Over the next six months, Gov. Phil Scott's Administration is set to examine a number of proposals that are designed to improve the reliability of Vermont Health Connect, the state's health care exchange.
There's no question that Vermont Health Connect got off to a rocky start in the Fall of 2013. Certain functions didn't work and there were numerous billing and coverage problems with the rest of the system.
Things were so shaky that a mandate requiring all small businesses to purchase their coverage through the exchange was never put into place.
Al Gobeille is the Secretary of the Agency of Human Services. In his former role as the chairman of the Green Mountain Care Board, Gobeille was very critical of the performance of Vermont Health Connect.
He thinks many of the troubles at the state's exchange can be traced back to a decision to use money available through the Affordable Care Act to help pay for an enormous upgrade of his agency's computer system.
The upgrade was needed to help determine if an individual is eligible for a variety of state services. It's known as the Integrated Eligibility Program.
"So we built a system that is the only system like it in the world and that's dangerous in computer land." — AHS Secretary Al Gobeille
”When the state did it, they did it in a way that was to use some commercial products but then we modified it and sort of it worked on it and patched it in our own way and so we built a system that is the only system like it in the world and that's dangerous in computer land,” said Gobeille.
As the Scott Administration looks to make changes to Vermont Health Connect, Gobeille says it's important to remember that the exchange is just a small part of his Agency's overall computer system.
"If you think about the eligibility platform that we built for Medicaid and for AHS's services and to determine qualified health plans, that's sort of like your iPhone,” said Gobeille. “The Vermont Health Connect or the qualified health plans part of it is simply just an app that goes in your iPhone."
Gobeille says the Administration will consider an option that will essentially separate Vermont Health Connect from the Integrated Eligibility system.
He says this will allow the state exchange to have its own computer programs with vendors who have developed a successful track record in creating these systems.
"Do we want to keep investing in the technology that we've built or do we want to come up with a new way of doing it with new technology or new partners and so that's what we are looking at."
"This was Vermont Health Connect's first fully automated open enrollment and all the customer renewal and changes were completed on time. And in 2016, many of the customer renewal changes were not completed until well into the calendar year." — Don George, Blue Cross and Blue Shield of Vermont president
As the Scott Administration considers its options, there's been a sizeable reduction in the number of major problems associated with Vermont Health Connect. Don George is the president of Blue Cross and Blue Shield of Vermont.
"This was Vermont Health Connect's first fully automated open enrollment and all the customer renewal and changes were completed on time,” said George. “And in 2016, many of the customer renewal changes were not completed until well into the calendar year."
Mike Fisher is the state's Health Care Advocate. He says his office gets roughly 30 calls a week from Vermonters who are experiencing problems with Vermont Health Connect but this number is a lot of less than it used be.
“That's been proven by the number of Vermonters that move through the system," Fisher says, "re-enrollment, managed changes in their lives, without major hassles."
Fisher is hopeful that the Administration will be able to improve the quality of services at Vermont Health Connect.
"I am happy to engage in measuring those proposals against how do we make the system better for Vermonters," said Fisher.
The Scott Administration plans to present lawmakers with its proposal concerning the future of Vermont Health Connect by next January.
