Saturday Short Cuts

This story out of the NY Times really deserves much more attention than I'm giving it, but I'm swamped:

For the first time, the Obama administration has deployed an important new power it has under the Affordable Care Act: proposing to pay doctors and hospitals based on the quality of care they provide, regardless of whether they want to be paid that way.

It rolled out two such programs this week. One would require all hospitals in 75 metropolitan areasto accept a flat fee for the costs associated with a hip or knee replacement — including the costs of surgery, medications, the joint implant and rehabilitation. And if the quality of the care is not judged to be good, Medicare will take back some of the money it paid. Another program would increase or decrease payments tohome health agencies in nine states, depending on how they perform on certain quality measurements.

This story is mainly included for reference if/when I'm able to do a market share/rate increase analysis of Illinois in the future:

After capturing an estimated 25 percent of new enrollees during the second year of the Illinois health insurance exchange, Land of Lincoln Health has a new West Loop headquarters for its rapidly growing staff.

The insurer, launched in 2013 under the Affordable Care Act to spur competition on the exchange, said it moved in June into 35,000 square feet at 222 S. Riverside Plaza.

...MCHC got $160 million in loans from the federal government to establish a health insurance co-op to compete with major insurers in the state as part of President Barack Obama's heath care overhaul. This year, Land of Lincoln estimates it signed up 1 in 4 new enrollees to give it about 12 percent of the total individual market.

Land of Lincoln said it signed up more than 50,000 people during the second year of the exchange, whose enrollment period ran from November 2014 to February 2015.

This story is a follow-up to my own entry on the same subject back on 6/26:

The U.S. Supreme Court ruling legalizing same-sex marriage has far-reaching effects in Kentucky, including triggering the opportunity for couples to enroll in Kynect, the state's version of the Affordable Care Act.

Montserrat Caballero is with the nonprofit group Enroll America, which helps people get coverage through the ACA. She says marriage, like childbirth and adoption, is a "qualifying life event," which means some updates are in order.

I hope they're able to pull this off from a simple state pride perspective, but to be honest, with King v. Burwell out of the way, it might make more sense for troubled exchanges like VT to simply give it up and shift over to HealthCare.Gov instead at this point:

Vermont Health Connect barely snuck past its June 1 functionality deadline, and now the controversial state health care exchange is working to meet an Oct. 1 deadline that will make or break the project.

Earlier this year, Gov. Peter Shumlin set goals and deadlines for Vermont’s troubled health exchange. One goal is that the system must be able to process changes of circumstance quickly enough so that a change reported before the 15th of a given month will be reflected on the customer’s next statement.

This one may seem surprising, since Illinois has never run their own "full" exchange, but the exchanges consist of more than just the website; the state is still responsible for the call center, customer service, enrollment outreach and so forth:

Gov. Bruce Rauner’s administration has eliminated 15 staff positions from Get Covered Illinois, the state’s health insurance exchange, three months ahead of the third annual enrollment period under President Barack Obama’s health care  law.

The layoffs raise questions about the Republican administration’s plans for helping consumers enroll in health  insurance coverage under the law - the Democratic president’s signature domestic policy achievement.

This news is, admittedly, not good at all:

District residents who want to purchase individual insurance plans on the city’s health exchange will have fewer options next year.

In fact, individuals searching for more flexibility than that offered by health maintenance organizations will have just one carrier to choose from — and the cost for some of its plans may jump by double digits.

Aetna Life Insurance has begun sending hundreds of city residents letters warning that plans purchased through the city’s health exchange, known as D.C. Health Link, will terminate at the end of the year.

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