Health-system upgrade worth the investment?

BETTER  SYSTEM?  Executive  Office of Health & Human Services Secretary Elizabeth H. Roberts, left, meets with Melba Depena-Affigne, Department of Human Services director, and Michael DiBiase, Department of Administration director. Roberts say most if the issues with the rollout of a health care technology upgrade have been resolved. / PBN PHOTO/ MICHAEL SALERNO
BETTER SYSTEM? Executive Office of Health & Human Services Secretary Elizabeth H. Roberts, left, meets with Melba Depena-Affigne, Department of Human Services director, and Michael DiBiase, Department of Administration director. Roberts say most if the issues with the rollout of a health care technology upgrade have been resolved. / PBN PHOTO/ MICHAEL SALERNO

Ken Block is not a fan of the state’s integrated eligibility system, half of the United Health Infrastructure Project, which went online mid-September and is an IT requirement of the Affordable Care Act.

“In my professional opinion a quality high school programming class would have done a better job,” said Block, the president of Warwick-based Simpatico Software Systems, of the integrated eligibility system and UHIP, the 3-year-old upgrade of the state’s antiquated health care IT system.

UHIP encompasses the creation of the state’s health insurance exchange and the integrated eligibility platform built to streamline how users apply for and enroll in state aid programs, such as modified adjusted gross income Medicaid, non-MAGI Medicaid, supplemental nutrition-assistance program, state supplemental payments, child care and RI Works.

Previously, if one user needed to enroll in multiple programs they had to meet with separate caseworkers, presenting each with the same information. The hope was that once the integrated eligibility platform was online, a user’s information could be accessed by multiple caseworkers.

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That is not the case, argues Block, who said there were “serious and surprising issues for a newly launched system with an incredible level of cost” – not to mention the numerous lasting, public glitches with the state exchange, now 2 years old.

When the integrated-eligibility-platform system first went online, Block himself signed up as a Spanish-language user and found the multilingual element of the software, “absolutely broken.” He recounted some screens were half English, half Spanish, while others were completely English. To top it off, he says he successfully registered his address as Miami, Rhode Island.

For $364 million, the quality of the product, he said, was “beyond shocking.”

For Block, UHIP is the farthest thing from a prudent investment, but at least some state officials say they are satisfied with it even as the price tag has grown.

Emphasizing the scale of data processed by the system and the expected 20-year longevity of the upgrade, R.I. Department of Administration Director Michael DiBiase said, “we are generally pleased with the level of smoothness” of the launch.

It was an “unprecedented ability to access a very large amount of federal funds,” said DiBiase of the fast-climbing cost. “This level of investment would have been hard to do as quickly [without federal aid].”

UHIP’s contract was signed in January 2013 for $105 million. To date, the state has covered $80 million of the cost, which now stands at $364 million through fiscal 2017.

“The second biggest shame of this whole mess was that it was not nearly as stimulating to Rhode Island’s economy as it should have been,” said Block of the contract, with much of the work being done overseas.

Neither Executive Office of Health & Human Services Secretary Elizabeth H. Roberts nor DiBiase could say how much of the overall funding was spent in Rhode Island versus overseas.

Deloitte Consulting, hired by the state as UHIP’s lead technology vendor, declined to comment on the issues raised by Block.

Roberts admitted the upgraded system’s rollout was not flawless.

“We take the understandable frustration of those who have experienced issues very seriously,” she said, adding most of the issues have been worked out and hours have been extended at the largest Department of Human Services field office to meet customer’s needs.

However, she emphasized, the end goal, a better system to deliver services to Rhode Islanders, is working for the almost 320,000 Rhode Islanders enrolled.

Roberts, who acknowledged the increased price, said the impetus behind the investment was the 90/10 federal money match. “We didn’t want to miss this opportunity,” she added.

She explained the system was a 30-plus-year-old Disk Operating System, the efficiency of which, when upgraded, “will make the government work the way it should in the 21st century.”

Block agreed the aging system needed to be addressed, but UHIP was not the answer. In fact, he called it a “poorly run project” with “unchecked cost escalations.”

By streamlining enrollment and eligibility of state aid, UHIP is projected to save Rhode Islanders $15 million this year. Initially, Roberts projected the state would also recoup its investment in two years, but one week after the system went online, extended her prediction to within a “few years.”

Some of that savings may come from cutting personnel, explained DiBiase. While the state is committed to “live customer service,” he said, “we have and will realize staff [redundancies] with this system [and] expect savings in the current year from that.” •

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