Key technological advancements are driving efficiencies for state-based exchanges
MOUNTAIN VIEW, Calif. – October 4, 2022 – In the lead up to open enrollment for plan year 2023, public sector healthcare IT leader GetInsured is working closely with state-based exchanges (SBEs) to address technological needs as they prepare for the end of the federal COVID-19 Public Health Emergency (PHE), work to increase operational efficiency, and improve the overall experience for consumers seeking coverage.
With seven state clients — California, Idaho, Minnesota, Nevada, New Jersey, Pennsylvania, and Washington – GetInsured serves millions of consumers through its innovative Software-as-a-Service (SaaS) technology, while working closely with insurance carriers, enrollment professionals, and state and federal regulators. The GetInsured platform enables state clients to respond quickly and efficiently to federal rule changes, resulting in record-level enrollments in all states where GetInsured operates exchanges in full or in part. During the 2021 open enrollment period, nearly three-quarters of all SBE enrollments were serviced by a GetInsured-built platform and since the launch of the Affordable Care Act (ACA), GetInsured has assisted 12 million individual enrollment transactions.
“While the past few years have been undeniably challenging, Your Health Idaho continued to see operational success of our health insurance marketplace thanks in large part to GetInsured’s proven and innovative SaaS platform, dedication to excellence, and years of expertise working with state-based exchange clients,” said Pat Kelly, Executive Director of Your Health Idaho. “Through our partnership with GetInsured, which began in 2014, Your Health Idaho has been able to simplify the eligibility process for consumers, leverage the advantages of modern technology, and help tens of thousands of Idahoans access affordable health insurance coverage – all while keeping costs low for our state. The policy and governance flexibility we gain by operating as an SBE has enabled us to enact changes quickly, access data that we wouldn’t otherwise be privy to on the federal marketplace and create jobs here in Idaho.”
In Idaho, GetInsured helped the state exchange, Your Health Idaho, transition to a modern real-time eligibility system that delivers tax credit results in seconds and entails tight integration and collaboration with the Department of Health and Welfare (DHW). This allows consumers to apply with Your Health Idaho or DHW and be transferred to the other if needed based on eligibility. This model was implemented in time for open enrollment which, in Idaho, begins October 15 – two weeks ahead of the federal open enrollment period. Your Health Idaho’s eligibility system offers real-time eligibility determination and lowers eligibility processing time from days to mere seconds.
“The health policy landscape is constantly changing at the federal and state level,” said Shankar Srinivasan, Chief Technology Officer and General Manager at GetInsured. “We work closely with our state exchange clients to develop solutions to meet their requirements and best serve their residents. When we consider system improvements, we look at the entire scope of the exchange’s responsibilities, including operational, compliance, reporting, and regulatory activities.”
GetInsured also recently introduced the following advancements in its SBE technology platform for client states in advance of open enrollment:
- A dashboard that provides 360-degree visibility into the customer data that is transferred between the exchange and Medicaid. Real-time visibility into the status of a data transfer decreases staff workload, allows immediate resolution, maintains program integrity, and reduces the time that consumers remain uninsured. This empowers state Medicaid agencies and SBEs to work more closely to resolve eligibility coordination issues quickly for beneficiaries, so they receive the right insurance coverage at the right time. This capability does not exist on the federal marketplace and will be critical to SBEs for assisting consumers when the public health emergency (PHE) ends.
- A broker mobile app launched in partnership with Your Health Idaho to support the broker community which, in 2021, was responsible for 75 percent of the state’s health insurance enrollments. The app provides self-service features that allow brokers to manage their business from anywhere, anytime and help consumers through the enrollment lifecycle with more ease.
- A suite of reports designed to surface enrollment reporting issues that will cause discrepancies when IRS 1095 forms are generated and sent to consumers for the prior plan year. By having these reports available on-demand, exchange staff can view and correct enrollment discrepancies throughout the year, minimizing the need for error corrections at year end and improving tax filing compliance and accuracy for consumers.
- Custom outreach for specific target groups of customers. SBEs can now conduct campaigns to encourage consumer engagement for specific target groups through the GetInsured platform. Exchanges can use this functionality to communicate new federal or state policies to targeted groups of consumers. Because this functionality is tightly integrated with the platform’s business intelligence capability, exchanges can also track the conversion rate of these targeted groups, rendering it particularly useful for handling the end of the PHE.
“Public sector health care agencies are also preparing for the inevitable unwinding of the federal COVID-19 Public Health Emergency (PHE), which puts the enrollment gains during the pandemic at risk due to Medicaid re-eligibility requirements,” continued Srinivasan. “Along with unprecedented demand across government agencies at the local, state, and federal levels for modern IT infrastructure solutions, GetInsured’s expertise and innovative SaaS technology continue to play a critical role in addressing these emerging and evolving challenges. Our technology empowers state-based exchanges like Your Health Idaho to exercise local control, such as tailoring messaging to consumers, determining open enrollment dates, or the availability of special enrollment periods. The flexibility afforded by the GetInsured platform puts SBEs at an advantage as we prepare for the end of the PHE.”
GetInsured, a Vimo company, is a leading technology provider for state-based exchanges, offering an ACA-compliant cloud-based SaaS technology platform and integrated consumer assistance center operations. GetInsured’s roster of clients includes Georgia, Pennsylvania, New Jersey, Nevada, California, Minnesota, Idaho, and Washington. The award-winning SaaS platform processed enrollments for 2.7 million consumers for plan year 2022, which represents approximately three-quarters of all state-based marketplace enrollments.