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Health Insurance Exchange Chief at HHS Announces He Will Be Leaving–Who Wants That Job, Really…

Posted Aug 02 2011 7:04pm

I’m not talking about the person holding the job right now at all but rather the responsibly the position has, you can never win here with dealing with all the insurers and their algorithms.  Just as soon as you have one hole plugged, 10 more erupt. It’s the algorithm business today and the way the business world functions and having people in high places today without some on hands Health IT background is tough and they have to rely totally on what they are told from those who do.  Think about that for a moment, Bill Gates and Steve Jobs are coders…look where they are at in the business world and where does our President look for guidance…remember not too long ago his trip to California that was highly publicized? 

I truly hope it’s a smooth transition like the article states, but darn I know better and prefer to be realist when it comes down to mathematics today, as that is what rearranged all the money in this country and the world for that matter.  Now if we entertained certifying some of their algorithms like we do for medical record software then that might plug up a few holes right away as everyone knows what the starting point is.  Again too you have to allow for technology breakthroughs and other software updates to come into play here too so forecasting is difficult and challenging. 

I’m not out of my mind, or at least I hope not but when you see news items such as the 3rd parties getting caught with their algorithms working in strange ways, it’s all there right in front of you.  This is just one example and there are more that come up all the time. 

Med Solutions and Blue Cross Caught On the Stress Test Denial Algorithm (video)

With the medical loss ratios to be met, you know the business world works the algos to find where money and savings can be realized throughout and that’s the way business operates today but sadly it hits many in the pocket book with reduced payment for brokers for one example below and I’m not even touching claims here. 

Medical Loss Ratios Showing Devastating Effects With Health Insurance Agents and Consumers

So what does a person in this position have to look forward to?  Again I feel for this person to make the algorithm madness work.  Government and regulatory agencies have not caught up to where the insurer business is today and it’s game of cat and mouse for profits and algorithms.  I guess to relieve the stress while we wait around for the exchanges, you could go off and play this data collecting game that Aetna devised and gosh knows what that cost and I hope that is not a cost under the medical loss ratios:)

Aetna To Offer Online Game Social Game For Personal Wellness- Joins Humana As They Have An Online Game Called FamScape

So much of what we have today as well is the steroid like marketing that is taking place and where the product, drugs, care or whatever you want to throw in there is somewhat secondary to the money made selling our profiles and data information.  It was nice to see someone on ZD net recently agree with me there.  Walgreens said their data intangible business is worth $800 million, a big chunk of money there.  We need some more tangibles made in the US and reduce our dependency on algorithms a bit for our economics, in other words balance.  I like technology and and what it does too so don’t mistake me for not being a fan because I am, but we are out of balance and the technologists can basically pretty much write and implement any code they want and gets millions funded for doing do.   Algorithms that help produce tangibles are great. 

You have states that are going along and some that don’t want to participate with exchanges so where’s the unison?  They don’t know the algorithms either and where they will play out for profit and fully work to support consumers.   I’ll close this rant with a post that I made back in 2009 and maybe it was a head of it’s time but is it finally time for a Department of Algorithms with some digital eccentric laws with some efforts along that line?  We’re going to choke if we don’t do it soon. 

“Department of Algorithms – Do We Need One of These to Regulate Upcoming Laws?

You can’t win for losing in that job unless you have a deep education on algorithms today as putting the exchanges together will require a ton of algos to make it work and requires more than just decisions but rather a lot of patience, hair pulling <grin> and what ever else you want to toss in there as the insurers will alter and adjust theirs which in turn will affect the entire structure of the program so there’s a ton of back and forth effort here with the algorithms.  I hope we are lucky enough to get someone with “nerves of steel” and at least a partial background as an “Algo Man” to fill these shoes.  BD  

WASHINGTON, Aug 2 (Reuters) - The official charged with overseeing the creation of U.S. state-based health insurance exchanges is stepping down at a critical juncture for the Obama administration's healthcare overhaul.

Joel Ario, director of health insurance exchanges at the Department of Health and Human Services, is leaving his job just as states begin to get guidelines for setting up the exchanges, HHS officials confirmed on Tuesday.

"It would certainly shake things up for the states who have had a very good working relationship with Joel, especially when we are all feeling the pressure to move forward ... so we can have our state-based exchanges up and running in 2014," Kansas Insurance Commissioner Sandy Praeger said in a statement.

"We're going to have a smooth transition. He's not leaving tomorrow," Larsen told reporters after a hearing on Capitol Hill when asked about Ario's departure.


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