The GHG Blog is just the tip of the iceberg. Check out the Point for complete access to all content from GHG experts.
- After Hours
- Agent Oversight
- Brain Food
- Health Insurance Exchanges
- Part D
- Performance Optimization
- Policy & Health Reform
- Prospective Evaluations
- Provider Relations
- Risk Adjustment
- Sales & Marketing
- Star Ratings
- callcenter972 on Call Center Metrics Reporting Should Be Robust and Actionable
- Sione Ayers on Diagnosing the ObamaCare Glitches: Who Farted and Is Pointing at the Dog?
- Tim Leary on New ACO Reg has some zingers
- Lisa Jefferson on What Happens to Medicare/Medicaid If There’s a Government Shutdown?
- Fred Hamlin on Big News: A Health Care Cost Indicator Went *DOWN*. AGAIN!
The Voice of John Gorman
Since the October 1 launch of the ObamaCare health insurance exchanges/marketplaces, there’s been a growing din over the field conduct of navigators and insurance agents, in the process of enrolling eligibles on behalf of the exchanges or the health plans participating in them. Meanwhile, the associations backing brokers are putting pressure on the Obama administration, insisting that brokers should be more involved in the enrollment process. Add a regulatory infrastructure that is lax – at best – when it comes to training and enforcement … does anyone else have a sense of déjà vu? It’s the market conduct growing pains of the Part D inception all over again. There is no doubt that some of the “navigators and agents gone wild” stories out there are simply anecdotal rumor mill reports coming from enterprising local reporters, or are “stings” by conservative bloggers and activists scoring cheap anti-reform points.
Of the many, many things I gave thanks for last week, there was Jeffrey Zients, the White House management guru brought in to sort out the mess that is the launch of ObamaCare, and for his geek squad working feverishly on the fixes. His long-awaited progress report was released on Sunday, and it’s amazingly sanguine for a government document. Knowing big IT projects as we do, it’s impressive how far the fix team has gotten in a matter of weeks, much of it in consumer-facing functionality on the “front end” of the website and the enrollment process. What remains to be seen is what can be done this month on the crucial “back end” functions that connect to insurance companies participating in the exchanges — the functions for which ObamaCare will ultimately be judged when coverage kicks off on January 1, and the true test for Mr. Zients and his geeks.
So, just hours from national debt default last night, a deal was struck to reopen the government and raise the debt ceiling. Our long national nightmare is over…at least until January 15, when this entire calamity could be repeated by battered ObamaCare dead-enders. It’s a crisis averted for Medicare and Medicaid, but not so for ObamaCare.
It’s been a rough couple weeks for the launch of ObamaCare. The only thing that’s kept the Federal exchange’s woes off Page 1 this week has been the continuing dysfunction on the Hill. Healthcare.gov traffic will wane, bugs can be recoded and dysfunctional processes redesigned pretty quickly, so we haven’t seen anything fatal thus far, unless we’re still having these problems a week away from the now-all-important effective date of January 1. But the sheer volume of Weeks 1 and 2, with CMS working on a shoestring with a night-shift staff in the middle of a government shutdown, and the hardest part of ObamaCare enrollment to come, has major implications for health plan operations in just a matter of weeks.
We’re fast approaching the end of Week 2 of Obamacare, and like the dysfunction between the Congress and the President, there’s still no end in sight. Healthcare.gov underwent major code fixes over the weekend, but is still rejecting logins, failing to load menus and hindering millions of uninsured Americans in 36 states from accessing the system. Cleaning up these issues for the 9 million-plus who’ve visited the exchanges thus far is going to cause several operational tsunamis for health plans in the weeks ahead.
If you’re paying any attention to the worsening drama here in DC, dig in because the calendar is not our friend. With the stalemate over the government shutdown ossifying, the Congress just backed into the debt ceiling, which we’ll hit in less than two weeks. Now we’re going to need a big deal both reopening the government and raising the debt ceiling to get out of this mess, at the very moment postions are hardening. A few days ago, I thought a shutdown would go on for about a week…now I’m thinking it might be a month, or even longer. And that could have big implications for ObamaCare, Medicare and Medicaid.