Closing the Gap Between the Health Insurance Exchange and Consumers: An Interview with Cover Oregon CIO Aaron Karjala

Date: February 21, 2013||   0  Comments

aaron karjala, CIO, cover oregonThe diversity between different states means different approaches toward similar health IT goals. In the state of Oregon, Cover Oregon is positioning itself as the central marketplace where Oregon individuals and employers will be able to shop for health insurance plans and access financial assistance to help pay for coverage.

Aaron Karjala serves as the Chief Information Officer of the Cover Oregon directing the strategy, development and operation of Oregon’s Health Insurance Exchange’s technology functions. Prior to joining the exchange, Aaron worked in multiple sectors including transportation, logistics and Health and Human Services. Aaron previously held the position of Deputy Chief Information Officer within the Oregon Health Authority. Healthcare IT Connect sat down with Aaron to check in on the progress that Cover Oregon is making ahead of its October 2013 HIX unveiling.

Zach Urbina: 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 HIX developers can apply to make the user’s experience simple, intuitive and efficient?

Aaron Karjala: Cover Oregon is implementing our web portal using a user centered design process.  As part of the process, Oregon participated in a multi-state consortium that was lead by Ideo, a Palo Alto based design firm to perform ethnographic research on potential customers of the exchange.  Oregon took the usability framework provided by Ideo, as well as Oregon consumer feedback as inputs to our development process.  As part of the development process, Oregon creates interactive prototypes and tests future users of the exchange which include individuals, small business owners, employees, tribal members, etc.  Feedback is gathered and incorporated into the prototypes which informs development of the portal. Oregon will closely monitor users of the portal once implemented and make quick adjustments to better meet consumer needs.

ZU: Oregon’s HIX will be rolled out in tandem with the states planned Medicaid expansion, how closely has the collaboration been between Cover Oregon and the Oregon Health Authority, which technology platforms can potentially be shared?

AK: Cover Oregon has closely partnered with the Oregon Health Authority to implement the exchange technology.  The technology platform is currently shared between the two organizations, with OHA providing many of the technology personnel for implementing the exchange.  CO and OHA meet on a daily basis to discuss the operations, policy and technology aspects of the HIX to Medicaid integrations.  The goal is a seamless process and technology implementation for the citizens of Oregon delivered through an integrated portal and customer contact center.

ZU: What has been the process for Cover Oregon to ensure Insurance Carriers are able to successfully participate in the exchange?

AK: CO has closely partnered with commercial insurance carriers over the last year and a half.  The partnership began as a series of forums focused on policy, technology and operations.  CO also hosted 5 months of Joint Application Development sessions with the carriers.  The sessions which often had in excess of 100 people attend either onsite or via remote web presentations allowed CO to adjust our design to meet not only our requirements and objectives, but also consider carrier needs.  We continue to host forums with the carrier leadership and are collaborating with their technology teams to build the connections from the Exchange to the their systems.

ZU: What are some of the key privacy provisions that HIX developers should consider to both provide for personal information privacy protection and to assuage public fears over the potential of future privacy breaches/threats?

AK: Because we’re implementing a commercial website, it is imperative to balance privacy and security with usability.  CO is committed to protecting personal information by implementing security best practices that are found on sites in banking and healthcare. We are fully committed to implementing a HIPAA compliant site and are ensuring compliance with IRS and other regulations for protecting private and financial information.  Our user centered development process takes the best practices as inputs and allows us to explore ways to implement the stringent security requirements in a usable fashion.  In addition, Cover Oregon will partner with a firm specializing in assessing and implementing security best practices for an independent audit of how security and privacy controls are implemented within our technology framework.

ZU: When developing a governance process to effectively run a health insurance exchange, are you seeing opportunities for data analytics arising form the exchange that could contribute to the broader health reform process in Oregon?

AK: Data analytics are key to a successful exchange launch.  CO is implement an entire suite of analytics tools that will be used starting at go live.  For example, we intend to monitor usage of the portal and call center and quickly adjust operations and technology to attract and retain consumers.  In addition, Oregon has a larger reform effort that analytics can inform through information provided on our site.  We will be able to clearly measure the types of consumers purchasing commercial insurance and applying for medicaid within the portal.  This information will help policy leaders adjust reform efforts to decrease the cost  and increase access to healthcare.

ZU: Given that HIX technology implementation is going to be slightly different from state to state, what are some of the opportunities available to states to have taken to learn from each other’s experiences and to share modular IT components required to build out an exchange?

AK: States have many options for collaboration.  Over the last year and a half, Oregon has worked with the Federal Government and other states to share project approaches, procurement methods, business rules, design prototypes and our operational structure.  In addition, Oregon chose to implement a configurable framework of software products to support our exchange operations.  These configurations can be shared with other states to jumpstart technology implementations.

Technology strategists and thought leaders from State Medicaid agencies and their HIX counterparts will be continuing the discussions around the IT roadmap for implementing HIX and upgrading Integrated eligibility and enrollment systems at the 2013 State Healthcare IT Connect Summit – May 21-22 in Baltimore, MD (registration information).

Speakers talking to these topics include: James Wadleigh, CIO, CT Health Insurance Exchange, John Supra, Deputy Director and CIO, SC Department of Health and Human Services, Pradeep Goel, CEO, Engagepoint, Thomas Baden, CIO, Minnesota Department of Health Services, Saleem Sayani, CIO, Maryland Dept. Health and Mental Hygiene, Ed Kennedy, CEO, Dorado Systems, Gary Heckert, Director Division of Management Services, Department of Health and Social Services, State HIT Coordinator.

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