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A key Obamacare program that uses bonus payments to improve medical care didn't work in its first year, new research suggests.

The program is called Hospital Value Based Purchasing, and its meant to reward hospitals that do really well at 20 metrics, including things like responding quickly to heart attacks and giving patients discharge instructions when they leave the hospitals.

Beginning in 2011, hospitals stood to lose as much as 1 percent of their Medicare revenue if they did badly at these measures — or earn an additional 1 percent if they outperformed their competitors.

This put a total of $1.1 billion at risk for hospitals, who could either earn part of that pool of funds by doing really well — or end up paying into it when they didn't hit the right targets.

The aim of the penalty and reward system was to encourage all hospitals to improve the care they deliver. That might not have happened.

Weill Cornell Medical College's Andrew Ryan worked with a team of researchers to look at how hospitals did on quality measures since this new program began. The research looks at the hospitals in the incentive program and compares them against a smaller number left out (Maryland hospitals, for example, didn't participate because they have a totally different payment scheme worked out with the feds).

Ryan and his team matched up hospitals in and out of the program that had similar quality metrics before the incentives kicked in. Then they looked at whether the hospitals in the incentive program improved faster than the ones left out. They found no difference.

"We found that the timing of the hospital value-based purchasing system wasn't associated with any additional improvement," Ryan says. "We would have hoped to have seen more responsiveness."

Under the hood, Obamacare’s official fiscal neutrality partly relies on a clever budget gimmick – the employer mandate.

Beginning in 2015, the law will require employers with 50 or more full-time equivalent workers to offer coverage to their full-timers, or else pay a penalty. The Congressional Budget Office projects that these penalties will amount to around $139 billion over 10 years – not nearly enough to offset the $1 trillion in subsidies, but still no small potatoes. But there’s a more important gimmick at play here – by requiring employers to provide insurance coverage, the number of people receiving subsidies is likely reduced quite a bit, making it that much easier to pay for the law. This makes it costly for employers to “dump” their workers onto the exchanges, while still ensuring that coverage numbers increase.

To give people in the resort counties who were flattened by Obamacare premium increases a break, state officials ultimately decided to move the resort group, Garfield, Pitkin, Eagle, and Summit counties, into a rating area that included all of the western counties except Mesa County. Moving the resort county group to the western group lowered the premiums for the resort counties and raised them in the western counties. On the map below, the western group is everything west of the black line with the exception of Mesa County, in blue stripes.

Unfortunately, the majority of the counties in the western group had lower estimated household incomes than the counties in the resort group according to 2012 Census estimates for average county household incomes. As the Census map shows, counties with lower average household incomes will have their premiums go up so that people with higher average household incomes can have their premiums go down.

In Colorado, at least, Obamacare is such bad policy that it encourages politicians to take from the relatively poor and give to the relatively rich.

Hundreds of thousands of people risk losing their new health insurance policies if they don't resubmit citizenship or immigration information to the government by the end of next week -- but the federal Healthcare.gov site remains so glitchy that they are having a tough time complying.

Some Missourians are unable to get the healthcare they need because of denials and delays in Medicaid coverage.

Elise Tabor is just one of thousands painstakingly waiting. "I need it because, I can't hardly walk. I have a back disease, and I'm supposed to be having back surgery," says Tabor.

A curved spine and herniated discs are part of Tabor's problem, but she's also frustrated that her Medicaid benefits have been cancelled for a second time this year. "It makes me mad; it really does, because I did what they wanted me to do," Tabor says.

Tabor says she's filled out the renewal application twice. "They told me that since it's still pending in Jefferson City, and it's pretty much over 2 months since it was supposed to be actually in and they didn't note it in their system, I got completely cut off. I had to reapply, and they said there's a chance I will be denied," Tabor says.

"We're having a few glitches with the system, but they're starting to work those out," says [State Representative Jeff] Messenger.

Batboy2/75 wrote:You can not have both a welfare state and open borders.

The average number of emergency department (ED) visits to hospitals in expansion states increased 5.6 percent from second-quarter 2013 to second-quarter 2014. This change was greater than expected from the variation over the last two years, and resulted in the highest number of average visits over that time. In comparison, hospitals in non-expansion states reported a 1.8 percent increase in Emergency Department visits between the second quarters of 2013 and 2014.

A flaw in the federal calculator for certifying that insurance meets the health law’s toughest standard is leading dozens of large employers to offer plans that lack basic benefits such as hospitalization coverage, according to brokers and consultants.

The calculator appears to allow companies enrolling workers for 2015 to offer inexpensive, substandard medical insurance while avoiding the Affordable Care Act’s penalties, consumer advocates say.

Insurance pros are also surprised such plans are permitted.

HHS is aware of potential problems with the calculator but has not changed it, said industry authorities.

Across all states, from before the reform to the first half of 2014, enrollment-weighted premiums in the individual health insurance market increased by 24.4% beyond what they would have had they simply followed state-level seasonally-adjusted trends.

T>1200 wrote:This is so 2013. Nobody cares anymore. Not even the Grand Old Party.

T>1200 wrote:This is so 2013. Nobody cares anymore. Not even the Grand Old Party.

California's health insurance exchange is vowing to fix enrollment delays and dropped coverage for about 30,000 consumers before the next sign-up period this fall.

Covered California said it failed to promptly send insurance applications for 20,000 people to health plans recently, causing delays and confusion over their coverage.

Another group of up to 10,000 people have had their insurance coverage canceled prematurely because they were deemed eligible for Medi-Cal based on a check of their income, officials said.

When millions of people in the individual health insurance market lost their health plans in late 2013, ObamaCare supporters claimed those lost plans were "substandard" or "crappy." However, they failed to support that contention.

This study examines the claim that the policies on the individual market were inferior in quality to those on the ObamaCare exchanges. First, it compares the premiums and the size of the deductibles as well as maximum out-of-pocket costs of policies on the individual market prior to the exchanges to those of current polices on the exchanges. Second, it examines the quality of provider networks by comparing the number of plans that are HMOs versus those that are PPOs in the individual market prior to the exchanges and those now on the exchanges.

The study finds that there were many policies on the individual market that had lower premiums and lower or equal deductibles and out-of-pocket maximums than the cheapest plans now available on the exchanges. It also finds that the individual market prior to the exchanges offered a greater choice of hospitals and physicians since it contained far more PPO policies than HMO policies, whereas the exchanges offer more HMO policies.

Turdacious wrote:

When millions of people in the individual health insurance market lost their health plans in late 2013, ObamaCare supporters claimed those lost plans were "substandard" or "crappy." However, they failed to support that contention.

This study examines the claim that the policies on the individual market were inferior in quality to those on the ObamaCare exchanges. First, it compares the premiums and the size of the deductibles as well as maximum out-of-pocket costs of policies on the individual market prior to the exchanges to those of current polices on the exchanges. Second, it examines the quality of provider networks by comparing the number of plans that are HMOs versus those that are PPOs in the individual market prior to the exchanges and those now on the exchanges.

The study finds that there were many policies on the individual market that had lower premiums and lower or equal deductibles and out-of-pocket maximums than the cheapest plans now available on the exchanges. It also finds that the individual market prior to the exchanges offered a greater choice of hospitals and physicians since it contained far more PPO policies than HMO policies, whereas the exchanges offer more HMO policies.

http://www.nationalcenter.org/NPA663.html

This week’s double-barreled release of government statistics on health insurance coverage leaves us with only one question: How many Americans are insured because of Obamacare? Remarkably, the two highly regarded government surveys released this week do not even agree whether the number of uninsured increased or decreased. The survey that received a great deal of attention said there were 3.8 million fewer uninsured. The other, which was hardly noticed, found that there were 1.3 million more uninsured.

Finding a doctor who takes Obamacare coverage could be just as frustrating for Californians in 2015 as the health-law expansion enters its second year.

The state's largest health insurers are sticking with their often-criticized narrow networks of doctors, and in some cases they are cutting the number of physicians even more, according to a Times analysis of company data. And the state's insurance exchange, Covered California, still has no comprehensive directory to help consumers match doctors with health plans.

This comes as insurers prepare to enroll hundreds of thousands of new patients this fall and get 1.2 million Californians to renew their policies under the Affordable Care Act.

The bailout measure is the Affordable Care Act's controversial "risk corridor" program, which provides financial "protection" against losses to insurers that sponsor exchange plans. The idea of this short-term program was to create a pool of funds from the profits of some insurers with ObamaCare plans to offset the losses of others.

A 2013 analysis by the Society of Actuaries says that the risk corridors program "provides a strong incentive for insurers to participate in the health insurance exchanges set up by the Affordable Care Act." Perhaps too strong an incentive, budget experts worry.

Obama is asserting executive authority to subsidize money-losing plans. Rubio and nine other Senators say that he needs a congressional appropriation under the Constitution. Rep. Jack Kingston, R-Ga., chair of the House subcommittee that handles health appropriations, made the same point in a recent letter to the White House.

The U.S. Government Accountability Office agrees, ruling Tuesday that the Department of Health and Human Services can't provide funds to insurers for excessive losses on ObamaCare plans without Congress' formal approval.

The Department of Health and Human Services is in the spotlight for claims it is violating the Affordable Care Act.

The lawsuit was filed by Mehri & Skalet attorney Jay Angoff, who used to oversee ACA implementation for HHS. Filed on behalf of a Missouri consumer advocacy group, the suit claims the federal agency is not following through on its obligation to make rate filings for 2015 publicly available in time for the public to comment on them.

U.S. patients are likely to face growing challenges in access to care if shifting patterns in medical practice configurations and physician workforce trends continue. This is one of the key findings of a major new survey of 20,000 physicians commissioned by The Physicians Foundation.

According to the research, titled “2014 Survey of America’s Physicians: Practice Patterns and Perspectives,” 81 percent of physicians describe themselves as either over-extended or at full capacity, while only 19 percent indicate they have time to see more patients. Forty-four percent of physicians surveyed plan to take steps that would reduce patient access to their services, including cutting back on patients seen, retiring, working part-time, closing their practice to new patients or seeking non-clinical jobs, leading to the potential loss of tens of thousands of full-time-equivalents (FTEs).

More than a dozen states plan to cancel health care policies not in compliance with ObamaCare in the coming weeks, affecting thousands of people just before the midterm elections.

"It looks like several hundred thousand people across the country will receive notices in the coming days and weeks," said Jim Capretta of the Ethics and Public Policy Center.

The policies are being canceled because states that initially granted a reprieve at the request of President Obama are no longer willing to do so.

In coming weeks, 13 states and the District of Columbia plan to cancel such policies, which generally fall out of compliance with the Affordable Care Act because they don’t offer the level of coverage the law requires.

Virginia will be hardest hit, with 250,000 policies expected to be canceled.