Five Questions With: Christine Ferguson

Executive director of HealthSource RI talks about the demand for the state’s health exchange and small businesses’ willingness to participate. More

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Five Questions With: Christine Ferguson

PBN FILE PHOTO/RUPERT WHITELEY
"We can’t use any of the federal dollars to pay brokers. That was an early-on plan."
Posted 2/17/14

Christine Ferguson, the executive director of HealthSource RI, has been in health care and public policy for more than 30 years. She has served as Commissioner of the Massachusetts Department of Public Health, Director of the Rhode Island Department of Human Services, and Counsel and Deputy Chief of Staff to the late U.S. Senator John H. Chafee.

PBN: What are you happy about with the most recent release of numbers?

FERGUSON: I think it’s going really well. We have a high demand – it’s a little bit higher than I expected. So, that’s all good. It’s giving a chance to work through all the issues that are normal in a project this big. So, we’re pretty happy about the numbers.

PBN: Is there anything with the most recent numbers that makes you less happy?

FERGUSON: I think we would like to see higher small-business participation. But I’ve talked to all of the other states that are trying with small business, and on a per-capita basis we’re doing much better than the other states. It’s still not anywhere near good enough, from my perspective. It’s largely about the fact that you’re not dealing with a fixed, open enrollment period. It’s renewals, and renewals happen over the course of a year, month by month. We’ll see a pickup in that, over time. And that’s a challenging crowd. This is an issue that they tend to say, “Oh, my God, do I have to do the health insurance again?”

PBN: If you were a broker, would you be reluctant to guide a client through Full Employee Choice, even though there are people waiting at the Call Centers to assist brokers, given that you won’t make more money than you were paid previously, before the introduction of the exchange?

FERGUSON: We can’t use any of the federal dollars to pay brokers. That was an early-on plan. What we’re trying to do is wrap a set of services that are in-kind around brokers. So, the ones that are really interested and see the future, and see what the opportunities are with this, they are embracing it. It’s interesting – a lot of times brokers who have been in it for a longer period of time are the ones who are saying, “This is long overdue.”

PBN: So, brokers shouldn’t feel threatened?

FERGUSON: I have been eminently clear, in my conversations with the legislature, in my speeches, that we view brokers as a partner. We want to support them in that partnership. And we are doing everything we can to make that possible. This has only been up and running for actual renewals for only a month and a half. You could only start on SHOP if you were renewing January 1. I have found that many of the brokers that we’ve been working with closely understand the health care system in ways that a lot of times health care experts don’t understand it. They have a really interesting take on what has to happen in the health care system to control costs. I have found them to be an extraordinary resource. I think there is a fear among some of them that we’ll replace them. I don’t think that that’s going to happen. I think the ones that are fighting us are perceiving what has to happen in a way that isn’t reflective of what we’re actually doing.

PBN: What is going on in terms of back-end issues with the exchange?

FERGUSON: No. 1, there are back-end issues, no question. I said all along there were going to be back-end issues. No. 2, we have a team of people in place, that’s a conglomeration of the system builders, our state folks and contractors, and the contact center. And we are addressing those and cataloguing them. We have a SWAT team. There are problems that we had in October that have been fixed, but new ones crop up all the time. So, we have a team, we have an approach, and, so far, it’s not as fast as anybody would like. But, again, it’s only been six weeks that we’ve been up. I think’s reasonable to try to make the fixes.

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