Insurers Getting Faulty Data From U.S. Health Exchange

[Purveyor]

By Drew Armstrong and Alex Nussbaum - Oct 8, 2013

Insurers are getting faulty and incomplete data from the new U.S.-run health exchange, which may mean some Americans won’t be covered even after they sign up for an insurance plan.

While it’s not clear how widespread the problem is, the reports from industry consultants are the first hint that the technical troubles faced by consumers trying to enroll in health plans under the Affordable Care Act may also be hitting the insurers. The companies are receiving electronic files that can’t open or have so much missing information on new enrollees they’re unusable, the consultants said.

Some insurers have been forced to fix entries by hand, said Bob Laszewski, an insurance-industry consultant based in Arlington, Virginia.

“If we don’t see substantial improvement by the end of this week, then I would throw up the yellow flag,” said Dan Schuyler, a consultant advising states and insurers on the exchanges. “If we don’t see it in the next two to three weeks, it’s time for red flags. The concern is some people could get to Jan. 1, and not have coverage.”

more...

http://www.bloomberg.com/news/2013-10-08/insurers-getting-faulty-data-from-u-s-health-exchanges.html

[Kelvin Mace]

1. Come on people...

We had plenty of time to prepare for this. Overloaded servers I can understand, but corrupt or incompatible data formats?

No. Just no.

[PoliticAverse]

2. This is why software projects need a beta testing period. Consider that October. n/t

[Puzzledtraveller]

4. Too many disparate systems trying to communicate together.

I have been a SNAP and Medicaid worker for almost 5 years. When I began I could not believe how outdated our systems were. I was also surprised to learn that there is no unified system to check eligibility and verify information. For example, each state has a closed system for SNAP, there is nothing at all to inform us if applicants are receiving benefits in another state. Our Medicaid application system uses the same one as our SNAP. It suffers from the same limitations. We have recently undergone a transition to a newer system and even still we do not have full compatibility for programs and data sharing. It was an eye opener when I began working there.

[Kelvin Mace]

9. This is the problem plaguing the VA and SS as well

One day, they will join the 21st century.

[uponit7771]

6. One outside vendor not translating data != HOF time "While its not clear how widespread the problem"

... = .... lets use the outliar to define the norm by lazy MSM

[SunSeeker]

7. "the numbers...have been small enough that insurers can fix bad data file by file"

No need for setting hair on fire just yet. Also, I don't see where in the article it says there are "incompatible data formats"; there's always going to be a small percentage of corrupted files (like there is now, and which the article notes is small enough to allow fixing by the insurers) and problems with people who are signing up but not providing all the information requested on the website.

This tends to happen when a website is deluged, such as occurred recently with Grand Theft Auto V (see my post #3 below), and THAT company has done this before, yet they still screwed up.

More servers have been added and things are getting better, as the article notes. No reason to discourage people from the website--or worse--telling them not to sign up for health insurance (not sure what you mean by "No. Just no.&quot .

[Kelvin Mace]

8. What I meant

Was no, this is not acceptable. Just no.

Correction: I meant "incomplete", not "incompatible".

By all means I want people to use the sites, but every screw up gives ammunition to the enemy, and they had amply time to prepare for this.

Cecily Strong said it best on Weekend Update:

Loser, the ObamaCare website. Which had technical issues all week because of too much web traffic. You can't campaign on the fact that millions don't have health care and then be surprised that millions don't have health care. How could you not be ready? That's like 1-800-Flowers getting caught off guard by Valentine's Day.

[SunSeeker]

14. Ah yes, Cecily Strong, SNL's healthcare exchange Website expert.

You mean, like Grand Theft Auto selling 15 million games and not expecting 15 million people to try to log on to use them?

Here, the exchanges were supposed to be primarily run by the states, and for the states that didn't want to screw their citizens, those state exchange websites are working relatively well, as the article notes. The federal exchange ended up with more traffic than anticipated and budgeted for after more red states than anticipated refused to set up their own exchanges, and amazingly thereby refused huge amounts of free Medicaid money, leaving their citizens to the federal exhange website.

Plus, the media and trolls went on the website as well, which didn't help matters. That will die down and the websites will get easier to access. They already are getting better.

[Kelvin Mace]

18. Hey, its humor

We don't require Jon Stewart to be an expert on every topics he comments on.

I am hoping you are correct.

[SunSeeker]

3. The private sector is no better; Grand Theft Auto's servers crashed when hit with a similar deluge.

And that is after they got a clear heads up to anticipate the number of people that would log on to the Grand Theft Auto website, since they sold over 15 million Grand Theft Auto V games by the end of September, and knowing those folks would be attempting to log on a week later per instructions for the game. They had a whole week to add more servers, beef up their website, etc., yet failed to do so. They sure as hell can't blame it on lack of resources like the government can; the company took $1 Billion within three days of GTA V going on sale. That's ALL this company does, and has plenty of resources, and yet they still screwed up.

http://www.bbc.co.uk/news/technology-24335528

[Pretzel_Warrior]

5. It's day 8, you people who love to freak out. Don't trust

Insurance companies. Someone on government side needs to go audit what insurers are actually receiving/seeing.

They would love to be taking in premiums and then saying "oops! You're not covered".

We need to strangle these companies out of existence.

Fuck you, Blue Cross, United Health Care, and the whole lot of you!

[Fla Dem]

10. Aetna, Cigna, Humana and UnitedHealth Group, four of the biggest for-profits, are not

planning to participate in many of the marketplaces, it's because they know they cannot be competitive and still satisfy the profit expectations of their shareholders."

http://readersupportednews.org/opinion2/272-39/19727-beginning-of-the-end-for-major-health-insurers


I'm sure some of the issues are with the nonprofit health insurers, including the brand new co-op plans that were created.

[kelliekat44]

11. Just wonder how much of this is sabotage? nt

[chill_wind]

12. Still testing..

"The U.S. is still operating a parallel testing website that was meant to help iron out problems before the Oct. 1 opening."

[grantcart]

13. Bob Laszewski

So I google one name from it and what do I find:

Bob has the thinnest of resumes but the two references he has are Koop and the McLaughlin Group.

And amazingly Bob knew about this a year ago. Here he is put on a panel because he is a skeptic against the ACA:

http://www.politico.com/multimedia/video/2012/10/politico-pro-health-care-luncheon-10-4-12.html

and here before the launch

http://healthpolicyandmarket.blogspot.com/

The country is so cynical about Obamacare that any more screw-ups will only add to that cynicism. The administration has been saying that the prices for the insurance plans are a lot lower than expected and that there will be plenty of good access to a wide variety of providers for these prices.

The administration hasn't managed expectations––it is has spun them.

or

I will tell you that Romney and Ryan have taken the more courageous political stand—they say Medicare can’t be preserved and big fixes have to happen. Now, that doesn’t necessarily mean they have the right policy answer only that they are willing to face the problem.

...

Romney and Ryan are now proposing a very different system where health plans have to bid their price in each market. They argue that competitive bidding will result in real competition in the market and, with consumers now having a greater incentive to shop their limited premium support payment from the government, costs can be controlled.

They see a senior market where health plans, including the traditional Medicare program, will have no choice but to work harder to manage costs by using all of these new devices and payment systems where millions of seniors will be intently looking for affordable care.

So let me ask one question:

Why should we be giving any credence to stories that are filled with RW hacks?

[SunSeeker]

15. Amazingly, the right wing seems to have no trouble getting into OP's on DU. nt

[grantcart]

16. Well to fair only a couple of dozen of us have been cleared to have the top

secret Google program.

I probably shouldn't even have shared the name of the secret search engine with you.

[Purveyor]

17. LOL

[Pretzel_Warrior]

20. Just laughter? No mea culpa?

[Purveyor]

22. 'mea culpa' for what, posting an article from the widely read and recognized Bloomberg News?

Hope you are not waiting...

[ProSense]

21. Krugman

nailed it. The RW is still trying to portray Obamacare as a failure, but now that it has reached enrollment stage, they're harping on glitches. Bottomline: People are rushing to sign up.

Reform Turns Real

By PAUL KRUGMAN

At this point, the crisis in American governance has taken on a life of its own. Some Republicans are now saying openly that they want concessions in return for reopening the government and avoiding default, not because they have any specific policy goals in mind, but simply because they don’t want to feel “disrespected.” And no endgame is in sight.

But this confrontation did start with a real issue: Republican efforts to stop Obamacare from going into effect. It’s long been clear that the great fear of the Republican Party was not that health reform would fail, but that it would succeed. And developments since Tuesday, when the exchanges on which individuals will buy health insurance opened for business, strongly suggest that their worst fears will indeed be realized: This thing is going to work.

Wait a minute, some readers are saying. Haven’t many stories so far been of computer glitches, of people confronting screens telling them that servers are busy and that they should try again later? Indeed, they have. But everyone knowledgeable about the process always expected some teething problems, and the nature of this week’s problems has actually been hugely encouraging for supporters of the program...let me say a word about the underlying irrelevance of start-up troubles for new government programs.

Political reporting in America, especially but not only on TV, tends to be focused on the play-by-play. Who won today’s news cycle? And, to be fair, this sort of thing may matter during the final days of an election...Obamacare isn’t up for a popular referendum, or a revote of any kind. It’s the law, and it’s going into effect. Its future will depend on how it works over the next few years, not the next few weeks...the glitches of October won’t matter in the long run. But why are they actually encouraging? Because they appear, for the most part, to be the result of the sheer volume of traffic, which has been much heavier than expected. And this means that one big worry of Obamacare supporters — that not enough people knew about the program, so that many eligible Americans would fail to sign up — is receding fast...it’s important that people who want to sign up can actually do so. But the computer problems can and will be fixed. So, by March 31, when enrollment for 2014 closes, we can be reasonably sure that millions of Americans who were previously uninsured will have coverage under the Affordable Care Act. Obamacare will have become a reality, something people depend on, rather than some fuzzy notion Republicans could demonize. And it will be very hard to take that coverage away.

- more -

http://www.nytimes.com/2013/10/04/opinion/krugman-reform-turns-real.html

http://www.democraticunderground.com/10023789871

[FarCenter]

19. The other issue is whether the data entered, eligibility rules, and premium computations are right

Presenting a product -- an insurance policy -- isn't the hard part. The hard part is figuring out which federal and state programs and tax credits a person or family is eligible for. Getting that part right takes creating an extremely complex rules engine.

About 1,700 individual rules affect eligibility for health insurance subsidies in Oregon. Children might qualify under different rules from their parents, or half-siblings might have different eligibility based on their parents' income. In Oregon, writing the eligibility rules engine took 12 people nine months. Confirming eligibility requires integration with multiple outside data sources, such as confirming income and citizenship with federal sources, and that process is what separates it from ecommerce sites.

"When you go to Amazon you're not applying to get a product for free if I say what my income was last year and what I think it is going to be next year and who I'm related to and all those type of things," says Karjala.

http://www.informationweek.com/healthcare/policy/obamacare-health-exchanges-how-oregon-go/240162074

The thing about projecting 2014 income sounds a lot like the "liar loan" of mortgage crisis fame.