To get the Patient Protection and Affordable Care Act (PPACA) exchanges and their insurer-suppliers ready to open Oct. 1, 2013, technology vendors may really need to have final, workable, flexible program specifications and details by July 1.
Even having the details available in a flexible, easy-to-digest form by June 1, 2013, would require the technology vendors to cope with a “very aggressive timeframe.”
John Sarich, vice president for strategy at VUE Software, a health plan software and service hosting company, gave that assessment during a recent interview about PPACA implementation.
VUE sells and runs systems that can help the insurers that will be selling “qualified health plans” (QHPs) through the PPACA exchanges with matters such as bringing agents and brokers on board, managing producer relationships, customer service, billing, electronic contracting, handling new business, managing producer incentives, and running broker portals.
Clients include many big national and regional insurers, including some — including BlueCross BlueShield of Vermont and UnitedHealth — that have already agreed to participate in one or more exchanges.
VUE already has systems that could plug into exchange systems or QHP systems up and running, but simply tweaking one enterprise-level system to connect with another enterprise system can easily take months Sarich said.
In theory, if an exchange or QHP that was starting up Oct. 1 agreed to use a plain-vanille VUE system hosted on VUE servers by Sept. 1, and all went well, VUE could hook up a system by the Oct. 1 deadline, Sarich said.
But, before that, VUE would want at least two months, and, ideally, three months to get its systems ready to plug and play in the new PPACA universe, Sarich said.
Getting the systems PPACA ready could be challenging, because, in many cases, regulators have been developing regulations that seem to be hard to understand and hard to administer, Sarich said.
But Sarich said he believes that, in the long run, whatever money insurers spend on preparing for the arrival of the PPACA exchanges will be money well spent.
“This is going to happen in some form,” because insurers see using exchanges as a good way to cut administrative costs, regardless of what happens to PPACA, Sarich said.
But, especially at first, Sarich thinks smaller companies will be more likely to sell through the exchanges.
If the PPACA exchanges work well, the larger companies will simply buy out that companies that have figured out how to use the new system, rather than spending $100 million to $200 million to develop their own exchange divisions, Sarich predicted.