If Minnesota wants to run a better state-based public health insurance exchange this fall, it needs to name an exchange information technology (IT) manager, consultants told the exchange board.
MNsure, the exchange, also needs to hire a testing manager, improve communications between the different people working on the project, and establish a clear, consistent list of priorities, the consultants said.
The consultants, from Deloitte, described their concerns about MNsure in a report included in a MNsure board meeting packet. Minnesota gave MNsure enthusiastic support. The Patient Protection and Affordable Care Act (PPACA) exchange has succeeded at enrolling 52,233 people in private qualified health plan (QHP) coverage through the exchange. The exchange also has enrolled 152,662 people in Minnesota’s Medicaid program and 52,154 people in a program aimed at moderate-income resident.
In October 2013, when the individual QHP open enrollment period was just starting, exchange officials said they hoped to use the exchange to enroll about 80,000 people in individual or group QHP coverage during the open enrollment period and about 39,000 people in QHP coverage during the rest of the year. But IT problems hampered enrollment, and, in their report, the Deloitte consultants say that IT management weaknesses remain.
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At the time Deloitte reviewed the project, it saw “fragmented and unclear decision-making authority and role confusion across the project at multiple levels is leading to decision-making delays, bottle-necking of issues in need of resolution, protracted activity planning, and unmet objectives,” the consultants say.
“Vendors are given conflicting direction on priorities of work and system requirements from business, technology and management teams operating in ‘silos,’ without coordination or integration across state and vendor teams,” the consultants say. The workers at each agency involved in the exchange project operate in separate silos, and that makes matters worse, the consultants say.
The board helped run the exchange while it was looking for a new executive director to replace the first executive director, who left. The board is continuing to stay heavily involved in management, and that’s adding to problems with setting priorities and making other types of decisions, according to the consultants.
The Minnesota technology team is hiring a project director now, a technology agency representative said.
A representative for MNsure said Deloitte’s recommendations were well-received by the MNsure board, MNsure and MNsure’s partner agencies. ”Most of the recommended project governance structures have been adopted, and any remaining are in the process of being adopted,” a MNsure representative said. “This supports the MNsure board resuming a role of oversight and direction.