By Jeff Cohen, WNPR
Thu, Feb 27 2014
Kevin Counihan, the CEO of Access Health CT, is walking through the 15th floor of a downtown Hartford office building that houses Connecticut's health insurancemarketplace. He passes the legal department, the IT folks and the consultants, then stops in front of three large, wall-mounted computer screens.
"These are showing in real time activity on our website. So, for example, right now you're looking at the number of concurrent users on the site," Counihan says. "So you can see that there are 212 people in the process of applying for insurance on the site."
Those metrics, monitors and technology are just a part of what his agency is doing well. Connecticut is widely seen as one of the states that is succeeding with the Affordable Care Act. Its website works well, and it has already exceeded its first-year enrollment goals. Other states have noticed.
"We were approached by several states who called us and said, 'Would you have any interest in franchising your exchange to us as a state?' And so, as we thought about that, we began coming up with this concept of an Exchange In A Box," says Counihan.
Think of it as Obamacare a la carte. Need a better executive team? Let Counihan's people run your show, for a fee. Need help managing your vendors? They can do that, too. His technology infrastructure is "scalable," he says, which means don't rebuild your own website - let them do it. They can deliver a state-specific look and feel, too. Sales. Marketing. Legal. Why do it yourself, when Connecticut can do it for you?
"My only point to some of these other states is, why go through all that agita?” says Counihan, referring to the aggravation involved. “Why recreate a wheel somebody else already built?" Counihan says, sounding every bit the salesman. And he is, because the effort could help Counihan bring new revenue into the exchange.
The question is, can it work? Consultant Rosemarie Day of Day Health Strategies worked with Counihan years ago when Massachusetts built its own health insurance system. She says the idea of an Exchange In A Box is intriguing, but it's got to be nuanced, too.
"I think you can't just cut and paste, if it works in Connecticut, boom," Day says. "Doing that kind of organ transplant and reconnecting things can take longer."
She cautions that it's important to consider the complicated insurance markets in different states and their politics.
"States that have embraced having their exchange have a fair amount of buy-in from their governor's office, and the governors wanting to put their own stamp on what they're doing for their constituents," says Day.
Ego plays a role, too. States that seem like they are running successful exchanges may still need help behind the scenes, she says.