Washington DC Health Benefit Exchange
The District of Columbia’s expensive commercial-off-the-shelf (COTS) software failed after implementation during its first renewal period in 2014.
IdeaCrew re-implemented the District’s state-based marketplace using open standards and cloud technology to quickly become one of the leading and most financially sustainable platforms in the nation.
IdeaCrew has provided health benefit and marketplace solutions to the District of Columbia since 2014. The District of Columbia Health Benefit Exchange Authority (HBX) launched its state-based marketplace in 2013. The District had invested in expensive commercial-off-the-shelf (COTS) software products and reputable systems integrator to deliver its new marketplace. The stakes were high to implement something that had not been implemented before. DC Health Link, the District’s new health insurance marketplace, launched on time in October 2013. On the surface the launch was successful. Individuals and households in the District were getting health coverage and Federal subsidies for the first time. There were problems brewing. Behind the scenes the new expensive software and its costlier integration was failing. Transactions were getting lost. Data was out of sync. Wheels were spinning as online customers experienced slow website performance and crashes. Calls into the call center were mounting.
In fact, the stakes for the District were even higher. The District was facing these software issues at the same time that it was dealing with political challenges. Under new regulations the District had to provide health insurance coverage to Members of Congress and their staff, while simultaneously managing the first open enrollment period for individuals and small businesses. In addition, policymakers required all individuals and small groups in the District to purchase health insurance coverage through DC Health Link. Purchasing coverage directly from health insurance carriers was no longer an option. There was substantial resistance by major stakeholders in the District, and attention at the national level, to moving Members of Congress to DC Health Link and to requiring customers (small businesses, in particular) to purchase their coverage through DC Health Link, rather than direct from the carriers.
IdeaCrew stepped in. After quickly assessing the systems architecture, data and performance IdeaCrew developed a strategy that prioritized the needs of the District’s customers and business partners.
- Journaled all enrollment transactions and data so that it could be verified and curated to ensure correct EDI transactions were sent to carriers
- Deployed a new web portal in 6 weeks for 15,000 Members of Congress and their staff to compare and enroll in health benefits
- Replaced the expensive COTS health benefits eligibility, plan shopping and enrollment software products with more modern, configurable, open standards software hosted in the cloud
- Implemented new CMS and IRS reporting
- Integrated provider and formulary lookup tools and out of pocket calculator for customers to really evaluate the different health plan choices available
- Worked with brokers to implement new quoting and appointment tools to help more customers enroll
- Integrated with the Medicaid system to handle customers determined eligible for Medicaid coverage
- Connected the Individual and Small Business marketplaces so that customers could easily apply and receive health benefits in each of the two markets depending on their circumstances
Since IdeaCrew stepped in enrollments through DC Health Link have increased from 20,000 to 100,000 members. All customers enroll online–there are no paper applications. Call center wait times dropped immediately from 8.7 to 1.5 minutes and abandonments dropped from 23% to 6%. These metrics have improved consistently since rollout. Cloud hosting has saved the District millions (DC Health Link received multiple IT innovation awards from Amazon Web Services). These annual cost savings allowed the District to lower the insurance tax on Carriers that pays for the exchange by 10%. And Members of Congress are no longer opposed to selecting their health benefits through DC Health Link.
The SHOP system IdeaCrew delivered exceeded our expectations…The online marketplace is easy for customers to use. Feedback from enrolled businesses and their workers, brokers, and our congressional customers is very positive.