Choicelinx: the product behind the company

Lost in the political firestorm surrounding Choicelinx and how it won an $890,000 state contract, is the company’s product — an agile and robust benefits software system that can save insurers and employers thousands of dollars.

The Manchester-based firm was co-founded in 2000 by Donna Lencki, a former CEO of Healthsource who brought on board several other former employees of the managed care company that was acquired bought by Cigna in 1997. Their goal was to develop an on-line benefits management application that would support the needs of employers, employees and health plans, yet be transparent to all three.

For employers and insurance companies, Choicelinx has taken a time-consuming, paper-driven process and automated virtually all of the administrative tasks, amounting to a significant cost savings in labor — as much as tens of thousands of dollars per month, according to Tracey Turner, vice president of corporate communications — as well as increasing the accuracy of data collection.

“We differ from other human resource management systems most significantly by the way we thought through the interface with the insurance companies,” Lencki told New Hampshire Business Review in a recent interview. “We also differ by the way we break down the health-care dollar and benefits configuration.”

The product’s benefits were cited when the state awarded Choicelinx the $890,000 contract last June with the goal of managing employees’ health and dental benefits.

But the bad press for Choicelinx began after news reports emerged that the contract was never actually put out to bid, despite claims that four other companies mentioned in a contract letter sent to the Executive Council were never contacted about providing similar services.

The news reports, and ensuing criticism of the process, eventually led to the resignation of Linda Pepin, a volunteer for Gov. Craig Benson who is being investigated by the attorney general’s office for accepting fees as an unlicensed broker for contracts she set up, including the Choicelinx contract. Critics also pointed to the participation by Lencki on a health-care advisory group for Governor Benson’s transition team, although she also advised former Gov. Jeanne Shaheen and worked on other health-care projects for the Shaheen administration.

While the attorney general’s office says it is concerned that a “sweetheart” deal took place, Ann Rice, associate attorney general, made it clear that the AG’s investigation is focused on “the events surrounding how the Choicelinx contract was handled, not the company itself.”

Despite the unwanted publicity, it’s business as usual at Choicelinx, said Turner.

“As far as we’re concerned, we’re moving forward with the work stipulated in the contract,” she said.

Simple to use

The spotlight on how the contract was awarded has turned people’s attention away from the Choicelinx product, which has apparently garnered interest not only from the state of New Hampshire, but has resulted in a national agreement with the Blue Cross Blue Shield Association to market the program to its 41 independent health plans, which cover 88 million members, said Turner.

So what about the product?

Underneath the hood, Choicelinx is built on solid technology and proven metrics.

The application itself resides on a separate co-located server and uses a real-time, ASP-driven interface, so there is little or no impact on a client’s existing infrastructure. The data engine is built on actuarial tables derived from nationwide statistics.

The company also worked with every major health information system platform to assure that translation of benefit selection choices sent back to the health plan would be compatible regardless of the formats used in the employer’s systems. Even the health-care quality data uses evidence-based metrics from LeapFrog and the National Committee for Quality Assurance (NCQA), considered the gold standards in health-care quality.

“The Choicelinx technology offers health-care consumers a level of flexibility, customization and simplicity in selecting their benefits that is very attractive,” said Don Curry, New England regional general manager for Cigna HealthCare, the state’s insurer as of October 2003. “The agreement with Choicelinx allows us to expand our consumer choice offerings in a way that responds quickly and effectively to the demands we are seeing in the marketplace today.”

Choicelinx is a Web-based suite of modules, each designed to work alone or in concert with each other.

One of the modules, Plan Selector, enables employees to see their plan choices, total plan costs and employer and employee contributions over any time period (monthly, weekly, etc.). Plan Selector is not limited to only medical and dental benefits, but also can show health savings accounts, life and disability benefits as well, displaying at a glance the associated costs.

The Benefits Configurator module helps employees choose their individual benefits within a product — for example, the co-pay costs associated with emergency room visits under a PPO plan versus an HMO plan.

By “breaking up the health-care dollar,” a running total of the employer-provided contribution is kept as the member chooses benefits. Once the employer’s contribution is used up, the remainder of the costs are displayed as the employee’s contribution, Lencki said.

At any point, employees can scroll down to view more information about covered benefits, hospitals, physicians and other providers, or even make adjustments to available co-pay tiers on the fly, and see the potential effects on their paychecks.

Choicelinx also can be configured to help employees with pre-existing conditions find the best products based on their responses to customized questions. “If the employee chooses to fill out this information, condition management can begin day one,” said Turner.

Plans call for the employee-provided information to be integrated with the provider’s system, “so they will also know the member’s specific benefits when they come in to the office,” said Lencki.

Choicelinx is available to state employees through the state Web site, allowing employees to have access at any time. (The Web-based aspects of the product have caused some concern, since not all employees have access to the Internet at work. To mitigate that concern, Choicelinx also provides telephone accessibility.)

To make a program this uncomplicated for the user was actually a complicated process involving years of research, said Turner. “We’ve done a lot of usability testing with people who have had computer experience as well as those who haven’t. It has tested very well with all of those people,” said Turner.