This past February, HHS awarded seven states multimillion dollar grants as part of the Early Innovator program. Three of those states aren’t in the running anymore: Kansas and Oklahoma sent their grant money back, and Wisconsin has halted all health care reform efforts.
But almost a year into the program, the rest of the states that still have the grants are meeting their benchmarks and on their way to living up to their name.
The goal was to have these states lead the way in building the information technology to support exchanges, and then have them share information, or even entire exchange platforms, with surrounding states.
The states with Early Innovator grants are Maryland, Oregon, New York, a New England consortium of states led by Massachusetts, and Wisconsin. With the big exception of Wisconsin — where Gov. Scott Walker has put health care reform implementation on hold — the Early Innovators have made some significant strides in creating their IT infrastructures.
Massachusetts perhaps has the smallest lift in terms of setting up technology, but one of the largest tasks because it is working in conjunction with Connecticut, Maine, New Hampshire, Rhode Island and Vermont. Figuring out a platform that works for all these states is no easy feat, said Dr. Jay Himmelstein, who is heading up the exchange work through the University of Massachusetts medical school.
“It will not be as much of a lift to build the exchange portal for Massachusetts, since we already have a fully functioning exchange,” Himmelstein said. “We have built in enough time. We’ll be able to deliver. The big challenge is: Can the systems be built in time to fully integrate with other state’s systems?”
And it helps that the Early Innovator states have a good working relationship with CMS. Himmelstein noted that the agency is also working on building an exchange, and the information-sharing relationship is working both ways.
“We’re all learning from each other. CMS especially can learn a lot from the Massachusetts experience in exchange development, and we have a lot to learn from them with regard to the new federal hub technology. They have a pretty heavy lift too, having to design the federal exchange. I like to think of them as the 6th Early Innovator,” he said.
And things are progressing smoothly in Maryland and Oregon. Both states say they are meeting all required benchmarks that CMS has set, and they’ll be ready by October 2013, when open enrollment for the exchanges begins.
The big setback? They’re still waiting on final guidelines from CMS.
“The challenges that we see are few: the aggressive timeline that we have, we have to be up and running in a very short period of time and CMS has guidelines and guidance that are still evolving. We have to take that into consideration,” said Saleem Sayani, chief information officer at Maryland’s health department.
While New York, the consortium, and Maryland all have their requests for an exchange vendor out, Oregon has already contracted with the company Oracle to build out their eligibility software.
“From a benchmark perspective, we are totally on target to be done in time,” said Nora Leibowitz, who’s heading up policy and implementation of Oregon’s health insurance exchange. “I’m not going to say everything is perfect and great, but it’s going to be a busy year and we plan to be ready.”
New York, with its $27.5 million grant, may face the greatest challenge. An exchange bill has yet to pass through the state Legislature, and planning has stalled because of it.
Gov. Andrew Cuomo has repeatedly stated his commitment to implementing the Affordable Care Act in the state, and Peter Constantakes, a spokesman for the New York health department, said the state is doing its best with the innovator grant despite the setback.
Overall, the states that are still in the program should provide enough models for their neighbor states to follow, according to Timothy Jost, a law professor and National Association of Insurance Commissioners consumer advocate.
“There is still a diverse group of states left, that will be able to share their technology and information. So it seems that it doesn’t matter a few states needed to make political statements with their Early Innovator grants,” Jost said.
And if CMS is having problems with the Early Innovators’ progress, the agency isn’t saying so.
“Early Innovators are leading the way on building affordable insurance exchanges, and we are pleased with the progress made to date,” said spokesman Bennett Blodgett.
Source: Politico
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