The Obama administration said Saturday that the rate of inaccuracies in a key enrollment records from HealthCare.gov is declining, but a federal analysis shows about 15,000 consumer sign up forms were never sent to insurance companies due to technical problems with the website. Following the botched rollout of HealthCare.gov, the online enrollment tool for Americans to sign up for health insurance, Obama administration officials vowed to get the site working for the vast majority of users. But since the October 1 site launch and start of open enrollment, insurers have reported issues with application forms known as 834 forms sent from HealthCare.gov to the insurance companies.
1. Tracking patients with chronic health problems. Insurers will be paying hospital-and-clinic systems based on how well patients fare. People with multiple health problems, such as high blood pressure and diabetes, face much higher risks of expensive crises. That means there is much more opportunity to prevent excess care and spending on them than there is on healthy people. Dr. David Swieskowski, a vice president of Des Moines' Mercy Medical Center, shared financial numbers that illustrate why chronically ill people are the prime target for quality-improvement efforts. Wellmark Blue Cross and Blue Shield pays Mercy's ACO about $960 per month to care for patients with two or more chronic conditions, he said.
Catholic health care came into existence to care for patients like Cathy — people who are not welcome at other hospitals, who are too poor, too risky, too complicated. It caused me great sadness, then, to read about the ACLU's lawsuit against the U.S. Conference of Catholic Bishops. The suit alleges that a Muskegon, Mich., woman, Tamesha Means, was put in danger by a Catholic hospital that refused to perform an abortion because it followed the Ethical and Religious Directives for Catholic Health Care. Those are the guidelines, published by the Conference of Catholic Bishops, which outline "the ethical standards of behavior in health care that flow from the church's teaching about the dignity of the human person."
Traditionally, health care and retail haven't mixed well together. Typically, health care companies haven't sold products to people. Instead, insurers sold coverage plans to employers and hospitals negotiated payment with insurers. But that is changing. The Affordable Care Act is accelerating several trends that spotlight individuals as stakeholders in their own health care. For one, employers, uncertain of the ACA's impact, are offloading more of the cost of care onto employees through high-deductible plans and health savings accounts. According to a study by the National Institute for Health Care Management, 69% of employers plan to shift even more of the cost of care onto consumers over the next four years.
Between the troubled federal insurance enrollment website and uncertainty over Medicaid expansion, the months leading up to the kick-off of President Barack Obama's new health care law have been bumpy in Iowa. Now, with weeks to go before the program starts, those issues have largely been resolved, though questions remain about if the state is ready. Starting Jan. 1, many of the provisions of the health law go into effect, including insurance coverage for those who signed up for private plans on the federal enrollment website. The state's modified Medicaid expansion which uses federal dollars to offer coverage to some low-income Iowans has been granted federal approval and will also begin that day.
Indiana hospitals and outpatient medical centers have a $31.3 billion economic impact, according to a report that examines the financial role of health care facilities in the state. Local hospital executives are not surprised by the finding, but some say the figure does not fully measure the role of a hospital in a community. Franciscan Alliance Northern Indiana Region CEO Gene Diamond described the report as interesting and informative. "But, if anything, I think it underestimates the economic impact of hospitals," Diamond said. "Hospitals, by engaging in their mission work, particularly in working with their local communities on preventive care and wellness initiatives, have an impact that is significant, beyond what is recorded in reports of this kind."