Insurance exchange success could hinge on interoperability

Information technology represents a sizeable obstacle to the implementation of the health insurance exchanges required under healthcare reform, and could ultimately prove to be the undoing of such efforts, Politico reports this week.

Lingering concerns over the interoperability of such systems on a state-to-state basis persist, stoking talks of possible partnership models that would be created in conjunction with the U.S. Department of Health & Human Services. Federally collaborative systems, though, would stifle the ability to customize exchanges and enrollment processes to each state, according to the article.

Such systems will need to be able to connect with state Medicaid and Children's Health Insurance Program agencies for verification of eligibility for both programs, according to guidance released earlier this month by HHS.

"People fear that the technology piece is just not going to be quite there," Mila Kofman of Georgetown University's Health Policy Institute, told Politico. "The states that want the state-based exchange might not be able to be certified."

An additional problem for state-run exchanges, according to Politico, will be integrating with a yet-to-be-built federal data repository that will store information to help establish a person's eligibility for coverage. HHS still is haggling with programs about contributing necessary information to the hub.

So far, only 34 states and the District of Columbia have accepted federal grant money to establish insurance exchanges, according to FierceHealthPayer; of those, only 15 have started the process of establishing those exchanges. Earlier this month, New Jersey Gov. Chris Christie became the second governor in the nation--following New Mexico Gov. Susana Martinez--to veto the Affordable Care Act, according to the New York Times.

To learn more:
- read the Politico article


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