Protecting Your Information at HealthCare.gov

By Kevin Counihan

 

The third year of Open Enrollment is just around the corner. Starting November 1, you’ll be able to enroll or re-enroll in quality and affordable coverage at HealthCare.gov. Over the last several months, we’ve been working hard to make the consumer experience even better this year – learning about what information you need to make decisions and how to improve the help and support we provide throughout the enrollment process. An important part of that is continuing to protect your privacy when you’re shopping for health coverage.

 

We’re committed to providing you with the opportunity to personalize your experience.  Here are a few of the updates you can expect from HealthCare.gov. Today, we launched a simple way to give you more control over the information you choose to share with us – a new privacy manager. We’re also supporting the Do Not Track browser setting for our digital advertising. And, you can check out our updated privacy notice to learn more about these tools and to understand the steps we’ve taken to protect your privacy. We tried to make the policy easy to navigate while also being a lot more specific.

 

We know privacy is important to you when you use the web. In the process of signing up for health care coverage, you may provide us with personal information. For instance, you may enter your email address so that you can stay up to date with announcements and alerts from HealthCare.gov and learn about your affordable health coverage options.  When you sign up for health care coverage, you provide information such as your name, Social Security number, and income so that we can verify your eligibility to purchase coverage. We take protecting this type of personal information very seriously and only use it to help you get – and keep – your coverage.

 

Like all other websites, we receive some information automatically when you read, browse, or download information from HealthCare.gov. This is information that your web browser sends when you browse the internet – such as your domain, IP address, type of device, and date and time you visited. We use this information to better understand how the site is being used – and to learn about how we can make it more helpful. 

 

We also employ commonly used web tools like Google Analytics to analyze HealthCare.gov’s technical performance, as well as to facilitate, enhance, and measure the effectiveness of our digital advertising outreach efforts. These tools can help us do things like understand which pages on our website need improvement, to increase the speed and functionality of HealthCare.gov and make the site more useful to consumers. You can learn more about each of the third-party tools currently in use by reviewing our privacy notice.

 

There’s one tool, our new privacy manager, which we want to make sure you know about.  This simple tool makes it easy for you to opt-in or out of the different types of third-party tools used by HealthCare.gov – Advertising, Analytics, or Social Media. If you choose to opt-out, you’ll still have access to everything on the site, but we won’t use information from your visit to analyze the site’s technical performance or use digital advertising to remind you about helpful information like deadlines. You can check out the privacy manager now by clicking on “Privacy Settings” at the bottom of HealthCare.gov.

 

In addition, if you have Do Not Track enabled in your browser, we’ll automatically observe your preferences related to digital advertising from HealthCare.gov.

 

The internet is constantly changing, and we have an obligation to keep evolving alongside it. We’ll keep reevaluating our own privacy notice, the tools we use, and how they intersect with the evolving landscape of privacy on the web. We are committed to protecting the information you entrust with us at HealthCare.gov.

 

We wish you a great shopping experience this year.

According to a recently-released survey,

...in March 2015, the percentage of adults who had been covered by health insurance for a full year, but reported an unmet need for dental care due to affordability, by income level, was:

• 30.8% of low-income adults
• 23.8% of adults with family income between 139% and 399% of the federal poverty level
• 11.4% of adults with family income at or above 400% of the federal poverty level

Source: "Health Reform Monitoring Survey," The Urban Institute, September 24, 2015, http://hrms.urban.org/quicktakes/Gaps-in-Dental-Care-for-Insured-Adults-Remain-under-ACA.html

Women Are 27% Less Likely Than Men to Receive Angioplasties

Blue Cross Blue Shield Association recently conducted an analysis on gender disparities in post-heart attack treatment. Here are some key findings from the report:

·         Women are 27% less likely than men to receive angioplasties to open arteries following a heart attack.

·         Coronary bypass surgery was 38% less likely to be performed on women following a heart attack than men.

·         Women were nearly 5% less likely to receive coronary angiography post-heart attack.

·         0.73 out of every 1,000 women experienced a heart attack compared to 1.95 per 1,000 men.

·         Women are more likely than men to die within one year of a heart attack.

·         Heart attack risk is 3x higher for women in Kentucky and Ohio than Colorado, Idaho and Wyoming.

Source: Blue Cross Blue Shield, September 29, 2015

Agents and Brokers: Have You Completed Plan Year 2016 FFM Registration and Training?

The Centers for Medicare & Medicaid Services (CMS) would like to remind agents and brokers that they must complete Federally-facilitated Marketplace (FFM) agent and broker registration and training for each plan year prior to assisting consumers with enrolling in coverage through the FFM. Plan year 2016 registration is now live, and training is available through the CMS Marketplace Learning Management System (MLMS), as well as through the following CMS-approved vendors:

• America’s Health Insurance Plans, Inc. (AHIP)
• Gorman Health Group (Gorman)
• National Association of Health Underwriters (NAHU)

Agents and brokers can access the MLMS and CMS-approved vendor trainings via the CMS Enterprise Portal. Please note that a Spanish version of the MLMS training is also available.

Agents and brokers who are new to the FFM and have not previously registered must:

• Create an FFM user ID, complete identity proofing, and request the agent/broker role on the CMS Enterprise Portal
• Complete training through the MLMS or a CMS-approved vendor
• Complete an MLMS profile and execute the applicable FFM Agreements on the MLMS

Returning agents and brokers who previously completed identity proofing or requested the agent/broker role as part of the registration process for a prior plan year do not need to repeat these steps during the annual registration renewal process. Please ensure that you are using the same FFM user ID that you used in prior plan years.

If you complete FFM agent and broker training through a CMS-approved vendor, you will still need to execute the applicable Agreements with CMS on the MLMS prior to assisting consumers with selecting and enrolling in health coverage through the FFM.

To ensure the best experience with the MLMS, please use Firefox or Chrome as your web browser. If you are unable to access the MLMS, this may be due to a large number of people currently using the system. The best days and times to access the MLMS are typically Monday through Friday, between 5:00 PM and 11:00 AM Eastern Time and on the weekends.

For additional information please visit the Agents and Brokers Resources webpage. There are a number of links and documents that will help you to learn more about registering to participate in the FFM for plan year 2016. CMS will continue to update this webpage over the coming weeks with additional resources that help explain the registration process. CMS will also provide updates via email blasts, the monthly News for Agents and Brokers newsletter, as well as through Twitter (@CMSGov).

For questions, please contact the FFM Producer and Assister Help Desk at FFMProducer-AssisterHelpDesk@cms.hhs.gov.

50% of large firms (200 or more workers)

...versus 18% of small firms offering health benefits either offer or require employees to complete a health risk assessment, according to a recent survey.

Source: "2015 Employer Health Benefits Survey," The Henry J. Kaiser Family Foundation, September 22, 2015, http://kff.org/report-section/ehbs-2015-section-twelve-health-risk-assessment-biometrics-screening-and-wellness-programs/

Primary care makes strides in improving quality and costs

CMS BLOG

http://blog.cms.gov/2015/10/07/primary-care-makes-strides-in-improving-quality-and-costs/

 

October 7, 2015

By Dr. Patrick Conway, CMS Deputy Administrator for Innovation and Quality and Chief Medical Officer

 

Primary care makes strides in improving quality and costs

Today, the Centers for Medicare & Medicaid Services (CMS) announced promising results of the first shared savings performance year for the Comprehensive Primary Care (CPC) initiative. This model is part of our broader effort at CMS to promote better care, smarter spending, and healthier people.

 

In 2014, CPC practices showed positive quality results, with hospital readmissions lower than national benchmarks and high performance on patient experience measures, particularly on provider communication with patients and timely access to care. CPC practices that demonstrated high quality care and reduced spending above a threshold shared in savings generated for Medicare. 

 

During this first shared savings performance year, the initiative decreased Medicare Part A and Part B spending compared to spending targets while achieving high quality outcomes. The CPC initiative generated a total of $24 million in gross savings overall (excluding the CPC care management fees). These results reflect the work of 483 practices that served approximately 377,000 people with Medicare and more than 2.7 million patients overall. Four of the CPC initiative’s seven regions (Arkansas, Colorado, Cincinnati-Dayton region of Ohio, and Oregon) generated gross savings. The Greater Tulsa region decreased costs in excess of the CPC care management fees, generating net savings of $10.8 million and earning more than $500,000 in shared savings payments.

 

Quality highlights from the first shared savings performance year include:

 

• Over 90 percent of CPC practices successfully met quality targets on patient experience (as determined by the Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys) and utilization (hospital admission and readmission) measures, indicating quality scores that matched or exceeded national comparisons.
•  
• All regions had lower-than-targeted hospital readmission rates. Readmissions can be burdensome to patients and caregivers and costly to the healthcare system. Lower readmissions indicate better coordination of care during transitions and patient support during the post-discharge period.

• Patients receiving care from CPC practices scored their primary care practitioners highly, particularly on how well clinicians communicate and on getting timely access to care. 

The CPC initiative launched in October 2012 to advance primary care by paying clinicians to deliver accessible, comprehensive, and coordinated care. Advanced primary care is the foundation of a high-performing health system. In addition to attending to patients’ acute, chronic, and preventive health care needs, primary care practices act as the quarterback of the health care team. CPC practices help patients navigate their care, communicate with specialists and hospitals, and ensure that patients with complex social and medical needs do not “fall through the cracks” of the health care system.

 

Authorized by the Affordable Care Act, the CPC initiative is a multi-payer partnership between Medicare, Medicaid, commercial payers, and primary care practices in seven regions (Arkansas, Colorado, New Jersey, Oregon, Capital District and Hudson Valley in New York, Cincinnati-Dayton region in Ohio and Kentucky, and Greater Tulsa in Oklahoma). Participating practices identify patients who are sick or at risk and provide targeted care management to improve outcomes and prevent potential adverse events. Patients at CPC practices have 24/7 access to a provider, and receive enhanced self-management and decision-making support. The CPC initiative supports these efforts by paying an additional fee for non-face-to-face care, such as tracking hospital discharges to provide follow-up support to patients.

 

We are encouraged by the results so far and look forward to seeing the results of our independent evaluation of these practices. Our prior experience with primary care demonstrations shows that it takes time for primary care practices to build infrastructure and improve care delivery. These CPC initiative improvements came earlier than expected in a model involving significant changes in the delivery of primary care. We look forward to supporting these innovative practices in their progress as the initiative continues.

Two-Thirds of Americans Surprised by Medical Bill in the Past 12 Months

Vitals recently conducted a survey on healthcare cost management. Here are some key findings from the report:

·         Two-thirds of American adults (155 million people) have been surprised by a medical bill in the past year.

·         7% of respondents said they receive incentives from their health plan to shop for cost-effective care.

·         Over half state that medical costs "seriously" or "very much" impact their household budget.

·         3 in 5 people never ask their doctor about the cost of medical services they're about to receive

·         28% said price of care wasn't discussed because they believed insurance would foot the bill.

·         Almost one third stated they didn't think their doctor knew the cost.

Source: Vitals, September 30, 2015