1. Organizing Health Reform Early Lessons from Massachusetts
Rosemarie Day
Deputy Director and Chief Operating Officer
Commonwealth Health Insurance Connector Authority
State Coverage Initiatives National Meeting
Nashville, Tennessee
Thursday, February 7, 2008

2. Key element of MA Health Care Reform
Share the responsibility

3. Government’s Role Multiple State Agencies Involved

4. Health Connector Organization
Health Connector was established by the law as an independent public authority overseen by a board of ten directors.
Many key policy decisions left to Connector Board
Organization was free from some state agency constraints (e.g. hiring, procurement).

5. Health Connector Key Tasks
Launch and administer Commonwealth Care program
Launch and administer Commonwealth Choice program
Define minimum creditable coverage
Establish Affordability standards
Promulgate regulations on S. 125 Plan requirement for Mass employers
Administer waivers and appeals related to the individual mandate

6. Health Connector Rapid Ramp-up
Law passed April 2006.
Executive Director was hired in June 2006.
First Board meeting was held on June 7, 2006.
Core staff was hired during the summer and fall of 2006.
CommCare implemented October 1, 2006.
CommChoice implemented May 1, 2007.

7. Health Connector Strategic Outsourcing

8. Health Connector Role in insurance market
Young Adults
Small Biz.
Voluntary Plans
Indiv.& Families
Making the market work better:
Set standards
Increase transparency
Simplify consumer experience
Create more affordable options
Standardize benefit plans

9. Health Connector State-of-the-art Website

10. Results Broadened Access (as of 1/1/08)
Net new commercial insurance ,000
(includes almost 16,000 with
coverage through Commonwealth Choice)
Commonwealth Care ~170,000
Medicaid enrollment growth ,000
________
TOTAL > 300,000

11. Results Steady Growth in Commonwealth Care
As of 1/1: 168,924 members
- 42,114 premium paying
- 126,810 no premium

12. Results Steady Growth in Commonwealth Choice

13. Health Connector Implementation Lessons
Overall, implementation has been helped by:
Tight deadlines
Continued stakeholder support
Flexibility in the law
Board of Directors
Partnerships with existing state agencies
Sufficient start-up funds

14. Health Connector Implementation Lessons
Specifically, Commonwealth Care implementation was facilitated by:
Existing MassHealth infrastructure
Uncompensated Care Pool “members”
Auto-assignment
Virtual Gateway infrastructure
Outreach grants

15. Health Connector Overall Lessons
Be a “virtual organization” (buy, don’t build)
Take incremental steps (“walk before run”)
Over-prepare for every Board meeting
Be a “learning organization”