Ferguson: Exchange committed to small businesses

INTERESTED PARTIES: The health care summit at the Crowne Plaza Providence-Warwick tackled several topics and attracted professionals from the health and  insurance fields, as well as business owners.

Page 16. Story 2
Photo Credit 2 = PBN PHOTO/MICHAEL SKORSKI / PBN PHOTO/MICHAEL SKORSKI
INTERESTED PARTIES: The health care summit at the Crowne Plaza Providence-Warwick tackled several topics and attracted professionals from the health and insurance fields, as well as business owners. Page 16. Story 2 Photo Credit 2 = PBN PHOTO/MICHAEL SKORSKI / PBN PHOTO/MICHAEL SKORSKI

There’s plenty to like about the state’s new health-benefits exchange, HealthSource RI Executive Director Christine Ferguson told approximately 300 business owners, health care providers and insurance professionals at a Feb. 27 health care summit co-sponsored by Providence Business News.
But that doesn’t mean it couldn’t be working better, she acknowledged.
Ferguson admitted, for example, that service at a contact center set up to help people enroll in the exchange has not always been optimal, despite what she described as “an amazing team … guiding people through the glitches that we thought would happen.
“We are not anywhere close to what I would like to be for customer service,” Ferguson said during the first of two panel discussions at the Crowne Plaza Providence-Warwick.
Asked how many enrollees were previously uninsured, Ferguson said she didn’t have hard data but believes “a good percentage of the people who signed up are people who were uninsured before.
“We have a question in the application that asks in a less direct way than I would like,” she explained. “We’ll have more data after the March 31 deadline, unless we have an executive order from the White House that changes that, and we’ve had quite a few of those.” The U.S. Department of Health and Human Services acknowledged it also failed to include a question in its enrollment process about whether enrollees previously had health care.
Ferguson’s primary message, however, was that the exchange is doing better than most others across the country, and the people behind it remain committed to improving.
“By all objective standards that are being used by the national media and by the Centers for Medicare and Medicaid, we’re one of the top two exchanges in the country,” she said.
The first panel discussion focused on the state exchange and the Affordable Care Act. On the panel were Ferguson; Sam Slade, the leader of the health benefits group at USI Insurance; Dr. Kathleen Hittner, the Rhode Island health insurance commissioner; James Raiola, a certified financial planner and insurance broker and Stephen Boyle, president of the Cranston Chamber of Commerce and co-creator of the new HealthSource RI small-business hotline.
Hittner agreed that the state’s exchange and those running it deserve far more praise than criticism. “Is it perfect? No, it’s not perfect,” she said. “They follow up, they call back. They’re working harder than any team [across the country]. Even shopping on [Amazon.com] isn’t that easy.”
Ferguson pointed to the extreme difficulties being faced by the first state in the union to create an exchange, Massachusetts, since the new exigencies of the Affordable Care Act came into play.
“It’s been a team effort,” Ferguson said. “We’re lucky in Rhode Island – we rock. Look up north, I mean, they’ve collapsed.”
Unlike Rhode Island’s exchange, the Massachusetts Health Connector website, also known as the Connector, has struggled with technical issues. Last month, Gov. Deval L. Patrick brought in a Blue Cross Blue Shield executive, Sarah Iselin, to oversee the effort to get the website up and running. There was a backlog of 72,000 people in the middle of February who had submitted applications for coverage that were unprocessed and in limbo. Those applications have had to be hand-processed.
In Rhode Island, however, many small businesses are still reluctant to enroll through the state’s exchange for a variety of reasons, including concerns about cost and difficulty working with the system. Ferguson says she remains hopeful about winning more of them over.
A $6.1 million grant from the Centers for Medicare and Medicaid Services will be used to assist the exchange with its small-business enrollment efforts.
“We’ve been asked by many people and some states to show what we’ve been doing with [the Small Business Health Options Program],” she said. “What we’ve done in terms of wraparound and outreach to the business community, when you look at it compared to California and many other states that are taking the small-business piece down. We are very committed to small business and have been since the beginning. That’s where you see the return on investment.”
Slade said that the major benefit for small businesses to switch to insurance plans offered through the exchange is federal tax credits they couldn’t get anywhere else.
“With our clients who are small businesses, one of the first things we do is determine if they’re qualifying for the tax credit,” Slade said, “and when we determine that, it’s kind of a no-brainer. But there aren’t that many businesses that qualify. “If you don’t qualify for the tax credit, that’s when it gets challenging,” he said. “The all-in-one, or 16-plan decision, for many small businesses, there’s a lot of information that they need to process. There’s a lot of legal and compliance that they have to go through.”
Raiola discussed some of the challenges facing brokers, even those who may be enthusiastic about the act and how it is being implemented by the state’s exchange.
“A typical 15-employee company would have taken me about 15 minutes to enroll as a group,” Raiola said. Now, the first 15 minutes is spent examining what the act means for that business, and that actually takes me the first hour. And then they want to be educated on HealthSource RI. We spend another 20 to 30 minutes learning about that. All told, an enrollment now takes 90 minutes.”
Boyle said that a small-business hotline created by the Cranston Chamber of Commerce was not a competitor to HealthSource RI, but instead a funnel to the exchange.
“We’re not replacing anything,” Boyle assured, “but we want to see who qualifies [for the tax credit] and get them enrolled.”
Hittner insisted the exchange would become more high-functioning in the future.
“The exchange a year from now will be a well-oiled machine that will be easy for people to use,” she said. “There’s also going to be a lot more information we can give to people. We also believe this will lead to better care for a lower price, through a patient-centered medical home. I think the exchange can not only be a place to sell insurance but a place to improve the health care delivery system.”
The future of the exchange, including how it will be funded (annual cost for it has been estimated at between $20 million and $24 million), was on everyone’s mind at the summit, as Ferguson acknowledged. She said the question of funding will be decided in part by what the state decides it wants to get out of the exchange.
“The question that has to be answered is, what do the legislature, the business community and the candidates for governor want?” Ferguson said. “At the end of the day, that’s your decision.” •

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1 COMMENT

  1. The Exchange, it’sDirector, and its staff deserve a high level of commendation for the work they have done so far getting it off the ground. They are putting countless hours in including evenings and weekends,to make it a success.