Web glitches hurt Obamacare-created health insurer

An experimental new health insurance company created under a provision of Obamacare — with 
$88.5 million in federal funds — is now struggling to enroll members because of the state's broken Health Connector website.

"It's not a pleasant turn of events, but it is what it is, and we're dealing with it," Minuteman Health CEO Thomas Policelli said. "We certainly look forward to when it's fixed."

Minuteman, which bills itself as a low-cost health plan that will be run by its members, has only managed to pick up a few hundred customers so far through the state Health Connector.

"It's certainly far fewer than we would have hoped," Policelli said.

The Connector website is supposed to allow Bay Staters to enroll in health plans as required by Obamacare. It was revamped to comply with the federal law and has since been riddled with problems. Website woes are also frustrating bigger, more established insurers, who have redeployed staff and even hired temps to work on enrollment.

"It does create the potential that other projects may be placed on hold, but we all recognize the importance of this and know that members come first," said Eric Linzer of the Massachusetts Association of Health Plans.

Connector spokesman Jason Lefferts said: "We participate in twice-weekly all-carrier conferences, weekly one-on-one meetings with each carrier, and staff are constantly working with carriers every day."

An emergency review of the glitch-plagued Connector website is scheduled to be completed today.

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Correction: Health Overhaul-Spanish story

ALBUQUERQUE, N.M. — In a story Jan. 12 about the Spanish-language health care website, The Associated Press erroneously cited a U.S. Census Bureau statistic on the number of U.S. residents who speak only Spanish. A 2013 Census report said 12.9 percent of Americans speak Spanish at home, and more than half of them are fluent in English as well; not that 12 percent of U.S. residents speak only Spanish.

A corrected version of the story is below:

Health care website frustrates Spanish speakers

Critics say health care website is translated into 'Spanglish,' causing problems for Latinos

By RUSSELL CONTRERAS and KELLI KENNEDY

Associated Press

ALBUQUERQUE, N.M. (AP) — Mirroring problems with the federal health care website, people around the nation attempting to navigate the Spanish version have discovered their own set of difficulties.

The site, CuidadoDeSalud.gov, launched more than two months late.

A Web page with Spanish instructions linked users to an English form.

And the translations were so clunky and full of grammatical mistakes that critics say they must have been computer-generated — the name of the site itself can literally be read "for the caution of health."

"When you get into the details of the plans, it's not all written in Spanish. It's written in Spanglish, so we end up having to translate it for them," said Adrian Madriz, a health care navigator who helps with enrollment in Miami.

The issues with the site underscore the halting efforts across the nation to get Spanish-speakers enrolled under the federal health care law. Critics say that as a result of various problems, including those related to the website, many people whom the law was designed to help have been left out of the first wave of coverage.

Federal officials say they have been working to make the site better and plan further improvements soon. Also, administrators say they welcome feedback and try to fix typos or other errors quickly.

"We launched consumer-friendly Spanish online enrollment tools on CuidadoDeSalud.gov in December which represents one more way for Latinos to enroll in Marketplace plans," said Health and Human Services Department spokesman Richard Olague in an email to The Associated Press. "Since the soft-launch, we continue to work closely with key stakeholders to get feedback in order to improve the experience for those consumers that use the website."

Still, efforts to enroll Spanish-speakers have fallen short in several states with large Hispanic populations, and critics say the translated version of HealthCare.gov could have helped boost those numbers.

In California, officials have acknowledged the need for improvements, saying fewer than 5,500 people signed up for health care in Spanish in October and November, the most recent period for which records are available. About 4.3 million California residents speak only Spanish, according to census data. It's not clear how many of these residents are without health insurance, but observers say few groups are more vulnerable.

"Spanish speakers are typically the ones who need to sign up for health insurance," said Veronica Plaza, a professor who teaches medical Spanish at the University of New Mexico. "They are the ones who could use the support."

In New Mexico, the state with the nation's highest percentage of Latino residents and where more than 20 percent of the state's population goes without health insurance, fewer than 1,000 people total signed up for coverage in October and November.

In Florida, federal health officials have not said how many of the state's nearly 18,000 enrollees for October and November were Latino, but that group accounts for about one-third of the roughly 3.5 million uninsured people in the state. About 1.2 million people in the state speak only Spanish.

Federal officials have said that about 4 percent of calls to a national hotline were Spanish-only as of last month. The Census Bureau said in a 2013 report that 12.9 percent of the nation's 317 million people speak Spanish at home, and more than half of those speak English well.

Many blame at least some of the enrollment problems on the trouble-plagued site.

"In my opinion, the website doesn't work," said Grettl Diaz, a 37-year-old Miami gas station cashier who is originally from Cuba.

Diaz said she tried to sign up at home using CuidadoDeSalud.gov. After she couldn't get the website to accept a scanned document, she called the government's Spanish hotline seeking help. However, she was repeatedly told to call back because the site was down. She got through days later and waited over an hour for an operator before she was ultimately disconnected.

"I'm very frustrated," she said through a translator this month. "I've spent at least one week on the phone, and I couldn't get it done."

Diaz, who speaks very little English, finally went to a counselor for help and is now waiting for an email from health officials saying she can proceed with her application.

Diaz hasn't had insurance since moving to Florida two years ago. She will likely qualify for a tax subsidy to help pay her monthly premiums and has said she wants insurance mostly for peace of mind.

"Now, I am healthy," she said. "But I don't know what will happen tomorrow."

Such stories have frustrated Latino advocates, especially since the problems with the site come after an unprecedented collaboration between competing Spanish-language media outlets and Latino businesses, urging members of their communities to sign up for health care on Oct. 1. But advocates say despite promises from federal officials, the Spanish-language site was not up until Dec. 6.

"In many states, groups were cooperating and ready to go," said Patricia Perez, a partner of the VPE Public Relations, a Pasadena, Calif.-based firm that focuses on U.S. Latinos. "It was a missed opportunity."

Univision Communications Inc., which runs the largest Spanish-language media network, has been airing daily public service announcements about the health care overhaul. It hosted and aired a live town hall meeting out of Los Angeles last month to discuss the law, and another such event has been planned for February.

The network frequently airs segments about the Affordable Care Act on its weekend health shows, and it produced a documentary exploring obstacles Latinos face signing up for health insurance, network spokesman Jose Zamora said.

The film, featuring a 19-year-old Mexican-American whose father suffered three heart attacks with no insurance aired Dec. 1 — five days before CuidadoDeSalud.gov went live.

Since the site has been active, users have reported disappointment and frustration in both the functionality and language.

For example, links comparing insurance plans took users to the English version of the options. That glitch was fixed last week after The Associated Press contacted Health and Human Services to ask about the problem.

As for the language, Plaza, the New Mexico professor, said a recent examination by her research students concluded that the translations were done "by a computer-generated process" and came across as awkward.

"There are problems with the verbs and word order that make sentences hard to understand," said Plaza, who helped develop an audio version to help residents in New Mexico sign up.

"Sometimes," she added, "it's just the terms they use."

The website translates "premium" into "prima," but that Spanish word is more commonly used to mean a female cousin, Plaza said. A more accurate translation, she said, would be "cuotas," ''couta mensual" or "costo annual."

According to Health and Human Services, the website was translated with the same methods and team used to translate content into Spanish for the Centers for Medicare & Medicaid Services.

But health care workers in Miami also have reported technical problems that don't exist on the English version of HealthCare.gov.

Nini Hadwen, a health care navigator, said she also prefers to use the English website even when she's enrolling Spanish-language applicants. CuidadoDeSalud.gov "doesn't navigate as smoothly from page to page," she said. "It takes longer."

Also, navigators say Spanish-language applicants must provide income and immigration documentation. Frequently, applicants are required to scan and fax supplemental documents, which can also be challenging, as Diaz's case shows.

However, Jane Delgado, president and CEO of the National Alliance for Hispanic Health in Washington, D.C., defends the site, saying Friday that delays were merely "part of the process" and that she was confident federal officials would get it running better soon.

"Insurance is way complicated. It's not like paying for a cellphone," she said. "Technology is only part of the answer."

Overall, Delgado said Spanish-speaking Latinos will benefit from the federal overhaul in the long-term because the population is less likely to be insured compared with other groups.

Still, Gabriel Sanchez, a political science professor at the University of New Mexico, said the problems hurt the credibility of federal officials and reinforce the belief held by some that authorities are indifferent to the plight of Latinos.

Sanchez said, "They will look at this, and think, 'Man, they really don't care about us.'"

___

Kennedy and Associated Press writer Laura Wides-Munoz contributed to this report from Miami.

___

Follow Russell Contreras at http://twitter.com/russcontreras.

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Google develops contact lens glucose monitor

MOUNTAIN VIEW, Calif. — Google unveiled Thursday a contact lens that monitors glucose levels in tears, a potential reprieve for millions of diabetics who have to jab their fingers to draw their own blood as many as 10 times a day.

The prototype, which Google says will take at least five years to reach consumers, is one of several medical devices being designed by companies to make glucose monitoring for diabetic patients more convenient and less invasive than the traditional finger pricks.

The lenses use a minuscule glucose sensor and a wireless transmitter to help those among the world's 382 million diabetics who need insulin keep a close watch on their blood sugar and adjust their dose.

The contact lenses were developed during the past 18 months in the clandestine Google X lab that also came up with a driverless car, Google's Web-surfing eyeglasses and Project Loon, a network of large balloons designed to beam the Internet to unwired places.

But research on the contact lenses began several years earlier at the University of Washington, where scientists worked under National Science Foundation funding. Until Thursday, when Google shared the project with The Associated Press, their work had been kept under wraps.

"You can take it to a certain level in an academic setting, but at Google we were given the latitude to invest in this project," said one of the lead researchers, Brian Otis. "The beautiful thing is we're leveraging all of the innovation in the semiconductor industry that was aimed at making cellphones smaller and more powerful."

American Diabetes Association board chair Dwight Holing said he's gratified that creative scientists are searching for solutions for people with diabetes but warned that the device must provide accurate and timely information.

"People with diabetes base very important health care decisions on the data we get from our monitors," he said.

The device looked like a typical contact lens when Otis held one on his index finger. On closer examination, sandwiched in the lens are two twinkling glitter-specks loaded with tens of thousands of miniaturized transistors. It's ringed with a hair-thin antenna.

"It doesn't look like much, but it was a crazy amount of work to get everything so very small," Otis said at Google's Silicon Valley headquarters. It took years of soldering hair-thin wires to miniaturize electronics, essentially building tiny chips from scratch, to make what Otis said is the smallest wireless glucose sensor ever made.

Other non-needle glucose monitoring systems are also in the works, including a similar contact lens by Netherlands-based NovioSense, a minuscule, flexible spring that is tucked under an eyelid. Israel-based OrSense has already tested a thumb cuff, and there have been early designs for tattoos and saliva sensors.

A wristwatch monitor was approved by the FDA in 2001, but patients said the low level electric currents pulling fluid from their skin was painful, and it was buggy.

"There are a lot of people who have big promises," said Dr. Christopher Wilson, CEO of NovioSense. "It's just a question of who gets to market with something that really works first."

Palo Alto Medical Foundation endocrinologist Dr. Larry Levin said it was remarkable and important that a tech firm like Google is getting into the medical field, and that he'd like to be able to offer his patients a pain-free alternative from either pricking their fingers or living with a thick needle embedded in their stomach for constant monitoring.

"Google, they're innovative, they are up on new technologies, and also we have to be honest here, the driving force is money," he said.

Worldwide, the glucose monitoring devices market is expected to be more than $16 billion by the end of this year, according to analysts at Renub Research.

The Google team built the wireless chips in clean rooms, and used advanced engineering to get integrated circuits and a glucose sensor into such a small space.

Researchers also had to build in a system to pull energy from incoming radio frequency waves to power the device enough to collect and transmit one glucose reading per second. The embedded electronics in the lens don't obscure vision because they lie outside the eye's pupil and iris.

Google is now looking for partners with experience bringing similar products to market. Google officials declined to say how many people worked on the project, or how much the firm has invested in it.

An early, outsourced clinical research study with real patients was encouraging, but there are many potential pitfalls yet to come, said University of North Carolina diabetes researcher Dr. John Buse, who was briefed by Google on the lens last week.

"This has the potential to be a real game changer," he said, "but the devil is in the details."

Among those is figuring out how to correlate glucose levels in tears as compared with blood. And what happens on windy days, while chopping onions or during very sad movies? As with any medical device, it would need to be tested and proved accurate, safe, and at least as good as other types of glucose sensors available now to win FDA approval.

About 35 miles from Google in the beach town of Santa Cruz, high school soccer coach and university senior Michael Vahradian, 21, is ready for less invasive glucose monitoring.

He has been pricking himself up to 10 times a day for the past 17 years. A cellphone-sized pump on his hip attaches to a flexible tube implanted in his stomach which shoots rapid-acting insulin into his body around the clock.

"I remember at first it was really hard to make the needle sticks a habit because it hurt so much," he said. "And there are still times I don't want to do it; it hurts and it's inconvenient. When I'm hanging out with friends, heading down to the beach to body surf or going to lunch, I have to hold everyone up to take my blood sugar."

Karen Rose Tank, who left her career as an economist to be a health and wellness coach after her Type 1 diabetes diagnosis 18 years ago, also is encouraged that new glucose monitoring methods may be on the horizon.

"It's really exciting that some of the big tech companies are getting into this market," she said. "They bring so much ingenuity; they're able to look outside the box."

---

Follow Martha Mendoza at https://twitter.com/mendozamartha

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Concert Pharmaceuticals trumpets plans to go public

A Lexington company that claims it can make approved drugs and drug candidates safer, more tolerable and more effective has become the fourth Massachusetts biotech company in the past month that intends to go public.

In a filing this week with the U.S. Securities and Exchange Commission, Concert Pharmaceuticals said it intends to raise 
$74.75 million in an initial public offering on the NASDAQ under the symbol "CNCE," although it did not indicate the number of shares or the price.

In the past month alone, three other local biotechs — Dicerna of Watertown, and Eleven Biotherapeutics and Genocea Biosciences, both of Cambridge — also have filed plans to go public, on the heels of a year that saw nine such companies raise about $885 million in IPOs.

John Sullivan of Leerink Partners said the biotech industry became more attractive to investors after 2012, when the Food and Drug Administration approved 39 new drugs, the largest number in a single year since 1996.

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State criticizes closing of Isis

The state's Office of Consumer Affairs & Business Regulation is calling on Isis Parenting to give its customers — many of them expectant parents — better information to help them adjust to the chain's sudden closure announcement.

The Needham company, which announced late Tuesday that it would no longer offer prenatal and early parenting classes and would shutter its 13 stores, should tell customers when those stores are closing so they can use gift cards and merchandise credits, according to Undersecretary Barbara Anthony. Isis also should arrange for another retailer to accept its outstanding gift cards once it closes, she said.

"Consumers need to know what's the deal," Anthony said. "How long do I have to use this? How long are you going to stay open? I think that they owe that to their loyal customers to figure that out fast and give them information."

Isis did not respond to Herald inquiries yesterday. The company has said its stores will be open for limited hours for a short period to sell remaining merchandise. Posts on the company's Facebook page stated Isis is "addressing each client situation" and would be in touch by email yesterday with customers who registered for classes in the past few days. The company also said online retail orders would either be filled or, if the company did not have the inventory, the sales would be cancelled.

"We are working with our partner hospitals to try to transition the prenatal classes — that is why the notification process will take some time," another Isis post said.

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B.R.A. OKs $500M Landmark center

Mayor Martin J. Walsh told hundreds of retailers the city will soon usher in a "new era of transparency" at the Boston Redevelopment Authority, just hours before the agency met for the first time since he took office, approving a massive Landmark Center development project in the Fenway — with full property taxes.

"From big business to small business, from neighborhood businesses and downtown businesses, we will make reforms, including better organization of our staff under a new economic development chief," Walsh told real estate professionals and investors at the Colliers International Annual Seminar at the Boston Convention & Exhibition Center yesterday. "That will keep our economy growing. We will make Boston a leader in streamline transparent and effective job and business growth from Seaport Square to Dudley Square."

The Herald first reported Sunday that Walsh would seek a brand-new cabinet-level economic development czar to oversee the BRA and submit Beacon Hill legislation to reform the agency. Brian P. Golden, a former state representative and BRA executive director, has been named the agency's interim director. Walsh will also call for an independent audit of the BRA, though he's been short on specifics about what the probe will focus on.

Meanwhile, the BRA approved a major redevelopment of Landmark Center last night.

The Landmark developers will have to pay property taxes on the new construction. The same property had been previously granted tax breaks as a blighted area in 1996. The BRA came under fire following Herald reports during the final months of the Menino administration for granting breaks to high-end projects. Yesterday's approval with taxes took place without fanfare.

The project will create 550 apartments, 110,000 square feet of new retail space, 75,000 square feet for a new Wegman's grocery store, and 15,000 square feet of office space and parking. The $500 million development will feature three residential towers, a new food court and the Wegmans and have clear access to the T, developers said. They plan to demolish much of the existing building, but maintain the historic 200-foot Landmark tower, originally built in the 1920s for Sears, Roebuck and Co.

"It's been years in the Fenway working on various buildings and master planning and revitalizing of the neighborhood," said Steven Samuels of Samuels & Associates, the developer. "When acquisition of Landmark became available a couple of years ago, we envisioned it as a key piece in the final turnaround of the Fenway."

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High-end rentals offer way of life

It may be off-season for rentals, but a thousand high-end apartments have hit the Boston market.

The Victor near North Station has come on with 286 units, there's 381 apartments at the Kensington in Chinatown, the 99-unit Gatehouse 75 in Charlestown is also open. The 50 units at 11 West Broadway in Southie and the 202 units at 315 on A in Fort Point are both ready for move in.

The race is on to sign up tenants, and the developers believe that there's a pent-up demand out there. Normally it takes about a year to fully lease larger rental buildings.

Rents are high. At The Victor, they start at $2,795 for a studio up to $5,000 for one or two-bedroom units. The Kensington rents are even higher, ranging from $2,920 for a one-bedroom up to a staggering $10,645 for an upper-floor two bedroom. Rents at 315 on A straddle the two, starting at $2,279 for a studio, up to $5,289 for an upper-floor two bedroom.

They say in real estate it's all about location, location, location. But for these big new luxury apartment buildings, that's only part of the draw. Just as important are the amenities and creating a great urban living experience for their tenants.

These buildings offer condo building finishes, with quartz and granite counters and custom cabinets, on-site fitness centers — so you don't have to join a health club — and elaborate outdoor terraces that provide a sense of 
nature in the hard-edge city. They have common kitchen areas, lounges and club rooms where residents can serve meals or host a party and where guests can come over to watch a game. And they offer conference rooms and work spaces that allow residents who work at home to present a more professional face to their clients.

"The rents are high, but people are seeing the value in all the amenities, and that you can have it all right here in the building," said Drew Boujoulian, The Kensington's resident services manager. And that even includes dog-walking and pet-sitting services.

It appears to be drawing tenants. The Kensington is already 48 percent leased.

These buildings create their own neighborhoods even as they exist in larger neighborhoods. Residents can go out and get to know their surroundings, or if they don't have the time or inclination, create a community in the building they live in.

And these buildings aren't just drawing young professionals, but a lot of empty-nesters, testing the water for city living in 
environments that help them ease into urban life.

Each building has its own personality. The Victor has a wood-floored sports court — a homage to the nearby TD Garden — and a unique gift-wrapping station. At 315 on A, there's a common kitchen/lounge and fitness center on the 20th floor offering spectacular views. The Kensington has an outdoor pool and a shared car service.

The Victor seems more for corporate people, The Kensington has an air of urban exclusivity, while 315 on A targets its appeal to creative types.

Kelly Saito, president of 315 on A developer Gerding Edlen, added: "One big difference between what we offer and other big apartment dwellers is our focus on sustainability."

From the reclaimed wood on the lobby floor to its photovoltaic array on the roof, to the building's cogeneration heating and cooling system, 315 on A 
offers every imaginable green amenity.

The pitch seems to be working. Jessica Ryan, property manager of 
315 on A, said 26 percent of the building is leased.

Even though The Victor has only leased 10 percent of its units, the building's community manager 
Gabrielle Strahl says things are picking up, with eight leases already signed this month. And she doesn't even mind that lease-up is proceeding slowly.

"It's given me time to work out the hiccups and get to know personally everyone who's moved in here," Strahl said. "You don't get to do that when it gets really busy."

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Mass. hospital group to defend expansion

BOSTON — The largest hospital and physician network in Massachusetts is defending its plan to merge with Weymouth's South Shore Hospital and a related doctors' group, saying it save about $27 million annually in health care costs.

Partners HealthCare, under growing pressure from regulators to abandon expansion plans, contends that a state commission's preliminary report criticizing the deal as costly and anticompetitive uses flawed reasoning and contains "inexplicable omissions."

The rebuttal Friday says the Massachusetts Health Policy Commission's analysis concluding that the merger would give Partners too much market power is absurd.

The health care organization provided an advance copy to The Boston Globe (http://b.globe.com/1eQgZg1 ).

Stuart Altman, a professor of health policy at Brandeis University and the commission's chairman, would not comment on the report Thursday because he had not read it.

___

Information from: The Boston Globe, http://www.bostonglobe.com

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Partners: State board wrong on South Shore Hospital acquisition

Medical giant Partners HealthCare is hitting back after a state commission last month said its proposed acquisition of South Shore Hospital would raise costs and do nothing for the quality of care.

In a document it will give the Health Policy Commission today, the nonprofit health care provider accuses the board of ignoring facts and misreading others.

Partners calls the commission's estimate that the deal will add $23 million to $26 million in annual health care costs "merely speculation."

Partners, already the biggest hospital system in Massachusetts, argues that acquiring South Shore Hospital in Weymouth will bring "value and efficiencies" to the region.

This is the first time the Health Policy Commission, a new body formed by a 2012 health care cost-containment law, has challenged a hospital acquisition.

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US employers advertise most jobs since March 2008

WASHINGTON — U.S. employers advertised more jobs in November and more Americans quit, positive signs for millions who are unemployed and looking for work.

The Labor Department said Friday that job openings rose 1.8 percent to a seasonally adjusted 4 million, the most in 5 ½ years. And the number of people quitting increased 1.9 percent to a seasonally adjusted 2.4 million, a five-year high.

Job openings haven't topped 4 million since March 2008, just a few months after the Great Recession began. Openings at that level are generally consistent with a healthy job market.

And more workers quitting can also be a positive signal, because people usually quit when they either have a new job — typically for more pay — or are confident they can find one.

The data suggest the competition for jobs is getting a little bit easier. There were 2.7 unemployed workers for each available job in November, down from 6.7 just after the recession ended in July 2009. In a healthy economy the ratio is roughly 2 to 1.

More job openings and quits suggest greater opportunities for the unemployed. But those positive trends haven't recently translated into additional hiring. Overall hiring ticked up just 0.2 percent in November to nearly 4.5 million.

The figures also follow a disappointing report on December job growth. The government last week said employers added just 74,000 jobs in December. That's the fewest in three years and below an average gain of 214,000 in the previous three months.

The unemployment rate fell to 6.7 percent, the lowest in more than five years. But the rate dropped mostly because more Americans gave up looking for work. The government counts people as unemployed only if they are actively hunting for jobs.

Last week's employment report shows net payroll gains — the number of people hired minus those who were laid off, quit or retired. Friday's report, known as the Job Openings and Labor Turnover survey, provides more details.

For example, it shows the overall number of people hired each month, rather than just the net gain. Total hires reached 4.6 million in September, a five-year high, but hiring has dipped since then.

In the past year, the number of job openings has increased 5.6 percent. But total hiring is only 1.7 percent higher.

Economists point to several reasons for the gap. Employers may not be offering sufficient pay and benefits to persuade more workers to take the jobs. They may also be pickier, believing they can find top-notch candidates with the unemployment rate still elevated.

Many employers say they can't find enough qualified workers, particularly in high-skilled industries such as manufacturing and information technology.

Both Federal Reserve Chairman Ben Bernanke and Janet Yellen, who will succeed Bernanke as chairman next month, have cited greater overall hiring and quits as key signs of the job market's improvement.

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