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Key Upgrades Made To Vermont’s Health Care Exchange

Vermont Health Connect logo
Vermont Health Connect

This past weekend Vermont upgraded its health care exchange system.  State officials say the updates were successful, but critics continue to question the long term viability of the state-run exchange.

Vermont Health Connect, the state’s health care exchange, has been plagued with problems since it went online in October 2013.  It started with functionality problems that haunted the system, along with cost overruns.

The state eventually canceled its contract with system developer CGI and hired Optum to fix the system.

This past weekend, Optum completed a major upgrade.  Chief of Health Care Reform Lawrence Miller reports the software changes took less time than anticipated and it’s expected to significantly streamline service.   “You’re talking about a change from 120 minutes to 10 minutes. You’re moving the decimal point and anytime you move the decimal point you can get a lot of effect.  This is a clear sign that the project has been turned around and is moving on a sound footing towards delivering the level of customer service that Vermonters deserve.”

A priority within the revamp was to assure that the so called ‘change of circumstance functionality,’ that is, adjusting things like addresses or marital status, was fixed.  Miller says that has been the single biggest handicap at the exchange.  “This is a really big deal.  This will take a process that takes a couple of hours to put a change into the system and bring that down to about ten minutes. It means that people won’t have to have their change request put into a queue to be fixed later.  They’ll be able to have that change taken care of right when they’re on the phone.”

Vermonters for Health Care Freedom has been critical of the state run exchange.  Founder and President Darcie Johnston isn’t certain what impact the upgrades will actually have.   “I think it’s hard to know since there’s no third party verification.  They’ve just written the scripts for the outcome that they wanted and needed.  Too many people have experienced a bad outcome and have fought with problems for months. There’s no evidence to the user, to the Vermonter, who’s paying.  This is all going to be done on the back end for the Vermont Health Connect staff to make it easier on them.  Which is great if that’s true.”

Johnston adds that the latest upgrades don’t change her key criticisms of the system.   “One that it’s mandated. Number two is that the policies are so expensive. And then they’ve spent $200 million to build a system that this year is costing $51 million to maintain. What’s that cost going to be going forward?  I don’t think we can afford it.  This is just continuing a pipedream that has serious impacts on Vermonters’ ability to have the freedom to choose the health care insurance that they want and need.”

Miller counters that policy questions have been settled by the legislature and costs are being addressed.  “There is great need to be very careful about spending growth in Vermont’s health care system.  We’ve got the Green Mountain Health Care Board and a number of initiatives that are specifically designed to help contain the cost of health care. That’s really what we have to focus on.  Changing health care policies to be cheaper because they don’t provide all the coverage people need, that doesn’t seem like sound reform to me.”

The next milestone facing the Vermont Health Connect is an October 1st deadline for Optum to deliver technology for 2016 enrollments and renewals.

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