Connector Prepares for the ACA While Running Current Programs

Today, the Connector Board met to discuss the impact of the Affordable Care Act (ACA) on the Connector, vote on the 2012 Affordability Schedule, and analyze data from the FY12 Commonwealth Care member survey.

Materials from the meeting are posted here and our full report is on the flip side.

Glen Shor began the meeting with the Connector’s program enrollment numbers as of March 1, 2012:

  • Commonwealth Care: 173,476 (increase of 14,500 from February, mostly due to reintegration of CommCare Bridge members)
  • Commonwealth Choice: 38,747 (decrease of about 600 members)

National Health Care Reform Update (Kaitlyn Kenney & Roni Mansur)

Level 1 Establishment Grant
The Connector received a Level 1 Establishment Grant of $11.6 million in February.

Activities funded by the grant include:

  • Product Development: Ensure Connector offers products that meet Affordable Care Act (ACA) requirements pertaining to Platinum, Gold, Silver, Bronze, Catastrophic tiers.
  • 3Rs (risk adjustment, re-insurance, and risk corridors): Identify the state’s options to implement the 3Rs.
  • Outreach & Education: Develop strategies for educating individuals and small businesses about the ACA and the new health care options available to them.
  • Project Management Assistance: Provide project management to help facilitate workgroup coordination and adherence to key milestones.

ACA Operations & IT Transitions
Roni Mansur reviewed the Connector’s current operations of the Commonwealth Care and Commonwealth Choice programs.  The ACA will have several impacts on the Connector’s programs and operations:

  • Medicaid expansion underscores that the Connector needs to focus on qualified health plans (QHPs) and commercial insurance in the small/non-group market.
  • The ACA does not separate subsidized and unsubsidized insurance in the Exchange, as the Connector currently does.
  • The ACA requires several changes to health insurance plans available through the Connector, which will change the current online shopping experience and supporting IT/business processes.

The Board had a very spirited discussion about the cross-market risk adjustment requirements (which fall under the third bullet above) and the possible impact it will have on the Connector’s plan offerings.

Key Operational Transition Activities

  • The Early Innovator/Health Insurance Exchange Integrated Eligibility System (HIX-IES) is a collaborative effort between MassHealth/EOHHS, the Connector and UMass Medical School, to develop new IT systems to support ACA-driven changes, including creation of an integrated real-time eligibility determination process.
  • The Connector has several workgroups that focus on other aspects of ACA transition – including
    Exchange business processes, customer service, plan certification, outreach and education, 3Rs, navigator program, oversight, and policy/appeals.  The Connector plans to engage key stakeholders in this work.

Federal Regulatory Guidance

  • Essential Health Benefits (EHBs): Each state needs to select a benchmark plan that will serve as the reference point for EHBs in that state.  The Division of Insurance (DOI) is in the process of compiling comparative benefit information for the plans HHS designated as benchmark plan options.
  • Actuarial Value and Cost-Sharing Reductions: HHS release guidance last week describing its intended approach for implementing cost-sharing reductions for eligible Exchange purchasers.

State Legislative Updates & Analysis

  • The Legislature approved the Governor’s FY12 supplemental budget language that designates the Connector as the ACA-compliant Exchange in Massachusetts.
  • The state’s inter-agency taskforce, which represents 20 state agencies, and its affiliated workgroups, is in the process of identifying additional legislative changes necessary to implement the ACA and when these changes need to take place (2012 or 2013).

Insurance Market Reform

  • DOI and the Connector head the Health Insurance Market Reform Workgroup, which has scheduled several open stakeholder meetings on various issues.

The meetings are posted at

Final 2012 Affordability Schedule (Kaitlyn Kenney)

The Board voted unanimously to approve the 2012 Affordability Schedule proposed by Connector staff.  The schedule increases required premium contributions by 1.5%.  The ACT!! Coalition submitted comments that support this proposal.

FY2012 Commonwealth Care Member Survey Results (Stephanie Chrobak & Jen Flint)

As a follow up to the February 9th meeting, Connector staff provided a more in-depth look at results from the FY12 CommCare member survey.

The survey contacted 750 CommCare members with three areas of oversampling:

  • New Plan Type I members with limited health plan choice;
  • Members who changed their health plan during open enrollment; and
  • Members who were enrolled in Network Health prior to open enrollment.

According to the Connector, key takeaways from the survey include:

  • Overall high member satisfaction (77%)
  • Access to care remains robust for members
  • Premiums and copays are affordable
  • CommCare members are informed consumers
  • The open enrollment process works well

Interestingly, for the first time, affordability of premiums made the top five reasons for member satisfaction.  While quality and access measures were positive, there remain barriers to care for members.  For instance, 33% of members surveyed responded that they were told by a doctor’s office/clinic that they weren’t accepting their insurance.  Nancy Turnbull asked if the Connector could dig into this more, and Connector executive director Glen Shor responded that they can dig more into much of the data.

Dolores Mitchell suggested that the Connector compare these survey results to the Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys the National Committee for Quality Assurance (NCQA) requires commercial insurers to do to get accreditation.  Celia Wcislo expressed concern about the small percentage of CommCare members who cited barriers to finding a doctor that spoke their language.  Nancy Turnbull concluded that the Connector has the best data of its kind on how a subsidized Exchange program works, particularly after changes in procurement strategy that led to utilization of limited networks as a cost control measure.  She suggested using the data to inform Exchange development in other states.

The next Connector Board meeting is scheduled for Thursday, April 12th from 9:00-11:00am at One Ashburton Place, 21st floor, Boston.
-Suzanne Curry

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One Response to Connector Prepares for the ACA While Running Current Programs

  1. fender says:

    you mean obamacare

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