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HealthSourceRI striving for quick fixes and honest answers


RICHMOND — When HealthSourceRI, the state’s health insurance exchange, opened up on Tuesday, 6,000 concurrent hits crashed the website.

“It was fixed within two hours,” said Christine Ferguson, director of HealthSourceRI. “We’re very quickly responding whenever there’s a problem.”

She expected glitches in a new system that large, she told about 20 people who had gathered at the Richmond Senior Center, and was pleased when the problems came early. Early glitches, she said, mean early fixes.

HealthSource RI opened Tuesday as a way for individuals, families, and small businesses to buy health insurance. It is one of the state exchanges established as part of the 2010 federal Affordable Care Act.

It took nine months to create the software platform that allows people to compare insurance plans and rates, and to apply for tax subsidies to help pay for the insurance. People in the private sector said it couldn’t be built that quickly, she said, but it was.

The exchange offers 12 plans for individuals and families, and 16 plans for businesses with less than 50 employees. Businesses can also choose full employee choice, which allows employees to pick their own plan, without costing an employer any additional money.

“We are the only state in the country to focus on small businesses,” she said.

Tax subsidies for individuals and families who meet income limits, as well as for businesses that meet certain requirements, are available only when insurance is purchased on the exchange.

Individuals who make less than $15,000 a year can qualify for Medicaid through the exchange, Ferguson said, which is a change in policy. Before, only individuals with children could qualify for Medicaid. Now, the only requirement is income.

People on Medicare are not eligible to use the exchange.

All plans are required to offer the same services, and the only differences are the premiums, deductibles, and how care is delivered, such as through a health maintenance organization (HMO) or a preferred provider organization (PPO). Premiums vary by family size and the age of the oldest person being insured, and insurers are no longer allowed to charge more for female customers and deny coverage because of a pre-existing condition.

When asked if the system discourages companies from hiring older employees, Ferguson said the system has always been that way.

“That’s the way it works today. You just don’t know it,” she said.

That transparency, Ferguson said, is what HealthSource RI is trying to achieve. Some state exchanges only show the amount a person pays after a subsidy, but the Rhode Island exchange shows the total cost as well.

“Our philosphy is, everyone needs to know what it costs,” she said.

For 2015, Ferguson expects that two more insurance companies will join the exchange. She also said she wants to see more diversity in how care is delivered in the future, so that people can choose between organizations such as HMOs, integrated healthcare networks, and community care centers.

“Next year, I hope we will have more choices about how you get your care,” she said.

Ferguson said the exchange is developing analytics to study the quality of the different offerings, and she wants people to communicate their needs to HealthSource RI so that she can be an advocate for all residents and offer what people need.

“We want to hear from everyone,” she said. “The beauty of where we’re going is if you want something, you’ve got to speak up.”

The exchange is available for individuals and families through March 31. Small businesses may sign up at their normal renewal time. HealthSource RI can be accessed on the Internet at HealthSourceRI.com, via phone at 1-855-840-4774, or in person at 70 Royal Little Drive in Providence. Residents can also visit the navigator at Wood River Health Services, 823 Main St., Hope Valley. A navigator is a person trained to help others navigate through the exchange.

lrovetti@thewesterlysun.com



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