Great technology tools may help a public exchange grow in the short term, but knowing the customer base and business well enough to make the right investments is critical to an exchange becoming sustainable and successful in the long run.

Acknowledging that state-run exchanges launched quickly with a lot of competing priorities amid a substantial policy debate, Philip Poley, managing director at Accenture, said now is the time for exchange heads to understand what business they are in. Technology will not bail the exchanges out, but effective management will, he said at a HIX policy conference in Washington Tuesday.

“You are charged with making wise investments in products that technology [vendors] bring you so you can be sustainable,” he said to room of exchange heads and providers. “Where does innovation start? It starts with exchange directors knowing they are in business and knowing what business they are in.”

Also see: Healthcare.gov CEO: Market runs ‘risk of offering too much choice’

The underlying issues are core to figuring out how state-based marketplaces move to a place where they are not just sustainable but are also growing, said Chini Krishnan, CEO of GetInsured. Key to their success is understanding three key items, he explained:

1. Changing from designers of technology to consumers of technology: Exchanges are in the distribution business, not software business. “The idea of trying to build these exchange platforms from the ground up in a customized matter is over,” he said. “The first thing that states should look at is, ‘Can we create a shared services platform?’”

2. Better distribution: Exchange products need to be more available in more places other than just an exchange website, Krishnan said. Other new products, he said, usually start in a local store, and then an entrepreneur wants the product to be available at big box retailers. For public exchanges, distribution is limited to the websites. “In the long term, that is wrong,” Krishnan said. “You must ‘Uberize’ your experience. Make it social. Make it mobile. No product in history [has been successful] where distribution does not proliferate.”

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3. Embracing reusability: Halfway through enrollment, consumers may realize they are eligible for Medicaid, a related product,  just as when consumers go to Amazon.com and the website offers them related products. For an exchange, “creating that fluid experience is very important,” Krishnan said.

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