California Healthcare Foundation offers states insurance exchange prototype

By Mary Mosquera
06:26 AM

The California HealthCare Foundation and a group of innovators have released a technical prototype and road map for states and the federal government to create a health insurance exchange.

The Enroll UX 2014 offers a blueprint for an online process for application, eligibility determination, enrollment and health plan selection. It can be customized by states to be the public face of their health insurance exchanges.

A coalition of 11 states, the Centers for Medicare and Medicaid Services, eight charitable foundations and a Silicon Valley design firm collaborated to develop the reference model, which will be available at no cost to every state and the federal government.

The Patient Protection and Affordable Care Act (ACA) requires states to develop self-service online enrollment processes similar to banking, travel and other consumer service websites.

State health insurance exchanges are scheduled to go live in 2014, but must be ready to be operational in 2013 or the federal government will stand up an exchange for them.

Design firm IDEO interviewed consumers in three states to understand their perspectives on public and private health coverage enrollment to help develop an easy-to-use consumer interface. They also spoke with policy and industry experts and studied how similar challenges are handled in parallel industries.

The road map includes an interactive prototype that walks the user through a complex enrollment scenario, a detailed design specifications manual to support state and federal customization, and original icons and illustrations.

"CMS is working to leverage aspects of the design for the model application and Internet portal as well as our build of the federally facilitated exchange," said Timothy Hill, deputy director of the CMS Center for Consumer Information and Insurance Oversight (CCIIO).

"The design offers a modern and consumer-friendly approach built on research and best practices to provide a consistent customer experience to individuals and families seeking coverage," he said in the June 8 announcement.

While the Supreme Court will decide later this month on a lawsuit challenging the health reform law, the availability of the health insurance exchange prototype is important no matter how the justices rule, said Dr. Mark Smith, president and CEO of CHCF, which led the collaborative.

"Enroll UX 2014 is a major step forward in modernizing the health insurance enrollment process for millions of people — and at no cost to the public," he said.

States participating in Enroll UX 2014 include those whose governors and legislatures  support health reform and those that don’t, but whose state exchange organizations want to be prepared to act to meet tight deadlines if the Supreme Court upholds the ACA. The states are: Alabama, Arkansas, California, Colorado, Illinois, Massachusetts (in a consortium with Rhode Island and Vermont), Minnesota, Missouri, New York, Oregon, and Tennessee.

Besides CHCF, the foundations that financed Enroll UX 2014 were: The Atlantic Philanthropies, Blue Shield of California Foundation, The California Endowment, The Colorado Health Foundation, Kaiser Permanente Community Benefit, New York State Health Foundation, and the Robert Wood Johnson Foundation.