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HealthCare.gov to be run by Connecticut exchange leader


By Darius Tahir
Posted: August 26, 2014 - 2:15 pm ET
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The leader of one of the most successful state-based insurance exchanges will head to Washington to become CEO of the federal marketplace. The CMS named Connecticut's Kevin Counihan to the newly created post on Tuesday.

His appointment is the first step in reorganizing the agency's leadership for HealthCare.gov, which the CMS previously said would also include a new chief technology officer. The CMS did not immediately respond to a request for information on when that post would be filled.

During Counihan's tenure in Connecticut, the state's uninsured rate dropped by nearly half. The state's marketplace was so successful that it began efforts to sell its technology expertise to other states trying to implement their own exchanges.

“Picking Kevin as the CEO of HealthCare.gov is a brilliant move” by HHS Secretary Sylvia Mathews Burwell, said Dan Schuyler, senior director for exchange technology for consulting firm Leavitt Partners.

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However, the short window left before the next open enrollment period begins Nov. 15 may make it difficult for Counihan to have a big impact, Schuyler said. “Time is definitely the enemy here, and while Kevin is a great leader, there is still a lot of work to be done.” Schuyler believes that the next open enrollment period will still feature its share of bumps, but that the long-term future of the federal exchange is more assured.

Counihan's success in Connecticut was driven by more than technology. Gov. Dannel Malloy has also credited the state's efforts to build pop-up insurance stores as an important step to spreading the word about insurance in a May event. But It wasn't all successful. Malloy also has expressed disappointment about the number of small businesses that had signed up for the state's Small Business Health Options Program, or SHOP, exchange.

A lack of direct accountability in the Obama administration has been frequently cited as a factor in the disastrous development and launch of HealthCare.gov.

The management structure was diffuse and workers often reported to multiple managers, according to a report by the liberal Center for American Progress. The reports authors included two former White House advisers on healthcare reform, Neera Tanden and Ezekiel Emanuel.

They recommended that the administration install a permanent CEO to oversee the federal and state marketplaces, as well as insurance regulation.

A July 2014 GAO report similarly found weak oversight and management of the marketplace. During a House hearing on the report, a GAO official called on the CMS to better manage its contractors, noting that CMS employees changed contract requirements on 40 occasions without the authority to do so.

“They have the tools in place,” William Woods, the agency's director of acquisitions and sourcing management, testified, of the oversight. “They just didn't use them.”

Follow Darius Tahir on Twitter: @dariustahir


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