This morning, I will be on a panel at #NICAR14 about health data. I put together this handy tip sheet that discusses a few of my favorite health data sets. Do you have others that you like? I would love to hear about them.
There have been a flood of stories, including one by me, about what we can learn from the Obamacare enrollment numbers released by the U.S. Department of Health and Human Services earlier this week. Here are some of the more-insightful reads:
A guide to understanding Obamacare’s sign-up numbers, by Sarah Kliff, Washington Post
Implementing Health Reform: A January Exchange Enrollment Report, by Timothy Jost, Health Affairs blog
Subsidized exchange enrollment data and trends, by state, by Galen Benshoof, The Incidental Economist
Sorry, Conservatives: Based On The Latest Sign-Up Figures, There Won’t Be An Obamacare Death Spiral, by Avik Roy, Forbes
Most states lag in health insurance sign-ups, by Ricardo Alonso-Zaldivar and Kevin Vineys, AP
For Many, Few Health-Plan Choices, High Premiums on Online Exchanges, by Timothy W. Martin and Christopher Weaver, the Wall Street Journal
One-Fifth of New Enrollees Under Health Care Law Fail to Pay First Premium, by Robert Pear, New York Times
Finally, be sure to check out the Kaiser Family Foundation’s data. Way cool.
Flipping through the New York Times magazine a few Sundays ago, former hospital executive Paul Levy was taken aback by a full-page ad for the da Vinci robot.
It wasn’t that Levy hadn’t seen advertising before for the robot, which is used for minimally invasive surgeries. It was that the ad prominently featured a dozen members of the surgery team at the University of Illinois Hospital and Health Sciences System. “We believe in da Vinci surgery because our patients benefit,” read the ad’s headline.
(Photo by Paul Levy)
“While I have become accustomed to the many da Vinci ads, I was struck by the idea that a major university health system had apparently made a business judgment that it was worthwhile to advertise outside of its territory, in a national ad in the New York Times,” Levy, former chief executive of the prestigious Beth Israel Deaconess Medical Center in Boston, told me by email.
As Levy scanned the ad further, he noticed that at the bottom the ad bore a copyright for Intuitive Surgical Inc., the maker of the da Vinci system. It included this line: “Some surgeons who appear in this ad have received compensation from the company for providing educational services to other surgeons and patients.”
Well before enrollment began in Obamacare’s new insurance exchanges, Blue Cross and Blue Shield of Rhode Island dominated the state’s individual insurance market, with a 95 percent market share in 2011.
Fast forward two years and little has changed. In the first four months of enrollment in Health Source RI, the Blue Cross plan has seen its market share grow, as hard as that is to believe—to nearly 97 percent.
A similar situation is playing out in California.
Much has been written (and will continue to be written) about the spectacular failure of health insurance exchanges in Minnesota, Massachusetts, Oregon and Maryland—all blue states that support the Affordable Care Act.
All were woefully unprepared for their Oct. 1 launch, and unlike HealthCare.gov, the federal marketplace, they are still having trouble getting back on their feet. As a result, enrollment in those four states has lagged behind other states, including many that actively oppose the health law.
The New York Times recently reported on how problems in these states could give Republican candidates an opening. “Last month, the Republican National Committee filed public-records requests in Hawaii, Maryland, Massachusetts, Minnesota and Oregon seeking information about compensation and vacation time for the exchange directors, four of whom have resigned. All five states have Democratic governors whose terms end this year. Three of them — Gov. Neil Abercrombie of Hawaii, Gov. Mark Dayton of Minnesota and Gov. John Kitzhaber of Oregon — are seeking re-election,” The Times reported.
One common element emerging in the coverage of these exchanges is that at least some state employees knew they were heading for disaster but didn’t take action early enough to remedy it. All the states have blamed some, if not all, of their problems on outside tech contractors. Here’s a sampling of what has been reported in each state.
I’m often asked by colleagues how I stay abreast of health news and developments across the country. It takes time and it takes work. I start each day plowing through a slew of emails that summarize and aggregate health news from around the country, each with a different bent. So focus on the politics. Some focus on the policy. Others are state focused. While it may not be realistic to sign up for all of the email lists I do, here’s what I read.
I’m sure this list isn’t complete. Do you read anything else? Drop me a note at Charles.firstname.lastname@example.org.
HealthLeaders Media: (I get the Daily News and Analysis)
Kaiser Health News: (I get the Daily Health Policy Report)
We have now passed several key milestones in the open enrollment cycle for the Affordable Care Act: The deadline to sign up for coverage that was effective in January, the due date to pay for that coverage, and the deadline to enroll in coverage that is effective this month. The latest update from the Obama administration is that more than 3 million consumers have signed up for coverage on the federal and state insurance exchanges. Unknown is how many have paid for their plans and how many of these enrollees are newly insured (as opposed to people whose coverage was canceled).
Periodically during this open enrollment cycle, I’ve checked in with experts to get past the sound bites so endemic in this heated political debate. This week, I talked to Dr. David Blumenthal, president of the Commonwealth Fund, a New York foundation that conducts health policy research and whose mission is to “promote a high performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society’s most vulnerable.” While the foundation does not endorse legislation, it is generally seen as supportive of Obamacare’s goals.
Blumenthal was previously the national coordinator for Health Information Technology in the Obama administration. He is the brother of U.S. Sen. Richard Blumenthal, D-Conn.
The Commonwealth Fund has recently issued reports exploring Americans’ experiences with the health insurance exchanges and how states are implementing the act. The fund has a wealth of data that’s worth exploring. My Q&A with Blumenthal has been edited for length and clarity.
Q. It almost feels like after such a disastrous launch, folks have a bit of Obamacare fatigue. Is that a fair way of putting it?
Fed-up consumers, armed with questions and concerns about their new health insurance under the Affordable Care Act, are flocking to social media websites to seek answers and vent their frustrations.
For some, it’s because they can’t get through on the phone. For others, it’s a way of getting attention right away before trying phones or email.
This digital equivalent of line-jumping appears to be working.
A week ago, New Jersey writer Jen A. Miller sent a tweet asking:
Anyone else having problems with the @horizonbcbsnj site? I’d LIKE to pay my bill, but they don’t seem to want to take my $$.— Jen A. Miller (@byJenAMiller)January 23, 2014
A representative of Horizon Blue Cross Blue Shield replied the following day and asked for more information.
@byJenAMiller We’d like to help. Email SocialMedia@HorizonBlue.com w your ID#, contact info and issue.We’ll have someone call you to assist.— Horizon BCBSNJ (@HorizonBCBSNJ)January 24, 2014
“After an email exchange, HorizonBCBSNJ called and figured out that a ‘glitch’ delayed the mailing of the February bills,” Miller told me in an email. “I ended up paying over the phone.”
Miller said she turned to Twitter first because the last time she had an issue with Horizon—with her website login—“it took 40 minutes and two calls (including the part where the first person I talked to gave me the wrong number to call).”
“So when I had this issue, I tried Twitter first.”
When California pharmacist Kevin Kingma received a letter last fall notifying him that his high-deductible health plan was being canceled because of the Affordable Care Act, he logged into his state’s health insurance exchange and chose another plan beginning Jan. 1.
Thanks to a subsidy, Kingma’s monthly premium went down, from about $300 to $175, and his benefits improved.
But this month, Kingma logged into his bank’s website and saw that his old insurer, Anthem Blue Cross, had deducted $587.40 from his account and had enrolled him in another of its insurance products for this year —he says without permission.
Hundreds of other consumers are caught in the same predicament, insurers acknowledge. And the California Department of Insurance said it is exploring whether any laws were broken when insurance companies withdrew money from consumers’ accounts for plans they didn’t select.
Here’s what happened to Kingma and others: When they received letters last fall, they were informed that their plans had been canceled. But within the letter, it also said that if they did nothing, they would be switched over to a different plan and if they had set up their payment to autodraft from their account, it would continue to do so.