The Hummel Report

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Trying to Enroll

In its first four months HealthSourceRI - the state’s vehicle to the Affordable Care Act - has attracted thousands of people wanting to sign up. But enrollment has been a struggle for those who contacted The Hummel Report complaining about the process. This week Jim Hummel sits down with a subscriber who spent 21 hours on the phone trying to troubleshoot. We also hear from the director of HealthSourceRI, who says while the program is doing what it was designed to do, the problems we brought to her attention are unacceptable.

 

SCRIPT:

The million dollar advertising campaign is one that you probably have seen - on TV, on Facebook or on billboards around the state. And it was one of those ads that caught Mike Kelly’s attention in December.

So he checked out HealthSourceRI’s website and quickly got the answer he was looking for.

Kelly: ``You can just go on and give basic information and it will give you the cost. And the cost was about a third of what it cost to buy a plan on my own directly through an insurance company. ‘’

HealthSourceRI is the vehicle to make the Affordable Care Act - Obama Care - a reality in Rhode Island.

And it was designed for people like Kelly and his wife, who own this business in Barrington. They have no other employees so Kelly was just looking for insurance to cover them and their two sons.

Kelly: ``Before I completed enrollment I called and I had the girl go through my entire application with me before I submitted. I didn’t want to submit it and then it went up three times what it said.  She went through it and said `No that’s your cost, go ahead and submit it. ‘”

That was December 4th - he got confirmation the next day, and he made his first payment immediately. He would periodically check his account on the website.

Kelly: ``The money cleared, we have our cards, it started January 1st. We got all of the welcome packages from insurance companies.’’

Hummel: ``So you figured you’re part of the family.’’

Kelly: ``Yeah, I’m all set and then it said I was disenrolled. I didn’t even know what that meant. Disenrolled. So I called and that’s where the nightmare began.’’

Over the next month Kelly would be disenrolled and re-enrolled repeatedly - without every touching his account. He talked to 15 different people, mainly at this call center in Providence, but also one in Florida. Because he didn’t have coverage, his wife had to cancel three scheduled doctor’s appointments even though they had paid their premiums.

Kelly: ``Twenty one and a half hours on the phone to get it straightened out. I used to time it. Because I couldn’t call from my business phone and my cell phone has a timer on it so every time I got on the phone and ended the conversation I wrote down how long I was on the phone for.’’

Kelly is not alone - and his situation mirrors that of many who have contacted The Hummel Report over the past several weeks. They want the insurance, but are having problems with the logistics of getting enrolled.

Ferguson: ``As far as I’m concerned, it’s not acceptable.’’

Christine Ferguson is the director of HealthSourceRI, which she says has been working to deal with a higher-than-expected number of people wanting to enroll.

Ferguson: ``The percentage of people who have had significant problems are relatively small in the larger scheme of things.’’

Hummel: ``But that doesn’t matter to…’’

Fergusion: ``But that doesn’t matter to the person who’s got the problem and what we’re striving for is 100 percent and excellent customer service across the board.’’

The numbers tell the story.

In the first four months HealthSource RI has had more than 16,000 people enroll.

The Medicaid enrollments exceed 35,000.

Many of those people either came to the headquarters in Providence or contacted this call center in an adjacent part of the building.

The center, through Feb. 8th had received more than 179,000 calls.

A total of 16,000 people walked into the center for help.

And close to half a million people have visited the website.

Ferguson: ``One of the things we did was ramp up the number of people because we were slammed. We didn’t expect the level of response that we got so we underestimated. So we’ve brought in another 30 people and they’ve been trained.’’

Kelly: ``They speak to you and say I have to speak to a supervisor - just put the supervisor on the phone, let’s cut it out. This is taking forever. No the supervisors don’t get on the phone.’’

In one week alone he spent 560 minutes - more than nine hours - with representatives of the call center. Kelly spent so much time on the phone - he got a text message he was about to go over his cell minutes - something he’s never done in seven years.

Kelly: ``They’re pleasant, they try to help. I think they’re way undertrained. They might just be throwing people in there because of the volume of the phone calls and not giving them a chance to be trained properly. They all give you a different answer, they all say they’ll call back and none of them do.’’

Hummel: ``Did you feel your people were trained well enough going into it?’’

Ferguson: ``I think they were trained as well as they could have been at the time, so again, if you look at…’’

Hummel: ``Is that because of deadline, because of new issues?’’

Ferguson: ``It’s the deadline. Listen, no private sector company would have brought something up this fast; no private sector company would have had five federal data hubs that they had to relate to plus all of the carriers.’’

Kelly: ``They cannot stop apologizing. I say, alright I get it, you’re sorry.’’

Hummel: ``Get it done.’’

Kelly: ``Let’s fix it. I’m not mad at you personally, so let’s just move on. I can’t be the only person that’s been enrolled and disenrolled because they were quite familiar what was going on.’’

Hummel: ``It wasn’t like you were a new case.’’

Kelly: ``No.’’

Ferguson: ``No one ever thought, including me, that this would go off without a hitch so there are problems - we built in a mechanism - a series of mechanisms - to address those problems as they come up.’’

We showed Ferguson the sheet Kelly had printed out with the travel of his travails.

Hummel: ``As you see that what are you thinking? Enroll, disenroll.’’

Kelly: ``I’m thinking it’s crazy. So I’m thinking this isn’t what’s supposed to happen and it’s not what we’re striving toward. And I know in a percentage of cases it has.’’

Before our interview last week Kelly thought he had everything straightened out. But he contacted us on Monday to say he’d been disenrolled - again.

That prompted a call to him from Ferguson personally.

Ferguson: ``I know normally people are always trying to defend. Oh there’s not a problem…I’m not trying to defend, right? We absolutely know that we’re going to encounter all kinds of issues as we go along. We’ve built into ways to deal with them. It’s critically important that people let me know when there are problems.’’

She remains upbeat about what she believes Health Source RI can do in providing coverage.

Ferguson: ``We really have a shot at really having an impact on the cost of healthcare,  how healthcare is delivered and finally for the state actually having the data and the analytics that answer the questions about where our money is being spent and how it’s being spent.’’

Mike Kelly agrees with that but says the state needs to walk before it can run.

Kelly: ``The message is: train your people. Train ‘em. Don’t let someone just answer the phone who doesn’t know what they’re talking about. You have to train them.’’

In Providence, Jim Hummel for The Hummel Report.