December 5, 2013 at 5:02 PM
While Washington’s health exchange website – wahealthplanfinder.org – has fared far better than the federal government’s multi-state site, it has not fully resolved its own nagging performance issues.
The site was taken down for repair Tuesday at about 2 p.m. and remains down as of late Thursday afternoon.
“We are having issues,” acknowledged Curt Kwak, CIO of the Washington Health Benefits Exchange, the public-private company that manages the exchange. Kwak says his staff first noticed performance issues on the site about 2 1/2 weeks ago. “We tried to implement hot fixes before the Thanksgiving holiday and it seemed to have worked at the time,” said Kwak. “But when we got back from the holidays it started to act up again. We’ve been managing that ever since.”
The only thing Kwak is sure of is that the problem isn’t being caused by the site’s links to its partners, including the state eligibility system and the federal data hub. His team has been concentrating on the potential issues with the site’s databases, routers and Web servers. “It has been a very difficult thing because the problems are very random and intermittent,” said Kwak. “We still haven’t located the root cause.”
When asked if he could estimate when the site would be up again, Kwak replied, “Nothing is clear at this point.”
December 5, 2013 at 11:08 AM
At the end of my daughter’s annual checkup this year, her doctor asked if we had any concerns. Almost as an afterthought I mentioned the little wart at the end of one of her toes (note to self: get my kid flip- flops for the gym pool and showers!).No problem, said the pediatrician. In a flash she pared away some of wart with a small scalpel and froze what remained with liquid nitrogen on a Q-Tip. It took five minutes.
Historically, I have been a lazy health-care shopper. My family has always had insurance through employers and we’re generally healthy. I never ask what something will cost (chances are the doc won’t know anyhow) and I rarely scrutinize doctor’s bills.
That’s before I got the wart invoice.
Our doctor’s office billed $269 for the procedure, which was coded as “DESTRUCTION EG, LASER SURGERY.” Our insurance carrier, Aetna, got that reduced to $204.40, and that’s what we’re going to have to pay. For wart removal.
The New York Times this week published two more articles on the cost of U.S. medical care in its “Paying Till It Hurts” series. The series compares the costs of various procedures at hospitals and clinics around the country, and between nations. It’s terrifying. A story Monday delved into stitches costing $500 a piece. An article yesterday documented ambulance rides lasting two blocks and costing $900.
December 4, 2013 at 8:10 PM
The Washington Healthplanfinder website came back online about 7 p.m. today after having been taken down earlier because of ”intermittent slowness and outages” on the site.
The Washington Health Benefit Exchange, which operates the Healthplanfinder site, did not have a statement about the specific cause of the problems.
More information about the cause of the shutdown is expected to be available Thursday.
December 4, 2013 at 2:01 PM
UPDATE: The Washington Healthplanfinder website was down for a second day Wednesday.
The Washington Health Benefit Exchange, which operates Healthplanfinder, posted a status update around noon stating that the site will be back online at 4 p.m.
The exchange had announced Tuesday evening that the website would be back up by noon Wednesday, but it missed that target.
The website has been down continuously since 2 p.m. Tuesday as the Exchange’s IT staff work to address what the exchange calls ”intermittent slowness and outages.”
December 4, 2013 at 11:09 AM
Washington Insurance Commissioner Mike Kreidler told lawmakers Wednesday he is concerned about the narrow provider networks of some health plans on the state’s online insurance exchange but said his office will do everything it can to make sure insurance carriers provide consumers appropriate access to the benefits promised in their policies.
Testifying before the U.S. House Ways and Means Health Subcommittee, Kreidler said his office has made clear to insurance carriers that if a customer cannot get access to a covered benefit from a provider in their network, the carrier must cover the cost of the service from an out-of-network provider at the in-network benefit level. “If the promise has been made in the insurance policy, we are going to make sure the insurers live up to that promise,” he said.
Kreidler appeared as a witness during a hearing that focused on the “adverse impacts” of the Affordable Care Act. He had been invited to testify by the subcommittee’s ranking Democrat, Rep. Jim McDermott of Seattle.
In his testimony, Kreidler urged the panel to have patience with the new insurance exchanges during the early enrollment period. “Rome wasn’t built in a day,” he said. He also noted that in Washington, one of 14 states running its own exchange, more than 175,000 residents have enrolled in coverage to date.
Other witnesses focused on current and potential problems with the online insurance exchanges.
Scott Gottlieb, resident fellow at the American Enterprise Institute, a conservative think tank, highlighted the narrow provider networks of some exchange plans.
Gottlieb said most consumers probably won’t know until after they enroll in a plan which doctors and hospitals are included.
He said the AEI has looked at some of the plans to try to determine which doctors and hospitals they include in their network, but with little success. “This information isn’t available,” he said. “We looked hard for it.”
Kreidler responded that such information is indeed hard to find, including in Washington state. “Dr. Gottlieb identifies one of the challenges we have,” he said. “That information isn’t as readily available right now, but we’re working to correct that.”
He said consumers who want to know details about a plan’s network should call the insurance company and ask those questions. “People can find out,” he said. “It’s just a little bit more challenging right now.”
Kreidler received national media attention recently after President Obama announced he would allow insurance companies to extend individual health insurance policies set to expire at the end of 2013.
Kreidler announced almost immediately that would not implement that proposal in Washington state.
He was asked about that decision by Rep. Dave Reichert, a Republican from Auburn who is a member of the Ways and Means Committee but not the health subcommittee.
Reichert noted that 290,000 people in Washington received cancellation notices from their insurers this fall and that President Obama had offered to let people keep their canceled plans.
“You decided, sir, to separate yourself from the president on that request and not allow those 290,000 people to keep their health insurance,” he said to Kreidler. “Did you speak to any of those insurance carriers before you made that decision?”
Kreidler responded that he had not, but that he had received a statement from the Association of Health Insurance Plans (AHIP) that indicated that health insurance companies “were very distressed by what the president proposed.”
Reichert interrupted Kreidler then, noting that his time to ask questions was about to expire.
December 4, 2013 at 7:29 AM
The website for Washington Healthplanfinder, the state’s online insurance marketplace, was down most of Tuesday for unscheduled maintenance and will be offline Wednesday morning until noon, according to the Washington Health Benefit Exchange, which operates Healthplanfinder.
The website was taken offline Tuesday after users reported “intermittent slowness and outages” on the site, according to an update posted at 8:30 a.m. Tuesday by the Exchange.
By 10:50 a.m., the Exchange’s IT team took down the site for “quick maintenance.”
Healthplanfinder was back online by 1 p.m. But it wasn’t running for long.
By 2 p.m., the website was taken down again for further maintenance. According to the Exchange’s status update, “After bringing Healthplanfinder back online, the IT team discovered that some users are still experiencing intermittent slowness and outages. Any update will be posted here when available.”
At 7:30 p.m., the Exchange posted an update that Healthplanfinder was expected to be back online at noon Wednesday.
The deadline for enrolling in health insurance coverage through Healthplanfinder is Dec. 23 for coverage that begins Jan. 1, 2014.
December 3, 2013 at 7:00 PM
Washington Insurance Commissioner Mike Kreidler, who refused President Obama’s offer to let people keep discontinued health plans, will testify before the U.S. House Ways and Means Health Subcommittee early Wednesday morning about how the Affordable Care Act is working in Washington.
Kreidler was invited to testify by Rep. Jim McDermott, a Democrat from Seattle, who serves as the ranking member on the subcommittee.
Kreidler, a Democrat, may face some uncomfortable questions from some subcommittee members, some of whom are hearing from disgruntled constituents whose insurance plans were pulled because they didn’t meet the ACA’s requirements.
The New York Times noted a “fresh wave of legal challenges” to the law, as well as a hearing to be held by the House Judiciary Committee to examine whether President Barack Obama is properly using his executive powers to alter provisions of the law. The committee also will examine the theory behind the lawsuits — that tax credits or subsidies cannot be granted to people who purchase insurance through the federal exchange.
Washington is among a minority of states with its own state exchange.
About two-thirds of the 290,000 Washington residents who currently buy individual insurance plans were covered by “catastrophic” policies with limited benefits, the state insurance office says. Most of them learned this fall that their policies were being discontinued.
The discontinued plans likely insure healthier people, since insurers formerly could reject people with health problems. Kreidler, and insurers generally, said that allowing the discontinued policies to continue — and to keep those policyholders out of the marketplace — could disrupt the stability of the market, since insurers carefully priced plans based on projections of the health of their enrollees, among other things.
In addition, letting people keep “bare bones” plans, Kreidler said, was not in keeping with the consumer protections of the Affordable Care Act, which mandated coverage of such areas as prescription drugs and maternity care.
The hearing, at 7 a.m. PST, will be streamed live; to watch, click here.
December 3, 2013 at 6:36 PM
More than 175,000 Washington residents have signed up for health insurance through Washington Healthplanfinder, the state’s online insurance marketplace, according to the latest enrollment figures released Tuesday by the Washington Health Benefit Exchange.
The vast majority of enrollees qualified for the state’s Medicaid program, Apple Health, which is expanding eligibility in 2014 to include adults with incomes up to 138 percent of the federal poverty level, which is about $16,000 for an individual.
A total of 176,468 residents enrolled in coverage through Healthplanfinder in October and November, the first two months of open enrollment for coverage in 2014.
That figure includes 18,131 residents who bought private health-insurance policies, known as “qualified health plans.” More than 91,000 are newly eligible for Medicaid because of expanded eligibility that takes effect Jan. 1, 2014. More than 66,000 enrollees qualify for Medicaid under the current guidelines and will receive immediate coverage.
Officials project that about 130,000 residents will purchase qualified health plans by Jan. 1, 2014, and that 280,000 will enroll by Jan. 1, 2015.
The latest enrollment numbers are still well short of that goal. But in addition to the more than 18,000 residents who have purchased qualified health plans, more than 43,000 have completed applications. The only remaining step for that group is submitting payment, which is due by Dec. 23 for coverage that begins Jan. 1, 2014.
In addition, more than 54,000 residents have started applications that the Exchange describes as “in-process.”
Some residents have been prevented from completing their applications because of problems with the website.
Those problems continued Tuesday, when the exchange took the Healthplanfinder website down most of the day to address problems reported by users.
Exchange spokeswoman Bethany Frey said late Tuesday that the IT staff put the site into maintenance mode to address the slow loading times some users were encountering both Monday and Tuesday.
Applicants frustrated with the website have deluged the customer support center for weeks, but have also run into problems getting their calls answered.
December 2, 2013 at 6:04 PM
Anticipating the coming wave of patients under the Affordable Care Act, Group Health and Bartell Drugs are building three in-store, walk-in retail clinics in Seattle, Bellevue and Ballard. The clinics will be open to the general public and charge a set price for minor illnesses and treatments for common injuries.
The “CareClinics,” staffed with Advanced Registered Nurse Practitioners (ARNPs), will charge $75 per visit for a list of common conditions, including colds and flu, sinus infections, allergies, burns, rashes and cuts, pinkeye, sore throat, head lice, warts, sprains and strains, bronchitis, ear infections and urinary-tract and intestinal infections. Care is available to patients age 2 and over.
The clinic will collect co-payments and bill most insurers for non-Group Health members, and create an electronic medical-record file through Epic, the most commonly used type of system, that can be forwarded to a patient’s primary-care or specialty provider, said Dr. Wellesley Chapman, medical director for the clinics. The idea is to make it convenient and easy for the customer, he said, an concept more common in the retail world than in health care. ”I think we can agree that health care in general is not built around customer service,” he said.
The first site is slated to open in mid-January at Bartell Drugs in University Village. In the next two months, the partnership plans to open clinics at Crossroads in Bellevue and at a new Bartell Drugs in Ballard.
Patients have said they want more choices and more transparency, said Group Health President and CEO Scott Armstrong, who said the clinics are “a sensible extension of the things we’re doing well already.”
Too many patients go to emergency rooms for simple problems that could be easily treated at such a clinic, he said, and a many are admitted for problems that were preventable. “If your goal is to advance the overall health of a population of patients, then you should be doing exactly what Group Health is doing,” he said.
Helen Neville, Bartell Drug’s senior vice president of marketing, said her company, like Group Health, has long valued customer service. And customers were saying they wanted more options for convenient access to health care. “This is the right idea and the right partnership.”
The clinics likely will be open the same hours as the in-store pharmacies, and decisions about expanding the program will be made after a six-month evaluation, the two companies said.
In early January, the partnership will launch www.care-clinic.org for more information.
November 21, 2013 at 6:51 PM
A week ago, President Obama announced a policy reversal that would allow insurance carriers to extend individual health policies that do not meet the standards of the Affordable Care Act.
But within a few hours of the President’s announcement, state Insurance Commissioner Mike Kreidler, a Democrat, said he would not implement the proposal in the state of Washington.
On Thursday, during a hearing of the state Senate Health Care Committee, Republican state legislators had a chance to grill Kreidler about his decision.
Committee chairwoman Randi Becker, R-Eatonville, noted that 290,000 people are in the state’s individual insurance market and most of them have received cancellation notices for their current policies.
She told Kreidler, “I just really want to reach out to the 290,000 people in this state that could have benefited by you at least taking longer than two hours to make that decision.”
Becker asked Kreidler if he contacted the carriers to see if they were interested in extending the canceled policies. “Or did you make the decision that at the end of 2013 their plan just could not continue?”
Kreidler responded that after “serious discussions” with insurance regulators around the country, he did not see how it would be possible to make the changes the President was proposing without major disruption to the state’s insurance market.
“It was clear to me there was only one course of action,” he said. “I can tell you none of the health insurers contacted me, asking me to do that extension.”
“But I look at that as your job,” Becker replied. “You could have reached out to them, but I’m hearing that you did not reach out to them.”
Kreidler conceded that he could have done so. But he stood by his decision. He said the majority of people in the individual market are going to see “vast improvement” in their coverage under the new policies available through the exchange, which are required to cover essential health benefits and cannot discriminate against people with pre-existing conditions.
“The point is, people are calling my home and they are saying, ‘I did not even get a choice,’ ” Becker said. “They’re mad, and so I just want you to be aware of that and hear that from me directly.”
But the committee’s ranking Democrat, Sen. Karen Keiser, D-Kent, said she has been struck by “the lack of outrage” over the canceled plans..
Keiser said members of the Senate Democratic Caucus have received complaints from only 16 constituents. “It doesn’t sound like we’ve got an uprising on our hands of people who want to keep what they had,” she said.
Kreidler added later, “I certainly would have rethought it, Sen. Becker, if we didn’t have a functioning marketplace. But we do have a functioning marketplace, and so we’re a very different category than any other state.”
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