Maryland has selected IBM to build system functions for eligibility and enrollment for its state-based health insurance exchange, the Maryland Health Connection.
Maryland Health Connection will offer a single website that residents and small businesses can visit to determine eligibility for tax credits and cost-sharing programs, compare health insurance plans and enroll in private plans or public programs, such as Medicaid and the Children’s Health Insurance Program (CHIP).
The application incorporates new income standards and enables Maryland to capture and store the data required to streamline the eligibility and verification process for citizens, according to an Oct. 4 IBM announcement. The system has more than 3,000 social services processes and rules included in its engine, so agencies are able to quickly introduce new programs and support federal guidelines for Medicaid and other state social service programs.
The state expects more than 100,000 residents to buy health insurance through the exchange in its first year alone. The Maryland Health Connection has said it will be open for enrollment in October 2013.
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“Maryland Health Connection will bring affordable health insurance coverage within reach of all Marylanders, creating a transparent marketplace for consumers and small businesses-- providing them with information they can trust and understand,” said Rebecca Pearce, executive director of the Maryland Health Benefit Exchange in the announcement. Minnesota also uses IBM software as the backbone for its health insurance exchange.
Maryland also recently selected the state employee plan as the benchmark for its essential health benefits plan for the small group and individual markets in 2014, as part of its rollout of the health reform law, according to Dr. Joshua Sharfstein, secretary of the Maryland Department of Health and Mental Hygiene and co-chair of the Maryland Health Care Reform Coordinating Council.
Maryland is one of 13 states and the District of Columbia that have said they will run their own exchanges.
Earlier this week, a report from PricewaterhouseCoopers (PwC) Health Research Institute said that more states are likely to involve the federal government than previously expected in developing their health insurance exchanges.
PwC anticipates that a majority of the remaining 37 states will have the federal government directly involved in running their exchanges. Of those, eight states have already chosen to have a federally-facilitated exchange, while three have selected an approach that divides duties in a state/federal partnership.
[See also: Report outlines IT challenges and guidelines for states' HIX.]
All states must provide HHS a blueprint for their exchange plans by Nov. 16. If they don’t, HHS will operate a federally-facilitated exchange in the state and perform the exchange-related programs of risk adjustment and reinsurance.
The state online marketplaces aim to let consumers shop for and compare health coverage and are scheduled to go live Jan. 1, 2014, under the health reform law. Consumers in every state will be able to buy insurance from qualified health plans directly through these marketplaces and may be eligible for tax credits to help pay for their health insurance and determine if they are eligible for Medicaid.
States then have two crucial decisions to make this fall: whether to expand Medicaid coverage, which the Supreme Court ruled was optional, and how to create an open insurance marketplace that meets their needs, the report said.
