rosemarie day deputy director and chief operating officer thursday, july 12, 2007 assessing the...

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


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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


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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


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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


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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.


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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


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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


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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


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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


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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


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• 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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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


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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


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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


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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


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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).


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.



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Overall Goal:Work towards short and long term success of health care reform through outreach, website enhancements, and program evaluation.


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.


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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.



rosemarie day deputy director and chief operating officer thursday, july 12, 2007 assessing the...

Documents

results fiscal year

operations progress

members progress

reviews progress

connectors progress

networks progress

fpl progress

commonwealth care objective