Optum blasts Minnesota exchange systemsNews added by Benefits Pro on January 27, 2014
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By Allison Bell

The state-based Minnesota exchange needs help from agents and navigators to overcome severe computer problems, but those same problems have hampered efforts to actually pay them.

Officials and consultants talk about the problems in documents included in MNsure board meeting packets.

The exchange had enrolled 80,085 people in all kinds of public and private plans by Jan. 18, and 27,775 had enrolled in private “qualified health plan” coverage. The exchange has about 40 percent of the QHP enrollees it hopes to attract by April 1.

Unlike most exchanges, MNsure already has started to give information about premium payments.

The exchange had processed a total of $5.4 million in premium payments by Jan. 17, and it sent about $4 million in payment information for about 13,000 transactions during the week that ended Jan. 21.

But consultants at Optum – a unit of UnitedHealth Group Inc. – gave the MNsure board a scathing report blasting exchange IT system governance and quality.

“Current program management structure and process is nonexistent, and management/leadership/decision making is occurring via crisis mode,” the consultants conclude in the report.

Fixing the problems could take more than a year, the consultants say.

Exchange managers noted in a draft operations report that another area of weakness has been the relationship with brokers and with navigators – nonprofit exchange ombudsmen.

As of earlier this month, the exchange had not yet made payments to the brokers and navigators.

“This is a large query and reconciliation effort,” exchange managers said.

The exchange said it was trying to come up with the internal resources to make the payments.

Originally published on BenefitsPro.com
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