Covered California To Begin Outreach for Second Enrollment Period

It's hard to believe that a whole year has gone by for the Affordable Care Act.  News about the second enrolllment period is beginning to trickle out from the not-so-secret dungeons of California's DHCS. which administers Medi-Cal as well as Covered California, the state run exchange.

Questions arise:

Will the IT structure work better on the second go around?

Has the backend been completed to cross check eligibility with other stated incomes ie, IRS, Franchise tax board, or SS ?

Executive Director, Peter Lee receives bonus of $50,000.

Wednesday, September 3, 2014

RELATED TOPICS:

• Covered California

Next week, Covered California will begin to prepare for its second open enrollment period by launching an advertising campaign aimed at encouraging residents to apply for first-time coverage or renew their current policies, the Los Angeles Times reports.

Covered California is the state's health insurance exchange under the Affordable Care Act.

Details of Enrollment Campaign

The $74 million ad campaign will run for the duration of the exchange's second enrollment period, which runs from Nov. 15 to Feb. 15, 2015.

During the next enrollment period, Covered California officials are aiming to:

• Increase enrollment from 1.2 million residents to 1.7 million residents;
• Fix problems consumers faced during the first open enrollment period; and
• Simplify the renewal process (Terhune, Los Angeles Times, 9/2).

Details of Renewal Process

Consumers will be able to renew their exchange plans beginning on Oct. 1. However, individuals who want to change their coverage will have to wait until Nov. 15 to do so (Abelson, New York Times, 9/2).

Exchange policies will automatically be renewed by Dec. 15 if enrollees do not specify that they want to change plans, according to the Los Angeles Times. Beginning in mid-October, insurers will mail renewal notices that show a consumer's:

• 2014 premium;
• Current federal subsidy; and
• Premium rate for next year.

The initial notices will not include information about the enrollee's 2015 federal subsidy. However, updated notices with subsidy information will be mailed between Oct. 10 and Dec. 15, according to officials.

Advocates Urge Consumers To Shop for Better Coverage

Meanwhile, some consumer advocates say individuals should hold off on renewing their plans and search for better deals, the Los Angeles Times reports (Los Angeles Times, 9/2).

In July, Covered California officials announced that the average premium for health plans offered on the exchange will increase by an average of 4.2% for the coming year. The rates vary depending on region, but most will see slight increases (California Healthline, 8/1). Some insurers will raise premiums by more than 10%, but others are cutting rates to increase competition, according to theLos Angeles Times.

Rates are expected to be finalized by Sept. 30.

Covered California 2015 Rates Will Increase an Average of 4.2%

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The rates will be reviewed by state regulators before being implemented officially (Robertson, Sacramento Business Journal, 7/31). 

The rates vary depending on region, but most will see slight increases:

• In Alameda County, the weighted average increase is 2.8%;
• In Contra Costa County, the weighted average increase is 3.8%;
• In Fresno, Kings and Madera counties, the average weighted increase is 3%;
• In Kern County, the weighted average increase is 4.5%;
• In Los Angeles County, which includes two pricing regions, the weighted average increases are 4.4% and 4.3%;
• In Northern California, the weighted average increase for premiums is 4.7%;
• In Marin, Napa, Solano and Sonoma counties, the weighted average increase is 5.4%;
• In Mono, Inyo and Imperial counties, the weighted average increase is 3.8%;
• In Monterey, San Benito and Santa Cruz counties, the weighted average increase is 2.9%;
• In Orange County, the weighted average increase is 6.3%;
• In the Sacramento area, the weighted average increase is 3.7%;
• In San Bernardino and Riverside counties, the weighted average increase is 4.5%;
• In San Diego County, the weighted average increase is 5.8%;
• In San Francisco County, the weighted average increase is 6.6%;
• In San Luis Obispo, Santa Barbara and Ventura counties, the weighted average increase is 5.1%;
• In San Mateo County, the weighted average increase is 3.7%; and
• In Santa Clara County, the weighted average increase is 1%.

All 10 insurers that participated in the state exchange during its first open enrollment period submitted bids and were approved to return in 2015, including:

• Anthem Blue Cross of California;
• Blue Shield of California;
• Chinese Community Health Plan;
• Health Net;
• Kaiser Permanente;
• L.A. Care Health Plan;
• Molina Healthcare;
• Sharp Health Plan;
• Valley Health Plan; and
• Western Health Advantage (Covered California release, 7/31).

Betsy Imholz, special projects director at Consumers Union, said, "We want to encourage people to shop first and not just default into a plan" (Los Angeles Times, 9/2).

Apple and HealthKit Is it HIPAA Compliant ? mHealth Part III

Consumers rarely are aware of privacy and confidentiality regulations except when interfacing with a hospital registration, or a medical office environment.  HIPAA applies to a wide variety of industries, insurers, insurance companies, medical device manufacturrers, home health services, and HIT such as EHR, HIX, and growing influence of home remote monitoring, and mobile health apps already on the market at the Google Chrome Store, Apple's iTunes site, and Window's Store.

Apple announced it is tightening privacy rules for  HealthKit, it's new mobile health developer's site. Apple appears to be the first company to satisfy HIPAA and gives it an advantage in the market place for serious adoption of mHealth for both remote monitoring and consumer oriented fitness monitoring apps that have become ubiquitous. The latest update to apple's iOS developer program licene agreement, Apple said developers must "not sell and end-user's health information collected throught the HealthKit API to advertising platforms, data brokers or information resellers". 

The privacy clampdown comes as Apple seeks to differentiate itself against rival Google, which relies on targeted ads for much of its income.

Apple, known for it's domination by games and chat apps discussed 'medical applications' with the U.S. Food and Drug Administration  during January 2014.

Predictions that mobile health medical apps would experience more popularity among consumers in 2014.  In June 2014 Flurry, a mobile analytics firm recently acquied by Yahoo reported a 62 percent increase in usage of health apps, outpacing the wider market's growth. Many of those apps, especially if free to download rely ofn a dvertising for their income.

This announcement coincides with the release of Apple's new iOS8

HealthKit allows apps that provide health and fitness services to share their data with the new Health app and with each other. A user’s health information is stored in a centralized and secure location and the user decides which data should be shared with your app. 

Is Aetna dumping its health data platform a bad omen for HealthKit and Google Fit?

This week  Aetna dumped it's mHealth offering, CarePass.   At almost the same moment Apple announced "Health Kit' and       also .  

Our last post, Can we rely on Mobile Health Apps  analyzes how mHealth apps can stagger even the largest user.

The Apple OS store and the Android OS (Chrome Play store)  offer two highly visible marketplaces for mobile health apps. Microsoft also offers mobile health apps such as Health Vault, HealthVaultmobile, Microsoft also features a Health and Fitness guide for developers but has no specific product of it's own. The Windows phone store offers Fitbit, Active Fitness  Gym Pocket Guide, Runtastic, and 30-Minute Boot Camp. All of these collect and store data, however have no remote monitoring functions. Microsoft and others have multiple focused apps for excercise with titles such as: Ab Builder to Pullups

While mHealth pertains to a wide spectrum of devices in size, as a wearable, or implanted device, it oftens require merging many different components to work, requiring wifi,smartphones, tablets and pcs to integrate an application.

Smartphones are being replaced by Smartwatchs such as Gear S, 

GoogleFit

The latest reports suggest that Apple will announce a wearable device, the so-called "iWatch," in September—earlier than previously expected. The only clue to its function in Apple's documentation is HealthKit's ability to record heart-rate data from a wrist-based device.  HealthKit also records sleep-quality information, distinguishing whether you're in bed or actually asleep—data that devices like the Jawbone Up, Fitbit, and Runtastic Orbit can collect.

 Start the Countdown Timer on Whatever Old-Fashioned Piece of Junk You Have on Your Wrist Right Now

Remember back in June when I said Apple hoped to schedule a special event in October to show off a new wearable device? Remember how I also said this: “Could things change between now and fall? That’s certainly possible.” Turns out that was a prescient hedge, because things have changed. Apple now plans to unveil a new wearable alongside the two next-generation iPhones we told you the company will debut on September 9. (Funny “joke,” Gruber.) The new device will, predictably, make good use of Apple’s HealthKit health and fitness platform. It will also — predictably — make good use of HomeKit, the company’s new framework for controlling connected devices — though it’s not clear how broadly or in what way. Sure would be nice to turn the lights on and off from my wrist, though — or navigate my Apple TV (caution: Total speculation). Oh. Could things change between now and September 9? That’s certainly possible — har-har — but I doubt it. Invitations should be going out any day now, right? No word yet on the fate of the October event I mentioned earlier this summer, though I imagine it’s still on. With its best product pipeline in 25 years, Apple should have more than enough hardware to fill two events. Apple declined comment.

  

Can We Rely on Mobile Health Apps?

Exclusive: Aetna to shut down CarePass by the end of the year

Troubling news from Carepass, After MobiHealthNews spotted and reported on the departure of two Aetna executives on the CarePass team, Aetna has confirmed exclusively to MobiHealthNews that it will be phasing out the platform, and that the previously announced employer pilots will not be going forward.

Carepass has been available in the Chrome Store and on iTunes, however Aetna will cease to support the platform.

“At this time, we have decided to make no further investments in the CarePass platform,” an Aetna spokesperson told MobiHealthNews in an email. “Current CarePass users will continue to have access to the CarePass platform for the time being, but we plan on closing the CarePass web and mobile experiences by the end of this year. In addition, we will not be conducting pilot programs with Aetna plan sponsors that were previously reported.”

In additional comments, the company emphasized the exploratory nature of the platform and stressed that valuable lessons had been learned.

The company found no shortage of willing partners to feed data into the app. Over the two years of its existence, CarePass interfaced with MapMyFitness, LoseIt, RunKeeper, Fooducate, Jawbone, Fitbit, fatsecret, Withings, breathresearch (makers of MyBreath), Zipongo, BodyMedia, Active, Goodchime!, MoxieFit, Passage, FitSync, FitBug, BettrLife, Thryve, SparkPeople, HealthSpark, NetPulse, Earndit, FoodEssentials, Personal.com, Healthline, GoodRx, GymPact, Pilljogger, mHealthCoach, Care4Today, and meQuilibrium.

The news is noteworthy because CarePass, which Aetna launched last year and allowed consumers to track certain health apps from one online hub, was a unique mobile approach in the insurance industry that garnered widespread support and collaboration from mobile companies, including MapMyFitness, FitBit and Care4Today.

Aetna's CarePass also received consumer support, at least initially. "Overall, for the CarePass integrated apps, the downloads are more than 100 million. We started around the most popular spaces in mHealth--fitness and nutrition really dominate. So those are where you get the most downloads," Martha Wofford toldFierceHealthPayer in an interview before she departed Aetna as head of the CarePass program. Recent surveys have shown a very high dropout rate for users after an initial spurt of interest.

Aetna cancelled another mobile project — InvolveCare — earlier this year, although the company had invested considerably fewer resources in that product than in CarePass. Although Aetna had begun to downplay CarePass in recent months, for most of its existence it was the face of Aetna’s consumer health outreach and its mobile health endeavors.  This was despite expertise from Pivotal Labs after initial difficulty developing the platform.

The comments from Aetna follow a pattern of what has become a 'boiler-plate' statement by insurers and anyone connected with HIT. 

“One of the primary ways that Aetna is improving health care is through the increased use of innovative technology,” the spokesperson wrote. “We are consistently creating technology-based solutions that make it easier for consumers to navigate the health care system and get the most out of their health benefits. While we are continually developing these solutions, we also need to evaluate our investments to ensure that we are providing the most value to our members.”  “Aetna is committed to being a consumer-focused company that helps build a more connected and effective health care system,” 

Aetna CEO Mark Bertolini had high hopes for the product, saying it would reduce healthcare costs and “make our economy healthier”.

Aetna is a major insurer with deep pockets. Software is not inexpensive to develop and early failures will lead to increasing costs.  Despite measures to create uniform interoperable electronic health records for providers, the same cannot be said about consumer oriented products.

When all is said and done, many enthusiastic and dedicated developers will find the going difficult.  Time will tell, and those mHealth apps with the most demand on the consumer side, or provider dependent mobile apps which are necessary for practice operations will suceed. 

Providers will insist on mobile health portals for communication and accessing data on the run.