Industry skeptical states will be ready for October insurance exchange deadline

Seventy percent of healthcare professionals are skeptical that the state and/or federal health insurance exchanges (HIX) will be ready to launch by the Oct. 1, 2013, deadline, according to a survey conducted by Edifecs which polled health insurers and healthcare provider attendees of Edifecs' 2013 Healthcare Mandate Summit.

The study also found respondents are concerned about states’ ability to overhaul existing IT systems to comply with all aspects of the Patient Protection and Affordable Care Act, and to create interfaces among the Medicaid, HIX and children’s health insurance program (CHIP) systems at the same time they are developing their HIX infrastructure. Even if they choose not to run their own exchange, many states must complete significant system upgrades.

Other top findings from the HIX survey include the following:

• 75 percent are very concerned with being able to reconcile premium, enrollment and payment records received from HIXs.
• 88 percent are concerned about potential disruption to existing IT enrollment infrastructure and processes.
• 93 percent say state exchanges should share more information with—and take more feedback from—health insurers.

The survey was taken of more than 125 senior healthcare professionals who are actively involved in their organization’s compliance initiatives and carry significant responsibility for ensuring compliance with government mandates, according to Edifecs researchers. They represent a wide range of healthcare organizations, including commercial health insurers (68 percent), healthcare providers (11 percent), government entities and agencies (9 percent) and other healthcare industry organizations (12 percent).

Regardless of a potential delay on open enrollment for health insurance exchanges, payers across the country are moving forward with their plans to participate by the Oct. 1, 2013 deadline, according to Edifecs. The vast majority (95 percent) of respondents said they plan to participate in an exchange, and 80 percent will be on an exchange in 2014. However, most (70 percent) said they're skeptical that the exchanges will be ready by the October deadline.

The study follows last week’s deadline for states to inform the federal government of whether they intend to leverage a partnership HIX or participate on the federally facilitated exchange.

The full study, "HIX Insights from the 2013 Healthcare Mandate Summit," can be found here.