New Enrollment Numbers and a Silly New Controversy

Data from Georgia’s Insurance Commissioner indicates that insurers received 221,604 applications through the marketplace through the end of March. Premiums had only been received for 107,581 of those policies by March 31st, covering 149,465 lives. Given that more than twenty percent of the total enrollment occurred in the last two weeks of March it is likely that the final number of covered lives is likely to be higher. About two thirds of paid enrollees through the exchange are receiving subsidies.

When all is said and done the numbers of individuals covered through the exchange reflect about 40% of Georgia’s individual insurance market. Especially in Georgia however many of those who had coverage in the individual market continued with that coverage purchased outside of the marketplace.

What is not yet know is how many of those who purchased coverage in the marketplace were previously uninsured. The Rand Corporation’s survey completed in mid-March estimated that …

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Nothing is Certain Except Death and Taxes (and ObamaCare Ain’t Helping)

taxesIn a 1789 letter from Ben Franklin to Jean-Baptiste Leroy, Mr. Franklin said “… in this world nothing can be said to be certain, except death and taxes.”

Yes, it’s that time of year again. Tax time.

This is second year of what will likely be annual occurrence: increased taxes to pay for ObamaCare.

You see, when the President and Congress “cooked” the budgetary scoring for ObamaCare. President Obama stated in a joint session of Congress in 2009 that ObamaCare would cost $900 billion over ten years. More specifically, he said, “Now, add it all up, and the plan that I’m proposing will cost around $900 billion over 10 years.”

However, just a few weeks ago, the non-partisan Congressional Budget Office (CBO) has revised its cost projections. At $2.6 trillion, the new price tag is almost three-times more than what president promised.

So how are we going to pay for ObamaCare. You guessed it: Higher taxes. And once again, Ben Franklin was correct. Nothing is …

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It’s a Good Time to be in Healthcare Technology in Georgia

It’s a good time to be in technology in Georgia, especially healthcare IT, according to the latest State of the Industry report from the Technology Association of Georgia. Several of the reports’ takeaways highlight sentiments shared with me by Tee Green, CEO of Greenway Health. I had the opportunity to recently chat with him about what it means to lead a company in a state devoted to sustaining the title of the “Nation’s Capitol of Healthcare IT.”

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All Georgia Taxpayers Lose When the State Refuses to Expand Medicaid

There is legislation close to passing the Georgia legislature (it may already be passed by the time this is published) that prohibits “the state nor any department, agency, bureau, authority, office, or other unit of the state nor any political subdivision of the state shall expend or use moneys, human resources, or assets of the State of Georgia to advocate or intended to influence the citizens of this state in support of the voluntary expansion by the state of eligibility for medical assistance under” Medicaid. Its not clear what this legislation actually does, (its not clear it’s authors know what it does), but it could limit the state’s ability to actually run the existing Medicaid program, and perhaps it could prohibit public university professors from answering simple questions about the Affordable Care Act. Is it “advocating or influencing citizens” to report simple facts?

The simple fact is that expanding Medicaid under the Affordable Care Act makes every …

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Georgia’s Health Information Technology Industry: Making A Difference Everyday

health-info-techA couple of weeks ago, a group of health information technology leaders from around the state came to Atlanta to celebrate “Georgia Health Information Technology and High Tech Day at the Capitol.” Georgia State Senator Brandon Beach, Chairman of the Science & Technology Committee, welcomed over 100 Georgians to the State Capitol and talked about Georgia’s status as the nation’s “Health Information Technology Capitol.”

Georgia-based health information technology companies are a serious economic engine. The health IT industry generates more than $4 billion in revenue each year and provides over 15,000 jobs in Georgia. There are more than 186 health IT companies which call Georgia “home.”

And, the health IT industry in Georgia is growing. Georgia’s health IT businesses are growing at a phenomenal 40 percent rate, creating more jobs, more investment and more revenue for Georgia.

Georgia’s health IT industry boasts the likes of heavyweights McKesson Technology …

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Georgia Takes Center Stage at World’s Largest Health IT Conference

HIMSS is well known for putting on the largest conference in the world dedicated to health IT. For the third year in a row, the state of Georgia – the only state to do so – has had a pavilion in the exhibit hall to showcase just a few of its many health IT companies. I had a chance on the HIMSS show floor to talk with Carol Henderson, Director of Health Sciences and Advanced Technologies at the Georgia Department of Economic Development, about the advent and growth of the pavilion, and why it sets such an example when it comes to showcasing Georgia as the nation’s capital of health IT.

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It is that Time Again

It is that time again when the Office of Inspector General (“OIG”) publishes its Work Plan for the fiscal year outlining the areas of focus that it will investigate. The Work Plan highlights the OIG’s top priority to “fight fraud, waste and abuse”. The OIG’s strategic plan for fiscal year 2014 through 2018 specifically references using data analytics and risk assessments to identify suspected fraud, waste and abuse. The OIG also utilizes enforcement resources, including, but not limited to its partnership with the Department of Justice to impose penalties and potential criminal or administrative actions against individuals or entities who have allegedly committed fraud. All healthcare providers are subject to the OIG’s enforcement actions. Accordingly, it is imperative for each healthcare provider to establish an effective compliance program. Healthcare providers should utilize this Work Plan to establish what types of audits should be conducted during the …

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Time is Running Out for ICD-10

ICD-10 is not a bad word but sometimes it sounds like one. The estimates for cost of transition from ICD-9 to ICDE-10 in a small practice is expected to range from over $50,000- $80,000 according to the Nachimson Advisors Studies. However, many providers continue to drag their feet hoping the cost will go away but, from all indications, it won’t this time. The deadline for implementation of the new codes is October 1, 2014.

ICD-10 is the International Classification of Disease tenth revision. This is a coding system created by the World Health Organization that codes for diseases, signs, symptoms, complaints, social circumstances, and other clinical descriptions that are documented in the medical records of hospital and ambulatory medical settings. Most people relate the coding to medical billing. When your physician accurately codes to support clinical services this can lead to better financial reimbursement for their medical practice. Most importantly it can correctly …

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Obamacare: Two Steps Forward, One Step Back

Friend and fellow blogger, Wayne Oliver, give a harsh critique of the Affordable Care Act (ACA) / Obamacare.  I felt compelled to respond and add my thoughts to the conversation, from the perspective of an executive working in the industry.

To begin, I think it fair to say that most people don’t fully understand the law.  Last September, the Washington Post stated that 62 percent of Americans said that they don’t have the information they need to understand the law.  Furthermore, most Americans, or 55%, disapprove of the way the President is handling the implementation of the new healthcare law.  So, it’s not a surprise that there has been loud objections by pundits and general disapproval by the public.  It is a complex law and, by most measures, the Administration has done a poor job of explaining it.  Yet, it doesn’t mean that there isn’t substance there.  In fact, a number of changes have already helped millions of average Americans and has the potential …

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ObamaCare: One Step Forward, Two Steps Backward

flaD AND STETHISCOPEI have been rather vocal in my opposition to the Affordable Care Act (or ObamaCare). There have been too many problems, too many issues and too many unintended consequences.

According to a report released this week by the non-partisan Congressional Budget Office (CBO), ObamaCare will “reduce the supply of labor by the equivalent of roughly 2.3 million full-time workers through 2021.”

Just as the economy is attempting to recover, we are moving forward with the implementation of a federal healthcare disaster that will kill even more jobs.
There is some good news. There is a new, legitimate “repeal and replace” movement led by US Senators Orrin Hatch (R-Utah), Richard Burr (R-NC) and Dr. Tom Coburn (R-Oklahoma). This “repeal and replace” effort has substance and includes many thoughtful, private sector based reforms and includes some of the provisions of ObamaCare that address access to health coverage.

The new Patient CARE (Choice, Affordability, …

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