Wednesday, June 19, 2013

Getting the Word Out on New Health Insurance

    Get Covered America, a national campaign to inform Americans about the new upcoming opportunities on health insurance, is planning two organizing meetings in South Florida this weekend.
    In Miami-Dade, a "launch canvass" is planned for Saturday, June 22, at 10 a.m. at the Mejias Medical Center, 3091 Coral Way.
    In Broward, the meeting is scheduled for noon Sunday, June 23, "just outside the entrance" of the Broward West Regional Library, at 8601 W. Broward Blvd., Plantation.
    The meetings are dedicated to getting word out about the upcoming exchanges, which will be pools of coverage so that individuals and small businesses can get cheaper group rates while not banning benefits because of preexisting conditions. Details on exchanges are supposed to be available by Oct. 1, with coverage starting Jan. 1.
     The organization's website,, says it's an effort of Enroll America, which has its own website identifying itself as a nonprofit corporation. Enroll America's board includes Ron Pollack, executive director of Families USA; Sister Carol Keehan, chief executive of Catholic Health Association of the United States; and Richard Umbdenstock, chief executive of the American Hospital Association.

     The Get Covered Meetings are hoping to attract volunteers who will be part of a door-to-door effort to explain the benefits. In South Florida, the new exchanges could benefit hundreds of thousands of uninsured persons and those who now struggle to afford coverage in individual and small-group markets.
      Santiago Leon, a Miami health insurance broker and board member of Florida CHAIN, told a healthcare summit last week that he's concerned that so little has yet been done to get word out about the opportunities coming with the Affordable Care Act.
    Persons seeking more information can contact Jimmy Tan at 718-208-5024.

Monday, June 17, 2013

Uncertainty permeates South Florida healthcare industry

By John Dorschner

The healthcare industry in South Florida is overwhelmed by uncertainty as providers wait for major provisions of the Affordable Care Act to kick in next Jan. 1.
    That was the underlying buzz in Fort Lauderdale on Friday at the annual summit of the South Florida Hospital and Healthcare Association.
    Vendors were quietly talking about how hospitals are postponing major purchases in equipment and software until they see how the federal healthcare reforms impact their operations. Healthcare construction companies are taking any small jobs they can find, hoping that major hospital building will resume when the future becomes clearer.
    The issues were put into sharp focus by one of the nation's top experts in healthcare economics who said the future of the industry -- and the nation's delivery system -- hinge on what he calls "four big bets," tied to the upcoming momentous events.
    Richard Clarke, former chief executive of the Healthcare Financial Management Association, said the nation faces huge uncertainties.
    The first is whether people will enroll in Medicaid. The Florida Legislature so far has rejected expanding Medicaid, which could have added perhaps one million persons to health insurance -- a move that would have reduced the hospital costs of uninsured patients -- costs hospitals are now passing on to those with private insurance.
    The second is whether employers will drop health benefits after 2016, deciding it is better to pay the federal penalties than continue to fund workers' premiums, said Clarke. On the flip side, will those employees without coverage purchase insurance as the law requires?
    The third: Will the state manage its responsibilities under the Affordable Care Act. At the moment, Florida is doing virtually nothing to prepare for the act, and is leaving everything -- including the formation of insurance exchanges -- to the federal government.
    And -- perhaps biggest of all -- Clarke asked whether healthcare delivery systems will be able to cut costs over time through remedies such as accountable care organizations, medical homes and bundled payments.
    PricewaterhouseCoopers estimates that there's $1.2 trillion in waste in the healthcare system, but that's hard to squeeze out, especially without incentives, Clarke said.
    Clarke cited one hospital's experience in which it reduced readmission rates of patients with congestive heart failure by 48 percent. That action was achieved at a cost to the hospital of $1100 per patient. Insurers saved far more than that, but didn't reward the hospital for its actions.
    Clarke described this as a "conumdrum" in which hospitals want to do the right thing, but face disincentives in doing so -- a tension that could make for considerable turmoil in trying to reduce healthcare costs.
    At present, Clarke said, the message that the government and insurers are sending: "If you are going to do good, you're going to do worse."
    At an afternoon session, the state's Medicaid director, Justin Senior, told the conference that the state could save $1 billion a year for the first three years in accepting Medicaid expansion just in some secondary costs -- such as the Medically Needy program, which is now paid for by the state but could become part of Medicaid expansion.
    Chris Paterson, chief executive of Sunshine State Health Plan, said there are "a lot of unknowns" about the exchanges that start Jan. 1, designed to create pools so that individuals and small businesses can get lower group rates and people can't be denied coverage because of "preexisting conditions."
    Paterson said a million people in Florida could go into the exchange, which will be designed by the federal government, but "we really don't know who is going to sign  up for these programs. ... We see a lot of trepidation among providers."
    Steven Ullmann, a health policy expert in the University of Miami School of Administration, asked a media panel whether the media didn't have a responsibility to inform the public about the opportunities starting Jan. 1 -- and advocate that people join.
    The three media panelists, which included this reporter, said that advocacy wasn't the media's job, but agreed that it was important to inform the public about what's available.
    Santiago Leon, a Miami health insurance broker and board member of Florida CHAIN, said he was concerned that not enough was being done in the region to inform the public about what opportunities would be available in the Affordable Care Act and to get people behind a push to get Medicaid expansion approved in the state.
    CHAIN is a state advocacy group to improve access to affordable quality healthcare.
    Healthcare providers haven't given up on Medicaid expansion, and the Florida Hospital Association has developed a website,, to promote the need for Medicaid expansion.
    Leon said after the meeting that there are disincentives for males, the young and healthy to sign up for the exchanges, and under a worst-case scenario, it was possible that fewer persons in Florida might be insured after Jan. 1 than are now insured.
    Many experts have noted that it took years of tinkering with Medicare, after it was introduced in the 1960s, to get it the point where it worked smoothly. They anticipate the complexities of Obamacare will also require considerable tinkering, but that the present stalemate between Congress and the White  House make cooperative changes unlikely in the near future.
     The writer can be reached at