Some health exchanges are better than others

In the two months since health insurance exchanges have been open to the public, it's clear the state-run marketplaces have fared better than their federal counterpart. 

Exchanges are running smoothly in four states, in particular--Connecticut, Kentucky, Rhode Island and Washington--primarily because of simple and well-tested functions, Stateline reported.

Even considering some states haven't fared as well, including Hawaii, Oregon, Maryland and Vermont, the 14 state-run exchanges and the District of Columbia accounted for more than 50 percent of all Medicaid enrollments and 75 percent of private insurance enrollments in October. In particular, Connecticut boasted in October that people younger than 35 years old accounted for almost 33 percent of its roughly 1,200 applications, a key demographic insurers hope to enroll to help offset increased costs, FierceHealthPayer previously reported.

Kentucky's exchange, which has signed up more people for private insurance and Medicaid than any other state on a per capita basis, is a perfect example for state-based success. Instead of launching an exchange with multiple features, it offers a simple and easy-to-use site.

"Our system doesn't have a lot of bells and whistles," Carrie Banahan, executive director of the Kentucky exchange, Kynect, told Stateline. "There aren't a lot of graphics that would take a lot of bandwidth."

The four successful states also let consumers browse available plans without first creating an account, which avoided error messages and screen freezes that consumers using the federal exchange, HealthCare.gov, often experienced.

These states also spent months testing their systems. Kentucky tested for three months before rolling out its exchange. However, federal officials allegedly only tested for two weeks before HealthCare.gov launched.

What's more, states with well-run exchanges used outside management teams to help develop and test their sites. That included hiring "systems integrators" to ensure the exchanges could connect with Medicaid enrollment systems and other state and federal databases.

To learn more:
- read the Stateline article

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