Vermont cites improved health exchange, Optum contribution

Vermont is publicly touting the improvements in its health insurance exchange, Vermont Health Connect (VHC), and has cited work by Optum, VHC’s systems integrator, as a big reason for their success.

Administration officials recently delivered their final monthly report on VHC to the state legislature, a largely positive document that listed numerous improvements and successes on the exchange. Then, Steven Costantino, commissioner of the Department of Vermont Health Access (DVHA), cited numerous improvements in an interview with Vermont Public Radio, the state’s National Public Radio (NPR) outlet.

“There’s been improvement on almost every single metric in terms of customer service,” Costantino said in the VPR interview. “And to have that kind of improvement, I think, is an amazing story that has not really been talked about in a way I think should be talked about.”

Costantino pointed out that the backlog of customers awaiting resolution to insurance issues is now below 1,500 people, half of what it was in May, and down eightfold from this time last year. The error rate on Health Connect’s transaction inventory has been halved since May. And 85 percent of customer requests are being successfully completed within 10 days of receipt, according to the state.

In his report to the legislature, Vermont’s chief of health care reform, Lawrence Miller, said, “I am pleased to say that you will see a dramatic improvement in operational metrics across the board. These results can largely be attributed to system improvements made in an effort that we have dubbed the ‘Maintenance & Operations (M&O) Surge.’ As discussed in prior reports, we finished major system development in March, but still had a punch list of defects to fix, errors to troubleshoot and improvements to make.”

Miller cited Optum contributions to the VHC improvements. “Our M&O partner, Optum, stepped up to the plate with a series of initiatives and deployments throughout the spring and early summer. Optum’s dedication, along with that of state staff and other partners, is the reason we have seen this improvement. We are grateful that they have brought our system to a steady state, and we will not rest until every customer gets the service they deserve.”

The work Optum has done on VHC over the past two years has resulted in much more than a stable, reliable exchange from which Vermont residents can select health coverage — it also has helped Vermont drive down its already low uninsured rate, one of the state’s most important goals.

At the start of 2015, the Vermont Household Health Insurance Survey revealed that Vermont’s uninsured rate was cut nearly in half from the fall of 2012 to the fall of 2014 — from 6.8 percent to 3.7 percent — a number officials attribute both to increased access provided by VHC and broadened Medicaid coverage offered by the ACA.

In early 2016, the National Center for Health Statistics used U.S. Census Bureau data to estimate that Vermont’s uninsured rate fell even lower by the end of 2015 — to 2.7 percent, passing Hawaii and Washington, D.C. to attain one of the two lowest uninsured rates in the nation (Massachusetts is the other). More than one in three Vermonters is now covered by a VHC plan, either a qualified health plan or Medicaid for Children and Adults (MCA).

Further, Lawrence Miller pointed out publicly that VHC enrollment data shows that Vermont is also reaching the challenging “young invincible” demographic — more than 20 percent of new VHC enrollees are in the 26–34 age group, compared to just 12 percent of the renewing population.

Miller said that the increase in Vermont’s number of insured residents could be attributed to the work of state staff, contractors and others who worked “tirelessly to make sure every Vermonter who needed health coverage was able to find and enroll in the right plan.”

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