July 8: Exchange presents technical challenges on tight deadline

  • Article by: JACKIE CROSBY , Star Tribune
  • Updated: August 10, 2013 - 10:11 PM

Officials say the new insurance exchange hub will be ready by Oct. 1, though some functions won’t be in place yet.


April Todd-Malmlov, executive director of MNsure, stands in one of the St. Paul offices where software engineers are building Minnesota’s health insurance exchange.


The no-frills space where high-tech wizards are building Minnesota’s health insurance exchange looks like a war room for a political campaign.

IT consultants work elbow to elbow around computers in a center island. Along one wall, stripes of blue tape and clusters of neon-colored notes demark key dates on the march to an unrelenting Oct. 1 launch date.

It’s a labyrinthine process that ultimately will connect a brand new pathway for buying health insurance with Minnesota’s aging computer system and a massive federal hub.

“It’s a difficult project, one of the first of its kind,” said Leslie Wolfe, a division president for Maximus, the state’s lead contractor on the project. “There’s not a lot of precedent to draw from.”

Thus far, the state is hitting the required milestones to prove that the exchange, called MNsure, will be ready for open enrollment in October. But in one indication of the challenge at hand, officials for the first time are dialing back expectations for what to expect out of the gate.

April Todd-Malmlov, MNsure’s executive director, alerted the MNsure executive board in late June that some low-income workers and individuals who are new to public health programs will be automatically assigned an insurance plan during MNsure’s first months. That’s a departure from what proponents have touted as a key advantage of the exchange — consumer choice.

Some bells and whistles, such as being able to compare hospitals and doctors, will come in a series of planned upgrades.

“We know we’ll run into bugs, little glitches,” Todd-Malmlov said. “It won’t be perfect.”

The state exchanges, marketplaces where people can comparison shop for coverage, are an essential platform to implement the most sweeping reform elements of the Affordable Care Act starting in 2014.

In Minnesota, about 71 percent of workers get insurance at the workplace. The exchanges are meant to help everyone else — individuals, businesses with fewer than 50 workers and those in public health programs.

A key to making it work is getting the agency’s 35-year-old computer system up to snuff. Today, the Department of Human Services still sends out thick paper packets to enroll people in public health programs at significant cost to taxpayers and great hassle to citizens.

It’s a “monumental undertaking,” said Scott Keefer, vice president of government affairs at Blue Cross and Blue Shield of Minnesota. “Someone likened it to trying to get your Blackberry to talk to your rotary phone to talk to your iPhone.”

Responsibility for overseeing the construction of the complex technology behind the MNsure exchange lies with Maximus, a $1.2 billion publicly traded company based in Reston, Va. Maximus runs call centers and administers government programs in the United States, Canada, Australia and Saudi Arabia. The company also has a hand in exchanges in New York, Connecticut, Hawaii, Vermont and Maryland and will run call centers in some of the 34 states that will use federally run exchanges.

Minnesota hired Maximus because it “came with a whole package,” Todd-Malmlov said. That package included relationships with the three companies that now are doing the heavy lifting on the IT side: EngagePoint of Fort Lauderdale, Fla.; IBM’s Curam Software and Connecture of Brookfield, Wis.

Maximus’ role is as a grand conductor — making sure the subcontractors stay on track and the regulatory requirements are met.

Maximus and its subcontracts must build the architecture for a system that will take data from hundreds of thousands of individual Minnesotans, verify it with a half dozen state and federal systems, overlay it with information provided by health plans and spit out a simple set of choices the average citizen can understand.

Underneath the hood, more than 40 software programs are running to keep the data private, and verify such things as household income, citizenship and other workplace insurance offerings.

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