WASHINGTON – 
States have not had to do much overhauling of their healthcare IT capacity in the past few years. But soon, requirements under the Affordable Care Act (ACA) will change all that.
Two major ACA requirements due by 2014 will pose a problem for states if they don’t plan ahead: the huge wave of Medicaid enrollees coming through in 2014 and the need for speedy and accurate enrollment; and the need for healthcare IT to launch state health insurance exchanges. Both of these situations will require more help from vendors and healthcare IT consultants than ever before.
On July 11, the Department of Health and Human Services released the proposed regulations for state health insurance exchanges, a key part of the healthcare overhaul. States have until the end of 2012 to demonstrate that they have a plan in place.
Greg DeBor, a partner at Falls Church-Va.-based CSC Healthcare Group said very few health plans have advanced-enough service to offer a consumer the ability to purchase insurance directly online. This is the capacity that state health insurance exchanges will have to provide under ACA, and this will open up a whole new vendor marketplace for healthcare IT vendors that can help health plans gain this capacity, he said.
Some healthcare IT companies have already begun to cash in. Medversant Technologies is helping states and private health plans to verify physician credentials at a rapid pace, a needed capability for Medicaid and health insurance exchanges in the coming years.
Matt Haddad, president and CEO of Medversant, said currently most Blues outsource this capacity.
Medversant, which provides Web-based credential verification solutions for the healthcare industry, currently has a contract with the state of Michigan, begun through a $5.5 million grant. Haddad said Washington State, Oregon, Alaska, Kentucky, Mississippi and West Virginia have also expressed interest in Medversant’s assistance.
