Exchange Board Meets, Discusses SHOP, Outreach, Navigators, and more

Yesterday the Exchange Board held their 2nd of 3 meetings this month.  Last week’s meeting did not include a public session, with board members meeting in closed session to discuss contract matters.

In his Executive Director’s report, Peter Lee announced the Exchange’s intent to award the CalHEERS contract to Accenture, pending final federal approval.  Additionally he said that the Service Center contract would be announced soon.

Ogilvy, the Marketing and Outreach contractor, made a presentation based on some findings from a few focus groups that they have conducted in order to fine tune their plan for marketing the Exchange in California.  One key finding so far is that affordability is going to be a very important factor and the board expressed some concern over being able to match consumers’ expectations of affordability.  “The worrying has begun” said board member Kim Belshe.

The Board went on to have a discussion about the Small Business Health Options Program, more commonly known as the SHOP Exchange.  There was much discussion about the amount of choice that should be available regarding coverage, cost, and which insurance companies are included.  The Board made no decisions, but it was acknowledged that generally the more choices anyone has, the greater the cost incurred by the employer and their employees.  A Field Poll released this morning indicated that 67% of small employers found the SHOP Exchange a very attractive alternative, particularly if they got to choose the insurance carrier and the plan included coverage for prevention.

The next main discussion topic was Outreach & Marketing.  There was generally recognition that California is a big state and any marketing and outreach plan would have to be very large to be effective.  The general public’s knowledge of health care reform is very limited and is not helped by so much misinformation and distortions.   Almost all comments urged that outreach efforts should begin as early as possible, include paid advertisements as well as localized, community-based efforts, and making strategic use of regular and non-traditional partnerships. Commenters urged the Board to include multiple languages for their outreach efforts and consider both efforts to get people to enroll, but also remain with their coverage.  

Next the Board tackled issues related to Navigators and “Direct Benefit Assisters”.  The staff announced a proposed change that would allow modest reimbursement for community-based organizations that assist with enrollment of people into the Exchange.   There was general approval of the broadening of the definition of navigators and assisters to permit this direct reimbursement (although many said the amount of the fee was too small to compensate for the amount of work needed for hard-to-reach consumers).  There is an ongoing effort to rename and redefine these titles and clarify functions. 

Lastly, the Board discussed Financial Affairs.  The Board is in the process of putting together their request for additional federal dollars to accomplish the initial objectives of the Exchange.  The next request (estimated to be $188 million) will be submitted by the end of June 2012.   Although the Exchange will largely be financed by federal dollars for their start-up costs, the Exchange must come up with a plan to be self-sustaining in later years.  

The next Exchange Board meeting will be on Tuesday June 19th.

Health Access California promotes quality, affordable health care for all Californians.