Health Insurance Marketplaces: Beyond Oct. 1 (Contributed)

A public-private partnership in Maryland helped unite the state's health insurance marketplace and other social programs in a single eligibility platform.

by Justin Stokes / September 27, 2013
Downtown Baltimore, Maryland Shutterstock

Reading all the prognostications about the Oct. 1 launch of the state-based health insurance marketplaces, I’m reminded of the familiar adage, “It’s a marathon, not a sprint.”

To be certain, Oct. 1 marks an important milestone, and in Maryland we view this date as the starting line. Come Oct. 1, the state’s uninsured citizens -- about 14 percent of the population -- will be able to sign up for health coverage and find out if they are eligible for tax credits through Maryland Health Connection, the new public online portal. Individuals will be guided through the process to select from 65 qualified private health plans, bringing affordable coverage to hundreds of thousands of Maryland residents who currently do not have health insurance.

Maryland believes that we have the opportunity to do more than just comply with the new health-care law. Maryland Health Connection provides an opportunity to create a smarter system of health care and social services for all the state's citizens. 

When we began this journey in August 2011, we developed a grander vision than simply meeting mandates. The question we asked ourselves was not, “How do we meet another federal mandate?” but rather, “How do we improve the health and well-being of citizens across the state?” We saw this as an opportunity to develop a platform that transforms the delivery of all health and social services programs. 

Preparing for this transformation required a hard look at the value of our existing programs and tools. Like many states, Maryland’s social programs were built for specific functions, often inflexible in meeting changing policy and citizen needs. For example, every policy change or update requires extensive recoding on legacy mainframe systems. 

For every new program, we employed a new IT system or introduced a code change and module within the existing mainframe infrastructure. It seemed logical at the time. However, we now have dated systems that are onerous and inflexible to maintain, requiring significant resources and lead times to update in order to align with changing policy and citizen needs.

But what if we could bring all of these systems together under a single platform? What if we could enable citizens and case workers to draw meaningful insights and interactions from the data and tools across the spectrum of our programs? Oct. 1, we realized, provided Maryland with an opportunity. 

Maryland teamed up with IBM, in addition to Noridian, EngagePoint and Connecture, in a public-private partnership, creating a system that not only prepares us for the Oct. 1 starting line, but also takes us well beyond that initial goal. The new system creates a single eligibility platform for the new, public health insurance marketplace and all of our social programs. For example, the new system brings together all of the information in one place, enabling administrators to better measure the impact and effectiveness of our programs across the state. These insights will help us maximize efficiency and extend access where programs are needed most, and will provide valuable information for policy decisions. 

We have our sights on Oct. 1 and are prepared to meet this initial deadline. However, Maryland is using this mandate to launch a platform for transformation, expanding access to health-care coverage while laying the foundation for improving the efficiency of service delivery and effectiveness of all social programs delivered in the state. For Maryland, that’s the real finish line.

Justin Stokes is a program manager with the Maryland Health Connection.

Platforms & Programs