How Nevada is tackling its healthcare exchange


As the calendar quickly flips its way toward Oct. 1, states are working hard to make sure their health insurance exchanges will be ready for open enrollment, but are taking a number of paths to get there.

The majority of states are taking the federal government’s solution and tailoring the exchange to their own communities’ needs. Some, like Oregon, have built their own system from the ground up, while places like Colorado have partnered with a third-party company to manage its system.

Then there is Nevada, which has taken an innovative approach to putting together its exchange; first in building the exchange and then in plans to keep down long-term consumer costs.

In an interview with StateScoop, C.J. Bawden, communications officer for the Silver State Health Insurance Exchange, said the state first looked for an advanced consumer-off-the-shelf solution to speed up the implementation process. The state went with Xerox, which provided the exchange framework, and Deloitte, which augmented its eligibility system to be compliant with the Affordable Care Act mandates.


“Using this approach helped us get off the ground a little faster than others that decided to build their system solely from the ground up,” Bawden said.

Nevada chose to build its own exchange for political reasons. Nevada Gov. Brian Sandoval disagreed with the ACA but federal law still required he get an exchange in place. To keep the system as free from federal intervention as possible, the state went with a COTS solution, instead of choosing the pre-built federal solution.

Bawden said that Nevada has worked diligently with its own community to build a solution that works for the state’s residents.

“We’ve looked at best practices from other states and used them when our research matches the conclusions they’ve come to,” Bawden said. “But the majority of what we’ve done has come from the community level as we’ve let our research dictate how we proceed with a number of different aspects of the exchange.”

Now the state is turning to community outreach. There is still confusion over the enrollment dates and how the exchange will work, Bawden said. So the state has planned its next phase of television advertising to educate residents on the ACA.


“We’re working around a lot of misinformation in the marketplace,” he said.

Nevada has also decided to allow advertisements on the exchange itself, making it unique among among exchanges nationwide to this point.

Starting in mid-2014, Bawden said, companies can buy advertisements on the exchange, although the health insurance providers will not be allowed to promote products already on the exchange.

“We don’t want it to look like Nevada Health Link is advocating one of the solutions,” said Bawden, who mentioned that while the advertisements are open to anyone, it will likely be focused on healthcare-related services, like dental or vision coverage, or for healthcare products.

“We believe that over the long run, these advertisements will allow us to cut the amount that the providers pay for each customer on the exchange and they will be able to pass those savings onto the consumer,” Bawden said.

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