Whether you're ready for it or not, the implementation date for Health Insurance Exchange is coming.

A change in the industry as fundamental and controversial as HIX is naturally accompanied by confusion about what it will mean, by procrastination from those opposed to the change and by rumors and speculation over when it will actually happen.

The wise course is to ignore the rumors and to stop the procrastination before it starts. Whether Health and Human Services holds to the January 1, 2014 start date or not, HIX is coming. Preparing for it now positions your organization for greater opportunities for success when it arrives. The more your organization understands about HIX and the practical implications it has, the better equipped you will be to define an operational model that positions your company for success.

Preparing for HIX is obviously imperative, but how will you do it? What role will it play in your organization and how are you going to implement it? When an organization faces a change as significant as HIX, it is all too easy to lose sight of the big picture and become so engrossed in the tactical aspects of implementation that the strategic aspects are ignored. However, in order to participate in a HIX you need a clear vision of how it fits with your organization’s strategy. The ability to articulate the vision and strategy is key to preparing the organization for the implementation and ongoing support and administration of HIX. You must not only decide how your organization will accommodate HIX, you must also make certain the employees tasked with implementing it understand what needs to be done, and that they have complete "buy-in" to the process.

When an organization is embarking on a strategic initiative with the scope of HIX, it's not at all uncommon to find that the majority of the employees don't completely understand what's involved or its degree of importance to the company. They must understand the value it brings to the organization, how it will impact them and an approach for assessing the initiative and identifying what will be required to support it. HIX isn't scheduled to go into effect until 2014, which makes it easy for employees to see it as more theoretical than real. It needs to be seen as real now. If the project feels real, concrete and immediate, the engagement level of team members increases. They begin to think beyond the implementation phase to how they will actually operate and support changes.

A key component that is often overlooked until late in the process is defining the operating model. How will your organization support HIX once it has been implemented? Too often, organizations try to absorb a new
initiative into their current operating model, mistakenly believing they can adequately support the initiative with minimal staffing and process changes. The result is quite the opposite. Once implemented, organizations find themselves struggling to support the new initiative. They don’t have the appropriate processes and skills in place, customers are unhappy, the organization is in a reactive mode, and additional investments are required to restore business to a normal operating cycle. Thus, it is vital to first understand the strategy. How will HIX fit in the company? Is your organization a passive participant, doing only what
is necessary to offer your products on the Exchange? Or will you leverage HIX as a way to grow your business?

As with any change the magnitude of HIX, forming a strategy for it and determining how it will fit in your organization seems like an all but insurmountable obstacle when you first look at it. However, there are some
practical steps you can take to define your operating model and reduce the work to manageable tasks.

  • Map your strategy and HIX requirements to your organization’s current capabilities to assess where you stand currently vs. where you need to be.
  • Identify the gaps in capabilities and impact to the critical path for HIX in order to establish priorities for closing the gaps.
  • Assess your processes to determine if they are robust enough to support the HIX requirements and determine where new processes need to be developed and existing processes need to be remediated.
  • Evaluate your staffi ng models to determine if you have the right skill sets and staffing ratios to support HIX processes.
  • Apply this information against your strategy to determine the type of operating model that is going to work best for your organization. The operational model must be able to support your organization’s strategy
    with the ability to evolve as the industry model for HIX matures over the next few years.

HIX is coming. It's possible it will be pushed back from its 2014 start date, but it is still coming. The only question is if your organization will be ready for it. The advice given above will help your team determine the direction they need to go and identify the right way to get there. Creating a viable operating model early in the process will set the direction for your team, provide a basis and foundation for decision making, and ensure that your organization can successfully execute your HIX strategy. HIX can be a tremendous opportunity, but only if you are ready for it.