Monday Short Cuts

When patients need simple health care, they can get impatient about having to wait.

That’s prompted more health care systems to stress convenience.

This month, North Memorial Health Care will open two easy-access clinics in new Hy-Vee grocery stores in New Hope and Oakdale, hoping that shoppers might add treatment for warts, fever and other ailments to their grocery lists.

The resurgence of retail health clinics by hospital operators comes as they also pump money into online programs that let patients tap into care through computers and smartphones without leaving home.

This one is a heck of an eye-opener, considering the ongoing technical problems Vermont has had with their exchange website...

A new federal report shows Vermont Health Connect to be the best state-run health care exchange in the nation.

The report from the U.S. Government Accountability Office gives high marks to Vermont’s health care exchange, judging it fully operational in three of four criteria and placing it at the top of the exchanges operated by 12 other states and the District of Columbia.

“Well, I think what it means is we’ve made some major improvements over time,” said Steven Costantino, commissioner of the Department of Vermont Health Access.

The number of children without health insurance in the state dipped to 3.3 percent in 2014, ranking Rhode Island 7th in the nation, according to newly released data from the U.S. Census Bureau's American Community Survey.

The drop from 5.4 percent in 2013 coincided with the full launch of the Affordable Care Act and helped Rhode Island move up from 16th place nationwide. The number of uninsured children fell from about 12,000 to 7,100.

The federal government still has a lot of work to do to improve the performance of the 14 state-run health insurance exchanges that were set up as part of the Patient Protection and Affordable Care Act. 

In a report, the Government Accountability Office outlines a number of IT weaknesses that continue to prevent the system from meeting full expectations. However, much of the information upon which the report is based is not up-to-date. 

The uninsured rate in Kansas dropped to 10.2 percent in 2014, as part of a national increase in insurance coverage that appeared due to health care reform.

About 12.3 percent of people in Kansas didn’t have insurance in 2013, according to the U.S. Census Bureau’s American Community Survey. The drop indicates about 57,000 fewer people were uninsured in 2014 than in 2013.

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Today, the United States Census Bureau released its report on health insurance coverage which shows that the number of people without insurance in the District of Columbia fell from 42,000 (6.7%) in 2013 to 34,000 in 2014 (5.3%). The District has a record of expanding health coverage to its residents.  The Affordable Care Act is working in the District of Columbia to help individuals and families have affordable quality health coverage – private and public. According to the Census, the District is tied with Hawaii for the third lowest uninsured rate in the nation behind Massachusetts and Vermont.

Note: It also includes a kind-of, sort-of enrollment number update, but nothing specific enough to merit updating the spreadsheet:

Since DC Health Link opened for business October 1, 2013, over 45,000 people have had private health insurance coverage through DC Health Link and over 118,000 people were determined eligible for Medicaid. 

Enrollment in Medicare Advantage plans is up by 7.3% from this time last year, and more beneficiaries are expected to sign up when the program's annual open enrollment period begins next month, Modern Healthcare reports.

CMS data show that about 17.7 million people are enrolled in an MA plan, up from nearly 16.5 million individuals at the same time last year. According toModern Healthcare, many individuals have been enrolling in MA plans because of their benefits, such as coverage for hearing aids with low- or no-cost sharing, and low premiums.

None of us would have the jobs we currently occupy without some ability to focus on details. Running a company, developing IT systems, managing a hospital, seeing patients and evaluating their concerns—all require the ability to dig deep and identify root causes and effective solutions.

But maybe that focus on the trees blinds us to changes in the forest, to use a well-worn aphorism.

With that broader perspective in mind, I’d like to suggest four reasons for optimism as we continue to move through this wholesale experiment in tinkering with the health care system of a large and diverse nation.

The state has spent $229,000 to find out what insurance customers think of Vermont Health Connect. The results, not surprisingly, aren’t exactly stellar. But officials say the survey will help them improve consumer satisfaction in the future.

The survey was conducted by the University of Massachusetts Medical School, and it included responses from about 2,500 people who either bought, or tried to buy insurance on Vermont Health Connect.

Hawai‘i’s health insurance premiums for small businesses have risen an average of 7% annually since 2003, according to “The Challenges Facing Hawaii 40 Years After the Prepaid Health Care Act (PHCA),” a study conducted by Hawaii Health Information Corporation, a healthcare data collector and analyzer.

The Centers for Medicare and Medicaid Services inspector general has issued a new report on what went wrong with the federal health insurance exchanges. Or rather, one thing that went wrong: how the agency mismanaged the contracts so that they experienced significant cost overruns.

You can take this report as a searing indictment of the agency and its contracting personnel. I took something rather different away from reading it:

1. The architects of the law were incredibly naïve.

2. Federal contracting rules are crazy.

Just 5.9 percent of the state’s population was uninsured in 2014, giving Minnesota the fifth lowest rate in the nation, according to data released Wednesday by the U.S. Census Bureau.

Anya Wallack, director of HealthSource RI, the state’s health insurance exchange, suggests that the Affordable Care Act is working.

Not surprisingly, the newly released American Community Survey also indicates Utahns were significantly more likely to be uninsured when their yearly household incomes fell below $25,000. The rate of uninsured blacks dropped 4.1 points, to 11.8 percent. In Utah County, it was 10.8 percent and in Davis County, 7.8 percent.

Rose & Kiernan Inc. CEO John Murray is in the business of selling -- the bulk of his compensation is from commissions.

But in some cases, he and the other brokers at the largest local health, property and casualty insurance firm are telling employers to hold off until next year on switching to the company's private health exchange.

Finally, here's a handy interactive map; the data only runs through 2013 but could still be useful for researchers looking at the historic uninsured rate prior to the ACA exchanges/Medicaid expansion launches: