Insurer quality ratings due in 2014

The board of California’s health insurance marketplace voted to display carrier quality ratings in next year’s open enrollment period. The Covered California management wanted to wait until October 2015.

The state Obamacare exchange made negative headlines in the past week for not offering quality ratings of health plans it handles. While not news — the ratings decision was addressed and explained last summer — Kaiser Permanente and two other insurers made public a letter sent to the Covered California board saying “there has never been a compelling reason to deny this information to consumers.”

Kaiser rates 4 out of 4 stars in the current ratings, available on the Office of the Patient Advocate web site.

Covered California said the available ratings would reflect past performance of health care providers’ services that would not be reflective of their revised offerings under the Affordable Care Act. Another issue was availability of ratings for all carriers of Covered California health insurance providers.

Covered California chief Peter Lee (pictured) said the outdated and incomplete ratings could give an unfair advantage to some insurers (primarily Kaiser) and possibly confuse consumers.

Lee told the board Oct. 24 that he “wrestled” with the issue because of the three insurers’ good work, but didn’t want to recognize Kaiser and the other two — West Health and Sharp — “at the expense of having fewer people enroll in Covered California and misleading them into thinking those other plans and other options are bad quality.”

Board member Susan Kennedy responded: “I understand the argument about misinterpretation and fairness, but I think we have to err on the side of being fair to consumers first and foremost.”

The board’s vote was to move ahead for 2014 instead of 2015.

Meanwhile, Lee told the board the SHOP marketplace for small business was in operation, but enrollment wouldn’t begin until mid-November. John Arensmeyer, CEO of the Small Business Majority group, cited “pent-up demand” and told the board: “If we don’t get that up by mid-November, it could be a big problem.”

Lee reviewed the Oct. 1, launch of Covered California enrollments, and noted any missteps were “fodder for headlines for failure” of Obamacare. “We are three weeks into the first month of a six-month opening enrollment period for a system that sets up the next 100 years of health care in California,” Lee told the board. “We are not perfect. But we are doing a pretty darned good job.”

Covered California’s web site continues to have issues, but they’re considered relatively minor in light of the disastrous launch of the federal Obamacare site.

Blue Shield of California, Health Net and Anthem Blue Cross supported the staff proposal to delay the quality ratings another year, as stated in Covered California’s brief to the board: “The earliest anticipated presentation of (quality ratings) information is open enrollment of 2015 and will include all plans offered on the Exchange.”

The August policy memo stating the decision to delete the quality ratings said “it was not possible to consistently and credibly make this similarity comparison for each health plan participating in Covered California in time for the deadlines associated with the (2013) open enrollment.”

The staff briefing paper of Oct. 24 said:

The overriding concern was not about the scoring performance itself, but that the use of historic performance could not accurately and reliably represent their future Exchange performance in large part due to differences in network composition and in some cases to differences in member attributes.