April 18, 2005
Up for debate | While some tout the success of DirigoChoice, others say it should be scrapped altogether
By Taylor Smith
Erin Hoeflinger already is well versed in dealing with critics of the DirigoChoice health program. Since the program was officially launched on Jan. 1, she's heard complaints about topics ranging from premium costs to enrollment targets. But Hoeflinger, who in January was promoted to president of Anthem Blue Cross and Blue Shield in Maine, the insurance company that administers DirigoChoice on behalf of the state, says the program already has exceeded her expectations.
Despite some bumps in the road during the product launch, Hoeflinger says that signing up new members and administering the DirigoChoice plan is going "exceedingly well." For starters, she says enrollment rates for the plan are significantly higher than what she's seen with other new health insurance products, including popular health savings accounts.
DirigoChoice, which was created as part of the Dirigo Health Reform Act in 2003, aims to offer affordable health care coverage to the state's uninsured population, which Karynlee Harrington, executive director of the state's Dirigo Health Agency, pegs at 136,000 people. Supporters and opponents of the DirigoChoice plan agree that there is a problem with the high number of uninsured people in Maine. But even though the DirigoChoice plan is still in its infancy, the two sides already are at loggerheads about whether the program, which is partially funded through the state budget, represents the best way to provide access to Maine's uninsured.
Some people, including Bill Becker, executive director of the Maine Heritage Policy Center, a think tank in Portland, believe that DirigoChoice failed right out of the gate. "I give the governor and the Legislature kudos for their efforts in this regard, but the devil is always in the details," says Becker. "You have to be bold enough to say this might not be the right path."
Hoeflinger says that while close scrutiny of the plan is expected, its overall success can't be judged by its first few months of operations. In many cases, she says, changes to the state's health care policy aren't allowed enough time to prove themselves before the next policy change is enacted, which results in an increasingly volatile health care environment for insurers like Anthem. "DirigoChoice just went live as a product offering in January, and there's already a push back about whether it is or isn't working," she says. "It needs time to play out."
The waiting game
Becker contends that giving DirigoChoice time to work itself out is a bad ˆ and costly ˆ decision that Maine can ill afford. He argues that Maine's lawmakers should admit a lapse in judgement and scrap the entire program. At the same time, Becker would like to see legislators repeal mandates that he says have made Maine's health care industry a heavily regulated one. Doing so, he says, would make Maine a more attractive option for private insurance companies. And more competition in the market would mean lower rates for consumers.
That kind of second-guessing over the initial progress of DirigoChoice is characteristic of what Hoeflinger says she's seen in Maine's health care industry since arriving from Indianapolis in 2000. (Anthem Blue Cross and Blue Shield of Maine is a subsidiary of Indianapolis-based Wellpoint Health Networks, which acquired Anthem Inc. in November.) In Indiana, she served as the executive director of both Anthem's mail service pharmacy and the client relations and operations division. In May of 2000, Anthem reached an agreement to purchase Blue Cross and Blue Shield of Maine, which had posted years of substantial losses. Hoeflinger was brought on board as vice president of health care management to help untie the financial tangle of BCBS's operations.
Since the acquisition, corporate executives including Hoeflinger have moved on to other challenges, such as launching DirigoChoice. Since August, when Anthem agreed to administer the plan on behalf of the state, the company has been pulled into the middle of the debate on the program. Because Anthem's success in Maine is tied in part to the success of DirigoChoice, Hoeflinger has become a vocal proponent of it.
Anthem has spearheaded what Hoeflinger describes as an "aggressive" marketing campaign in conjunction with the Dirigo Health Agency to publicize the program. The company has invested more than $500,000 to integrate DirigoChoice into its offerings, and another $500,000 has been earmarked for insurance brokers as incentive to sign up new members. "Anthem doesn't do marketing campaigns very often," Hoeflinger says. "But we've marketed this product more than any other product in Maine."
A look at the enrollment numbers seems to back up Hoeflinger's enthusiastic take on the program's first few months. By the beginning of April, the plan had signed up 5,263 members, including 1,540 new members in March, according to a press release from the Governor's Office of Health Policy and Finance. Among those DirigoChoice enrollees are employees of more than 400 Maine-based small businesses and 1,200 self-employed workers. Harrington expects enrollment to remain strong: In the first quarter of this year, 3,746 new members enrolled, an increase of nearly 63% over quarterly projections of 2,300 new members. "I feel comfortable that we'll hit our quarterly goals," says Harrington.
However, critics contend that enrollment is way below projections. The Winter 2005 issue of the Maine Heritage Policy Center's Dirigo Watch newsletter notes that enrollment should have reached 12,400 by March, and that sales of DirigoChoice through February have lagged projected sales by 67%. "We have tremendous concerns that the program isn't living up to its projections," says Becker. "It's been an underwhelming failure."
Despite Becker's suggestion that the program be eliminated, there has been no indication that Gov. John Baldacci's administration will do so. In the meantime, its critics and supporters will just have to watch and wait.
Despite some bumps in the road during the product launch, Hoeflinger says that signing up new members and administering the DirigoChoice plan is going "exceedingly well." For starters, she says enrollment rates for the plan are significantly higher than what she's seen with other new health insurance products, including popular health savings accounts.
DirigoChoice, which was created as part of the Dirigo Health Reform Act in 2003, aims to offer affordable health care coverage to the state's uninsured population, which Karynlee Harrington, executive director of the state's Dirigo Health Agency, pegs at 136,000 people. Supporters and opponents of the DirigoChoice plan agree that there is a problem with the high number of uninsured people in Maine. But even though the DirigoChoice plan is still in its infancy, the two sides already are at loggerheads about whether the program, which is partially funded through the state budget, represents the best way to provide access to Maine's uninsured.
Some people, including Bill Becker, executive director of the Maine Heritage Policy Center, a think tank in Portland, believe that DirigoChoice failed right out of the gate. "I give the governor and the Legislature kudos for their efforts in this regard, but the devil is always in the details," says Becker. "You have to be bold enough to say this might not be the right path."
Hoeflinger says that while close scrutiny of the plan is expected, its overall success can't be judged by its first few months of operations. In many cases, she says, changes to the state's health care policy aren't allowed enough time to prove themselves before the next policy change is enacted, which results in an increasingly volatile health care environment for insurers like Anthem. "DirigoChoice just went live as a product offering in January, and there's already a push back about whether it is or isn't working," she says. "It needs time to play out."
The waiting game
Becker contends that giving DirigoChoice time to work itself out is a bad ˆ and costly ˆ decision that Maine can ill afford. He argues that Maine's lawmakers should admit a lapse in judgement and scrap the entire program. At the same time, Becker would like to see legislators repeal mandates that he says have made Maine's health care industry a heavily regulated one. Doing so, he says, would make Maine a more attractive option for private insurance companies. And more competition in the market would mean lower rates for consumers.
That kind of second-guessing over the initial progress of DirigoChoice is characteristic of what Hoeflinger says she's seen in Maine's health care industry since arriving from Indianapolis in 2000. (Anthem Blue Cross and Blue Shield of Maine is a subsidiary of Indianapolis-based Wellpoint Health Networks, which acquired Anthem Inc. in November.) In Indiana, she served as the executive director of both Anthem's mail service pharmacy and the client relations and operations division. In May of 2000, Anthem reached an agreement to purchase Blue Cross and Blue Shield of Maine, which had posted years of substantial losses. Hoeflinger was brought on board as vice president of health care management to help untie the financial tangle of BCBS's operations.
Since the acquisition, corporate executives including Hoeflinger have moved on to other challenges, such as launching DirigoChoice. Since August, when Anthem agreed to administer the plan on behalf of the state, the company has been pulled into the middle of the debate on the program. Because Anthem's success in Maine is tied in part to the success of DirigoChoice, Hoeflinger has become a vocal proponent of it.
Anthem has spearheaded what Hoeflinger describes as an "aggressive" marketing campaign in conjunction with the Dirigo Health Agency to publicize the program. The company has invested more than $500,000 to integrate DirigoChoice into its offerings, and another $500,000 has been earmarked for insurance brokers as incentive to sign up new members. "Anthem doesn't do marketing campaigns very often," Hoeflinger says. "But we've marketed this product more than any other product in Maine."
A look at the enrollment numbers seems to back up Hoeflinger's enthusiastic take on the program's first few months. By the beginning of April, the plan had signed up 5,263 members, including 1,540 new members in March, according to a press release from the Governor's Office of Health Policy and Finance. Among those DirigoChoice enrollees are employees of more than 400 Maine-based small businesses and 1,200 self-employed workers. Harrington expects enrollment to remain strong: In the first quarter of this year, 3,746 new members enrolled, an increase of nearly 63% over quarterly projections of 2,300 new members. "I feel comfortable that we'll hit our quarterly goals," says Harrington.
However, critics contend that enrollment is way below projections. The Winter 2005 issue of the Maine Heritage Policy Center's Dirigo Watch newsletter notes that enrollment should have reached 12,400 by March, and that sales of DirigoChoice through February have lagged projected sales by 67%. "We have tremendous concerns that the program isn't living up to its projections," says Becker. "It's been an underwhelming failure."
Despite Becker's suggestion that the program be eliminated, there has been no indication that Gov. John Baldacci's administration will do so. In the meantime, its critics and supporters will just have to watch and wait.
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