, which is one reason why Certifi is eying contracts with states to run the back-end accounting and administrative systems, the Star Tribune wrote in a profile of the company.
In mid-September, Certifi's software was set to go live in Utah, home to one of the two exchanges currently operating in the country, with the other in Massachusetts. Certifi is handling the accounting, billing and payment processing for the small businesses buying plans, the three insurers and brokers operating in Utah Health Exchange.
The pending creation of exchanges is spurring a boom of sorts in a number of software and IT sub-sectors. As the Star Tribune put it, the exchange can be described as a stool with three digital legs; the first leg is the internet-shopping platform, the second is eligibility and enrollment software and the third is financial processing software.
All three stools need fairly advanced software and IT because, among other things, they can be hacked--as the Utah Health Exchange was several weeks ago.
As the Salt Lake Tribune reported, state officials described the hacking as "a pure act of graffiti. Words were garbled, headlines were blurred. You couldn't access some of the pages." No data was stolen, officials said, and there won't be a criminal investigation.
Minnesota business groups seek clarity on state HIX
Back in Minnesota, where state officials got $31 million in federal funding to create an exchange, the state Chamber of Commerce is criticizing Democratic Governor Mark Dayton's decision not to unveil exact details of his administration's plans for the exchange until November 6--the day of the presidential election and 10 days before the deadline to submit exchange blueprints to the feds.
"We just don't know. That's the frustration. We have no idea what this thing is going to look like," Minnesota Chamber of Commerce president David Olson told the Minnesota Post.
Among the group's concerns are the exchange's governance structure, financing and regulatory authority and the potential role of brokers, which the Minnesota Chamber supports. Various HIX models, discussed in concept and appearing in some proposals, have exchanges teetering between a somewhat laissez faire "market organizer" and an "active purchaser" that would strictly negotiate rates and plans, a model opposed by many business groups and the American Medical Association.
Minnesota Commerce Commissioner Michael Rothman, who's leading the state's exchange work, essentially told business groups they shouldn't worry. "The application is to show the federal government that we have the plans, the designs in place at a minimum, to have a state-based exchange. There's flexibility there. There could be changes," Rothman told Minnesota Public Radio and Kaiser Health News.