Vermont Health Connect Development Slowed By Contractor Switch, Open Enrollment

Aug 29, 2014

In the lead up to the state’s firing of contractor CGI as the developer of Vermont Health Connect, officials contracted a separate company to analyze the project’s development.

The 166-page report was handed over to state officials last night; it concludes that CGI wasn’t delivering on its promises, and the work it completed was often sub-par.

It says the state failed to take ownership over the project, so when CGI was putting out low-quality work, it wasn’t being held accountable by the state.

But for Vermonters who have been following the situation closely, these aren’t surprising revelations.

While CGI missed deadlines and sometimes all together failed to deliver on its promises, the report said that one one thing they did well was to build the technological foundation for a solid final product.

Mark Larson, the commissioner of the Department of Vermont Health Access, said that will give the state’s new contractor, Optum, a starting point.

“We realize there’s more work left to do,” he said, “but it’s a foundation that supports Vermont Health Connect today and is a foundation that we can build on moving forward.”

But the timeline for that final product has been muddled by the transition from CGI to Optum and by the looming open enrollment period. That’s the time of year – from November to February – when people renew their policies or buy new ones.

"We realize there's more work left to do, but it's a foundation that supports Vermont Health Connect today and is a foundation that we can build on moving forward." - Mark Larson, Commissioner of Vermont Health Access

Lawrence Miller, who directs the state’s health care reform efforts, says that between the handoff from CGI to Optum and the open enrollment period, no major improvements are coming to Vermont Health Connect before February.

“We’re going to follow good practice going into something like an open enrollment period and freeze code where we are,” he said, “so I don’t anticipate that we’re going to be looking at major developments for that period.”

That means the state won’t be able to fix the change of circumstance issue that’s been plaguing the exchange this summer.

The problem is preventing customers from being able to update their policy when something in their life changes, such as different income, new address, divorce or marriage.

For months, anyone trying to make such changes to their policy has been unable to do so, and it’s caused some serious headaches for both the state and those customers.

But that doesn’t mean the state isn’t making progress in helping customers who have a change of circumstance.

Optum Vice President Laura Groschen says most of those customers have already been helped, with customer service representatives manually updating the policies in the system.

“We’re about three fourths done with the change of circumstance backlog, so it’s approximately 10,000 of the 13,000,” she said.

Groshen said the backlog will be down to normal levels this fall.

As for the rest of the report, the state is still developing the technology contract with Optum that determines what the final version of Vermont Health Connect will look like.

Miller says the exchange will meet all federal standards, but it might not end up with all the design and automation features the state would like.