About Last Night: #DemDebate (Healthcare Edition)

Last night, roughly 6.7 million Americans viewed the Democratic Debates held in New Hampshire; the home of the 1^st Democratic primacy scheduled for Feb 9, 2016.

Most of the debate was consumed by topics on national security, the economy, and Donald Trump even though 29 million Americans still lack health care coverage.

However, near the end Clinton, Sanders, and O’Malley finally had an opportunity to share their views on healthcare for roughly 2 1/2 minutes:

What We Knew Already?

Healthcare represents 1/5^th of our Gross Domestic Product (GDP)
12 million Americans have gotten health insurance through the Affordable Care Act from the Health Insurance Marketplaces
There are 29 million Americans that still lack insurance coverage
Health plans on the Health Insurance Marketplaces have seen double-digit rate increases since 2014.
Healthcare deductibles have risen 65% over the past 5 years
Half of the CO-OPs created by the Affordable Care Act to compete with health insurance companies have gone out of business despite receiving start-up loans from the Federal Government.

What We Know Now After Tonight

Hillary Clinton: HillaryCare

Believes Healthcare is a basic human right.
Intends to “defend & extend” the Affordable Care Act and protect it from politicians that wish to repeal it.
Pointed out the growing prescription drug costs and wants the Center of Medicaid and Medicare (CMS) to use their buying power to negotiate with drug companies to lower costs.
Acknowledged the growing deductibles and out of pocket costs and calls for programs to lower them to a more manageable level.
Plans to continue federal funding to Planned Parenthood and non-profits like them.
Calls for more oversight on health insurance companies despite the hundreds of new rules that are now in place due to the passing of the Affordable Care Act.

Bernie Sanders: BernieCare

Believes the Affordable Care Act did not go far enough to cut healthcare costs and increase the number of Americans with healthcare coverage.
Believes in “Universal Healthcare” noting that the United State is one of the only industrialized nations in the world that does not give health coverage to all of its citizens.
Wants to extend Medicaid and Medicare programs to all Americans.
Believes in a “Single Payer” system that would allow the United States to negotiate prices with drug companies and hospitals. The program would create the American Health Security Trust Fund and be funded by tax credits and ‘cost sharing reduction’ funds provided in the Affordable Care Act and other government programs.

Martin O’Malley: MartinCare

Believes “every American deserves the opportunity to live a healthy life”.
Will build on the progress of the Affordable Care Act focusing on reduced costs, more access to physicians and hospitals, and higher quality care.
Touts successes in Maryland’s 2014 healthcare rankings, which showed the most improvement than any other state in America.
Will expand upon the payment reforms made in Maryland that removed the financial incentive of hospital payments based on “volume” to a Volume Adjustment System where payments are based on “value”.
While results are still pending, a January 2014 Health Affairs article stated that “the Maryland Model can serve as a template or as a springboard to creative efforts by other states to address an economically dominant provider industry and ever-rising health expenditures.“
Believes in Medical Homes that increase healthcare quality and cut costs by grouping together different doctors under one rook and allowing them to share medical data.
Wants to remove the confusion in Healthcare bills and increase legislation around anti-trust laws to prevent expensive prescription drugs.

What’s The Future?

All three candidates intend on building on the successes of the Affordable Care Act. There is definitely still more work to be done since based on a Kaiser Health Tracking poll 46% of Americans still have an unfavorable view of Healthcare reform:

Republicans: 14% Favorable / 79% Unfavorable
Democrats: 67% Favorable / 19% Unfavorable
Independents: 32% Favorable / 53% Unfavorable

Source: Kaiser Health Tracking Poll: The Public’s View on the ACA.
Question asked: “As you may know, a health reform bill was signed into law in 2010. Given what you know about the health reform law, do you have a generally favorable or generally unfavorable opinion of it?

Open Enrollment: Only 2 Weeks Left for Jan 1st Coverage (Video)

On Monday, November 2, 2015, Errol Pierre sat down with Arise America’s news anchor, Debbye Turner Bell to discuss the tips for the Open Enrollment seasons since the deadline for January 1st coverage is December 15th; only 2 weeks away.

Tip #1: Understand the Health Options Available to you for 2016

Every year health companies make changes to their benefit plans. This includes price changes and sometimes even changes to the doctors and hospitals you are able to visit.
Always shop around to see if there are better deals in the new year. Some health companies expire plans, some launch new ones, and others make benefit changes to current plans.
It is always important to reassess the market before renewing with your current health plan

Tip #2: Validate Your Doctors Are Still In The Network

Health insurance companies have a wide array of health plans. All these health plans come with their distinct network of doctors and hospitals.
Before choosing a new plan, confirm that your doctors accept the health plan you are planning to buy.
Double check that the doctor just does not accept the health insurance company, but they actually accept the health plan you are purchasing. Example: Does the doctor accept “ABC Insurance” as well as ABC Insurance’s “HMO Silver Plan”?
It is always good to verify their name and use the health plan’s online tool to look up the doctor as well.

Tip #3: Think About Whether You Are Eligible for Financial Help

75% of Americans who enrolled through Healthcare.gov were able to get financial help.
It is important to not leave money on the table when purchasing coverage so you can get the best plan for you and your family.
Also, if your income changes throughout the year, its important to go back to Healthcare.gov to share that information. Fluctuations in your income can impact not only your financial help but also your tax liability at the end of the year.

There are two types of financial help available through Healthcare.gov:

Advanced Premium Tax Credits (or APTC) that provides tax credits upfront to lower the price of insurance to the members monthly. This is available to members who earn less than ~$45,000 individual/95,000 family of 4 (or 400% of federal poverty level).
Cost Sharing Reductions (or CSR) that lowers the costs you have to play for getting services (e.g.: copayments and deductibles). This is available to members who earn less than ~$25,000/year (or 250% of the federal poverty level)

Tip #4: Maximize Your Health Plan Before the Year Runs Out.

Every health plan sold on Healthcare.gov provides $0 preventive care visits to your doctor. This benefit is for everyone including women and children.
It is important to take advantage of your free office visits. It allows your peace of mind to know you are healthy as the year comes to an end.
Additionally, many plans have deductibles where you have to pay money first out-of-pocket before the health plan kicks in. In those instances, your deductible may reset on January 1st. If that is the case, make sure you pick up any of your prescriptions and see any of your doctors before December 31st.
This will enable you to use your plan wisely before you have to select another that will start January 1st.

Tip #5: Pay your first bill!

This seems obvious, but you would be amazed how many people sign up for coverage and never pay the first month’s bill.
If the first month is not paid, your policy cancel you will have no insurance coverage.
If a new health plan is not purchased before January 31st, you will have to go the entire year without coverage unless you have a “qualifying event”.
A “qualifying event” is an event in your life that allows you to buy insurance or change your insurance during the year after the open enrollment period has ended.
“Qualifying events” include: change in income, moving, having a baby, getting married, getting divorced, or losing your health insurance coverage.

¡Pura Vida! Healthcare

In a recent trip to Jaco Beach, Costa Rica I was awestruck by the beauty of the country as well as the Costa Rican way of life. The term “Pura Vida” (pronounces poo-rah vee-dah) translates to pure life; an expression natives use to describe their way of living. What I soon discovered is this term encompasses everything amazing about Costa Rica, from the way people greet you, to the country’s progressive and efficient healthcare system.

With 5 million people and a gross domestic product worth $50 billion, Costa Rica is ranked 104^th out of 195 countries in terms of GDP. However, despite a moderate-to-low economic ranking, they have a high performing healthcare system ranked 36^th out of 191 countries based on a World Health Organization (WHO) report done in 2000.

Efficient use of funds has enabled Costa Rica to develop a healthcare system that provides access to care for practically everyone with high quality outcomes for relatively low costs (6.1 billion or 10% of GDP); thus proving money does not always correlate to quality.

In contrast, with a GDP worth $17.4 trillion, the United States was only ranked 37^th out of 191 counties by WHO landing below Costa Rica but spending far more on healthcare ($3 billion or 17% of GDP). If the United States could match Costa Rica’s healthcare expenditure percentage of 10%, they would spend $1.5 trillion less on healthcare services every year! However, to truly match the efficiency of the Costa Rican healthcare system, the level of care and access would actually have to increase despite the trillion dollars of cuts in funding.

How Is This Possible?

Early on, Costa Rica made a conscious decision to be proactive when it comes to healthcare and not being reactive. In doing so, they invested public funds towards eliminating homelessness, poverty, starvation and other lifestyle factors that eventually lead to illness and hospitalization. Many of these social reforms started in 1942 with the creation of the CCSS (Caja Costarricense del Seguro Social). This government agency became accountable for financing healthcare services for the entire country. By 1970, CCSS controlled all hospitals and through healthcare budgeting created incentives for the healthcare system to efficiently eliminating fraud, waste, and abuse. For example, pay-for-performance programs are embedded in the contracts CCSS has with its hospitals where 10% of revenues received by each hospital are contingent on meeting required performance metrics.

Many government controlled healthcare systems are critiqued for long wait times and a lack of choice. Costa Rica was no different. Prior to the 1990’s, private medicine was practically invisible due to the monopoly of the CCSS and the Ministry of Health. In fact, in 1995 close to 75% of physicians were hired by the CCSS. However, to ease the demands on the government to deliver care, the CCSS introduce more efficient ways to receive care through a variety of programs that opened the door to private doctors:

Mixed Medicine: Patients can pay for medical consultation out-of-pocket and the CCSS would cover drug expenses and other support services.
Enterprise Medicine: The CCSS would hire private doctors and nurses to proivide health care to Costa Ricans.
Part-time Flexibility: The CCSS allowed its employed doctors to work part-time in the hopes they would create their own medical clinics giving more options to receive healthcare.

With more avenues for accessing doctors, new models of healthcare were created that provided greater connections to urban and rural communities alike. This even included home assistance program and home doctor visits.

The Mechanics of ¡Pura Vida! Healthcare

Unlike the United States, most of Costa Rica’s health expenditures are financed by the government. For example, 75% of the country’s healthcare costs are financed by the government compared to roughly 50% for the United States. However, income and sales taxes only account for about 10% of healthcare financing; a 2% sales tax is dedicated to social programs for the poor with a 5% income tax levied on top.

Most of the health system is financed through payroll taxes:

Costa Rica – 0.25% of the total wages of workers
Employers – 9.25% of workers’ wages
Employees – 5.5% of personal wagers
Self-employed – 12.75% of total earnings

Health services in Costa Rica can be divided into three major categories:

Primary care – Representing 20% of all healthcare costs, 100+ small clinics providing basic preventive care and wellness to roughly 70% of the country. Costa Ricans must see their designated clinic and get referred to appropriate specialists and hospitals. This allows the CCSS to focus on cost controls and efficient use of dollars. Many physicians are employed by the government and paid a base salary that is not contingent on patient condition or volume. This eliminates adverse incentives of increasing patient volume for financial gain unlike the U.S.
Secondary care – Representing 30% of the total healthcare costs, this level of care is made up of 12+ peripheral hospitals and 35+ clinics that offer specialist care and handle more complex medical conditions.
Tertiary care – Representing the remaining 50% of the total healthcare costs, tertiary care represents the most acute types of healthcare and is provided by three main national hospitals.

Lessons from Costa Rica

Costa Rica has learned very simply that helping the poor will consequently improve the entire nation. By spending more than a third of government funds on reducing poverty, they have been able to keep their healthcare costs under 10%. High healthcare spending is largely attributed to populations of low income and low education. By working to improve the quality of life, Costa Rica has created one of the best performing healthcare systems in the world that even the most developed nations can learn from.

Click to Expand

Key differences & similarities between United States and Costa Rica

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Sources: (1) Universal Coverage in a Middle Income Country: Costa Rica by María del Rocío Saenz, Juan Luis Bermudez, Mónica Acosta, World Health Report (2010). (2) World Health Statistics 2015, World Health Organization. (3) Measuring Overall Health System Performance for 191 Countries by Ajay Tandon, Christopher JL Murray, Jeremy A Lauer, David B Evans. GPE Discussion Paper Series: No. 30.

Who Will Still Lack Insurance Coverage in 2016?

The Briefing Room has written in the past about the millions of Americans who have signed up for coverage since the passing of the Affordable Care Act. However, as the country gears up for its third year of coverage, questions still remain around those who are yet to sign up. Recent Gallup-Healthways polls show that the uninsured rate in America has fallen from 18% at the end of 2013 to 11.4% as of July 2015. That is a drop of nearly six percentage or points in only 18 months meaning millions of Americans have found coverage. This success has been largely attributed to the Affordable Care Act, which focused on enrolling low-income Americans from diverse backgrounds. In fact, since 2014, the largest declines in the uninsured were Black and Hispanic Americans aged 18 to 34 earning less than $36,000 a year.

However, there are roughly 30 million people nationwide who still lack access to affordable, quality health care coverage.

Below is a summary providing insights into who these folks are broken out by key demographics and characteristics. Understanding what this population looks and acts like can help health policy professionals create programs to reach and engage them.

Who are they?

Young & Savvy: These are often called the “laptops & lattes” crowd. They live in urban metropolitan areas earning $15,000 – $30,000 a year aged 26-34. They are mostly white single men who have graduated from high school and rate themselves as having “Very Good” to “Excellent health”. They are working in the service industry and tend to be “temps” and “freelancers” lacking a steady stream of income.

Mommy Making Ends Meet: These are single mothers earning less than $25,000 a year mostly under the age of 35 that are predominately African-American and Hispanic. Many have high school equivalent education or less working one or more jobs. However, there is a subset of this group that is no longer in the labor force due to no longer looking for work after long durations of unemployment. Many of these mothers enroll their children into health programs but not themselves; even though many are eligible for Medicaid. Many times their lack of insurance is due to a lack of awareness.

Dreamers: These are people not eligible for many of the health care programs offered by the government because they are “not lawfully present” in the United States. Despite being employed, most often their jobs pay them in cash, making heir incomes appear lower than the average uninsured person. Being foreign-born often means English is not their first language and they are aged 30-45. Lastly, many of these people live in states that did not increase the Medicaid income eligibility to 138% of the federal poverty level ($16,000) as prescribed in the Affordable Care Act.

Dissenter/Detractors: These are mostly single white men earning more than $40,000 a year and actually have disposable income to afford health coverage however choose not to buy it. They tend to rate themselves as having very good health and place other priorities above purchasing health insurance. They tend to be older in age (45-64 years old) and have some level of college education or higher.

The Common Thread

The Young & Savvy, Mommies Making Ends Meet, and the Dreamers all have one thing in common. They consider themselves financially insecure. Many have less than $1,000 in savings and have struggled in the past year to provide basic food and shelter for themselves or their loved ones. Additionally, when asked what they would do with more income, many would pay down debt or put money into savings before they would buy health coverage. Many forego health care due to the high cost of out-of-pocket expenses. However despite this, more than three-fourths believe health insurance is very important.

Source: U.S. Department of Health & Human Services , Office of The Assistant Secretary for Planning and Evaluation Health Insurance Marketplace: Uninsured Populations Eligible to Enroll for 2016

Appendix

In The News

Arise America Interview – 11/2/2015

Arise America Interview – 10/30/2014

Arise America Interview – 12/23/2013

Arise America Interview – 12/02/2013

2nd State Goes “Basic” with Health Plans

The Affordable Care Act passed on March 23, 2010, however not all sections of the law are in place across all 50 states. One such provision of the law is Section 1331, the Basic Health Program. This is an optional program for states that wish to offer even more affordable health coverage to uninsured Americans. All states offer metal plans (Platinum, Gold, Silver, and Bronze products) through the Health Insurance Marketplace. Since 2014, consumers have received financial help to defray the cost of monthly premiums and deductibles and copayments if they met specific income levels.

For example: In 2015, 70% of consumers can find a health plan lower than $75 a month after financial help. 80% can find a health plan for $100 a month. – HHS

However, despite financial help, many consumers still have found health coverage too expensive and deductibles still too high. The optional Basic Health Program aims to lower monthly premiums, deductibles, and copayments even further for low-income consumers by replacing certain metal plans with more affordable “Medicaid-like” health plans. This program specifically targets people earning too much for Medicaid, 138% of the federal poverty level ($16,242 per year for an individual) but less than 200% of the federal poverty level ($23,540 per year for an individual). Additionally, legal residents with incomes below the Medicaid eligibility level but do not meet the five-year lawful residency requirement for Medicaid are also eligible for the Basic Health. All consumers must be under 65 years of age. This specific population tends to have high rates of being uninsured based on recent studies.

How Does It Work?

States that would like to launch this program must first send in a blueprint outlining a plan of operations and seek approval from the Federal Government.
Upon approval, states can then contract with health plans to offer this coverage through the Health Insurance Marketplaces.
All Basic Health Program plans must offer the same essential health benefits as the metal plans being sold.
Monthly premiums and deductibles/copayments must not exceed what a consumer would have purchased has the Basic Health Program not existed.
To fund the program, states will receive 95% of all the money that would have provided financial help to consumers purchasing metal plans.
If the money received by each state is more than the money needed, the states must use the extra money to further cut monthly premiums and deductible/copayments.

Who’s Participating in 2016?

Minnesota: MN launched MinnesotaCare, their state-based Basic Health Plan in 2015. There was positive support for launching the program during 2014. Native American tribal groups advocated for removing copayments and deductibles for their constituencies and other organizations urged Minnesota to make sure an adequate number of health insurance companies take part in the program.

Household Income: Roughly 14% of households in MN earn incomes eligible for MinnesotaCare
Enrollment: MinnesotaCare has enrolled 108,290 people as of October 2015.
Uninsured Rate: Only 6% of the state lacks insurance, 5^th lowest rate in the nation.

New York: Implemented with a phased-in approach, the Essential Plan, New York’s Basic Health Plan, folded in many of the Medicaid members ineligible for Federally funded Medicaid due to residency requirements in April of this year. Essential Plan eligibility will increase up to 200% of the Federal Poverty Level in January 2016. Public comments from NY organizations were overwhelming positive. Many praised the efforts to increase affordability and many stakeholders asked NY to opt for continuous enrollment versus using an annual open enrollment period similar to Medicare or enrolling into metal plans.

Household Income: Roughly 20% of households in NY earn income eligible for the Essential Plan Program.
Enrollment: The Urban Institute forecasted that 468,000 people would enroll in the Essential Plan Program in 2016.
Uninsured Rate: Roughly 10% of NY lacks insurance leading the national average.

Healthcare.gov Turns Three!

November 1^st marks the third open enrollment period for the Healthcare Insurance Marketplaces (aka Obamacare). That means we are only one week away from millions of Americans being able to log into Healthcare.gov and either buy insurance for the first time or choose from new plans if they enrolled for health insurance coverage last year. Before the launch of Healthcare.gov there were over 45 million people who lacked health insurance coverage. 50% of the uninsured populations lived in the country’s largest states: California, Texas, Florida, and New York. At the time, the number one reason Americans lacked coverage was due to affordability. Despite it’s very rocky start, Healthcare.gov has not only increased enrollment, it also outlined the financial help Americans were eligible for that would defray the costs of health insurance.

Who Enrolled Last Year?

The results are in. In 2014, more than 8 million Americans were able to receive private health insurance via Healthcare.gov or a state-run website. Most enrollees did not have health insurance coverage last year. Close to 75% of these enrollees received financial help to make the monthly cost of health insurance cheaper through advanced premium tax credits (tax credits that range in dollar amount based on income available to consumers while buying online). California enrolled 1.4 million people in 2014 representing 18% of total nationwide enrollment. Texas, Florida, and New York followed. All in, these four states represented close to 45% of the nationwide enrollment.

What Happened This Year?

Overall enrollment increased by 46% in 2015 (12 million new enrollments through Healthcare.gov)

85% of the 8 million enrollees in 2014 renewed their coverage into 2015
Approximately 5 million new enrollments occurred in 2015

States with the highest growth year to year were from unlikely places:

Louisiana +83% growth
Oklahoma +82% growth
Virginia +78% growth
South Carolina +78% growth
Alabama +75% growth

If you recall, Republican candidate, Mitt Romney won these states (except Virginia) during the 2012 Presidential Election. As for Virginia, President Obama narrowly won the state by only 3.87% percentage points. Despite the Governors and many of the residents of these states being against the Affordable Care Act (voting against their own self-interests), more than 400,000 people in these states were able to gain affordable health insurance coverage in 2015; most of which received financial help.

Source: Urban Institute – Marketplaces make significant progress in 2015

Who Were The Winners?

Florida: With 1.6 million Floridians enrolled in a health plan from Healthcare.gov this year, the Sunshine state now represents the highest enrollment nationally surpassing California. This is again at political odds with the electorate since President Obama running to continue Obamacare lost this state by less than 1% (0.88%) to Presidential candidate, Mitt Romney , in 2012 calling to repeal and replace the Affordable Care Act.
California: Despite only growing by 2% from 2014 to 2015 barely adding 25,000 new enrollments, California is the 2^nd largest state with Healthcare.gov enrollments. While the number of enrollees with financial help grew by 3% this year, the state lost more than 10% of their residents that were paying for health insurance without financial help.
Texas: With 1.2 million Texans enrolled, the state remains in 3^rd place despite having the highest percentage of uninsured people in America. Texas’ enrollment grew by more than 64% growing from their 2014 enrollment number of 730,000.
North Carolina: North Carolina assumed New York’s 4^th place spot growing by more than 56% to 560,000 enrollments in 2015. Once again, ironic in the sense that Mitt Romney also barely won this republican state by 2% in 2012 as well.
Georgia: Georgia held on to their 5th place spot in 2015 growing enrollment by 70% to 541,000 enrollments. Gaining 16 electoral votes, Mitt Romney won Georgia 53.3% vs. Obama’s 45.5% with more than 2 million popular votes.

Ironically, three of the top four states that lead the nation in Healthcare.gov enrollment did not even advocate for this legislation back in 2012.

Source: HuffPost Election Politics – Marketplaces make significant progress in 2015

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Top 5 Things to know as Open Enrollment Enters its Final Week

On December 9, 2014, Errol Pierre sat down with Kori Chambers from Pix11 Morning News to discuss the Open Enrollment period under Obama’s Affordable Care Act. The deadline is quickly approaching; February 15th.

Click on the picture to view the video!

Below are the five tips that were shared with Kori and the Pix11 Morning viewers:

1. Open Enrollment Dates: The Open Enrollment period for 2015 coverage is November 15, 2014 to February 15, 2015. During this time, you can enroll or re-enroll for coverage on the NY State of Health website.

2. Auto Enrollment: If you chose a health plan on NY State of Health last year, you may be automatically enrolled in the same plan with the same premium tax credits and other financial assistance, as long as you still qualify. I recommend checking out the NY State of Health website or your specific health plan’s website during Open Enrollment. Make sure your current plan still fits your health needs and see if you qualify for additional financial help.

3. Uninsured Penalty: If you don’t have health coverage during 2015, you may have to pay a fee. That fee is a flat fee or a percentage of your family income, whichever is more. In 2015, the fee is two percent of your income or $325 per adult/$162.50 per child (whichever is greater).

4. Subsidies: Depending on your income, you may be eligible for lower premiums each month and for lower out-of-pocket costs. Check out www.healthcare.gov to find out more about subsidies and the premium tax credit from the IRS.

5. Dental and Vision Benefits: Many health plans on NY State of Health now include dental and vision benefits, as well as medical benefits.

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ACA: What Have We Learned 1 Year Later?

On Wednesday, October 29, 2014, Errol Pierre sat down with Arise America’s news anchor Debbye Turner Bell to discuss the Affordable Care Act (ACA) implementation in preparation for the upcoming QHP open enrollment period, which starts on November 15.

[youtube https://www.youtube.com/watch?v=mZMzUi27Qt0&w=1280&h=750]

Question 1: Has the percentage of uninsured people been reduced?

Yes – in fact of the 45M people uninsured, roughly 8M people got coverage nationwide
50% of them enrolled at the deadline – which was extended past march 31^st
60% have coverage before nationally (In NY it was 80%)
States like NY that built their own Health Insurance Marketplace had better results (e.g.: ~1M enrolled. 55% Medicaid; 38% Commercial/QHP; 7% Child Health Plus)

Question 2: Has insurance under the law been made more affordable?

Yes – A Congressional Budget Office survey showed that 94% of health plans were priced below CBO estimates
Also 85% of the enrollment nationally got financial assistant with the cost of coverage
There are 2 types of financial Assistances to lower the cost of health care

Advanced Premium Tax Credits (or APTC) that provides tax credits upfront to lower the price of insurance to the members monthly. This is available to members who earn less than ~$45,000 individual/95,000 family of 4 (or 400% of federal poverty level
Cost Sharing Reductions (or CSR) that lowers the costs you have to play for getting services (e.g.: copayments and deductibles). This is available to members who earn less than ~$25,000/year (or 250% of the federal poverty level)

Did the Affordable Care Act improve health outcomes?

It’s too early to tell. Almost half of the enrollment came on with an April or May effective date.
The data sets are not complete yet and the industry as a whole will know more in 2015
However, the ACA does require health plans and hospitals to focus on quality instead of paying providers on quantity. S
Quality indicators do show up on the Health Insurance Marketplace website and members can purchase based on those preferences

Will the online exchanges work better this year than last?

That is the hope
We learned a lot this past year and the Federal Gov’t changed vendors for IT, now using Accenture
There are still things to be done but there is hope that things will be better off this year than last year.
The only nuance here is with 8 million already enrolled – we have to worry about all of those folks renewing this year

Source: http://aspe.hhs.gov/health/reports/2014/marketplaceenrollment/apr2014/ib_2014apr_enrollment.pdf

NYU WAGNER GRADUATE MAKES “40 UNDER 40” HONOR ROLL FOR 2014

NYU Wagner alumnus Errol Pierre (MPA in Health Policy & Financial Management, 2013) has been awarded The Network Journal’s 40 Under 40 award for his volunteer work as a board member for two nonprofits, One Hundred Black Men and The YMCA.

While attending Wagner part-time, he helped implement the Affordable Care Act for Healthfirst, the largest Medicaid/Medicare plan in New York City, where he is now an assistant vice president.

Congratulations, Errol!

http://wagner.nyu.edu/news/newsStory/nyu-wagner-graduate-makes-40-under-40-honor-roll-2014