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Updates from RI’s health exchange crush

January 24, 2012

The working group devoted to designing Rhode Island’s health insurance exchange met today at 7:30am.  I was busy taking a shower, so I can’t give you a report on the meeting.

But I do have something to offer- advice from another state. Rhode Island might have been the first local government to win the second round of federal funding for the exchange, but it’s not necessarily first in everything. The folks working on RI’s online marketplace for health insurance tell me they have a little bit of a crush on the bureaucrats in Oregon.

Why? They tell me Oregon is further ahead in its efforts to build the actual technology to make this website happen. The public corporation in charge of the exchange has already partnered with a vendor and even written a draft of its business plan.

I grew up in Portland, Oregon and I’m always excited to make connections between my home state and my current home.  So, I chatted with Lisa Morawski, from Oregon’s Health Insurance Exchange.  At the time, she told me she didn’t have an official title because the organization was so new, but she described her job as “communications.” Here are some tidbits from our conversation earlier this month-

The Pulse: Rhode Island has found that it’s sometimes difficult to explain why the state is creating this health insurance exchange.  How do you talk about it to Oregonians?

Lisa Morawski:  A lot of times it is hard to explain because there’s nothing like it yet in the marketplace. A lot of times we’ll compare it to a Travelocity, which kind of resonates with people in that it’s a place where you’re going to be able to go and search for things that are important to you about health plans, whether that’s the cost or whether it includes a certain provider.  And put your choices in and the exchange will be able to present options to you for buying health insurance.

In terms of why we’re developing it and the value that it brings, it will be the first time there is a central place where people can really go and compare health plans and really compare them apples to apples. That’s just not available right now. It also will be one place where people can go for all kinds of health coverage… You can just go to one spot and put in your information and the system will figure out whether you’re eligible to buy a commercial plan and if you are, if you qualify for the federal tax credits that are available. But it will also tell you if you’re available for one of the public programs like Medicaid. It will do one application and you can enroll in any of those plans.

The small business piece of the exchange is also going to be pretty unique. Our goal in Oregon is to actually let employers do what’s called a “defined contribution model” where they say “OK, I’m going to pay X amount towards your premiums as an employee and you can go to the exchange and shop for all the plans that are offered on the exchange.”

The Pulse: The folks in Rhode Island say Oregon is known for being farther along in terms of implementing the technology to make this health exchange  happen. So tell me what you’ve done so far in terms of the actual website.

Lisa Morawski: Basically what we’ve done, we’re partnering with another state agency here that does Medicaid and Human Services type functions, we’re partnering with them on the IT piece so we develop a single IT system for both Medicaid eligibility and commercial health insurance. We actually chose a vendor. We’ve purchased an Oracle suite of software programs. So we’re really developing our system right now. And it’s challenging because we’re still waiting for a lot of requirements from the federal government.

The Pulse: So you’re ahead of the federal government in terms of what you’re supposed to be doing?

Lisa Morawski: Well, no, I just mean that the federal government is still developing requirements for the exchanges. We don’t know exactly what everything looks like for instance, around eligibility.  But we’re developing our system in chunks if you will, so we can keep moving forward while waiting for new information.

The Pulse: So if I were to go on to the beta version of the exchange right now, how far could it take me? What have you accomplished so far?

Lisa Morawski: Well we have a prototype coming out in the spring. So we’ll have something people can actually look at. I probably can’t tell you in a lot of detail what all they’ve built so far, but we are scheduled to release a prototype this spring.

The Pulse: Rhode Island says it’s excited about the kind of technology work that you’re doing. Do you see the possibility of sharing what you’ve accomplished with other states?

Lisa Morawski: Yes. Definitely. That’s part of the early innovator grants that went to the seven states. Whatever we develop with that grant money we’ll be sharing with other states.

The Pulse: So what can be shared and what is proprietary?

Lisa Morawski: Oh, I don’t know exactly to that detail. I could probably get back to you on that. [In a later email, Morawski wrote- “We will be sharing our planning and system configuration with other states, but if someone wanted to duplicate our system, they would have to buy the same Oracle products that we purchased.”]

The Pulse: Do you see Oregon and Rhode Island collaborating together in any way?

Lisa Morawski: I’d probably have to check to see if any of our folks have talked to anybody directly in Rhode Island. Like I said, as part of being an earlier innovator state, we’re definitely willing to share our solutions with all other states, so it’s something we’re open to. But I don’t know specifically if some of our folks have talked to Rhode Island. I know we’re in contact with a lot of other states. We tend to talk to Washington a lot just because they’re our neighbor.

The Pulse: Do you have any advice for Rhode Island? Are there any mistakes you made or learning moments that you feel comfortable talking about?

Lisa Morawski: One think I think has been really important to use in our work is stakeholder outreach.  We’ve really been trying to involve lots of different groups… I think just in general, communicating with people to find out what they’re looking for in the exchange and talk through options to see what’s going to work. I think that’s been really helpful for us.

Still want to know more about the Oregon Health Insurance Exchange? Geek out and read the public corporation’s business plan.

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