Government Technology - August 2008 - (Page 40)

e-government Personalized Health-Care Provider Comparisons MA Citizen A. Smith DOB: 2/27/63 7/25, 4:14 PM ET Male, 45 everybody is satisfied that what we’re selling is, in fact, what the providers are offering,” Nevins said. The Connector initially paid the CSC $700,000 for the solution over six months. Since then, the agency has paid that amount twice more for two six-month extensions of CSC’s help at running the site. Nevins said the Connector will likely extend its contract for an additional six months from July to December 2008. “Then we’re pretty much done with them. We’ll operate the thing on our own,” Nevins explained, adding he would likely add a few more IT staffers to keep information current on the site. The Connector agency is fine-tuning the site’s features that it didn’t have time to perfect during the initial implementation. For example, it’s changing the Java code powering the site to a “components-based” model, which would simplify site programming, said Nevins. The components-based approach would enable programmers to fashion “modules” of ready-to-use code they could apply elsewhere on the project. Using your information, we found 15 Health Connector plans for you. Click the plans that you want to see. You can click “Show Selected Plans” to see some plans. You can also decide to see all plans. Show Selected Plans Show All Plans Bronze Low premium. Most have deductibles and co-payments. Prescription drug coverage included. 4 plans $191.37$236.00/mo $258.53$324.78/mo $333.45$431.21/mo Silver Moderate co-payments. Some have no deductible. Prescription drug coverage included. 7 plans Gold Low co-payments. No deductible. Prescription drug coverage included. 4 plans AUG_08 ties when selecting health insurance. That research helped determine where on the site the Connector placed various pieces of information. For example, data showed citizens consider monthly premium amounts before anything else. “That’s the first thing we show next to the name of the policy,” Nevins explained. “Then they want to know the deductibles. After that, what are the co-payments for doctors, prescriptions and emergency room visits? What’s the deal with hospital stay costs and choosing doctors? If they want more details, they can click ‘view plan.’” The site displays each plan in row form with information in the aforementioned order. Providers offer various plans that fall within the Web site’s “gold, silver and bronze” price and service categories. Citizens can do side-by-side comparisons of different providers’ plans. “Say you don’t have to go to the doctor that much, but you want to have catastrophic coverage,” Nevins said. “You want to be sure you’re covered if something bad does happen. You don’t want to pay a lot per month. We wanted [providers] to offer a product in that category. We wanted them to offer a product in a middle tier, which we call ‘silver’ — a balance between the monthly premium and the co-pay amount. We also wanted them to offer a more comprehensive package that might interest families.” The Connector contracted with six insurance providers, representing roughly 90 percent of the state’s health insurance industry, according to the Connector. “This was the first time consumers could really do this comparison across different health plans,” Nevins said. “If you go to Harvard Pilgrim [a provider in the state], they wouldn’t tell you what their competitors charge — it doesn’t really serve their interest. Because we’re an independent state authority, and because our charge is to help people purchase affordable health insurance, we’re able to do this.” Heads-Up to Others States considering health insurance laws similar to Massachusetts’ could learn from challenges Nevins faced during his quick rollout. For example, a state should plan to accommodate a larger number of uninsured residents than it initially estimates. The Connector’s initial estimate put the number of uninsured at 370,000. The true number, according to Nevins, was closer to 550,000. Costs rose higher than the Connector planned. The agency expected roughly 136,000 of the uninsured to sign up for Commonwealth Care. Instead, 176,000 people enrolled in the program. The Connector also had to carefully craft communications when soliciting involvement from insurance providers. Insurance providers didn’t want to appear to not support the state’s health-care reform effort, said Nevins. “On the other hand, here we were, having an impact on the market and creating more competition. We had to approach that gingerly,” Nevins said. Back-End Operations Citizens get locked into a rate for 12 months once they purchase a plan through the Connector site. However, providers change the promoted rates on a monthly basis. Those operating the back end of the site’s operations must stay up-to-date on current prices. The Connector pays the Small Business Service Bureau (SBSB), a private company, to receive providers’ current rate information and run the Connector’s insurance plan phone bank. The Connector considers the SBSB its “subconnector.” The subconnector submits current rates to the Connector Authority via XML messages. “It’s a big dance going on between us, our subconnector and the carriers to make sure 40 http://www.govtech.com

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Government Technology - August 2008 Contents Point of View The Last Mile Big Picture On the Scene Four Questions for... Net Gains A Government Technology® Industry Profile: CA CA Contents IT Network Management: State and Local Governments Face New Challenges MyFloridaNet Arkansas Department of Information Systems Hartsfield-Jackson Atlanta International Airport Government Tightens Its Belt Rocking the Vote High-Speed Portal Project On Track Wi-Fi on a Shoestring From Paintball to Video Virtually Vulnerable How It Works Products signal:noise

Government Technology - August 2008

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