ACA Open Enrollment: Showtime For Health Insurance Sites - InformationWeek
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11/14/2014
05:31 PM
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ACA Open Enrollment: Showtime For Health Insurance Sites

During the next three months, consumers can sign up for health insurance during the Affordable Care Act open enrollment period. New technologies at health insurance websites aim to smooth the way.

8 Innovative Health IT Startups
8 Innovative Health IT Startups
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Americans will have an opportunity during the next three months to sign up for health insurance during the 2015 Obamacare open enrollment period. To prepare, health insurance websites are rolling out a number of new tools and technologies designed to reduce confusion and help consumers locate insurers.

Despite this third-party assistance, the US administration reduced by 30% the number of people it predicted would enroll in government-backed or state health insurance marketplaces over the three-month open enrollment period, which begins on November 15. Originally, the Congressional Budget Office expected 13 million people to enroll; now, they predict that between 9 million and 9.9 million will enroll, Reuters reported.

(Source: Healthcare.gov)
(Source: Healthcare.gov)

In addition, all may not run smoothly at Healthcare.gov, despite changes over the past 12 months. These included the hiring of Accenture to manage the site and back-end systems, InformationWeek wrote last month.

"Open enrollment this year will be a positive experience for the consumer," said US Health and Human Services Secretary Sylvia Burwell. But some things "will go wrong... we will have outages. We will have down time."

Healthcare.gov is not the only site using a new tech vendor.

Massachusetts' MassHealth switched to a system from hCentive, developer of Kentucky's website. Maryland turned to Deloitte, which was behind Connecticut's successful site, to replace its trouble-prone first iteration. Idaho debuted its own site, yourhealthidaho.org, with the help of GetInsured and Accenture. Others, like Nevada (which originally used Xerox) and Oregon (now suing Oracle) switched to Healthcare.gov this year after trying state-run sites. New Mexico -- which had planned to move individuals to a state-run site in 2015 -- opted to stick with the federal system for another year.

"When consumers shop for coverage, they want the kind of personalization they experience when they shop on Amazon and it suggests the best product for them. Amazon maps your personal purchase behavior and the behavior of millions of others to match you with the best fit. Americans want to be advised on the best investment for their bodies and their lives and then get on with their lives," Noah Lang, CEO of Stride Health, told InformationWeek.

In addition to the technology and integrators powering these websites, many states have invested in more call centers, navigators, and marketing to promote their services and encourage residents to sign on for insurance. Healthcare officials also are partnering with insurance brokers, agents who specialize in helping people select from among multiple insurance plans, according to the Seattle Times.

"For our sustainability, it's really important we get to those agents and brokers," Michael Marchand, communications director at state exchange Washington Healthplanfinder told the newspaper.

To help brokers, developers such as Limelight Health will soon offer mobile apps to compare plans and prepare quotes. QuotePad -- slated for release this year for iOS and Android operating systems -- is designed for small-business health insurance plans, and includes a custom, live interface with cost models, employer-sponsored health insurance options, and pricing compared across "thousands of health exchange systems at once," according to Limelight Health. The SaaS cloud-based software calculates subsidies, health reimbursement accounts (HRA), health savings accounts (HAS), and can be private-labeled, the developer said.

For individuals working alone or supporting a small or midsized business, websites including GoHealth and HealthPlans.com allow them to comparison-shop across a spectrum of insurance providers nationwide. This enrollment period, 73% of more than 1,100 consumers surveyed plan to evaluate new insurance plans, HealthPlans.com research found; that includes 63% of those who said they were "satisfied" or "very satisfied" with their current coverage.

Stride Health is authorized to sell plans from about three-dozen insurance carriers, working with large national companies and small, regional firms, said Lang. The company also teamed up with Healthcare.gov to deliver government assistance via tax subsidies like those available on the federal website, he said.

"We don't market our technology to those carriers though; we're 100% direct-to-consumer. The key is to build for the consumer, meet their needs, and speak their language. It's the path-less-traveled in healthcare in the US," said Lang. "Consumers aren't willing to download an app to buy health insurance, but they want an app-like experience. That's why we're launching a web app that looks and feels like a native app. It's a fast, seamless experience that gives consumers the experience they deserve when making a major life investment like health coverage."

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Alison Diana has written about technology and business for more than 20 years. She was editor, contributors, at Internet Evolution; editor-in-chief of 21st Century IT; and managing editor, sections, at CRN. She has also written for eWeek, Baseline Magazine, Redmond Channel ... View Full Bio

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Alison_Diana
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Alison_Diana,
User Rank: Author
11/25/2014 | 9:16:37 AM
Re: An Enormous Boost for Start-Ups
Once again you bring up some good, valid points, @Broadway0474. But in the case of these health insurance sites, some agencies relied extensively on external solution providers for some assistance. The problem, though, does tie back in to what you said: It appears, from articles my colleague Dave Carr and others wrote, that federal and state agencies (at least those that failed) often did not cede enough control to their system integrators. Rather, the agencies -- which may have included some long-time IT pros who were, perhaps, looking out for job tenure -- kept project management responsibilities, which should have gone to SIs, who had expertise in that role. Of course, that's not always what happened but does appear to have been the case in some states. 

I do know states are taking steps to encourage more sharing of ideas, success stories, etc., among their IT staffs. Certainly on the local government level there are several instances where IT leaders are proactive in discussing their successes (and failures) so others can learn and they can learn from their peers. The CIOs of Asheville, NC, and Las Vegas come to mind as prime local examples. It would be interesting to check out what steps state CIOs take to formally share ideas.
Broadway0474
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Broadway0474,
User Rank: Ninja
11/24/2014 | 8:42:07 PM
Re: An Enormous Boost for Start-Ups
Hi Alison, in terms of why public sector entities don't tend to learn from mistakes. Some of it could be the lack of profit pressure, sure. But do you think it could also be a matter of how fragmented the public sector is? Sheesh, as we learned in 9/11, intelligence services don't even communicate with each other, let alone other departments where there's less compelling reasons. Plus, public sector employees may tend to remain in one place for, say, 20-30 years, so there isn't as much knowledge sharing through talent poaching, etc.
Alison_Diana
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Alison_Diana,
User Rank: Author
11/24/2014 | 9:07:30 AM
Re: An Enormous Boost for Start-Ups
They certainly will IF state and federal agencies learn from these initiatives. I believe the private sector will learn from these mistakes; errors cost money. IMHO, although there's often public outrage about overspending and missed budgets with tax dollars, we don't always see lessons from poorly planned/executed initiatives transformed into enhancements in new projects. That said, we have seen some good IT changes in government: cloud adoption for cost savings, DR, and flexibility; datacenter consolidation... the things we see in the private sector all the time. 

Given how much these healthcare systems focus on consumers, how integral they are to ACA and health insurance reform, I believe these will improve. There's too much riding on these specific projects. That said, I really hope unrelated initiatives do learn from the successes and failures we've seen across the 50 states and feds!
Broadway0474
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Broadway0474,
User Rank: Ninja
11/20/2014 | 10:51:08 PM
Re: An Enormous Boost for Start-Ups
Alison, thanks for that. That's extremely valuable (although not overly detailed) information. It's amazing how wide the range of success there is among all the state exchanges, from Kentucky doing so well (who would have thunk it) to Maryland being so abysmal. The case studies that will come out of this experiment will be extremely valuable.
Alison_Diana
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Alison_Diana,
User Rank: Author
11/20/2014 | 9:44:04 AM
Re: An Enormous Boost for Start-Ups
USNews has a good breakdown. In 37 states, Healthcare.gov is the go-to site. DC and 13 other states built their own. And people can go to private sites, too, if they prefer (or are having problems with the federal site). 
Broadway0474
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Broadway0474,
User Rank: Ninja
11/19/2014 | 10:03:11 PM
Re: An Enormous Boost for Start-Ups
States that are running their own exchanges were free to use whatever means they wanted to to design and implement their website, right? The 30+ states that had exchanges set up by the feds were all essentially the same (failures), right? Or am I wrong?
Alison_Diana
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Alison_Diana,
User Rank: Author
11/19/2014 | 10:15:25 AM
Re: An Enormous Boost for Start-Ups
If ever we saw a need for high-quality systems integrators, Healthcare.gov and state-run health insurance sites are a prime example. It truly is incredible that some states had relatively few problems whereas others (yes, you, Oregon) saw nothing BUT problems arise. 
Broadway0474
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Broadway0474,
User Rank: Ninja
11/17/2014 | 10:42:23 PM
Re: An Enormous Boost for Start-Ups
You are right. One person's experience with ACA will be dramatically different than another's --- largely because it's not a "one-payer system." It's state based, and some states have implemented it better than others. Other states are leaning on the feds for their exchanges --- enter the ACA website fiasco. To make matters worse, it still involves the same-old insurance companies and not enough of them.
Alison_Diana
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Alison_Diana,
User Rank: Author
11/17/2014 | 9:52:22 AM
Re: An Enormous Boost for Start-Ups
There really was no excuse for the Healthcare.gov fiasco. Over the weekend I read about some slowdowns and technical glitches at various state online exchanges, but what struck me most was how over-staffed many sites were for the trickle of people coming in to sign up. One state crowed that it had signed on 200 people... over the weekend. Scarecly seems reason to cheer.

 
Alison_Diana
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Alison_Diana,
User Rank: Author
11/17/2014 | 9:50:44 AM
Re: An Enormous Boost for Start-Ups
Did that happen, though? For several years, I was self-employed: My last health insurance cost about $550 per month for me and my daughter. It was a top-tier plan with Blue Cross/Blue Shield of Florida, a PPO that included a lower deductible but did not include dental, maternity care, or mental health, among other things. As a full-time employee at a mutl-national corporation, I have not shopped for personal insurance since ACA went into effect but many friends have done so -- and their tales range from great experiences, with lower rates and deductibles, to horror stories where both rates and deductibles increased and coverage decreased. 

I think it depends, in part, on your income. It depends on your region and your state's participation with the federal program and Medicare expansion. And it also depends on the plan you used before. For those ofwho knew what they were doing, who carefully shopped for insurance because they knew the ramifications a poor plan could have, then ACA may not have done them any favors. Those who didn't self-educate, couldn't afford, or didn't consider health insurance may have benefited. Unfortunately, politics and profits have become involved so it's hard to discern the truth.
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