Tuesday, June 24, 2014

Employer Health Costs To Accelerate; MHBE Board Meeting

Employer Health Costs Forecast To Accelerate In 2015

Hospice for profits lack oversight 

Drug Discount Program Has Drugmakers Crying Foul

Information About January 2015 Proposed Rates For Health Plans on DC Health Link

The state of enrollment: Lessons learned in connecting Americans to coverage 

Here are my notes from today's MHBE board meeting. 

Maryland Health Benefit Exchange (MHBE) 
Board meeting
Chair: Dr. Josh Sharfstein 

1.       The board approved Carolyn Quattrocki, as permanent Executive Director.  She has been Interim Director for the past 8 months . Well deserved
2.       MHBE is hiring, positions are posted, many close this week.
3.       Secretary Fitzgerald reported on the status of the new computer based exchange system which adapts Connecticut’s system.  They are currently on schedule.  Informally, I was told the system would be ready by mid October.  The board approved contracts to continue this work
4.       The SHOP should be ready by the end of 2014. An RFP and RFA will be issued soon.
5.       The board approved an extension of the call center contract to 8/31.
6.       Staff reviewed enrollment progress, and new directions for this fall enrollment.
·         Greater use of libraries, storefronts, brokers, tax prep services, gyms
·         Community forums in Spanish



Tuesday, June 10, 2014

Wrestling with Medicaid; Healthcare.gov and the Cloud; +

In this blog post, I include several articles on Medicaid expansion or lack thereof, an article about Healthcare.gov and more.

In Texarkana, Uninsured and on the Wrong Side of a State Line

Excellent Video Healthcare for All Virginians, urging the state to expand Medicaid.
 Unfortunately,the effort was unsuccessful.

Tom Bell and Herb Kuhn: Veterans deserve better access to health care  Kansas City Star

Film: Tragic stories of Utahns in the Medicaid coverage gap  The Salt Lake Tribune

Is Healthcare.gov Floating Toward The Cloud?

Insurers Revisit Plans To Narrow Provider Networks  


Thursday, June 5, 2014

Uninsured rate at lowest ever +

U.S. Uninsured Rate Holds Steady at 13.4%

Premiums grew average of 10% before Affordable Care Act

The GOP’s incredible Obamacare disappearing act,

Quality of Care Higher in Medical Homes Compared with Other Practices

Patient-Centered Medical Homes: The Promise and The Reality


This was a program I attended


Key takeaways:
  • 61 percent of studies that reported costs saw cost reductions after PCMH implementation, Amy Gibson stated. However, medical homes vary because they serve different populations and have access to different resources and skill sets within their communities. She went on to say that PCMHs are incompatible with fee-for-service because incentives are currently aligned with volume of care instead of value.
  • The Center for Medicare & Medicaid Innovation (CMMI) seeks to engage multiple payers in its Comprehensive Primary Care Initiative (CPC), Pauline Lapin said. There are already 2.6 million active patients, and 2.3 million are impaneled to CPC providers.
  • The PCMH model focuses on payment innovation, provider empowerment, population health and personalized care, Amy Cheslock emphasized. In Colorado, WellPoint found that through a medical home pilot it could achieve 18 percent fewer hospital admissions, and 15 percent fewer ER visits.
  • Cheslock went on to describe a new contract for primary care physicians where the insurer pays a PMPM, or per-member per-month fee, to cover costs that are not traditionally paid for in the fee-for-service model. PMPM payments are also larger for higher-risk patients.
  • At Summit Family Physicians, becoming a PCMH reduced hospital visits by 160 patients in one year, but office expenses increased by 19 percent, Mark Frazer said. There is currently a shortage of primary care physicians, which can be addressed by improving reimbursement for care management.

Graduating from college? Here are 4 ways to get health coverage 

From Healthcare.gov 


UnitedHealth Group Raises Dividend By 34 Percent