Category: Trends In Health Care - Part 4

Health co-op first to rule that transgender exclusions are wrong

By Katie Kerwin McCrimmon A new health insurance company that is offering some of the lowest prices for health coverage on Colorados new exchange is now the first to decide that it will cover transgender care. Colorado HealthOP, a new nonprofit member-owned health cooperative formed with federal grants under Obamacare, has vowed that it will not discriminate against any groups. Currently most plans sold in Colorado and around the country specifically bar medical care for transgender people. That means most health carriers wont pay for hormone treatments or gender reassignment surgeries. Now that the U.S. Supreme Court has strengthened gay…

Health insurance like buying a BMW for some Spanish speakers

By Katie Kerwin McCrimmon When new Connect for Health Colorado ads launch this fall, Spanish speakers will hear a different message from other potential customers. The call to action will be Come and learn rather than Come and buy, the message that will bombard most other customers. Thats because many Spanish-speaking immigrants dont even ponder buying health insurance since they think its out of reach financially, according to a consultant who is advising Connect for Health. Spanish speakers have the perception that health insurance is not an option for them so they are not looking for health insurance, Melissa Burkhart,…

New red light warning for Colorado exchange

By Katie Kerwin McCrimmon Twenty-two days before the slated opening of Colorados new health exchange, the project manager issued yet another red light warning, signaling that data-sharing with Colorados Medicaid systems may not work by Oct. 1 and that Connect for Health Colorado managers might have to shift to contingency plans. On top of troubles meshing with the states Medicaid systems, managers at Connect for Health Colorado are contending with IT snafus from the federal government. Managers warned Colorado board members on Monday that the Social Security Administrations data system likely will be offline for four hours every night from…

Exchange preps for snafus — like squirrels

By Katie Kerwin McCrimmon Squirrels and software snafus have brought down NASDAQ over the years. Last weeks debilitating three-hour crash of the financial exchange appears to have been triggered by a software glitch, proving that even long-established networks can be vulnerable to catastrophe. In Colorado, an exchange of a different sort Connect for Health Colorado is bracing for different disasters: blizzards, floods and severed data lines. But the most likely potential problems center on connections with Colorados Medicaid computers, insurance industry websites and the federal data hub, which must provide information on tax subsidies to help cut the cost of…

Lifting the veil on wildly varied surgery charges

By Katie Kerwin McCrimmon Andrea Mahoney was skiing her last run of the day at Breckenridge in January when she heard her knee pop. It sounded bad. The diagnosis she got from her doctor confirmed her hunch. She had torn her ACL and MCL, and had damaged her meniscus. Mahoney had surgery in late February at a physician-owned outpatient center. After extensive pre- and post-surgical physical therapy and a grueling seven months of rehabilitation, shes pleased with her results and now is running again with a brace. Mahoney is eager to get back to her typical athletic routine full of…

Rates higher in resort areas, college towns

By Katie Kerwin McCrimmon People living in resort areas of Colorado will have to pay higher health insurance rates than those in other regions when plans start being sold through the states health exchange on Oct. 1. An average 40-year-old non-smoker living in a resort area who is buying a mid-level silver plan could be charged a base rate as high as $667 per month compared to the least expensive silver plan for a comparable 40-year-old in Greeley, whose base rate would be about $232 per month. Shoppers will also be able to choose from lower level bronze plans and…

Colorado approves 242 health plans for exchange

By Katie Kerwin McCrimmon Colorados Division of Insurance has approved 242 plans from 13 carriers for the states health exchange, Connect for Health Colorado, which is slated to open on Oct. 1. Deputy Insurance Commissioner Peg Brown briefed members of Colorados health exchange board on Monday on plans that her department has reviewed and approved. Were very pleased with the number of carriers and plans. It represents a wide variety of choice for the Connect for Health marketplace and healthy competition in the Colorado insurance marketplace overall, Brown said. Of the approved plans, 150 are targeted at individuals while 92…

Tech errors prompt red light warning for exchange

By Katie Kerwin McCrimmon Just seven weeks before the Oct. 1 launch of Colorados health exchange, managers said that their IT systems are not getting accurate data from state Medicaid systems, prompting a warning to board members Monday. Adele Work, the project manager who leads technology for Connect for Health Colorado, shifted her readiness estimate for synching with state systems from yellow, meaning cautiously moving forward,to red, meaning not ready. She highlighted her concerns Monday that state IT systems may not properly communicate with the exchange systems by Oct. 1. Work said shes prepared to shift to contingency plans on…

“My dear Watson” – from “Jeopardy” to a doc’s office near you

By Katie Kerwin McCrimmon KEYSTONE Best known for beating brilliant humans at Jeopardy, Watson, the super computer, soon may be coming to a hospital or insurance company near you. But dont call him (or her) Dr. Watson. The more appropriate reference may be to Sherlock Holmes my dear Watson, the indispensable right-hand man or woman as Lucy Liu now portrays Dr. Joan Watson in the re-imagined TV show, Elementary. IBMs Watson is actually named to honor the companys founder, Thomas J. Watson. But as Watsons creators dream up future roles for their intelligent machine medical sleuth, patient watchdog and reading…

Don’t fear failure, fail fast, harness data and adapt

By Katie Kerwin McCrimmon KEYSTONE If Silicon Valley venture capitalists were trying to fix broken health care systems, they would invest in multiple solutions at once and expect most to fail. But they would take action. That was the message from Rebecca Costa, an evolutionary biologist and a keynote speaker at the Colorado Health Symposiumsponsored by the Colorado Health Foundation. In nature, diversification ensures survival. In health care, Costa sees big organizations that want to meet endlessly, hold focus groups, then move tentatively, if at all, as they embark on singular solutions destined to fail at a glacial pace. Singularity…