Help is on the way for Nevada’s struggling health insurance exchange.
The board of the Silver State Health Insurance Exchange met Thursday to name an interim executive director and discuss adding technological aid to help Xerox, the contractor designing the exchange’s Nevada Health Link website.
They also sat stunned as Xerox reported pushing its original March 31 enrollment goal of 118,000 to 150,000. Nevada Health Link had fewer than 20,000 enrollees as of Wednesday.
Sorting it all out will require new leadership, and that’s where Steve Fisher comes in. Fisher, deputy administrator of the state’s Division of Welfare and Supportive Services, will step in as the exchange’s temporary executive director while the board searches for a permanent replacement for Jon Hager, who steps down on March 14.
The board also agreed to bring in information-technology staff from the state Department of Health and Human Services to work with Xerox to patch website problems and test systems. Members voted as well to bring in a third-party contractor to analyze the system’s problems.
Health and Human Services Director Mike Willden suggested the board choose as its outside vendor Deloitte, one of the four original bidders on the $72 million Nevada Health Link project. Deloitte has been working on technology projects for Health and Human Services for two years, Willden said.
Board members said they would seek feedback from Nevada Attorney General Catherine Cortez Masto’s office on a contract before they officially retained Deloitte.
Willden said it would take Deloitte or any other contractor three to eight weeks to “give us an unbiased opinion of what they could do” to repair problems with the glitch-riddled site, some of which has yet to be built.
That means guidance on how to make Nevada Health Link work may not come until after the March 31 deadline to enroll.
Board members nixed several other options in their hunt for solutions.
They decided against joining the federal exchange because it might take months to implement it in Nevada. That could imperil sign-ups in the next open enrollment session, which begins in November. Plus, the federal website’s payment function isn’t built, and its development process would not be “transparent” to Nevadans, said Shawna DeRousse, the exchange’s chief operating officer.
The board skipped over changing out ailing parts of the website with different platforms. And it wouldn’t pull the trigger on the final option — firing Xerox altogether.
That doesn’t mean board members have confidence in Xerox, though.
“We need to hear from the attorney general’s office, so I don’t think the board would be able to (end the contract) today,” said board Vice Chair Lynn Etkins. “But if this suggests that I have any confidence that this ship is going in the right direction, I do not.”
Board members also got an update from Xerox executives on the status of patches to Nevada Health Link’s website and call center. They said the company has resolved 128 of the 182 high-priority production fixes the website needs. They described running the operation 20 hours a day to help sign up consumers. They reported getting through more than 11,000 pieces of consumer correspondence, or about a third of a backlog of 32,000 unanswered queries. They even set up a special fund for enrollees who need medical care but can’t verify their coverage.
But it was Xerox’s boost in sign-up projections that got the most feedback from the exchange board and staff.
The pre-launch goal was 118,000 enrollees. Hager, the departing executive director, dropped that to 50,000 in mid-February, but the board insisted the objective stay at 118,000.
Just 19,320 people had signed up through Wednesday. Yet Xerox pushed its March 31 enrollment goal to 150,000.
DeRousse pointed out that Xerox was enrolling at most 2,000 people a week.
“To hit 118,000, or even 150,000, is definitely a huge target, and a huge undertaking,” she said. “I’m just not sure we can get there.”
Etkins was more blunt.
“I hear your numbers, and your testimony, and I continue to think that it does not true up with what I’m hearing from navigators, brokers and agents. They are still frustrated with the system, and it doesn’t sound like there’s still a synergy or understanding of a lot of these basic problems. The 150,000 number, if that’s the goal, doesn’t seem, based on 1,000 to 2,000 (enrolled) this past week, anywhere near reality. So I just continue to be troubled.”
The board plans to meet again next week to discuss hiring a third-party contractor.
Contact reporter Jennifer Robison at firstname.lastname@example.org. Follow @J_Robison1 on Twitter.