New Report Provides Guidance for States on Technology Infrastructure for Health Insurance Exchanges

Lessons from the “Early Innovator” and Advanced Implementation States

WASHINGTON--(BUSINESS WIRE)--One of the most challenging aspects for states working to implement health care reform is establishing the information technology (IT) infrastructure to promote access to and enrollment in health plans through exchanges and expanded Medicaid programs authorized by the Affordable Care Act (ACA).

“There are huge opportunities but also technological challenges for states as they implement the requirements of health care reform, including many that take effect in 2014”

A new report released by the University of Massachusetts Medical School (UMMS) and the National Academy of Social Insurance (NASI) examines the work and lessons learned from “Early Innovator” and other advanced states as they gear up for the changes brought on by health care reform.

“There are huge opportunities but also technological challenges for states as they implement the requirements of health care reform, including many that take effect in 2014,” said Michael Tutty, Director of the Office of Health Policy and Technology at UMMS, and co-author of the report. “We hope that by sharing the experiences of other states, particularly those that have been working on implementation the longest, we can bend the learning curve for policymakers and promote collaboration among those looking to prepare for and advance health care reform in their states.”

The report, Establishing the Technology Infrastructure for Health Insurance Exchanges Under the Affordable Care Act, authored by Michael Tutty and Jay Himmelstein, Chief Health Policy Strategist at UMMS, provides a thorough review of issues that policymakers should consider as they embark on a once-in-a-generation opportunity to build and enhance their own state-based technology infrastructures. Based on interviews with policy and technology leaders, five themes and takeaways arose as guidelines:

1) Agreeing upon a common vision, strategy, and plan for IT development is essential for meeting fast-approaching ACA deadlines;

2) The need for a careful assessment of a state’s internal and external IT resources;

3) Integration of policy and technology between an Exchange and a state’s Medicaid program is a complicated and pressing challenge;

4) Leveraging federal resources, reusing technologies developed by other states and federal agencies, and participation in multi-state collaboratives may accelerate development, and help minimize operational costs; and

5) Proceeding with development -- despite federal and state policy, technology, and political uncertainties – is necessary in order to meet aggressive federal implementation deadlines.

The report is a product of a NASI project funded by the Robert Wood Johnson Foundation to provide technical assistance to states developing health insurance exchanges. Related products include a toolkit offering legislative language for policymakers implementing Exchanges and issue briefs on Exchange governance, active purchasing, federally facilitated Exchanges, coordination with Medicaid and plan management.

Contact Information

For more information about Establishing the Technology Infrastructure for Health Insurance Exchanges Under the Affordable Care Act, contact Jay Himmelstein at [e-mail] or Michael Tutty at [e-mail]. For information about NASI’s Health Insurance Exchange project, please contact Lee Goldberg at [e-mail] or visit www.nasi.org.

The National Academy of Social Insurance (NASI) is a nonprofit, nonpartisan organization made up of the nation’s leading experts on social insurance. Its mission is to advance solutions to challenges facing the nation by increasing public understanding of how social insurance contributes to economic security.

The University of Massachusetts Medical School (UMMS) has built a reputation as a world-class research institution, consistently producing noteworthy advances in clinical and basic research. The Medical School attracts more than $250 million in research funding annually, 80 percent of which comes from federal funding sources. UMMS is the academic partner of UMass Memorial Health Care, the largest health care provider in Central Massachusetts. For more information, visit www.umassmed.edu.