Once, twice, third time at the Exchange Board

The Executive Director’s report included an update on some big upcoming decisions that the Board will be making in future meetings.
The next meeting will be on July 19, 2012 in the Bay Area at the RonDellumsFederalBuilding at 1301 Clay Street in Oakland. The agenda for that meeting include discussions of Qualified Health Plan and benefit design policies; plan partnership in terms of marketing and assistance, Exchange fee structure, and a CalHEERS update. The Board will likely be making decisions on SHOP policies, Service Center Options, Premium aggregation, and Agent Payment strategies for the individual Exchange. 
The Schedule for getting comments to the Exchange on upcoming topics is:
* Level 1.2 Grant Application – Comments Due THIS FRIDAY June 22
* ServiceCenter Options – Comments Due Next Wednesday, June 27
* By-Laws – Comments Due August 9
Also as part of the ED’s report, consultant Marge Ginsburg presented some findings from a survey of uninsured individuals regarding attitudes toward cost sharing structures and what factors impact decision making around cost.  Respondents were asked to discuss the fair way to structure cost sharing.  Some findings included confusion over co-insurance, a prioritization on keeping co-payments and deductibles low, and meeting the needs of those with greater health needs. The survey excluded any discussion of premiums, which are a big part of the consumer’s share of cost.
Next the Board delved into a landscape discussion of Service Center Options. In his opening comments, Peter Lee reiterated a commitment to customer service because, in his words, the Exchange will succeed or fail based on risk mix, and customer service is crucial to risk mix.  Juli Baker, the Exchange’s new Chief Technology Officer presented a number of options to the board.  Board and staff are accepting public comment these, including:
Potential Principles
  1. Provide a first class consumer experience
  2. Offer comprehensive, integrated and streamlined services
  3. Be responsive to consumers and stakeholders
  4. Assure cost-effectiveness
  5. Optimize best in class staffing to support efficient eligibility and enrollment functions
4 Models
  1. Statewide ServiceCenter – State Staffed
  2. Statewide ServiceCenter – Contracted Services
  3. Statewide ServiceCenter – State Central Distributed Branches
  4. Statewide ServiceCenter – Distributed Consortia Based
Staff will continue to work on these proposals over the next 4 weeks, but public input is due June 27. There is an input form on the Exchange website.  Staff will be holding a webinar to present updates the week of July 9.
The Board then heard presentations from a number of individuals who operate customer service centers including county representatives, MRMIB/Maximus, and Kaiser Permanente.  Board members asked a number of questions with an eye to how the Exchange will prepare their own call center operations, such as what the training requirements for each of the call centers.  Consumer advocates made several comments related to considerations such as hiring local expertise, bilingual staff, and a “no wrong door” approach.
Executive Director Peter Lee then outlined the final staff recommendations related to the Marketing, Outreach, and Education Program; as well as the Statewide Assisters Program.  Significantly, the Board approved the highest level of funding for outreach and education, and at the suggestion of Dr. Bob Ross, increased the amount of grant funding to community groups to $20 million dollars/year for 2 years.  Also, they made a decision to require Navigators to also enroll individuals into Medi-Cal and Healthy Families.  Advocates expressed concerns related to Navigators, including the lack of up front funding for Navigators and the exclusion of navigators to work in the SHOP. 
Lastly, the Board considered a draft of the Level 1.2 Grant that the Exchange will submit to the Federal Government by June 29th.  The staff will confer with a subcommittee of the Board before final submission, as well as taking public input, which can be submitted up to this Friday, June 22.  One area of concern highlighted by Health Access is the inclusion of resources for regulators to review marketing materials, which staff was not prepared to request until a future grant request, even though advocates believe that there will be a need in this grant period.  The draft was posted after the meeting began so advocates will be making more substantive comments after reviewing the document with greater attention.
The next meeting of the Exchange Board will be in Oakland on July 19.
Health Access California promotes quality, affordable health care for all Californians.
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