<p>Texaspg, these are projections…subject to change. :)</p>
<p>I dont have the national information.</p>
<p>According to this report for Cal…
Approximately…half the newly insured are going to sign up on the exchange. Half on medi-cal.</p>
<p>About 45 percent of signees will be the formerly uninsured.</p>
<p>Page 65, 66…etc…</p>
<p><a href=“http://economics.mit.edu/files/6404[/url]”>http://economics.mit.edu/files/6404</a></p>
<p>The state of Washington is doing very well. The state has a good shot at meeting projections.</p>
<p>What is also cool is the state publishes the amount of signees that actually pay. There is going to be a lag between the time people signup and pay.</p>
<p>This is a great site.</p>
<p>Takes the mystery out of ACA signups though.</p>
<p>[Affordable</a> Care Act (aka Obamacare) Health Insurance Signup Chart](<a href=“http://acasignups.net/]Affordable”>http://acasignups.net/)</p>
<p>69,000 people from Washington have enrolled but not paid up yet. Not a surprise.</p>
<p>I dont see 7,000,000 signups scross the country by Mar 31. I dont see 1.3 million signups in California.</p>
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<p>I can’t say for sure but from looking through a few MD/MPH programs, it looks like they just focus on the core classes (Epid, Biostats, Environmental Health, Health Policy, and some sort of behavioral science) + a few electives (2 semesters total, most of which are core classes) whereas the 2 year MPH programs generally have those + more required classes + a field placement/internship (so 3-4 semesters total). Yes, it does seem like they’re getting some credit from their MD classes. </p>
<p>Most MD/MPH programs are not CEPH/APHA certified. Which means it’s great for those who just want the additional training to work in community health, low-resource settings, or they want to move into some kind of administrative role. However, it’s not good for PH professionals who want to go into PH roles. Many PH jobs have a requirement that you have a MPH from a CEPH certified program. </p>
<p>As for my own classes, I don’t personally know any MD students. However, there is a Public Health Certificate that I think more MD students pursue. They have special classes open to them (such as weekend or online classes) that are not open to us. They have the same course title but have slightly different syllabi so I’m not sure what the difference is. I do know plenty of BSNs who want to work in administrative roles or who are looking to work in some place other than a traditional hospital.</p>
<p>ETA: You also need 42 credit hours to be CEPH certified which rules out one-year programs for certification without using previous credits.</p>
<p>Edit 2: I do have a family friend who has been a gastroenterologist for almost 20 years who is currently pursuing a traditional MPH at Ohio State. She wants to stay in medicine but no longer wants to continue practicing in a clinic. Her last employment was in a VA hospital and she wants to move up within the VA system into an administrative role. I’ll have to ask her if she knows any other MDs who have taken the same path… I just don’t know any in my specific program.</p>
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<p>Just to pile on the thread drift: not quite. </p>
<p>The two Big Kahunas in Public Health, Hopkins and Harvard, both offer an MPH in one year. (The former requires a summer start.) Of course, the differentiating factor is that neither school will accept a student into their MPH program without an advanced degree or years of significant work experience. Carolina, another high ranked program has similar requirements.</p>
<p>You’re correct, BB, but isn’t their previous experience/coursework counted towards that 42 credits? Or do they do summer classes? </p>
<p>In my mind, I was thinking one year = 2 semesters but if they have a summer/fall/spring program then it could be one year (I know one of the schools I got in to did this- I think it was Tulane?)</p>
<p>ETA: I just looked it up- Johns Hopkins is a year-round program. My mistake… stuck in a Fall/Spring frame of mind :)</p>
<p>Romani, what do you want to do with your mph?</p>
<p>I want to work in sexual/reproductive health. Ideally, I want to work to improve access to contraception and family planning methods (and knowledge) within communities at every level. I was originally interested in working in low-resource communities abroad (and I am pursuing my global health certificate) but recent events have highlighted the need for this type of work domestically. </p>
<p>I just was on a team that designed an intervention pilot program to increase LARC use among high school girls in a low-income magnet school in a major city. I really enjoyed it. I think I might be moving towards working with adolescents rather than adult women. </p>
<p>I’d be happy doing anything that improved maternal & child health though. </p>
<p>I truly did not mean to hijack this thread. Ask BD, I even moved it to PMs last night lol.</p>
<p>:)…</p>
<p>Romani…nice. Good luck.</p>
<p>Small business owner here—After working with a Insurance Broker, we found a cheaper and better health insurance than what’s offered on the NYS Marketplace. We will have lower deductibles and a wider network of doctors than the programs offered through the ACA. The programs offered on the NYS Marketplace stink for health care in our area. I don’t know of one local doctor accepting the plans. For example, although they accept BC/BS via independent purchase, they won’t accept the BC/BS plan offered on the through ACA.</p>
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That’s probably illegal. (I’ll look it up when I have time – but I’m pretty sure that some medical providers are going to be in deep trouble if they think they can pick and choose among their patients depending on whether they purchased otherwise identical policies on or off exchange). I believe that the ACA requires insurers who are participating in the exchange to also offer the same policies off-exchange – so I can’t fathom that it would allow medical providers to then use information they can glean off of the plan number or id card to shut the door on lower income patients to punish them for getting subsidies.</p>
<p>nysmile, is the plan you are buying ACA-compliant?</p>
<p>Yes it is fully compliant with the ACA—better coverage, lower deductible, wider network of doctors in our area. It’s not illegal for a doctor to accept one version of a plan and not another. The plans bought through the marketplace reimburse the doctors less than those bought through the individual marketplace. They have the choice to accept the plan or not. Why the heck should they accept a plan that pays pennies compared to a plan that reimburses them more money? A doctor can accept one tier of insurance from let’s say, BC/BS and not one of the lower tier plans from the same company.</p>
<p>The insurance plan we purchased for our very small business is the same purchased by a big bank in the area for their employees (they have quite a few branches). It starts Jan. 1 so we’ll see how it goes.</p>
<p>Way off topic, but on the MHA question – My d. looked at Hopkins and I know that she determined early on that she did not have the requirements for admission-- JHU has both a MHA and an MPH program – admission to the MPH program requires “two years of post-baccalaureate health related work experience or a doctoral degree in a field underlying public health.”</p>
<p>My d. did end up applying to a different program - I’m guessing the MPP program – but opted for a different school. But the point is that the various labels can be confusing, but I think the Hopkins MPH is specifically geared to be a fast, intensive program for people who already have considerable work experience in public health. Hopkins offers a combined MD/MPH but NOT a combined MD/MHA – more info about differences between MPH/MHA at JHU here: [FAQs</a> - Master of Health Administration - Degree Programs - Health Policy & Management - Departments - Johns Hopkins Bloomberg School of Public Health](<a href=“http://www.jhsph.edu/departments/health-policy-and-management/degrees-programs/master-of-health-administration/faqs.html#FAQ9]FAQs”>Health Policy and Management | Johns Hopkins | Bloomberg School of Public Health)</p>
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<p>ACA specifically requires that the insurers offer the SAME plans off the marketplace as are being offered on marketplace. The insurers can optionally offer additional plans as well, but they cannot play games about the coverage for the marketplace-equivalent plans, and certainly cannot offer differ provider reimbursement rates based on whether or not the patient bought directly from them or via the exchange.</p>
<p>nysmile, so what I don’t understand is why the insurers aren’t offering the same plans on the exchange and off the exchange. I realize that it’s their choice but what advantage is there to offering a worse plan on the exchange for the same price?</p>
<p>It’s because of doctors not wanting to sign up for the exchange plans isn’t it? They come with lower reimbursements and piles of paperwork. So docs are opting out.</p>
<p>I have no idea. I can say for sure that many local doctors here are not taking plans off the marketplace. In our area, some (most) are listed as accepting the platinum tier and not the lower tiers. </p>
<p>We used a broker. The plan we purchased for our business through him is cheaper and provides better coverage in our area than anything offered on the marketplace. We also made sure it included Stony Brook and Sloan Kettering (just in case) as well as our current primary care physicians and specialists. We also don’t need referrals with the plan.</p>
<p>CF, the appropriate question to ask is whether the plan is “qualified” - see: [url=<a href=“http://www.law.cornell.edu/uscode/text/42/18021]42”>42 U.S. Code § 18021 - Qualified health plan defined | U.S. Code | US Law | LII / Legal Information Institute]42</a> USC § 18021 - Qualified health plan defined | Title 42 - The Public Health and Welfare | U.S. Code | LII / Legal Information Institute<a href=“law”>/url</a>
[url=<a href=“http://www.law.cornell.edu/cfr/text/45/part-156/subpart-C]45”>45 CFR Subpart C - Subpart C—Qualified Health Plan Minimum Certification Standards | Electronic Code of Federal Regulations (e-CFR) | US Law | LII / Legal Information Institute]45</a> CFR Part 156, Subpart C - Qualified Health Plan Minimum Certification Standards | LII / Legal Information Institute<a href=“regulations%20governing%20qualified%20health%20%20plans”>/url</a></p>
<p>ALL new plans sold after 2014 must provide the minimum essential benefits specified by the law, but not all plans can be certified to fit within the “Qualified Health Plan” framework.</p>
<p>The law specifically prohibits insurers from charging different premiums for QHP’s purchased on or off exchange – and of course the law also requires that at least 80% of income from premiums go to pay benefits. So to have an off-exchange QHP that pays doctors better rates than an on-exchange plan, the insurance company would be setting itself up to lose money on one plan or another. It doesn’t really make sense.</p>
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<p>This makes no sense whatsoever. Suppose Acme Insurance has a plan, which they offer on the exchange and off the exchange. Acme gets the same money whether I buy the plan on the exchange or off the exchange. The doctor has exactly the same paperwork, whether I buy the plan on the exchange or off the exchange. So why would the plan cost less off the exchange? It’s the same thing.</p>
<p>Or, to put it another way, let’s say Acme has a certain plan. Acme has negotiated the reimbursements with its network of doctors. Why doesn’t Acme offer the plan both on the exchange and off the exchange? It costs the same, and if the plan is in both places it can get more customers.</p>
<p>As I mentioned earlier, while the local doctors will accept the platinum plans, they will not accept the lower tier plans. Perhaps if someone lives near a city with many choices of doctors, the marketplace plans may work for them. For people like us who live in a small community with fewer local doctors in the area, the plans just don’t seem to fit our needs.
What good is a plan when the local doctors don’t take it?</p>
<p>We chose to buy privately and got a better deal. It’s a plan not offered on the NY Marketplace. Our employees (as well as our family) are happy that we’ll be moving from a high deductible plan to a solid more traditional plan (reasonable co-pays and a much smaller deductible). The plans on the NY Marketplace for small businesses in our area stink and don’t fit with the doctors/hospitals in our area.</p>