How challenging will the Covered California enrollment website be?
Covered California provided a small glimpse of the internet website they have been working on that will allow individuals and small groups to purchase health, dental and vision insurance right through their website.
Accenture leads the charge
This massive undertaking to provide a central web portal is known as the California Healthcare Eligibility, Enrollment, and Retention System (CalHEERS) Project. Its main goal is to develop a single point of entry for individuals, families, small business, Medi-Cal eligible and Healthy Families participants to enroll in qualified health insurance plans offered through Covered California. The $183 million CalHEERS development project was awarded to Accenture last summer.
As easy as shopping Amazon?
Next to plan design and rates, most people have been wondering how California is going to stuff all these insurance widgets into one box. Any family or small business that has sought to review health insurance alternatives have been overwhelmed with the variety of carriers, plans, deductibles, copays, and an outline benefits that made comparison shopping difficult at best. In short, regardless of the implications of health care reform, the market place needs a good website to compare plans side by side. (Click on image to enlarge, but they are screen shots from the webinar and the final configuration may change.)
Nice welcome screen with different scenarios on Covered California enrollment website.
Covered California enrollment website
On a webinar hosted by Covered California and the Department of Healthcare Services, the CalHEERS project goals, time lines and progress were presented. Basic screen shots of the proposed internet website and flow of interaction seems straight forward and easy to follow. From acquiring the basic information, family data, income, eligibility on into enrollment the flow seems very intuitive.
Warehouse of data and tables to compile
Of course, screen shots, fields, and drop down menus are all fairly easy to put in place. The real heavy lifting happens behind the scenes in scores of tables and databases to assemble health insurance plan options for the user. The critical component for the exchange is analyzing the income data and applying the federal tax credit to the base rate if applicable.
Simple flow of data, income, eligibility and enrollment screens.
Smart sort questions smooth selection
CalHEERS work is not done and the user interface will invariably change as they work through the project. One item that looks very promising is the smart sort questions. These are essentially drop down menus for people to refine their search for a health insurance plan that meets their needs. Proposed smart sort menus will cover level of deductible, current medical conditions, and prescription drug use. This information will be used to supply a comparison of plans that best fit with the individual or family.
What insurance will my doctor accept?
Beyond what CalHEERS has proposed on the smart sort questions, I am hoping they will consider a few more based on my conversations with clients looking for health insurance.
Type of Network
PPO or HMO: some people will not consider a HMO style plan at all.
Physician, Physician Group or Hospital network
People want to know that the plan they select will allow them to keep seeing their current physician. There is no need to present an insurance option that does not have their doctor in plan’s network. Not all physician groups contract with all insurance carriers and California’s hospitals are prohibited from hiring doctors.
Health Savings Accounts (HSA)
Standard or HSA: many people still don’t know what an HSA is and have gotten stung when they opt for the less expensive HSA only to find out that many benefits are not covered until the deductible is met. Ouch!
Who’s your favorite insurance company?
Insurance company: While it is nice to see all the options, some people have had experiences with certain insurance companies, good and bad, and wish not to even consider insurance through a specific carrier.
Plan comparisons from enrollment information in Covered California.
Information overload?
I understand that potentially including more database information or selection criteria only complicates the whole program. These are suggestions that might be offered later after the site is up and running. But there are plenty of people who will select insurance based solely on what their doctor accepts.
Either way, it was great to see the “user interface” that Covered California is working on and hear that they are really trying to create the best customer experience possible.