Optum: MNsure managed by 'crisis mode,' IT system in disarray

  • Article by: JACKIE CROSBY , Star Tribune
  • Updated: January 23, 2014 - 6:27 AM

Consultants called the health exchange’s program management “nonexistent” and said leadership was “occurring via crisis mode.”

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Optum says MNsure needs at least 100 more workers in its call center and faces other costs to improve its website. December 2013 file photo of MNsure call center guide Christy Williamson.

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Minnesota’s new insurance exchange is beset with severe problems that include IT systems in disarray, a woefully understaffed call center and management that can’t get out of “crisis mode,” according to consultants hired to examine MNsure.

The software underlying the insurance marketplace might be so badly flawed that MNsure should scrap parts of it, the Wednesday report concluded. The consultants, from UnitedHealth Group’s Optum division, also pointed out significant issues in how MNsure has been managed.

“Current program management structure and process is nonexistent, and management/leadership/decisionmaking is occurring via crisis mode,” the consultants wrote.

Optum has been lauded for improving the federal insurance exchange and was brought in by the state to help find answers for its online exchange, which has struggled to accommodate the crush of residents seeking coverage.

The consultants laid out three scenarios for fixing the glitch-filled MNsure site, including pros and cons of each, but did not make a recommendation. No cost figures were included in the report.

Under a more aggressive rebuilding calling for a “re-architect solution” that could take two years, the “existing asset may need to be written off — sunk costs,” the report said.

MNsure interim CEO Scott Leitz, who took over last month, said the 26-page report provides a much-needed road map at a critical time, as consumers face a March 31 deadline to buy health insurance or face fines under the Affordable Care Act.

“We do intend to take actions,” Leitz said at a meeting of the MNsure board of directors.

Still, Optum said problems with the exchange won’t be fully fixed by that enrollment deadline. That raises the prospect that MNsure will sign up fewer people than expected and could face greater financial pressure as a result.

Review done at no cost

Optum, based in Eden Prairie, dispatched 15 consultants at the agency’s request two weeks ago for an intensive two-day study of its operations, at no cost to the state.

Optum officials acknowledged that while their report makes the problems seem “insurmountable,” each option has upsides and downsides in moving the state toward its goal of a functional system.

“Zero defects isn’t a realistic target,” Optum Senior Vice President Jim Eppel told the board. “It is a series of trade-offs.”

Despite the problems, “continuous improvements can be made in both the short-term and long-term,” the report said.

The only option available to complete the 2014 enrollment period is to continue with the existing system, Optum said, with short-term fixes that won’t resolve all issues.

“In its current state, the existing MNsure system will not support enrollment expectations,” according to the consultants.

For now, Optum suggests that MNsure double its call center staff and hire about 100 more operators.

It also said MNsure must set up greater accountability and a tighter chain of command to manage the work of outside vendors and state IT workers.

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