Pennie turns healthcare costs into savings
KPMG helped the Commonwealth of Pennsylvania assure quality when establishing its health insurance marketplace.
Pennie turns healthcare costs into savings
KPMG helped the Commonwealth of Pennsylvania assure quality when establishing its health insurance marketplace.
Client
Pennsylvania Health Insurance Exchange Authority
Sector
State and local government
Project
Technology implementation QA for health insurance marketplace
The Pennsylvania Health Insurance Exchange Authority, d/b/a PennieTM, is a state affiliated entity of the Commonwealth of Pennsylvania. It administers the Pennsylvania health insurance marketplace that enables eligible individuals to purchase private health insurance coverage as required under the federal Patient Protection and Affordable Care Act. Pennie was created to reduce premiums in the Commonwealth and better support the needs of customers purchasing health coverage.
When the Commonwealth of Pennsylvania decided to move from the federal health insurance marketplace to its own state-based marketplace, it only had one year to get ready to support more than 300,000 Pennsylvanians, making health insurance more accessible and affordable.
Quickly standing up the marketplace required the state to implement a new technology solution in time for the first day of open enrollment and provide the flexibility in COVID-19 times to extend enrollment for 11 additional weeks. The Commonwealth was required to deploy quality assurance protocols to oversee adherence to federal and state policy requirements to operate their state-based marketplace.
I can say, without question, the Pennie/KPMG partnership is one of the reasons we were able to meet or exceed all business metrics in year one of operations. KPMG services are appreciated and always add value.
Known for our experience in helping establish state health insurance marketplaces in other states and for delivering high-quality projects to other large Pennsylvania government agencies, KPMG was asked to manage quality throughout the marketplace implementation.
In establishing a quality management office, we developed and implemented quality assurance processes centered around policy, operations, and technology and delivered a robust testing approach to review and validate the technology platform installed by an external systems integrator.
In helping Pennie get ready for open enrollment:
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We also leveraged robotic process automation to automate the inquiry ticket creation process that occurs when Pennie receives emails from external parties, including customers and brokers.
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By relying on the KPMG approach to quality, testing, automation, and user-friendly design, the Commonwealth of Pennsylvania has expanded access to quality health coverage for its citizens, easily transitioned from the federal marketplace, and connected more customers to the financial assistance for which they are eligible. As a result, Pennie:
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When maturity and experience are critical
In the hectic environment of a time-compressed project scrutinized by the highest levels of state government, KPMG was a calming influence that could be relied upon to explain risks and issues, test thoroughly, and deliver the right technology solution.
A single team with deep strategic and technical experience
Our team combined a depth of knowledge across all facets of state based exchanges and federal health insurance regulations, enabling us to interpret the impact of federal statutes on the Pennie platform as it was being implemented. Our extensive quality assurance practice and automation development experience also helped ensure that the right solution was delivered, providing Pennsylvanians with a streamlined, user-friendly system.