As MNsure took steps Wednesday to bolster its shorthanded call center, some of its board members said they regretted not raising concerns earlier about problems that have plagued the state’s health insurance exchange.
“I don’t feel the approach I’ve taken in the past has been appropriate based on the current experience,” said Tom Forsythe, a vice president of General Mills Inc.
Since its Oct. 1 debut, the MNsure website has been beset with technical issues that have made enrollment difficult. The call center, which was supposed to be a resource for residents with questions, was overwhelmed with callers at levels far above projections and staffing.
To that end, the MNsure board of directors approved spending up to $750,000 to hire 100 temporary call center operators to help answer questions and relieve logjams ahead of an anticipated spike in traffic as the March 31 end of open enrollment looms. Minnesotans who haven’t bought insurance by then face tax penalties under the Affordable Care Act.
Erik Larson, MNsure’s chief operating officer, said some of the cascading issues that call center operators were trying to manage have eased because the website is “working much more effectively.” In the past, people were calling several times because they were concerned about getting stuck without coverage. Average wait times this week were between 7 and 14 minutes.
“I don’t want to paint this rosy picture that everything’s perfect,” Larson said, “but things are much better.”
Forsythe said he was “struggling to be a good board member here,” and that he continues to have “fundamental questions about operations” of MNsure, which is supposed to simplify insurance options for consumers.
Despite continuing problems with the website and call center, MNsure’s latest enrollment figures show that Minnesotans are finding and buying health plans.
About 90,400 people have used the state’s new online health insurance exchange to buy coverage as of Feb. 1, but much of the growth has come from new enrollees in Medical Assistance and MinnesotaCare, two government-subsidized plans. The number of people buying insurance through private plans remains well below projections, which could have budget implications if that remains the case by the end of March.
‘What we have’
“It’s what we have to live with today,” said board member Phil Norrgard, director of human services at the Fond du Lac Band of Lake Superior Chippewa. “But it’s very far from what we wanted.”
Like Forsythe, Norrgard said he has “misgivings” about his role and oversight, and that assurances received after the launch of the website have been slow in coming.
“The fact is, there wasn’t much information about operations,” Norrgard added, saying it was “like grasping at water. … It would run through your fingers.”
Scott Leitz, MNsure’s interim CEO, said ramping up the call center staff will help MNsure get closer to industry standards, which he defined as wait times of less than 1 minute for 85 percent of callers. About 50 additional workers are expected to be answering phones within two weeks and up to 50 more within a month.
Leitz, who took over as leader in mid-December, told the board that beefing up the call center will relieve some immediate needs, but fundamental problems with the website still need to be addressed.
Frustrations over those lingering IT issues led to barbed questions from some board members. And in one exchange about how quickly to start addressing the issues, board chairman Brian Beutner used a four-letter word to describe the current state of the system.
“If we keep deferring decisions … we, by default, have made the decision to keep grinding with what we’ve got,” he said.
Beutner said rising frustrations and the sharper tone of the meeting reflect a maturing board that is becoming more knowledgeable about MNsure’s operations.
“I’ll be blunt — three or four months ago, we wouldn’t have known what to ask for,” he said.
A contract to boost call center operations is expected to be signed Thursday or Friday with APAC Inc., an Illinois company with service center operations in Mendota Heights. The contract will run through the end of April.
The board voted unanimously to add call center staff immediately, while some pressed for details about the impact on MNsure’s budget, which has been funded entirely with federal grants.
Leitz said the original budget built in $350,000 in “overflow” costs, and that center costs above that amount would come from savings in salaries and other areas.
Republicans expressed frustration with the budget and process, which likely will get more attention at a meeting next week of the bipartisan MNsure Legislative Oversight Committee.
“Gov. Dayton and Democrats had three years to develop a plan, and have known for months that the call center was leaving Minnesotans frustrated without assistance,” Rep. Joe Hoppe, R-Chaska, a member of the committee, said in a statement. “MNsure should have issued a request-for-proposal, and cast a wide and competitive net to find experts who could fix this mess.”
The call center contract was signed under an emergency provision that Leitz said allowed the organization to hire an outside vendor on a fast track without going through the usual competitive bidding process. He said it was a hybrid method, where it sought bids from three vendors before selecting APAC.
To get the agency out of perpetual “crisis mode,” as described recently by an outside consultant, Leitz said he will work to improve project management on the IT side. He also plans to add two deputy-level positions to improve internal management functions, as the agency has grown from a small start-up to a more evolved agency.
Meanwhile, MNsure intends to hire a new “prime vendor” to help the agency make necessary changes to the overall system to make it work over the long term. Right now, many of the functions are being handled by hand, including taking paper applications and making the handoff from MNsure to various insurance companies.
The new vendor will help make sure that various vendors that are working on the complex website “work together in a better way,” Leitz said.