Wednesday, May 21, 2014

State Scraps Health Website

That means more people will die!

"The groundbreaking Massachusetts health insurance law may have prevented about 320 deaths a year, according to a Harvard study of the legislation that was used as a model for President Obama’s national health program. Some health policy specialists were dubious about attributing the decline in deaths to the law."

Except he f***ed it all up to integrate with Obummercare! 

Related(?): 

"John Hailer, chairman of the New England Council, a business lobbying group, pointed to two key Massachusetts industries in particular that are being reshaped by federal laws. The Affordable Care Act, also known as Obamacare, is dramatically altering the landscape for hospitals and other health care-related business. “Washington is very much involved in our daily lives.” 

Just saw it wandering around, that's all.

"Mass. scrapping flawed health insurance website; Next steps have uncertainties for users, insurers" by Liz Kowalczyk and Michael Levenson | Globe Staff   May 05, 2014

Massachusetts plans to scrap the state’s dysfunctional online health insurance website, after deciding it would be too expensive and time-consuming to fix, and replace it with a system used by several other states to enroll residents in plans.

Simultaneously, the state is preparing to temporarily join the federal HealthCare.gov insurance marketplace in case the replacement system is not ready by the fall.

The diagnosis keeps getting worse and worse!

The strategy announced Monday will still cost an estimated $100 million, and it creates many uncertainties, especially for insurance companies and consumers. Some customers might eventually need to change insurance plans.

Another $100 million to an already austerity-laden, taxed-to-the-hilt public. At least the elite of Bo$ton are doing fine in this economy.

As late as March, the state had considered rebuilding the balky Health Connector site, which has left thousands of consumers frustrated and many without coverage for months. But Sarah Iselin, the insurance executive whom Governor Deval Patrick tapped to oversee repairs to the site, said that approach turned out to be far too risky.

I'm sure Obama and Ortiz will get to the bottom of this.

The state’s online insurance system must be ready by Nov. 15 for consumers to enroll in new health plans for 2015, and Massachusetts is one of several states under pressure from the Obama administration to make sure it meets the deadline.

!!!!!!! 

After integration to his historic legacy of failure is what crashed the thing!

“The responsible and prudent thing to do was to have another plan,’’ Iselin said in an interview. “Unlike other IT projects where the deadlines are self-imposed, we have a law. It’s not flexible.’’

BULL! Just get Obummer to issue a waiver directive.

Iselin said that adopting the new software, called hCentive, and preparing to connect to the federal website simultaneously will cost about $100 million through 2015. That is about 30 percent less than the estimated expense of rebuilding the existing site, she said. But it is unclear how much money the federal government will contribute and how much will fall to Massachusetts taxpayers.

:-(

“That’s what we’re talking to them about right now,’’ Iselin said. “We have been very clear that digging ourselves out of the hole we are in is going to cost us more money than we originally anticipated.’’

:-( 

So why can't the $hitty $oftware contractors pay for it then? 

Another unknown is whether the transition will create disruption for consumers. Eric Linzer, a spokesman for the Massachusetts Association of Health Plans, said some insurers may not be able to afford to remain in the program, meaning consumers could end up having to switch coverage.

By con$umer they mean YOU, PATIENT! 

That is what is WRONG with OUR MEDICAL $Y$TEM right there! Doctror's diagnosis!

“I can’t overstate the complexity and technical issues that come with not having to develop just one but two separate systems,’’ he said. “Given the time frame in which all this has to be implemented, this is going to be a significant undertaking for plans.’’

Massachusetts also provides more generous subsidies than the federal health insurance program for residents with incomes below 300 percent of the federal poverty level. Iselin said whether the state can retain those unique aspects of its program if it connects to the federal site is still under discussion with the Obama administration. According to the state’s plan, use of the federal website, if necessary, would be for no more than a year, just until hCentive is ready....

I don't want to go anywhere near that federal site, and what a DICK ADMINISTRATION!

This is Massachusetts we are talking about here! I was told Deval's in with the guy would mean everything would flow smoothly! Can't even get a waiver for his f*** up, and now he's pressuring us to fix things!!

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Scrapping these, too:

"Exit plan for health site mess deserves scrutiny of its own"  |    May 08, 2014

Massachusetts’ experience in going from a sterling universal health care success to a crashing insurance-exchange website failure has been hugely discouraging. And now, as the result of poor management, overly ambitious goals, and a software contractor that couldn’t deliver, the Patrick administration has arrived at point of frustrating options.

Having decided that fixing the current website is a lost cause, officials at the troubled Massachusetts Health Connector today will recommend buying a software product from a different vendor, hCentive. But the Connector also wants to prepare to join Healthcare.gov, the federal website, in case hCentive’s “off-the-shelf” website product can’t be adapted in time to let Massachusetts residents secure health plans for 2015, for which enrollment starts on Nov. 15.

That course has left the state’s health insurance plans deeply concerned, and understandably so: Having invested heavily to prepare for the dysfunctional website, they’ll now have to prepare to work with two different websites. Sarah Iselin, the Blue Cross Blue Shield of Massachusetts executive brought in to set things rights at the Connector, has won good reviews for her work clearing up the backlog there. But the Connector board should scrutinize her recommended path forward with a measure of healthy skepticism.

There are two possible causes for concern: For one, Optum, the health-technology firm that the state hired to help fix its website problems, has a 24 percent ownership stake in hCentive, which stands to get tens of millions in state work. Board members deserve a clearer sense of which other options were considered.

Second, the agency hasn’t tapped Connecticut’s expertise. That neighboring state has managed to get right what the Patrick team couldn’t. Its website, developed in a closely managed process with Deloitte, works well. Given that fact — and the fact that Kevin Counihan, CEO of Connecticut’s health-insurance exchange, used to work for the Massachusetts connector — one would think Connecticut would be a valuable nearby resource. Actually, “there hasn’t been any kind of formal outreach,” says Counihan. “We haven’t had any substantive discussion.”

At least they can get something write once in a while.

See: State Health Site on Iselin 

Waiting for a while now.

For her part, Iselin says hCentive rose on its own merits due to high-quality website work in Colorado, Kentucky, and New York. She also says she spoke directly to Deloitte, which said it couldn’t adapt Connecticut’s website for Massachusetts in time. Then again, Massachusetts has had a troubled relationship with Deloitte, while Counihan’s advice might have proved helpful.

Thought we were done with them.

After a problem-plagued 2014 enrollment period, the state must get this right for 2015. To that end, the Connector board needs to take an active role in probing Iselin’s strategy — to make sure that the latest strategy for ending the website fiasco doesn’t lead the way to a new one.

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And now we find it is going to COST TENS MORE MILLIONS!

"New Mass. health website estimated to cost $121m" by Kay Lazar | Globe staff   May 08, 2014

The estimated price tag for ensuring that Massachusetts has a functioning health insurance website is $121 million, and, even then, consumers are unlikely to get a one-stop shopping experience this fall as they search for health plans, state officials said Thursday.

WhatTF are we paying for these days? 

Why is everything corporations and government serve you such shit?!!!!!!!!!!

Sarah Iselin, the insurance executive whom Governor Deval Patrick tapped to oversee repairs to the state’s broken Health Connector website, said Massachusetts intends to ask the federal government to pay for the fix.

Good luck with that bankrupt carcass.

The state has already received $174 million in federal funds to build a site that is compliant with the federal health care law, but about a third of that money has been spent, and Iselin said the Patrick administration is sorting out how much of the remaining $117 million has been committed to pay contractors for work already done.

What work already done? They f***ed it up!!!

The administration announced earlier this week that it plans to scrap its dysfunctional insurance website after deciding it would be too expensive and time-consuming to fix and to replace it with an off-the-shelf system used by several other states to enroll residents in plans.

We could have got off the shelf for cheaper? 

So WHAT WELL-CONNECTED CRETIN got the STATE CONTRACT? 

Oh, man!

Simultaneously, the state is preparing to temporarily join the federal HealthCare.gov insurance marketplace in case the replacement system is not ready by the fall.

Iselin told the Health Connector board Thursday that neither of the paths offers an ideal fix, and the federal option, in particular, will probably require the state to design a multistep online process so consumers could get the extra subsidies for health insurance coverage provided by state law.

They hold that carrot out in front of you when premiums have skyrocketed and costs continue to climb!

“I don’t want to sugarcoat this, there are no solutions yet,” Iselin said. “But we are pushing hard for customization.”

She said Connector officials are updating the US Centers for Medicare and Medicaid Services at least three times a week about their progress, and hope to be able to make a decision by midsummer about which track to go with for the fall.

With other state exchanges also faltering, including those in Oregon and Maryland, federal regulators are closely watching progress in Massachusetts.

RelatedOre. halts health insurance sign-up

Who designed their site?

Iselin said there were at least 20 officials from the federal agency in a meeting last week in Washington when Connector staff laid out their intentions for the dual-track system.

“We haven’t resolved any of these issues with CMS,” she said, referring to the design of the websites or the financial support from the federal government.

While the Connector board took a symbolic vote Thursday to support the dual-track solution, the ultimate decision was out of their hands, because the Patrick administration opted to use emergency procurement rules to buy software from a company called hCentive. That meant there was no competitive bidding that would have allowed other companies to vie for the contract.

Under the plan, hCentive will be a subcontractor to Optum, a company the state hired in February to repair the Connector site.

Optum has a 24 percent ownership stake in hCentive.

Yeah, the editorial board thought that might look funny, but whatever.

The Connector board voted 10 to 1 in favor of the adminstration’s approach, with member George Gonser Jr. the lone dissenter.

Gonser, an insurance broker, said in an interview later that while he appreciates the considerable work the Connector staff has done to try to fix the problems, he is concerned about the millions of dollars being spent, the assumption by state regulators that the federal government will keep paying the tab, and the scant discussions about the likely financial hardships to be borne by small businesses and consumers.

You expect government to be concerned with those things? I don't. They care about when they are getting their next buck, that's all.

“What is it going to mean to small busineses if there is an attempt to pass these costs along?” Gonser said. “I thought it was important to voice discontent in the entire process.”

Health insurers are livid about the prospect of having to build two software systems that could work with the state’s two-track approach, saying the costs to the 10 health insurance companies statewide could run into millions of dollars overall.

Well, THAT is NOT GOOD! Even the INSURERS are ANGRY!

“It’s a significant challenge that will really strain the resources of the plans,” said Eric Linzer, spokesman for the Massachusetts Association of Health Plans. “That may translate to higher costs for employers and consumers.” 

:-(

Linzer said health plan officials are upset that the Patrick administration has not worked closely with the insurers to fully understand the technology impact on the companies, even though the administration knew its insurance marketplace was in trouble as early as last fall.

The ARROGANT GOVERNMENT I so know and love!

“Looking forward,” Linzer said, “we hope the plans will be actively engaged.”

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Also see:

Mass. hospital profits rose last year, report says
Mass. insurers link steep losses to health care overhaul

What is with the differing diagnoses in the span of two days? 

3-hospital takeover by Partners OK’d

They all agree there!

"Partners HealthCare, state near wide-ranging deal; Cost controls and limits to growth included, but green light given for South Shore Hospital deal" by Robert Weisman | Globe Staff   May 17, 2014

Partners HealthCare System has reached a tentative agreement with state regulators that would allow it to complete a long-planned takeover of South Shore Hospital, but limit how much Partners can charge for medical services and prevent the state’s largest health care system from adding more hospitals and physicians’ groups for years, according to several people with knowledge of the deal.

The settlement with Attorney General Martha Coakley’s office follows five years of government inquiries into Partners’ pricing, competitive practices, and market power. An agreement came only after months of often tense negotiations, the parties familiar with it said. They spoke on the condition of anonymity because they weren’t authorized to discuss the matter.

Health care officials in Massachusetts and beyond have been closely following the long-running investigation into Partners’ market clout in anticipation that a resolution could establish a road map for costs and competition in an industry that is rapidly consolidating.

That's never good for patients, 'er, con$umers.

Under the deal, which has yet to be formally signed, Partners’ prices would be tied to the rate of inflation, currently about 1 to 1.5 percent. That is significantly less than the recent trend of health care cost increases.

Partners also agreed to negotiate separate contracts with health insurers, setting different terms for different kinds of hospitals. There will be one for its Harvard-affiliated teaching hospitals, Massachusetts General, and Brigham and Women’s; another for Partners-owned community hospitals such as North Shore Medical Center and Newton-Wellesley Hospital; and a third for the 378-bed South Shore Hospital in Weymouth. That would prevent the Partners community hospitals from imposing the higher rates paid to its teaching hospitals.

The state Health Policy Commission in February approved a report warning that Partners’ proposed takeover of South Shore Hospital, one of the largest remaining independent hospitals in the state, could drive up costs and hurt competition. It was left up to the attorney general to decide whether to let the deal go through.

Brad Puffer, a spokesman for Coakley’s office, declined to comment.

Partners said the parties have yet to wrap up their settlement talks. “There is no formal agreement at this time, and discussions with the Massachusetts attorney general’s office are ongoing,” said Partners vice president Rich Copp.

It was not immediately clear whether the US Department of Justice, which has been investigating alleged anticompetitive activity by Boston-based Partners, working in tandem with the Massachusetts investigators since at least 2010, is a party to the agreement. Daniel Stratton, a spokesman for the Justice Department, declined to comment.

The comprehensive agreement is being called a “conduct remedy,” meaning the attorney general’s office will sign off on the acquisition of South Shore Hospital on the condition that Partners accepts strict limits on its business practices and agrees to be monitored for as much as a decade.

Coakley and top officials in her office were said to have concluded that such an arrangement would do more to rein in costs and level the playing field in the state health care market than bringing a lawsuit to stop the takeover of the Weymouth hospital. They wanted Partners to “pay a steep price,” according to a health care professional familiar with their thinking.

Key to the deal is a series of so-called standstill provisions, or caps, ranging from five to 10 years, which limit how much Partners can command in reimbursements from insurers and preventing it from strengthening its market dominance by acquiring additional hospitals and physicians practices. The hospital cap does not cover Hallmark Health, parent of Wakefield Hospital and Lawrence Memorial in Medford. Hallmark signed an agreement in 2012 to be acquired by Partners, but the hospitals have yet to close on that deal.

The deal also prevents Partners from negotiating health insurance contracts on behalf of doctors groups affiliated with but not employed by Partners. And it allows Partners community hospitals to accept lower-cost insurance products even if its teaching hospitals don’t.

Health care analysts offered different views on the tentative settlement.

“It strikes me as a very fair approach and a very smart approach,” said Marc Bard, president of health care consulting firm MB2 in Newton. “The AG’s office is saying they want to limit the risks around cost and forming a monopoly but recognize the benefits of a very high quality hospital system bringing services to a community that could benefit from it.”

But Boston University professor of health policy Alan Sager called the settlement a “functional compromise” by Coakley, who is a Democratic candidate for governor.

“This strikes me as more of a political deal than a health care deal,” Sager said. “If we’re relying on competition to hold down health care costs, the more competitors the better. The harm to the public will accrue more slowly under this deal, but the harm will occur.”

SeeGubernatorial candidates react to Coakley’s deal with Partners

I see she's got the best of both worlds, and honey I know what it's worth.

The joint state and federal investigation into Partners became public in April 2010 when US antitrust regulators sent letters to Partners and three large Massachusetts health insurers demanding documents related to Partners contracting and other practices. The demand letters indicated they were seeking to determine whether the practices violated the Sherman Antitrust Act, which bars companies from using market influence to limit or artificially raise prices.

In November 2008, a Globe Spotlight team investigation examined the effects of the Partners health system on medical costs.

Yeah, but Marty has amnesia. I obviously do not.

Related: Mass. AG investigating whether Deloitte violated contract

Also see: Patrick Feeling His Oates 

More clouds over his legacy to add to DCF, Dookhan, meningitis murders, higher energy prices, and so many others it's become a cloudy legacy with no sun at all.

Whether the settlement between Partners and Coakley’s office spells the end to that five-year probe may not be known unless the Justice Department — which has never formally acknowledged the investigation — signs on to the deal or releases a statement clarifying its position.

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Related: Somerville Shopping Center

Need a better Steward:

What Steward brings to the table is a community care organization that is physician-led

"Ratings agency changes Steward’s credit outlook" by Robert Weisman | Globe Staff   April 10, 2014

Moody’s Investors Service said Thursday that it has changed its credit rating outlook for Boston-based Steward Health Care System LLC from positive to stable, warning that a “challenging operating environment” could slow the company’s financial progress.

At the same time, Moody’s affirmed Steward’s actual credit rating of B3, which a spokesman for the rating firm called “speculative grade” subject to high credit risk. If the rating were to be downgraded in the future, it would make it harder for the company to borrow money....

Steward, which is owned by private equity form Cerberus Capital Management, operates St. Elizabeth’s Medical Center and Carney Hospital in Boston along with eight other acute care hospitals, a rehabilitation center, and a larger physicians group in eastern Massachusetts.

What's with the three-headed guard dog to the gates of Hell as a mascot?

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Related: Bad Steward Post Puttered Away

Did I mention premiums were going up?

"Health insurance rates up slightly for small employers, individuals" by Robert Weisman | Globe Staff   May 16, 2014

Average health insurance base rates will increase by 2.9 percent for small employers and individuals whose policies renew in the third quarter, according to data released Friday by the state Division of Insurance.

The rate hikes, while higher than the 1.9 percent increases of a year ago, were not as big as expected in what is the first filing period since health insurers began being affected by a new tax to help finance the federal health care overhaul. That tax is projected to cost Massachusetts health insurers $213 million this year. 

Yeah, that makes me feel a lot better. 

How will those insurers every survive?

The tax resulted in steep first-quarter losses for the largest insurers, but the relatively modest base rate increases reflectsconfidence they can absorb the added costs and their determination to retain customers, said Barbara Anthony, state undersecretary for consumer affairs and business regulation.

“We are the beneficiaries of some transformation that’s going on in the marketplace,” Anthony said, citing new health insurance contracts that give doctors and hospitals fixed budgets for patient care. “They’re calculating rates that will allow them to be competitive.”

It's called rationing, folks.  

So premiums keep going up, costs keep soaring, and yet your medical care budget needs to be cut. What is wrong with thi$ picture? 

They spent how many millions on websites and public relations campaigns?

The so-called small group market affected by the rates covers about 147,000 people, including sole proprietors and employees of small businesses and other organizations. The period between July and September is one of the most active for health insurance policy renewals.

Third-quarter base rates are scheduled to edge up 1.9 percent for health maintenance organization members of Blue Cross Blue Shield of Massachusetts, the state’s largest health insurer, but decline 15 percent for members of its preferred provider organizations, according to the state. Blue Cross could afford to drop its rates for PPO members partly because it will receive cash from other insurers under a “risk adjustment” provision of the federal Affordable Care Act that seeks to more evenly spread insurance risk.

Among other large Boston area insurers, Harvard Pilgrim Health Care rates will climb 4.9 percent for HMO members and 4.3 percent for PPO members. Rates at Tufts Health Plan will increase 4.9 percent for HMO members and 4.8 percent for PPO members.

While they are an indicator of the general trend in health insurance rates, base rates are only one factor in what companies or individuals actually pay. Rates for most employers also include additional factors ranging from the type of industry to the age of employees. 

Meaning it is the lowest you will pay; it could be much, much more.

Health care consultant Jon Kingsdale, managing director of Wakely Consulting in Boston, said some insurers may be holding down rate increases in an effort to steal market share from competitors at a time of flux in the industry.

Meaning they will be going even higher!

“This is a period of considerable uncertainty in pricing,” Kingsdale said. “The rates suggest they’re more afraid of losing business right now — or interested in gaining business — than they are concerned about making a healthy profit.”

Must be why so many "health" articles are found in my bu$ine$$ $ection.

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