Wednesday, November 30, 2016

Biweekly Enrollment Snapshot

Centers for Medicare & Medicaid Services
November 30, 2016
Contact: CMS Media Relations
(202) 690-6145 | CMS Media Inquiries


Biweekly Enrollment Snapshot

WEEKS 3 AND 4, NOV 13 – 26, 2016 Four weeks into Open Enrollment, millions of Americans continue to visit and sign up for Marketplace plans, demonstrating the strong demand for quality, affordable coverage.  Over 2.1 million people have selected plans using the platform since Open Enrollment began on November 1, including over half a million new consumers and 1.6 million consumers renewing their coverage. Enrollments for these two weeks represent an increase of 167,000 plan selections versus the third and fourth weeks of Open Enrollment last year. In addition, the total number of plan selections at this point exceeds last year by over 97,000, even though this year’s totals include two fewer days. In addition to national data, this snapshot includes state-by-state plan selection estimates for those states using
“With plans available for less than $75 per month in premiums, 2.1 million Americans have already selected coverage through, more than had signed up at this time last year,” said Department of Health and Human Services Secretary Sylvia Burwell. “I hear from people across the country just how much coverage matters to them, so I continue to encourage all Americans who need health insurance for 2017 to visit and check out their options. Consumers should be sure to enroll by December 15th for coverage that starts January 1st.”
As in past years, enrollment weeks are measured Sunday through Saturday. Since this year Open Enrollment began on a Tuesday, the cumulative totals reported in this snapshot reflect two fewer days than last year’s Week 4 snapshot, yet enrollment exceeds last year’s total.
Every two weeks during Open Enrollment, the Centers for Medicare and Medicaid Services (CMS) will release enrollment snapshots for the platform, which is used by the Federally-facilitated Marketplaces and State Partnership Marketplaces, as well as some State-based Marketplaces. These snapshots provide point-in-time estimates of biweekly plan selections, call center activity, and visits to or The final number of plan selections associated with enrollment activity during a reporting period may change as plan modifications or cancellations occur, such as due to life changes like starting a new job or getting married. In addition, as in previous years, the biweekly snapshot only reports new plan selections, active plan renewals and, starting at the end of December, auto-renewals; it does not report the number of consumers who have paid premiums to effectuate their enrollment.
Later in the Open Enrollment period, HHS will produce more detailed reports that look at plan selections across the Marketplace, including both states using the platform and State-based Marketplaces using their own enrollment platforms.
Definitions and details on the data are included in the glossary.
Federal Marketplace Snapshot
Federal Marketplace Snapshot
Weeks 3 and 4
Nov 13 - 26
Nov 1 – Nov 26
Plan Selections (net)
New Consumers
Consumers Renewing Coverage
Consumers on Applications Submitted
Call Center Volume
Calls with Spanish Speaking Representative
172,642 Users
8,040,513 Users
Window Shopping Users
Window Shopping Users
23,931 State-by-State Snapshot
Consumers across the country continued to explore their health insurance options by reaching out to a call center representative at 1-800-318-2596, attending enrollment events in their local communities, or visiting or Individual plan selections for the states using the platform include:
Week 4
Nov 1 – Nov 26
New Hampshire
New Jersey
New Mexico
North Carolina
North Dakota
South Carolina
South Dakota
West Virginia
Plan Selections:  The cumulative metric represents the total number of people who have submitted an application and selected a plan, net of any cancellations from a consumer or cancellations from an insurer that have occurred to date. The biweekly metric represents the net change in the number of non-cancelled plan sections over the two-week period covered by the report.
Plan selections will include those consumers who are automatically re-enrolled into a plan, which occurs at the end of December.
To have their coverage effectuated, consumers generally need to pay their first month’s health plan premium. This release does not report the number of effectuated enrollments.
New Consumers: A consumer is considered to be a new consumer if they did not have Marketplace coverage at the start of Open Enrollment on November 1st, 2016.
Renewing Consumers: A consumer is considered to be a renewing consumer if they had 2016 Marketplace coverage on November 1st, 2016 at the start of Open Enrollment and either actively select the same plan or a new plan for 2017 or are automatically re-enrolled into a plan, which occurs at the end of December.
Marketplace: Generally, references to the Health Insurance Marketplace in this report refer to 39 states that use the platform. The states using the platform are Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Michigan, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Jersey, Nevada, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin, and Wyoming. States: The 39 states that use the platform for the 2017 benefit year, including the Federally-facilitated Marketplace, State Partnership Marketplaces and State-based Marketplaces.
Consumers on Applications Submitted:  This includes consumers who are requesting coverage on a completed and submitted application, including an application that is created through the automatic re-enrollment process, which occurs at the end of December, in a state that is using the platform. If determined eligible for Marketplace coverage, a new consumer still needs to pick a health plan (i.e., plan selection) and pay their premium to get covered (i.e., effectuated enrollment). Because families can submit a single application, this figure tallies the total number of people requesting coverage on a submitted application (rather than the total number of submitted applications).
Call Center Volume:  The total number of calls received by the call center for the 39 states that use the platform over the course of the weeks covered by the snapshot or from the start of Open Enrollment. Calls with Spanish speaking representatives are not included.
Calls with Spanish Speaking Representative:  The total number of calls received by the Federally-facilitated Marketplace call center where consumers chose to speak with a Spanish-speaking representative. These calls are not included within the Call Center Volume metric. or  Users: These user metrics total how many unique users viewed or interacted with or, respectively, over the course of a specific date range. For cumulative totals, a separate report is run for the entire Open Enrollment period to minimize users being counted more than once during that longer range of time and to provide a more accurate estimate of unique users. Depending on an individual’s browser settings and browsing habits, a visitor may be counted as a unique user more than once.
Window Shopping Users or Users: These user metrics total how many unique users interacted with the window-shopping tool at or, respectively, over the course of a specific date range. For cumulative totals, a separate report is run for the entire Open Enrollment period to minimize users being counted more than once during that longer range of time and to provide a more accurate estimate of unique users. Depending on an individual’s browser settings and browsing habits, a visitor may be counted as a unique user more than once. Users who window-shopped are also included in the total or user total.
Get CMS news at, sign up for CMS news via email and follow CMS on Twitter @CMSgovPress

30% of Heart Disease Deaths in 2014 Were Preventable

The CDC recently analyzed national statistics to determine changes in potentially preventable deaths. Here are some key findings from the report:

Potentially preventable cancer deaths decreased 25% between 2010 and 2014.
Preventable stroke deaths decreased 11% from 16,973 to 15,175.
Preventable heart disease deaths decreased 4% between 2010 and 2014.
Chronic lower respiratory disease deaths increased 1% from 28,831 to 29,232.
Deaths from unintentional injuries increased 23% (from 36,836 to 45,331).
30% of heart disease deaths in 2014 were potentially preventable.

Source: Centers for Disease Control and Prevention, November 18, 2016

Monday, November 28, 2016

Medication Adherence is 2.2% Higher In Medical Homes

The Annals of Internal Medicine recently published a retrospective study on medical homes and medication adherence. Here are some key findings from the report:


5.9% of patients in the study received care in patient-centered medical homes.
The average rate of adherence was 64% among medical home patients.
The medication adherence rate was 59% among patients in the control group.
Medication adherence was significantly higher in medical homes overall (2.2%).
Adherence was 3% higher for diabetic medical home patients vs control patients.
Hypertensive patients had 3.2% better adherence than the control group.



Source: Annals of Internal Medicine, November 15, 2016

Wednesday, November 23, 2016

Working to Achieve Health Equity: The CMS Equity Plan for Medicare One Year Later


November 23, 2016
By: Cara V. James, Ph.D., Director of the Office of Minority Health at the Centers for Medicare & Medicaid Services


Working to Achieve Health Equity: The CMS Equity Plan for Medicare One Year Later 

One year ago, the Centers for Medicare & Medicaid Services (CMS) launched its first ever Equity Plan for Improving Quality in Medicare at a conference commemorating the 50th anniversary of Medicare and Medicaid and the 30th anniversary of the Report of the Secretary’s Task Force on Black and Minority Health. The CMS Equity Plan for Improving Quality in Medicare is an action-oriented plan that focuses on six priority areas and aims to reduce health disparities among vulnerable populations including, racial and ethnic minorities, sexual and gender minorities, and people with disabilities. 

The foundation of the CMS Equity Plan for Improving Quality in Medicare, is our 3-part ‘path to equity’ framework. The path involves: (1) increasing understanding and awareness of disparities, (2) developing and disseminating solutions, and (3) taking sustainable action and evaluating progress. Our path to equity enables us to take a comprehensive approach to addressing health disparities because it promotes progress regardless of where stakeholders are in their efforts to achieve health equity. In addition, the path to equity can be adopted by a wide range of stakeholders and organizations and applied from the individual level up to the community, state, and policy levels. The priorities and activities described in the Equity Plan for Medicare were developed during a rigorous year-long process, which included examining evidence, identifying opportunities, and gathering input from a broad array of stakeholders across the country. The plan includes six priority areas and an array of activities.  They are: 

Priority 1: Expand the Collection, Reporting, and Analysis of Standardized Data

Priority 2: Evaluate Disparities Impacts and Integrate Equity Solutions across CMS Programs

Priority 3: Develop and Disseminate Promising Approaches to Reduce Health Disparities

Priority 4: Increase the Ability of the Health Care Workforce to Meet the Needs of Vulnerable Populations

Priority 5: Improve Communication and Language Access for Individuals with Limited English Proficiency and Persons with Disabilities

Priority 6: Increase Physical Accessibility of Health Care Facilities 

Since the launch of the CMS Equity Plan for Improving Quality in Medicare, we have been actively working to increase our understanding of disparities among Medicare beneficiaries with limited English proficiency and disabilities, and our knowledge of how to better prepare our workforce to meet the needs of vulnerable populations. To assist stakeholders in identifying disparities at a local, state, or regional level, we launched our Mapping Medicare Disparities Tool earlier this year.  The Mapping Medicare Disparities Tool is an interactive map, which can be used to identify areas of disparities between subgroups of Medicare beneficiaries in health outcomes, utilization, and spending. To assist in the identification of disparities within Medicare health plans, we released for the first time national and contract level quality data stratified by race and ethnicity

We have been working to develop solutions to help spur sustainable action. As part of our Building an Organizational Response to Health Disparities portfolio, we released the Guide to Preventing Readmissions among Racially and Ethnically Diverse Medicare Beneficiaries. This guide gives an overview of key issues related to readmissions for racially and ethnically diverse Medicare beneficiaries, as well as useful resources for hospital leaders to take action to address readmission. Our guide offers case examples of strategies and initiatives. We also released a compendium of resources for standardized demographic and language data collection to help organizations collect and analyze their own data, so that they may begin to increase understanding and awareness of disparities that may exist within their own organization. 

To ensure that actions around equity at CMS are sustainable, we have been working with our colleagues across the Agency to identify where equity can be embedded. To that end, reducing disparities, focusing on social determinants of health, and advancing health equity have been called out in a number of models and initiatives. Within the MeritBased Incentive Payment System (MIPS), achieving health equity is one of the areas for clinical practice improvement activities. At the heart of the Accountable Health Communities Model is identifying and addressing the health-related social needs of beneficiaries. 

While we have reached a number of milestones this year, we know that there is still much work to be done to achieve health equity. As we continue implementing the CMS Equity Plan for Medicare, we will focus on building on our accomplishments, strengthening our partnerships, and monitoring and evaluating our progress. We cannot do this work alone, so we encourage you to join us on the path to equity. By working together, we can truly achieve care and services that are high quality, effective, and equitable.   
To learn more about our accomplishments regarding achieving health equity in Medicare and other activities underway at the CMS Office of Minority Health, visit:     

61% of Large Employers Now Offer a CDHP (up from 59% Last Year)

While 61% of large employers now offer a CDHP (up from 59% last year), just 9% offer it as the only plan available to employees. This suggests that most of the latest growth in CDHP enrollment came from employees choosing to move from a traditional PPO or HMO. For employees, the difference in the cost of coverage can be substantial - on average, more than 30%. Among large employers, for employee-only coverage in an HSA-based CDHP, employees contribute $84 per month on average, compared to $132 for PPO coverage (see Figure 7). For family coverage, the difference is $321 vs. $467. In addition, 75% of large employers offering HSA-eligible CDHPs make a contribution to the employees' HSA; typically $500 for an individual.


Tuesday, November 22, 2016

25% of Cardiologists Cite Cost as Important When Prescribing

Stat News recently covered a survey by CMI/Compas on the top factors considered by physicians when prescribing treatments. Here are some key findings on cost considerations from the report:

47% of primary care physicians cite cost as their most important factor.
1 in 4 cardiologists pointed to cost as the most important factor.
Cost ranked as the fifth most pressing concern among dermatologists.
33% of oncologists cited cost, making it only the sixth most important issue
Neurologists named cost as the eighth most pressing matter.
Pulmonologists ranked cost as the least important factor when prescribing.

Source: Stat News, November 15, 2016

Monday, November 21, 2016

Pharma Companies Spent $148,047,760 on Lobbying in 2015

The LA Times recently released an article on healthcare industry political lobbying. Here are some key findings from the report:

Pharmaceutical manufacturing spent $148,047,760 on lobbying in 2015.
Hospitals and nursing homes spent $93,592,884 on lobbying in 2015.
Health professionals (including physician groups) spent $89,928,202.
Health services/insurers/HMOs spent $74,356,196 on lobbying in 2015.
In 2016 pharmaceutical companies contributed over $17 million to campaigns.
The top recipient of industry money was Paul Ryan who received $230,000+.

Source: LA Times, November 15, 2016

Thursday, November 17, 2016

10 reasons social selling is failing

Nov 17, 2016 | By Anthony Iannarino

Social selling isn’t living up to its promise. Those promises have been exaggerated and oversold. Social selling is failing.


1. Lack of content Your social selling program isn’t going to work without content. You may want to make noise on the social channels, and you may want attention. You can’t have attention without content. Salespeople without content are unarmed.

2. Link bait content isn’t content You see some social gurus and sales experts writing provocative content. If it’s not link bait, it’s comment bait designed to drive engagement simply by being provocative. If you want attention from your peer group, you’ll get it. You are not, however, gaining engaged prospects.

Here's how NOT to sell to someone using social media.

3. Content doesn’t compel change Infographics are really neat. So are inspirational images. And quotes. But they do absolutely nothing to explain to your dream client what’s going on in their world, why they are plagued with dissonance, and why they should change.

4. Too great a reliance on content to drive leads Content marketing is not going to generate enough leads for you to make your number unless you are the rare exception, a thought leader with an earned following. Inbound marketing isn’t supposed to provide you with 100 percent of your leads, plus the amount you need to make your number.

5. Too much faith that connecting is enough. You need to open relationships. You can do that on the social web. The barrier for someone to accept your LinkedIn connection request might now be lower than a friend request on Facebook. Prospecting means asking for a meeting.

6. Too much time spent on social channels It is a complete and utter time suck. Perhaps the greatest time suck and distraction in the history of mankind, approaching levels that exceed television. It is critical that you use the tools. And then it is critical that you set the tools down and do the work you really need to do. If you believe social is urgent and important, you are making a mistake.

7. Belief that social replaces traditional approaches Social fails when it is used as a replacement for the traditional approaches. You InMail isn’t prospecting. It is approaching spammy.

8. Activities are not strategic Sharing other people’s content is great. Liking and commenting is great, too. Posting status updates can be a great way to share with people you are connected to on social. It just isn’t strategic. If what you are doing doesn’t create value for your prospects and clients, it’s not strategic.

9. Lack of an integrated approach and campaigns What story are you telling with what you publish and share? What is the end goal? How is it aligned with a campaign that is a tailored message designed to move your dream clients to a place where they are willing and interested in engaging in a conversation around change?

10. Shift in platforms away from B2B Name all the great social platforms for B2B? If you named SnapChat, you’re just being funny. If you said Instagram, you’re teasing me. LinkedIn is the only platform for professionals, and it looks more like Facebook every day.

If salespeople and sales organization are going to use the social tools to generate sales, we’re going to have to do a whole lot better.