How Is Network Health Cutting Its Premiums 15%?

Network Health president Christina Severin

Stop the presses! Somebody’s health insurance premiums are actually going down!!

Network Health, a managed care plan owned by Cambridge Health Alliance, has just announced that as of July 1, its Commonwealth Care plan will cut its premiums by 15%. The cut will bring Network Health to the same price level as Celticare, which, with about 15,000 members, had been the only “lowest cost” Commonwealth Care plan. Now both will share that designation.

The announcement is timed to appeal to potential members during the open-enrollment period for Commonwealth Care, the state-subsidized health insurance for people with low and moderate incomes. The Network Health plan currently serves about 44,000 members, who’ll generally see a drop in monthly premiums of between $10 and $30.

WBUR’s Martha Bebinger reported in April that “plans that cover moderate-income residents through Commonwealth Care are holding rates flat by limiting where patients can go, negotiating tougher contracts with hospitals, and with better oversight of the sickest patients.”

In fact, The Globe reported then that the proposed limited-network contract from Network Health excluded all hospitals in the (expensive) Partners HealthCare system except two.

But that was when the news was about holding rates flat. Network Health is going a step further with its 15% cut, and I asked the plan’s president, Christina Severin, today how they were doing it.

She declined to discuss “exclusions,” like the Partners limits reported by the Globe. In general, she attributed the rate cuts to three main factors:

-Network Health had already been working “extremely hard” to control costs. In the current fiscal year, it had already seen zero growth in its medical expenses.

-Of the 15% cut, 10 percent comes through a “high value network”

-and 5% through “medical expense management.”

In other words, 10% from using lower-cost (though still high quality) facilities and 5% through the kind of proactive “care management” that keeps patients in better shape and thus avoids unnecessary expenses.

Christina provided a few telling examples of Network Health’s efforts at care management: Continue reading

Health Insurance Hassle: Massachusetts Portal Can’t Handle Macs

If Franz Kafka were writing in 21st-century Massachusetts, he might have penned a tale like this:

J., an educated and technologically capable man, went online to the state’s “health information portal” hoping to create an electronic account for Commonwealth Care, a subsidized insurance plan. He entered his name, social security number and date of birth. But the site spat back at him, “ReferenceError: Can’t find variable: ActiveXObject.” He tried again, and yet again. Finally, he called the functionaries responsible for the site, and after many minutes untangling the bureaucracy, received this answer: You cannot create an account on a Mac. You cannot use Firefox or Safari or Google Chrome. You can only use Microsoft’s Internet Explorer. This is a problem we hope to fix soon.

Sadly, Kafka is not here to do it justice, but this tale is true. When Jeff, a Hyde Park resident, first shared it, I confess that I doubted him. Can’t be! When was the last time I heard of an official Website that could only work with certain browsers? A decade or so ago??

So I tried it, on a Mac. I got the same error message. Try it yourself using Safari, Firefox or Chrome. Here’s the link. Hit the “Log In” button for Commonwealth Care, then try to Create a Login.

I called the Connector, the agency that helps Massachusetts residents shop for and obtain our (mandatory) insurance, and that manages the site that contains the health information portal. To be clear: You can use any browser to shop for and compare insurance on the Connector’s user-friendly site. And you cannot sign up with any browser for the Commonwealth Care program; you have to do it by mail. But if you’re already signed up and want to manage your account, you need Explorer.

Spokesman Richard Powers confirmed that the portal, which launched in June 2010, can only work with Microsoft’s Internet Explorer. The vendor that created it was Dell, he said. In his words:

“Our vendor’s product was initially written exclusively for Microsoft products and, in that sense, was somewhat outdated. It has always been their intention to upgrade the system to be compatible with other browsers such as Firefox 3.6, Apple Safari 5.0 and Google Chrome 9.0. We’re hoping to have that work completed by the end of the summer.”

Um — “somewhat outdated”??! Flamers, where are you? What do you have to say about a state that creates a Website in A.D. 2010 that cannot interact with any browser but Explorer? Please comment below. I can tell you that in an informal poll of the tech types I know, the word I heard most often was “Ridiculous!” The close runner up was “You’ve got to be kidding!” Though, they say, it’s not at all unheard-of, it’s just outdated.

Again, any browser can be used to explore and shop for insurance on the Connector’s broader site, Richard Powers emphasized. It’s just the “health information portal” — which about 36,000 Commonwealth Care members use to register, pay a premium or change a health plan during open enrollment — that has the browser limitations.

Sounds like a nice, convenient online interface — if you have a PC, that is. Jeff messaged CommonHealth: Continue reading

Mass. ‘Connector’ Chief Decries Prospect of Health Law Repeal

Connector chief Glen Shor

In his monthly message, just out today, the director of “The Connector” says that repealing federal health reform would be a “costly mistake,” bad for Massachusetts and even worse for other states.

Glen Shor, who runs the “Commonwealth Health Insurance Connector Authority Board” — the independent state agency that acts as an insurance broker of sorts in the post-health-care-reform era here in Massachusetts — writes:

Although repeal of national reform would not undo any of the provisions of our landmark 2006 Massachusetts law, it would have many downsides for our state.

First off, it would deprive Massachusetts’ residents and employers of a number of immediate benefits of national reform. Tax credits for small businesses would be repealed. We all know that small employers have been struggling with the cost of health insurance for their employees and need and deserve a helping hand. Senior citizens who find themselves in the donut hole will not get promised assistance with prescription drug costs. A provision in the new law that does away with co-pays for preventive care would be cancelled. New funding for community health centers would disappear. And the expanded protections allowing more young adults to remain on their parents’ health plans until the age of 26 would likewise be terminated. Continue reading

Blogger Calls Mass. Connector ‘Legal Pit Bull’

Fightin’ words from John Goodman of the National Center for Policy Analysis, on his blog here, taken largely from a Boston Herald story of Nov. 17. Goodman posts:

Massachusetts’ health insurance connector has turned into a legal pit bull by aggressively going after a growing number of Bay Staters who say they can’t afford mandated insurance:
The Commonwealth Health Insurance Connector Authority is cracking down on more than 3,000 residents who are fighting state fines of up to $2,000 a year.
All told, more than 7,700 people have appealed state fines for not having health insurance.
The agency has hired several private attorneys at $50 an hour to hear many of the appeals, and some 3,150 of them have been denied — and the losers told to pay up.
The connector has also hired the Hub law firm Bowman & Penski — at $125 an hour — to defend itself against 13 lawsuits filed by fed-up taxpayers who insist they can’t afford state required insurance premiums or the escalating fines.

(My first reaction: Wow, where did they find lawyers to work for so cheap?!?)
Mr. Goodman’s piece prompted several comments, including this one:

…If you drop the mandates, you also have to drop the continuously avaliable guaranteed issue requirement, or everybody in the state will start gaming the system. No one will insure unless he is sick.

Questions for ‘Connector’ Chief Glen Shor?

'Connector' Chief Glen Shor

Anything you’re burning to ask the new executive director of the “Commonwealth Health Insurance Connector Authority Board,” better known as The Connector? It’s the independent state agency that acts as an insurance broker of sorts in the post health care reform era here in Massachusetts, and we’re slated to meet with its new chief, Glen Shor, late this afternoon for his first in-depth interview since taking the job. Post your question as a comment on this post, and we’ll do our best to get an answer and write it up tomorrow.