Interview with George McNeil, CIO, Nevada Health Link
Date: August 9, 2013|Rob Waters|
George McNeil, IT Officer with Nevada Health Link, (previously the Silver State Health Insurance Exchange) was kind enough to take some time out of his day to sit down with Rob Waters, Program Director with Healthcare IT Connect to discuss the governance, operational and IT implementation at the exchange, as George and his team push to remain on schedule for the October 1st launch.
Rob Waters: Could you explain to our readers about the governance structure of Nevada Health Link? And has this affected the IT roadmap for the exchange implementation?
George McNeil: Nevada Health Link is governed by an Appointed Board. The board consists of seven voting members and 3 non-voting state officials. The Exchange is an independent State Agency formed to oversee the creation of Nevada’s state-based insurance marketplace (Nevada Health Link). The Exchange has partnered with Xerox State Healthcare, LLC. This partnership has allowed us to move at a very quick pace. States have had a very short time frame to create the State Based Exchanges and Nevada has been able to leverage our partner’s solution, knowledge and resources to meet these short timelines.
RW: Shopping for health insurance via a web portal is a new experience for the vast majority of consumers, what are some of the best practices that Nevada Health Link has applied to make the user’s experience simple, intuitive and efficient?
GM: Nevada Health Link’s web portal will employ many consumer tools to help with selecting the best plan for themselves and their family. The smart application is one of these features, if an individual appears eligible for Advance Premium Tax Credits or for Medicaid, the application will ask more questions to confirm eligibility. If a person does not wish to apply for either of these programs, they will be able to answer a much smaller set of questions and move directly into the shop and compare module. The consumer cost calculator on our shop and compare pages allows an individual to simulate use of the plan throughout the year. Consumers will be able to plug in the anticipated amount of doctors office visits, specialist visits, emergency room visits, prescription drugs and generic drugs to get a feeling of what the plan will cost them over the course of the year based on their usage. Consumers will also be able to select up to three plans and compare each plan side by side to look for differences in coverage, formularies and financial information such as deductibles and co-pays. If a consumer has questions or concerns, they can always us our web chat, email or customer service call center to get an answer right away. Although purchasing health insurance online is not as easy as booking a flight, Nevada Health Link is putting technology in place to make it easy to understand and find the coverage that is right for you.
RW: What has been the process for the Nevada Health Link to ensure Insurance Carriers are able to successfully participate in the exchange?
GM: The Exchange engaged insurance carriers in the state in early 2012. Over the first half of 2013 the Exchange conducted Carrier Onboarding sessions to outline all of the requirements in terms of application, technological requirements, reporting, network adequacy, marketing and appeals. Anthem, Health Plan of Nevada, Nevada Health CO-OP and St. Mary’s have filed Qualified Health Plans to be sold on Nevada Health Link this October.
RW: Given that HIX technology implementation is going to be slightly different from state to state, have there been opportunities for Nevada to leverage the experiences and technology components from other states to implement the exchange?
GM: As I stated earlier Nevada has partnered with Xerox State Healthcare LLC. We are implementing a Software as a Service (SaaS) system. The system has undergone a number of changes to both make it compliant with the Affordable Care Act and Nevada Revised Statutes. We do meet with other states on a normal basis to discuss experiences but we have not been able to really leverage their technology components.
RW: Protecting confidential consumer information at the exchange has to be a top priority, what provisions have been taken to mitigate against these risks at the exchange and for information shared with other HHS agencies?
GM: The Exchange will only collect the minimum information required to achieve its mission. The Exchange portal and supporting systems employ industry best practices for security, confidentiality and auditing with emphasis on federal and state information safeguards. Each Exchange is also required to undergo two distinctively separate security reviews from the IRS and the Centers for Medicare and Medicaid Services. The Exchange must past these reviews before certification will be allowed.