Bruce Pomfret, Vice President
With his leadership and passion for technology solutions to complex program requirements, Bruce leads NFP Health in the development of benefits exchanges for both private and government opportunities. He has unprecedented experience in designing, implementing and running health care exchanges, having focused exclusively in this industry since 2008.
Most recently, Bruce has led the implementation of the NFP Health premium billing system in two state exchanges. In Rhode Island, this six-month implementation included full billing services for individual and SHOP customers, and was one of the few systems in the country able to create and mail invoices in the first week of October. In the District of Columbia, Bruce and his team stood up a billing solution within six weeks over the holidays to replace an underperforming vendor, and that system has now issued four months’ worth of billing and collections since go-live in December.
Additionally, Bruce led NFP Health’s implementation of a premium billing solution for the Medical Security Plan, a unique program to insure the recently unemployed run by the Commonwealth of Massachusetts.
Bruce has a deep knowledge of the 2010 Patient Protection and Affordable Care Act, and a singular understanding of the challenges of implementing a statewide insurance exchange. Bruce has augmented NFP Health’s extensive commercial insurance background with his in-depth and hands-on experience in subsidized exchange distribution.
Prior to joining NFP Health, Bruce ran all aspects of IT for Dell Services Commonwealth Health Connector account. The Health Connector is the Massachusetts program designed to present health insurance options to individuals and groups, and is the model for federal health insurance exchanges under the Affordable Care Act. As IT director, Bruce designed and implemented a full service call center, complete with robust CRM and workflow capabilities. Additionally, the application suite included a premium billing system equipped with such modules as plan and price comparison, enrollment, invoicing and account tracking. Perhaps most importantly, the system integrated seamlessly with a variety of interfaces connecting the program with state systems, insurance carriers, mail houses and other entities. This entailed creating real time and batch interfaces with the state’s MMIS and eligibility systems, establishing connections with five managed care organizations, and connecting to lockbox and EFT banking systems. Bruce’s ability to understand the health care industry and the Connector’s specific challenges allowed him to design and implement this flexible and modular application suite. As a trusted business partner, he provided efficient technology solutions to such challenges as the loss of funding for legal immigrants, the roll out of a new MMIS system, and the merger of another state insurance plan into the program.
After the passage of the Patient Protection and Affordable Care Act (PPACA) 2010, Bruce became the IT point person for Dell’s State Health Services business division. His tasks included evaluating partners, designing product offerings for the mandated state exchanges, and working on bids for enrollment broker and eligibility contracts throughout the United States. His knowledge of and experience with Medicaid, CHIP and other state health programs made him a key player on the team.
Bruce has also served as a senior IT leader for eight years on Dell’s Harvard Pilgrim Healthcare account. In this capacity Bruce designed and implemented several major programs, such as the original online employer enrollment and management tool HPHConnect, the migration of all electronic data exchanges to HIPAA compliant ANSI standards, and the roll-out of the National Provider ID program at the carrier.