rosemarie day deputy director and chief operating officer thursday, july 12, 2007 assessing the...
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Rosemarie DayDeputy Director and Chief Operating Officer
Thursday, July 12, 2007
Assessing the Connector’s Progress: Fiscal Year 2007 Results and Fiscal Year 2008 Goals
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Outline of Contents
I. 6 Month Objectives (Fiscal Year 2007)
II. Results (Fiscal Year 2007)
III. Critical Projects & Results (Fiscal Year 2007)
IV. Fiscal Year 2008 Goals
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I. 6 Month Objectives (Fiscal Year 2007)
A. Commonwealth Care: Achieve stability and begin attracting members
B. Commonwealth Choice: Launch fully on May 1st
C. Health Care Reform: Help communicate new responsibilities by July 1st
D. Operations and Finance: Establish infrastructure to allow Connector to function independently and stabilize operations
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A. Commonwealth Care
Overall Goal: Achieve stability and begin attracting members
Progress: 92,046 members enrolled as of 7/1/07:
63,507 Type 1 18% above goal of 54,000
28,539 Types 2/3/4 68% above goal of 17,000
II. Results (Fiscal Year 2007)
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A. Commonwealth Care
Objective 1: Cover all qualified uninsured people whose incomes are below 300% FPL
Progress: 92,046 members enrolled as of 7/1/07: *63,507 Plan Type 1 *28,539 Plan Types 2/3/4
Objective 2: Facilitate informed choice of health plans by delivering quality, consistent, and measurable customer service to members
Progress: * 53% of members selected their own plan* Call center audits show 95%+ accuracy* Web visits continue to climb
Objective 3: Develop Commonwealth Care into a financially-viable, self-sustaining program
Progress: * Member self service options are increasing: web portal up in Jan 2007; Virtual Gateway pilot launching in July 2007* Maximus contract is under-budget
II. Results (Fiscal Year 2007)
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B. Commonwealth Choice
Overall Goal: Launch fully on May 1st
Progress: Individual shopping and enrollment capability launched May 1st
Web functionality for individuals launched May 4th
Web functionality for voluntary employers launched May 29th
Functionality for contributing employers to launch by Jan 1st, 2008
II. Results (Fiscal Year 2007)
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B. Commonwealth Choice
Objective 1: Cover a large share of uninsured people whose incomes are above 300% FPL
Progress: Working toward target enrollments: * 18,000 members by 1/1/08 * 35,000 members by 7/1/08
Objective 2: Stimulate the development of affordable, quality health plans, including select networks
Progress: * Six carriers offering total of 42 plans as of 5/1/07* Four carriers offer select networks
Objective 3: Facilitate informed choice of health plans
Progress: * New web site launched May 2007* Total visits per week have quadrupled since launch* Outreach and public info campaign launched May 2007* Strategic partnerships formed
II. Results (Fiscal Year 2007)
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B. Commonwealth Choice (Objectives Continued)
Objective 4: Minimize unintended disruption to the existing small-group insurance market
Progress: * Over 600 brokers trained* 85% of July growth was in existing distribution channels
Objective 5: Achieve financial stability & low administrative costs for commercial functions
Progress: In early stage of implementation.
II. Results (Fiscal Year 2007)
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C. Health Care Reform
Overall Goal: Help communicate new responsibilities by July 1st
Progress: Public info unit formed Jan 2007
Outreach and public info campaign launched May 2007
II. Results (Fiscal Year 2007)
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C. Health Care Reform
Objective 1: Inform employers about their responsibilities under Chapter 58, especially Section 125 plans and fair-share
Progress: * PIU is handling up to 1200 calls and emails per week * Over 100 business sessions conducted by Connector staff reaching over 10,000 people
Objective 2: Inform individuals about their responsibilities under Chapter 58, especially the individual mandate
Progress: * Partnering with community- based outreach organizations to conduct info sessions across the state* TV, radio and print ads statewide* 7 corporate partnerships; over $200,000 of donated publicity
II. Results (Fiscal Year 2007)
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D. Operations and Finance
Overall Goal: Establish infrastructure to allow Connector to function independently and stabilize operations
Progress: Commonwealth Care and Choice up and running with dedicated staff, infrastructure and reporting processes in place
II. Results (Fiscal Year 2007)
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D. Operations and Finance
Objective 1: Develop customer support and problem resolution process
Progress: * Public information unit launched in Jan 2007* Maximus and SBSB work to resolve problems from customers
Objective 2: Develop Connector’s standard operating procedures to ensure consistency
Progress: * Operated with guidance of Operations Plan for Dec 06 - Jun 07* Operations Plan for fiscal year 2008 under development
Objective 3: Meet current staffing target (40 FTEs) by April 30, 2007
Progress: * 35 FTEs hired by 5/07 * Will hire more as needed
II. Results (Fiscal Year 2007)
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D. Operations and Finance (Objectives Continued)
Objective 4: Develop and implement Connector financial reporting process and reviews
Progress: * Budget updates and regular reviews of actuals occurring
Objective 5: Complete office move by January 2007 with minimal disruption of basic operations
Progress: * Move completed by mid-Jan 2007 with no downtime for staff
II. Results (Fiscal Year 2007)
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A. Commonwealth Care
B. Commonwealth Choice
C. Health Care Reform
D. Operations and Finance
• 22 major projects initiated to support these areas • 17 projects completed, 3 in progress, 2 deferred
III. Critical Projects & Results(Fiscal Year 2007)
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A. Commonwealth Care
Status
1. Stabilize Phase I and launch Phase II
2. Implement appeals process 3. Implement sales and marketing plan, messages and outreach efforts 4. Specify rules for employer contribution subsidies Deferred
5. Evaluate, refine and promote the Commonwealth Care program in the context of an individual mandate to have insurance
Deferred
III. Critical Projects & Results(Fiscal Year 2007)
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B. Commonwealth Choice
Status
1. Issue RFR and select Sub-Connector
2. Issue RFR, select and certify health plans
3. Issue minimum creditable coverage regulations 4. Develop Young Adult Plans
5. Develop Section 125 plan regulations and operations
6. Market “Commonwealth Choice” 7. Develop sales program and incentives, including brokers
III. Critical Projects & Results(Fiscal Year 2007)
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C. Health Care Reform
Status
1. Develop state-of-the-art web site
2. Set up public information and problem resolution unit
3. Secure funding to support Connector’s health care reform role
4. Develop Mandate waiver/appeals process In progress
5. Launch public information campaign
6. Evaluate first year In progress
III. Critical Projects & Results(Fiscal Year 2007)
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D. Operations and Finance
Status
1. Hire and orient staff, develop standard operating proceduresIn progress
2. Complete Connector move
3. Develop Connector budget and plan of operations
4. Establish financial controls and oversight for high volume of monthly transactions
III. Critical Projects & Results(Fiscal Year 2007)
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Fiscal Year 2008 Goals (Draft)
A. Commonwealth Care: Solidify program and continue enrolling members.
B. Commonwealth Choice: Begin attracting members and fully launch employer services.
C. Health Care Reform: Work towards short and long term success of health care reform through outreach, website enhancements, and program evaluation.
D. Operations and Finance: Enhance infrastructure and reporting.
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Overall Goal:Solidify program and continue enrolling members.
Objectives:1. Based on 2006 DHCFP survey data, cover virtually all
qualified uninsured people whose incomes are below 300 percent of the federal poverty level (FPL)
▪Goal by 7/1/08 = 136,000 members2. Control costs of contracting with MMCOs.3. Refine program structure and operations to support
continue growth and overall Connector objectives (e.g. S 125 rollout).
A. Commonwealth Care
IV. Fiscal Year 2008 Goals (Draft)
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Overall Goal:Begin attracting members and fully launch employer services.
Objectives:1. Enroll nongroup members quickly
▪ Goal by 12/31/07 = 8,500 members ▪ Goal by 7/1/08 = 14,000 members
2. Establish fully automated Voluntary Employer services by 10/1/07 ▪Goal by 12/31/07 = 7,000 members ▪Goal by 7/1/08 = 14,000 members
3. Establish Contributing Employer services by 1/1/08 ▪Goal by 7/1/08 = 7,000 members
4. Continue investing in website as a critical tool for businesses and consumers.
5. Develop coordinated management of key partnerships: ▪Health plans (Seal of Approval reprocurement); ▪SBSB and CSC.
B. Commonwealth Choice
IV. Fiscal Year 2008 Goals (Draft)
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Overall Goal:Work towards short and long term success of health care reform through outreach, website enhancements, and program evaluation.
C. Health Care Reform
Objectives:1. Enhance Connector’s role as an easy-to-use source of information on health reform (includes web site) and inform/train employers, brokers and affected parties.2. Coordinate with other state agencies on health reform, including waiver renegotiation. 3. Define enforcement process for individual mandate.4. Define key measures of how Connector’s health care reform will be evaluated and invite researchers to participate.5. Begin to develop cost containment strategies to ensure health care reform’s longer term success.
IV. Fiscal Year 2008 Goals (Draft)
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Overall Goal: Enhance infrastructure and reporting.
Objectives: 1. Achieve administrative breakeven budget by end of FY08.2. Establish routine operational reporting for all Connector
programs.3. Ensure premium billing systems meet all programmatic needs.4. Identify and implement operational efficiencies.
D. Operations and Finance
IV. Fiscal Year 2008 Goals (Draft)
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