Thursday, April 24, 2014

Embarrassment of (Link) Riches

■ Say it ain't so! Seems that the Silver State's Health Exchange has a few problems, not the least of which is that it's intent on hiding its problems:

"Confidential documents which appear to be from a Nevada Health Link employee may reveal huge problems within the state health exchange."

See - I told you so!

And what, exactly, are these problems? Well, to start with, there's the case of Lawrence Basich. Regular readers may recall Mr B as the gentleman who's been trying - unsuccessfully - to sign up for an ObamaPlan since last Fall. Turns out, he (and upwards of 10,000 others in similar circumstances), may have been the victim of the Exchange itself, which was apparently miscalculating subsidies and premiums.

The scary part is that administrators apparently knew of these problems and, rather than fix them, chose to hide them.

But according to their state's senior Senator, they're all lying.

■ We've written pretty extensively on the Death Panel IPAB controversy, but as FoIB Holly R tips us, that may not be the worst of it:

"The Center for Medicare and Medicaid Innovation has flown below the political radar. That's due to its seemingly innocuous mission: promoting new and more efficient "payment systems" and "models of care."

As Bob pointed out almost two years ago, the CMMI may sound anodyne - it is anything but:

"Obamacare’s Center for Medicare and Medicaid Innovation will conduct payment and delivery reform demonstrations with a goal of changing Medicare from fee-for-service to “capitated” or salaried payments. Unlike a pluralistic system of competitive plans, Medicare patients will have little or no control over whether or not they will be subject to these changes."

Shorter version: bye-bye, Grandma.

■ Up is down and left is right:

"Actuary Jac Joubert, along with a pair of Oliver Wyman analysts, say a big new federal risk-management program could pay carriers too much for covering consumers with health problems and too little for covering low-risk people."

That's the take-away from a study of how the ObamaTax is faring thus far. Ms Shecantbeserious (well, for now) and her minions are using a "risk adjustment model" originally designed for  Medicare Advantage plans, which are vastly different than ObamaTax-compliant major medical policies.

The result: decreased profit margins and a faltering - or even failing - carrier.

Perhaps Ms Kathy sees this as a feature, not a bug?
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