Healthcare.gov CEO: ‘Perfect? No’ but Florida a ‘big success’

medical dollarsHe knows. He heard. Kevin Counihan is aware that opinions, especially in a state like Florida, remain sharply divided on whether healthcare.gov represents a stirring tale of innovation and progress or a federal Frankenstein that — by way of the courts or this fall’s election — deserves to die with a stake in its heart.

But the chief executive officer of healthcare.gov says the nation-leading 1.7 million Floridians who have signed up for health coverage through the federal marketplace give him plenty of reasons to feel encouraged about his work.

“We view Florida as one of our big success stories,” Counihan told The Palm Beach Post by telephone. He said administration officials are “hugely grateful” to navigators, agents and others in the state who helped people get coverage.

Counihan spoke ahead of a conference in Washington, D.C. Thursday designed to shed light on what federal officials call innovations that have helped the marketplace work better. Florida Blue, also known as Blue Cross & Blue Shield of Florida, is scheduled to be one of the featured examples.

To watch the 9 a.m. to 4 p.m. conference Thursday, go here:

http://www.hhs.gov/live

Granted, not everyone thought his decision to take the federal job nearly two years ago, after running Connecticut’s health exchange, was the safest career play, Counihan said: “Many thought it was kind of a foolish thing to do.”

After all, healthcare.gov notoriously sputtered under heavy traffic at its launch before he arrived, and political and legal battles over the Affordable Care Act that created the marketplace continue to this day.

But his wife and others were very encouraging, he said. Now he feels “very lucky” to do the job. By this past December, the marketplace was handling up to 11 enrollments per second, he said.

At Thursday’s conference, Florida Blue is scheduled to be featured in a 2 p.m. segment on “using data analytics to improve patient care.”

Here is a summary from conference materials:

Blue Cross Blue Shield in Florida closely analyzed its prospective Marketplace customers. From its analysis, they learned that their new market wouldn’t look the same as their pre-ACA individual market, and that there would be more variety in health issues across communities. Based on their research, they created plans for the different needs of unique communities. They used “place of delivery” care models to bring together nurses, analysts, pharmacists, social workers, and other experts into inter-disciplinary teams that focused on improving care for high-risk populations in particular communities.

As The Palm Beach Post reported, the company has acknowledged consumer complaints about problems with some of its marketplace coverage this year. Doctors listed as part of a healthcare.gov plan when  customers signed up were not there only a few months later, consumers said. One Palm Beach County customer called it “bait and switch.”

Company officials could not be reached to talk about Thursday’s conference, but in May said complaints largely focused on “one, new marketplace product, which is designed to provide access to affordable health care to more Floridians.”

The myBlue product, a spokesman said, is “focused on improving health outcomes, and therefore, requires greater engagement and collaboration among the patient, the doctor, and Florida Blue. This need for greater engagement has resulted in some modifications to the doctors available in this network, including some who have chosen to no longer participate in this product.” Company officials said they were working hard to resolve consumer problems.

Supporters of the law say despite a lot of talk about spiking costs, premiums for Floridians rose only 2 percent this year to an average monthly cost of $84 — after tax credits designed to make premiums more affordable. Nine out of 10 people signing up for marketplace plans in Florida get subsidies.

And nationally, fewer than 10 percent of Americans are uninsured for the first time in history, administration officials say.

Critics tell a very different saga. They say the problem isn’t just that consumers are not always getting what they thought with exchange plans. The system also masks spiraling premium costs that must be covered by taxpayers and others, they say. In Florida, for example, 15 insurers seek an average of 17.7 percent higher premiums for 2017 Affordable Care Act individual plans. That’s higher than approved rate increases under 10 percent for 2016.

In Texas, Blue Cross is seeking rate hikes of nearly 60 percent in three plans.

House Ways and Means chairman Kevin Brady, a Texas Republican, said in February things are not so rosy as the administration wants people to believe.

“Poor enrollment results show Americans just aren’t buying what the president’s selling on this law,” Brady said. “In fact, millions would rather pay the punitive individual mandate tax penalty than buy Washington-designed insurance they don’t want.”

Counihan sees things from another perspective. He sees a federal marketplace that is a “laboratory for innovations and strategies that are helping us build a better health care system.”

He said, “Perfect? No. Are we going to get better? Every year.”

 

 

 

 

 

 

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