Let the MNsure overhaul begin.
The agency overseeing the state's health insurance exchange said Wednesday that it has hired Deloitte Consulting for a nine-month, $4.95 million contract to help fix short-term problems and establish a path for long-term sustainability.
The contract still must be approved by the federal government, but MNsure interim CEO Scott Leitz said he expects approval to come within two weeks.
Deloitte was a top contender in 2012 for the contract to build the online health exchange, whose rollout was marred by ongoing technical problems. It has built successful state-based insurance exchanges in Connecticut, Kentucky, Rhode Island and Washington.
The New York-based company also recently signed a contract with Nevada, plus a deal worth a reported $40 million to $50 million with Maryland, whose troubled insurance exchange was built using the same suite of original vendors as Minnesota.
Deloitte's Kevin Kelly told the MNsure board of directors Wednesday that the firm will base its work in Minnesota on success it has had in other states.
"This is not a look backward, it's a look forward," Kelly said.
With the next round of open enrollment set to begin on Nov. 15, the pressure is on to resolve a number of key issues, including how county workers, insurance brokers and insurance carriers access the system.
MNsure has improved since its rocky start, and has signed up 185,000 people to date. But many "back end" operations that consumers don't see still rely on time-consuming manual processes, including the important handoff between MNsure and insurance carriers. Those unresolved issues led to confusion during the enrollment process and delays for people getting their insurance cards.
Julie Brunner, executive director of the Minnesota Council of Health Plans, said bringing in Deloitte is a good step.
"Nobody can go through the same experience this fall that we just came out of," said Brunner, who urged Deloitte to work closely with the insurance companies, counties and brokers and tap into their expertise.
"Our vision of the whole thing was there's no wrong door: If you go to a navigator, to a broker, to the county, or if you go to a health plan, everybody should be able to log into MNsure and help you enroll, because it's the only way to get a subsidy or health plan," Brunner said. "The way it's been set up, the only door was MNsure — and that door had a lot of problems."
An executive with PreferredOne, which signed up 59 percent of those who shopped for health care on MNsure, urged a return to simplicity.
"The more difficult and confusing the front end shopping experience is for MNsure consumers, the more problematic and error prone the data is that's received by the health plans," John Hofflander, PreferredOne's senior vice president and chief information officer said via e-mail.
Deloitte, which was awarded the contract after a competitive bidding process among seven companies, will prepare an in-depth analysis during its first 60 days that will help MNsure officials determine what to do with its existing system.
Leitz said for now, Deloitte will work with MNsure's existing vendors, but expects clearer direction within 30 to 60 days so the agency can make a decision about "which way we need to go next."
The assessment will include what needs to be done for open enrollment in the fall, as well as what MNsure needs in the long run, said Steve Dahl, Deloitte's lead client service partner in Minnesota.
At a meeting of MNsure's board Wednesday, Deloitte officials heard firsthand some of the urgent challenges they will be up against. Social service leaders from Hennepin, Dakota, Stearns and Olmsted counties shared a list of problems with the MNsure board, as they try to transition nearly 830,000 people to MNsure who are served by public health plans through Medical Assistance and MinnesotaCare.
County workers have their own way of connecting with MNsure, but it doesn't allow them enough access to get their work done or to update records for people who often are accessing several public program in addition to health care.
Much of the frustration and blame is absorbed by front-line workers working with people whose issues "need to be fixed today, and we can't help them," said Heidi Welsch of Olmsted County. "We're the ones who deal with tears."
The issues loom large for Deloitte, as more than two-thirds of new enrollees on MNsure qualified for a public program.
Deloitte will be paid out of existing federal grants, and the contract will be part of a $10 million chunk that MNsure set aside this year to pay for its IT efforts.
Minnesota has received federal grants worth nearly $155 million that were earmarked to hire outside contractors, pay staff and operate the system through its initial year. By federal law, it must be self-sufficient in 2015.
The state's original prime vendor, Reston, Va.,-based Maximus, has not had a lead project management role since January. The company hired three outside contractors — IBM/Curam, EngagePoint and Connecture — to create MNsure's complex IT structure.
Leitz said he was eager to get working with Deloitte, which earned higher scores than competitors.
"They have a great track record, and they're a great organization," he said.