On Sunday, customers will begin shopping for their 2016 insurance plans on Vermont Health Connect, and that means judgment day for a new piece of software that’s supposed to help the state avoid the technical glitches that plagued last year’s enrollment process. Administration officials say this time around, the exchange will be ready for prime time.
Lawrence Miller is chief of health care reform for the Shumlin administration, and overseer of Vermont Health Connect. Miller was in the same position last year, when the state had to resort to manual data entry to process tens of thousands of insurance applications.
“So that (was) the source of a lot of the errors that you heard about last year that were related to billing errors, it contributed to the large change-of-circumstance backlog that we had,” Miller says. “It was really a very challenging process.”
Miller says he is feeling far more optimistic about prospects for open enrollment this fall.
“It’s like night and day compared to last year,” Miller says. “We’ll be managing to accomplish in a few days what took four and half months last year.”
According to Miller, the technical shortcomings that necessitated the laborious manual workarounds in 2014 have been rectified by a piece of software that arrived at Vermont Health Connect at the beginning of October. Health Connect staff and contractors have spent the last few weeks putting the technology through its paces.
“That’s worked out very well,” Miller says. “We’ve identified a couple of things that needed minor corrections, made those minor corrections.”
Miller says that with a few exceptions, customers should expect smooth sailing when they try to navigate their way through the online insurance marketplace.
“We anticipate with any of these developments that there will be challenges for some accounts. And the reality is you look at any large customer service organization, and there are always some issues,” Miller says.
Cory Gustafson, director of government and public relations at Blue Cross and Blue Shield of Vermont, the state’s largest private insurer, says his organization is cautiously optimistic.
“Time will tell,” Gustafson says. “We’re encouraged by the progress we’ve seen, but the true test of the system will be on Nov. 1, when individuals begin enrolling in 2016 plans.”
Officials expect a surge of sign ups for this year's open enrollment period, in which Vermonters in need of health care can purchase coverage through the exchange. That period runs from Nov. 1, 2015 through Jan. 31, 2016.
Blue Cross officials say the long-term integrity of Vermont Health Connect hinges on more than just the success of the open-enrollment process. Even if the exchange can achieve optimal functionality, Gustafson says it’s unclear to Blue Cross at this point the state has the financial wherewithal to support maintenance and operation of the exchange over the long haul.
“I think we’ve learned over the last few years that IT is not an inexpensive endeavor, and so it would be important for the state to look at the costs and benefits of running its own exchange,” Gustafson says.
To that end, Blue Cross is calling for an independent assessment of Vermont Health Connect, wherein the state would hire an outside contractor to investigate whether this particular exchange is the right path for Vermont to commit to.
Given recent progress at Vermont Health Connect, Miller says he’s convinced that the program is the best solution for Vermont’s system-wide health care needs. Since Vermont’s exchange also supports Medicaid beneficiaries, Miller says, the federal government will cover a major portion of ongoing expenses.
“We’ve had any number of independent assessments at this point, and I don’t think we’re likely going to spend money on another one,” Miller says.