What Health Insurance Company Information Technology Executives Were Saying About The Obamacare Exchanges Last February
Selasa, 16 Oktober 2018
Health Insurance Reform,
Insurance Exchanges,
Obamacare,
Patient Protection and Affordable Care Act
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Were there signs the Obama administration was headed for trouble getting the insurance exchanges ready for October 1, 2014?
Last March, I did a post reviewing a survey of health insurance industry information technology executives' opinions on how well the Obama administration was doing toward launching the exchanges.
The federal health insurance exchange problems that have so far been obvious have been all front-end issues--being able to get the Obamacare's consumer portal to work.
What is concerning about this March survey is that it also identified big concerns the insurance industry had, and still has, over the critically important backroom transactions yet to come.
My conversations with industry executives in the last few days indicate those concerns continue. Instead of the federal exchanges being able to transmit clean data to the insurers on who is signing up for coverage, this element of the process is still in testing! When there are problems with the very few enrollees they have received information for, I am told the insurance companies are having trouble getting through to the special federal exchange help desk for the health plans--the phone is often not even being answered!
When they do get through to the federal exchange help desk a "ticket" is created for each batch of problems to be resolved later. That may be a good process if the carriers are only enrolling 20 people a day, as many are now, but this is going to be problematic when the real enrollment volume ultimately begins.
With all of the concerns expressed within the industry over many months, the Obama administration decided to launch on October 1. Time after time when given the chance HHS Secretary Sebelius, as well as her senior staff, refused to step away from the promise to be "ready on time."
Those who enroll for coverage rightfully expect that when they go to their doctor next January they won't have trouble getting the coverage they now want to sign up for. But this phase in the Obamacare rollout, still to come, could well be the most problematic.
In the original March post, I reported health insurance industry IT execs said:
Last March, I did a post reviewing a survey of health insurance industry information technology executives' opinions on how well the Obama administration was doing toward launching the exchanges.
The federal health insurance exchange problems that have so far been obvious have been all front-end issues--being able to get the Obamacare's consumer portal to work.
What is concerning about this March survey is that it also identified big concerns the insurance industry had, and still has, over the critically important backroom transactions yet to come.
My conversations with industry executives in the last few days indicate those concerns continue. Instead of the federal exchanges being able to transmit clean data to the insurers on who is signing up for coverage, this element of the process is still in testing! When there are problems with the very few enrollees they have received information for, I am told the insurance companies are having trouble getting through to the special federal exchange help desk for the health plans--the phone is often not even being answered!
When they do get through to the federal exchange help desk a "ticket" is created for each batch of problems to be resolved later. That may be a good process if the carriers are only enrolling 20 people a day, as many are now, but this is going to be problematic when the real enrollment volume ultimately begins.
With all of the concerns expressed within the industry over many months, the Obama administration decided to launch on October 1. Time after time when given the chance HHS Secretary Sebelius, as well as her senior staff, refused to step away from the promise to be "ready on time."
Those who enroll for coverage rightfully expect that when they go to their doctor next January they won't have trouble getting the coverage they now want to sign up for. But this phase in the Obamacare rollout, still to come, could well be the most problematic.
In the original March post, I reported health insurance industry IT execs said:
- The vast majority of those who answered the survey were planning to participate in the new health insurance exchanges.
- They were worried that, with the feds and states getting such a late start in detailing requirements and with so little time left, that their own organizations could be ready.
- They were also worried because the information they are getting from the health insurance exchanges in order to do their share of the work was poor, to very poor.
- They were not optimistic that the government-run exchanges will be ready on time.
- Almost all of those surveyed were concerned that the exchanges had not involved them as users in gaining input from the industry––traditionally a very bad sign in system development.
- And, the executives were very concerned about being able to reconcile billing and eligibility information from the exchanges.
