hCentive helping New York, Colorado and Kentucky with HIX implementation

By Diana Manos
10:49 AM

In the wake of the passage of the Affordable Care Act , Reston, Va.-based hCentive is striving to make life easier for states and payers as they set up health insurance exchanges (HIX).

hCentive currently has contracts with New York, Colorado and Kentucky to help with the implementation of their health insurance exchanges, according to CEO Sanjay Singh. Additionally, the company is also helping a several national and regional payers connect with state and federal health insurance exchanges, he says.

According to Singh, hCentive is the first organization to build an exchange solution from the ground up, post ACA. The "innovative technology" is helping insurers deal with the complexity of integrating their internal systems with the state insurance exchanges, he says.

[See also: Survey shows concern about HIX deadline.] 

Singh says he started the company in 2009, with the passage of the ACA, when he saw the need for organizations that could help payers and states connect as they prepare to implement the health insurance exchanges. “We started specifically to work on ACA; that is all we do,” he says. The work has spurred the company to grow to more than 300 employees. “With the demand after the election from payers and states, and with the (ACA) timeline, we can’t hire fast enough,” he says.

Singh says his fledgling company started following the debate on ACA, even as the bill was getting marked up. “Because we’ve been following it right from its creation, we thought of it without limitations. We were working from a clean slate,” he says. “We asked ourselves, what kind of technology solutions will be needed to help implement this law?” hCentive took the law and built systems from the ground up to provide what states and payers need for the exchanges."

“When we showcase, it becomes clear to buyers that what we’ve built is specifically for the exchanges, rather than just a way to patch in with something not inherently meant to be used,” Singh says.

“We looked at holistically what is needed. What can states stand up to build their exchanges? How will payers connect with these exchanges? We conceptualized it as an exchange connector that allows different payers to connect with the exchanges. It’s not just an exchange piece,” Singh explains.

According to Singh, hCentive provides exchange sites to states and connecting solutions to payers in every state.  hCentive’s solution isolates payers from all the changes on the state side.

“Payers can’t just wait every time for CMS to change things, forcing payers to have to change their backend systems,” he says. “We sit in between. Payers are completely insolated from the changes which are happening and are continuing to happen, as these things mature. That’s a new thing; nobody is doing it,” he says.

Singh says a number of top payers and major dental health plans are hCentive clients, and a fourth state is in the contract stage.

Overall, from what Singh has observed about the HIX market, “States that planned ahead are sitting pretty at this time, and some are still challenged.”

“The connectivity piece is crucial from the states’ perspective,” Singh says. "As late as this month, CMS is still finalizing and changing some of the regulation which impact the implementation. That creates challenges for systems and technology companies. This last minute back and forth sometimes adds to the uncertainty.”

[See also: States crafting HIX financing.] 





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