health care

Blueprint for Health Benefits Exchange submitted

Posted 12/17/12

PROVIDENCE – The state of Rhode Island submitted its progress report, known as the “Exchange Blueprint,” to the federal government on Dec. 12, detailing its plans for the online marketplace for health insurance to be created under the auspices of the R.I. Health Benefits Exchange.

Earlier in the week, the federal government gave conditional approval to six states – Colorado, Connecticut, Maryland, Massachusetts, Oregon and Washington – for their exchanges.

But Christine Ferguson, the director of the R.I. Health Benefits Exchange, told the Providence Business News that Rhode Island, seen as one of the leaders in this effort, had not fallen behind the curve.

“We chose not to submit the final documentation until we had run it through a couple of people to ensure that everyone who needed to review it had a chance to do so,” Ferguson said, respecting the broad stakeholder process.

Ferguson said she expects that Rhode Island will also be granted conditional approval by the federal government in the next 30 days. The goal is have the exchange up and running by October 2013.

The state is currently in negotiations to contract for a systems integrator, the firm that will develop the core system that will determine eligibility, according to Ferguson.

The next big “nodal point” in the process, Ferguson continued, “will be when we have a prototype, a demo that will be online so that people can browse through the kinds of plans and options” that will be part of the exchange’s operations. Ferguson said she expects that the demo will be available by the end of the summer.

Moving forward, Ferguson said, one of the next challenges will be negotiating what kinds of health plans will be offered on the exchange by the four Rhode Island insurance carriers – Tufts Health Plan, Blue Cross & Blue Shield of Rhode Island, UnitedHealthcare and Neighborhood Health Plan of Rhode Island. The issues, she said, include “developing what is actually offered, and what it sells for, what you are going to ask those health plans to provide, what the exchange is going to provide, and how that reflects the core values and mission of the exchange,” she said.

Ferguson acknowledged that there needs to be better messaging developed around what the exchange will do and what its value is to consumers and businesses in Rhode Island. “There was a big disconnect between some of the rhetoric that was present throughout the election and what will actually be happening a year from now, with the opening of the exchange,” she said. “I think it’s hard sometimes to really have an in-depth conversation with people about something that can’t yet see and when there hasn’t been anything else like it.”

Toward that end, the exchange is currently involved in conducting a series of focus groups to better understand some of the communications challenges, according to Ferguson.

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