Massachusetts’ experience in going from a sterling universal health care success to a crashing insurance-exchange website failure has been hugely discouraging. And now, as the result of poor management, overly ambitious goals, and a software contractor that couldn’t deliver, the Patrick administration has arrived at point of frustrating options.
Having decided that fixing the current website is a lost cause, officials at the troubled Massachusetts Health Connector today will recommend buying a software product from a different vendor, hCentive. But the Connector also wants to prepare to join Healthcare.gov, the federal website, in case hCentive’s “off-the-shelf” website product can’t be adapted in time to let Massachusetts residents secure health plans for 2015, for which enrollment starts on Nov. 15.
That course has left the state’s health insurance plans deeply concerned, and understandably so: Having invested heavily to prepare for the dysfunctional website, they’ll now have to prepare to work with two different websites. Sarah Iselin, the Blue Cross Blue Shield of Massachusetts executive brought in to set things rights at the Connector, has won good reviews for her work clearing up the backlog there. But the Connector board should scrutinize her recommended path forward with a measure of healthy skepticism.
There are two possible causes for concern: For one, Optum, the health-technology firm that the state hired to help fix its website problems, has a 24 percent ownership stake in hCentive, which stands to get tens of millions in state work. Board members deserve a clearer sense of which other options were considered.
Second, the agency hasn’t tapped Connecticut’s expertise. That neighboring state has managed to get right what the Patrick team couldn’t. Its website, developed in a closely managed process with Deloitte, works well. Given that fact — and the fact that Kevin Counihan, CEO of Connecticut’s health-insurance exchange, used to work for the Massachusetts connector — one would think Connecticut would be a valuable nearby resource. Actually, “there hasn’t been any kind of formal outreach,” says Counihan. “We haven’t had any substantive discussion.”
For her part, Iselin says hCentive rose on its own merits due to high-quality website work in Colorado, Kentucky, and New York. She also says she spoke directly to Deloitte, which said it couldn’t adapt Connecticut’s website for Massachusetts in time. Then again, Massachusetts has had a troubled relationship with Deloitte, while Counihan’s advice might have proved helpful.
After a problem-plagued 2014 enrollment period, the state must get this right for 2015. To that end, the Connector board needs to take an active role in probing Iselin’s strategy — to make sure that the latest strategy for ending the website fiasco doesn’t lead the way to a new one.