Obamacare: Kentucky’s 4 Lessons for Healthcare.gov
Kentucky’s state-based health care marketplace is in a unique position: It is receiving praise for how it has operated to date. According to the most recent status report, from October 1 to November 30, there have been 87,640 completed applications, representing 151,255 individuals seeking coverage.
In terms of applications, Kentucky’s marketplace is third, behind California and Washington. For the number of individuals seeking coverage and total people enrolled, it is fourth out of the 14 states that opted for state-run marketplaces.
Most importantly, users of the site did not receive a constant stream of error messages when they attempted to sign up for health coverage. WUKY, an NPR station in Kentucky, reported that as of December 2, around 40 percent of those who had selected a private insurance plan were younger than 35.
Kynect, the site Kentuckians use when shopping for health care, was lauded in a recent Pew Charitable Trusts study into why certain states experienced an easier time with their Web-based exchanges. As a result of their strategies, Kentucky and several other states are the examples people are looking to when designing exchanges. The following are the four factors earning praise for Kentucky.
Kynect has been able to enroll more people per capita than any other state, and its simple interface may be part of that reason. Carrie Banahan, executive director of the Kentucky exchange, said the “system doesn’t have a lot of bells and whistles. There aren’t a lot of graphics that would take a lot of bandwidth.”
Additionally, Kynect let users browse potential plans without first setting up an account and password. That tripped up the federal website, preventing users from even being able to see what was offered and encountering error messages instead of plans.
2. Tried and true testing
Julie Bataille, director of the Centers for Medicare and Medicaid Services’ office of communications, told reporters that “a compressed time frame” meant HealthCare.gov’s “system just wasn’t tested enough.” The Washington Post published her comments, as well as a statement that federal end-to-end system testing was lacking potentially as late as September 26.
Kentucky, on the other hand, tested its site for a three full months ahead of its launch.
3. Outside help
HealthCare.gov didn’t bring in IT experts until after the system failures were running rampant. It was then that the administration sought out a team led by Jeff Zients to identify and solve HealthCare.gov’s problems. The “tech surge” identified hundreds of issues administrators needed to work through in order for the site to fully operate.
States like Kentucky didn’t attempt to manage the IT in-house. From the beginning, “systems integrators” were used. The integrators’ job was to make sure the state website could function properly and would work with Medicaid sites as well as other states and the federal government.
4. Deloitte, not CGI
Of the top four states identified by the Pew Charitable Trusts as having a well-running website, Deloitte was the contractor used every time. Kentucky paid above the $30 per resident average for Kynect, with $57.69. Connecticut and Washington, other top states, were closer to the $30 mark at $32.36 and $21.86, respectively. Rounding out the group of four is Rhode Island, where $77.63 per resident was spent. In some cases, it cost a little more for states to have their sites operating, but the sites also function better.
The two states that spent the most per resident were Vermont ($266.97) and Hawaii ($145.33). Each state enlisted CGI, the same contractor used for HealthCare.gov, and the websites in those states appear to have similar problems to the federal marketplace.
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