By Jon Kamp
BOSTON--Massachusetts health officials said Monday they are
scrapping the state's problem-plagued insurance exchange in favor
of a private company's version used in other states, while
considering connecting to the federal site as a backup.
Massachusetts already has comprehensive health coverage, thanks
to a 2006 state law. But overhauling the state's online exchange to
comply with different rules under the federal health law, passed a
few years later, has raised technical challenges.
Tens of thousands of people submitted old-fashioned paper
applications and about 190,000 have been put on temporary Medicaid
plans until the state can determine exactly what coverage they are
eligible for. The state system has had a hard time sorting out
eligibility, among other issues.
In the new proposal announced Monday, the state said it plans to
use off-the-shelf software from private company hCentive Inc. that
has been used in Colorado and Kentucky. But Massachusetts also is
working on connecting to the federally run marketplace as a
backup.
The goal is to be ready by Nov. 15 this year, when the next
open-enrollment period begins.
This plan "certainly has its benefits and its challenges," said
Sarah Iselin, an insurance executive tapped by Gov. Deval Patrick
to lead the health-site fix.
"It does, however, solve for two realities: we need a reliable
website to help people during the next open enrollment period, and
we need to be in a position to achieve a fully integrated system in
2015," she said.
Ms. Iselin announced plans in March to begin severing ties with
CGI Group Inc., the company behind the current state site. CGI also
was responsible for parts of the federal exchange, HealthCare.gov,
which got off to a rocky start in October but has since
improved.
Massachusetts is still negotiating with CGI about ending that
relationship, and to date has paid $17 million on a $69 million
contract, a state spokesman said.
The hCentive software "has the best potential to fit" short- and
long-term needs, the state said in a release. The goal is to roll
out something basic this fall, and potentially upgrade later as
needed.
"The guidance from [the] state has been to minimize risk," said
Sanjay Singh, chief executive at Reston, Va.-based hCentive, in an
interview. "We will take something that is functional, already
working in other states, configure and maybe do minimal
customization."
The company doesn't yet know what it will be paid for its
efforts, Mr. Singh said. The state and hCentive plan to discuss the
matter after a Thursday board meeting for the Health Insurance
Connector Authority, which runs the exchange, he said.
Meanwhile, Massachusetts will work on connecting to
Healthcare.gov. This link possibly could be used for a year if the
hCentive effort takes longer than expected, the state said.
Oregon, which also experienced severe technical problems on its
state exchange, announced plans last month to start the federal
technology.
For Massachusetts, that switch will require significant
adjustments to tie in state-specific design features, the state
said. These include additional subsidies that Massachusetts is
offering some applicants, on top of those available from the
federal government.
"Based on our assessment of the Health Connector Exchange, we
agree that the dual-track strategy is the optimal approach for the
state to take at this point," said John Santelli, chief information
officer for Optum, a UnitedHealth Group Inc. business serving as a
technology adviser.
Write to Jon Kamp at jon.kamp@wsj.com
Subscribe to WSJ: http://online.wsj.com?mod=djnwires