The Commonwealth of Massachusetts Health Insurance Connector Authority

A Success Story in IT Optimization and Data Center Hosting to Drive Greater Efficiencies

By selecting Dell Services to manage IT systems and a number of critical business processes, the Health Connector was able to improve its insurance purchasing, enrollment, and billing services to more than 300,000 uninsured residents of Massachusetts.

The Challenge

When it was established in 2006, the Health Connector faced a daunting challenge. As an organization, it needed to create, deploy, and manage a number of complex business processes and IT systems, under very tight timelines, that would enable the organization to successfully identify, educate, and enroll Massachusetts’ uninsured residents. The Health Connector also needed to establish a customer information and support function that would assist its diverse customers with questions about enrollment, insurance benefits, costs, and billing.

In the first 27 months, The Health Connector added 200,000 people to the health insurance rolls – an increase of 9 percent. This helped contribute to achieving a rate of uninsured citizens in Massachusetts of 2.7 percent, the lowest in the nation.

In 2008, the Health Connector selected Dell Services, a leading Information Technology (IT) and business process solutions provider, to collaborate with the organization to achieve its ambitious objectives of improving the web portal, premium billing systems, and enrollment processing.

Dell Services helped analyze existing problems and implemented a solution to focus on Integrated Voice Response (IVR), Customer Relation Management (CRM), enrollment, and improved premium billing, information processing, and invoicing. While exceeding client service expectations is the goal of every one of our team members, the Health Connector and Dell Services knew that successfully implementing these systems was a key element of customer service and satisfaction.

Implementing Successful Solutions

The Health Connector relied on our team to customize commercial off-the-shelf IT systems and implement a number of highly optimized business processes solutions. This enabled the organization to successfully achieve its mission and support a diverse base of stakeholders, business partners, and customers.

Technology Solutions — Dell Services took responsibility for creating and implementing a series of complex IT systems allowing the Health Connector to concentrate on educating and recruiting the uninsured. We installed an advanced IT system that manages the Health Connector’s enrollment, billing, and other IT related financial, data management, and communications requirements. The system was up and successfully operating in record time.

The Health Connector utilizes our world-class data center infrastructure to store and manage its enrollee and financial data for nearly 200,000 enrollees. It also successfully handles between $7 and $9 million in receivables per month with our premium billing solutions processes.

Call Center and Business Process Solutions — Dell Services established a multi-lingual customer call center with representatives steeped in the process that Commonwealth residents need to follow in order to obtain insurance. Our associates personally assist each enrollee in navigating the managed care system, understanding their coverage options, pricing requirements, and in selecting the health insurance plan that best suits their needs. We also built an innovative and user friendly Web portal to allow easy access to information at any time or any place.

Using Dell Services proven technology and commercial best practices, the Health Connector realized cost savings of more than 30 percent from original projections. The call center manages approximately 40,000 inbound member calls and more than 2,000 outbound calls monthly to assist its customers. The team has conducted more than 80,000 customized member mailings, processed thousands of enrollment transactions, and facilitated more than 60,000 member invoices using the Dell Services solutions to enable the Health Connector to interface with multiple insurance payer systems.

Producing Reliable Results

Undoubtedly, the most significant improvement that resulted from the Health Connector and the Dell Services relationship is the ability to improve the quality of life for the newly insured. Many of the individuals and families insured through the Health Connector are able to build a relationship with a primary care physician and obtain preventive, rather than only acute, care.

The Health Connector relies on Dell Services, a proven healthcare business process and systems integrator, to successful and efficiently sustain the low rate of uninsured in Massachusetts. In addition to these solutions, Dell Services and the Health Connector have worked together to establish a strong governance structure and management relationship that has enabled them to build an entirely new model for an organization whose mission is unique and rests at the nexus of business, health policy, and politics. The Dell Services relationship with the Health Connector demonstrates how using information technology and solutions effectively can chart the course to transform healthcare.

About The Connector

The Commonwealth of Masschussetts (Health Connector) is breaking new ground in providing access to affordable health insurance for residents. The quasi-governmental organization is the centerpiece of ’ ambitious healthcare reform law, which was enacted in 2006. The organization was created by the legislature to facilitate the purchase of affordable, high quality health insurance to individuals who do not have access to employer-sponsored or other subsidized health insurance and by small businesses. Below are several results that indicate the success of Massachusetts Health Care Reform:

Working within the Private Insurance System: Thirty-five percent of the newly-insured citizens bought private insurance on their own.

Extending Coverage: Forty-one percent received public subsidies toward their insurance and twenty-four percent were added to the Medicaid rolls.

Dealing with Challenging Cases: The system has a proven record of getting those hardest to insure to buy health insurance. One of the most important results of the plan is that many healthy young men – the demographic subset most likely to think they don’t need health insurance – have bought into the system.

Preserving Choice for the Consumer: The system organizes the complicated health insurance marketplace so consumers can understand the full array of their choices, and it offers consumer education for those who need the help.