Calling technology challenges one of the biggest issues facing states with regard to setting up health insurance exchanges, a new report from the University of Massachusetts Medical School and the National Academy of Social Insurance examines lessons learned from "early innovators" and others well along in the process.
The biggest takeaway: Don't try to do it alone. The report's authors say collaboration for states falling behind is crucial both with states that are farther along and with the federal government on the required infrastructure.
"We hope that by sharing the experiences of other states, particularly those that have been working on implementation the longest, we can bend the learning curve for policymakers and promote collaboration among those looking to prepare for and advance health care reform in their states," Michael Tutty, director of the medical school's Office of Health Policy and Technology and co-author of the report, said in an announcement.
The report lays out five basic lessons from interviews with policy and technology leaders, including formulating a common vision and strategy, fully evaluating the state's internal and external resources, and charging forward in an attempt to meet the aggressive deadlines despite the political uncertainty.
The report, funded in part by the Robert Wood Johnson Foundation, also comes with a toolkit offering language for policy makers, and issue briefs on topic such as exchange governance and plan management.
Collaboration already is well under way. Eighteen states, led by the California Healthcare Foundation, have developed a free online platform for setting up health insurance exchanges that can be customized for individual states' needs. Some Republican-led states have been involved in that effort, though they're waiting for the results of the November elections before proceeding--a tactic this new report warns strongly against.
Key players in Accountable Care Organizations, another aspect of health reform, also have shared lessons from their IT implementations, including that vendors and payors might not be on board. That was an issue with the Kansas Health Information Exchange whose board recently turned control over to the Kansas Department of Health and Environment. Among its problems were getting providers to pay user fees to keep the project going after federal money runs out.