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You are here: Home / Features / Cover Story / Health Insurance Update: The Real Cost of Healthcare
Health Insurance Update: The Real Cost of Healthcare
May 1, 2014 By Doresa Banning 2 Comments
The healthcare industry, over many years, has been undergoing a gradual but major shift in how insurers pay providers. Against that backdrop, the state began implementing the Patient Protection and Affordable Care Act's (ACA) mandates, several of which the federal government has delayed or amended since. The ACA or Obamacare, as it has become known, has caused additional industry changes, and its rollout has been rocky.
"For some, it feels overwhelming," said Mike Murphy, president of Anthem Blue Cross and Blue Shield of Nevada and president of Anthem's national Labor and Trust, the division managing its union business. "The pace of change, the continuous change and the volume and enormity of change have been a challenge."
The state's exchange, or Nevada Health Link, offers numerous medical and dental insurance plans for small businesses, individuals and families.
Plans for small businesses are available through the exchange's Small Business Health Options Program, or SHOP, designed for operations with fewer than 100 full-time equivalent (FTE) employees to enroll for coverage. Small businesses may sign up for insurance via SHOP year-round. Through SHOP, Anthem and the Nevada Health CO-OP offer 19 medical plans and 42 dental plans for small businesses. Specifically, Anthem offers three HMO plans, two at the gold level and one at the silver.
"On the benefits side, we're trying to make sure we're setting out benefits folks can afford and that are seen as valued by their employees," Murphy said. "We'll continue to roll out small group plans when we're allowed to do so.
The Nevada Health CO-OP is a statewide, non-profit health insurance alternative. The ACA mandated establishments of these co-ops to introduce competition into the health insurance marketplace, allow for additional competitive health and dental insurance plans to be offered and drive innovation, said Tom Zumtobel, CEO of the Las Vegas-headquartered Nevada Health CO-OP.
The CO-OP's plans for small businesses are available both on and off the exchange whereas those for individuals are offered on-exchange. The insurer also offers off-exchange plans for large companies, those with more than 100 FTEs.
Much like a credit union, the CO-OP is consumer owned and operated. Revenue in the form of premiums only is spent on its members, not outside entities or individuals.
"We want to help people who need help, but we're a great carrier for people who want to be helped and be part of the solution," Zumtobel said. "That's what we believe is our sweet spot."
The advantages to small businesses of enrolling in a CO-OP plan are savings and employee satisfaction, Zumtobel said. Those benefits also extend to large companies in addition to having access to products previously unavailable to them.
When enrolling through SHOP, small businesses with fewer than 25 FTEs may qualify for the Small Business Health Care Tax Credit of up to 50 percent of what they pay for employees' insurance. The credit is available on- and off-exchange through 2014 then only on-exchange in 2015.
Employers with 50 or fewer FTEs can provide choices to their employees, select from different coverage levels and customize a package, for example, in which their workers can opt for different components, said Steve Fisher, interim director of the Silver State Health Insurance Exchange (SSHIE), and deputy administrator at the Division of Welfare and Supportive Services. The original SSHIE executive director Jon Hager resigned effective March 14th of this year. As of the end of March, national recruitment for a long-term replacement was underway.
"I just don't know that many businesses are either qualifying for [the credit] or realizing that they qualify," said Valerie Clark, president of Reno-based Clark & Associates, a company that provides insurance benefits, including benefits-needs analysis, employee retention, wellness and human resources compliance.
For individuals and families, four insurers offer various plans through the exchange: Health Plan of Nevada (United Healthcare), Anthem, Nevada Health CO-OP and Saint Mary's HealthFirst.
Enrollment Numbers
In 2013, many small businesses renewed their existing plans for 2014, so they haven't yet had to address health insurance this year, Clark said.
As for individuals, as of March 21, 34,000 selected a plan; 23,000 of those made a payment. As of the end of February, the system identified 142,000 enrollees as potentially eligible for Medicaid, government-funded healthcare coverage for low-income individuals and families. Of those, Medicaid approved 71,000.
Those who qualify for Medicaid in Nevada are adults living at or below 133 percent of the federal poverty level (FPL), which is $11,490 a year in wages for one person and $23,550 a year in wages for a family of four, and pregnant women living at or below 159 percent of the FPL.
When the most recent enrollment period and the state's contracts with six major navigators ended on March 31, Nevada hadn't met its revised target of 50,000 non-Medicaid-eligible enrollees (its original goal was 118,000).
A major reason was numerous technical problems with the exchange website, Fisher said. As of mid-February, Xerox, the company engaged in a $72 million contract to build the site, noted 49 of the original 182 critical issues with it remained. Another significant problem was the lack of response to consumers with questions or needing help.
Consequently, the board overseeing Nevada's exchange approved adding a 60-day special enrollment period between April 1 and May 30, Fisher said, and retained, of the six navigators, the top three performers through the next open enrollment periods that begin November 15, 2014 and February 15, 2015.
Additionally, in late March, the state contracted with Deloitte Consulting at $1.5M to, over five weeks, assess the operational and technical problems with Nevada Health Link and provide a remediation plan. Xerox, too, has added numerous resources to eradicate the remaining issues.
"Things have gotten better," Murphy said. "There are still challenges, and people are working really hard to make sure it works."
Fisher anticipates another 10,000 will enroll by May's end, taking the total (including those approved for Medicaid) to 104,000, which would equate to about a 17.7 percent decrease in the number of Nevada's uninsured under age 65 due to Obamacare. Nevada had about 588,000 people in that age range without health insurance in 2011-2012, according to the Henry J. Kaiser Family Foundation's State Health Facts.
"We have set some goals and haven't achieved those goals, but we're reducing the number of uninsured in the state of Nevada," Fisher said. That's really very positive."
Zumtobel agreed it's a good start, but lots more work needs to be done.
"We have a really long way to go for access for everybody," he said.
Effects on Businesses
To date, the ACA and Nevada Health Link, even with its problems, hasn't had a major impact on businesses, large or small, excluding healthcare providers.
"From the employer standpoint, being able to offer and decide what kinds of benefits to offer employees isn't riddled by the problems we're hearing about with the exchange," Murphy said.
Starting January 1, 2015, companies won't be able to keep their existing health insurance plans if the plans don't meet ACA requirements. They'll need to move to acceptable ones if they decide to continue offering health insurance. Most likely, they'll select their new plans around October. According to Clark, companies' costs likely will increase starting in 2015 due to the start of some ACA mandates, including Employer Shared Responsibility. The ultimate pros and cons to businesses can't be assessed until everything goes into effect.
"We probably will see a lot of people become very upset," Clark said. "If the rate changes are what we've been told that they're going to be, you're going to see a lot of really upset small businesses."
All involved parties are trying to understand how they'll be impacted in the future and make decisions accordingly, Murphy said.
Small groups are seeing employers that have had a change in their rates. They're looking at their plan options and considering whether or not to keep their coverage and/or help employees pursue insurance through the exchange.
Larger employers are assessing the potential impact fees, taxes and changes to benefits and determining what they need to do, if anything, going forward.
Physicians, hospitals and other healthcare groups are pinpointing how Obamacare will affect their practices and businesses and what changes they must make accordingly.
One issue is Nevada's physician shortage, specifically primary care providers, in the face of an influx of thousands of newly insured people. Another is that providers, hospitals and health systems are dealing with decreased reimbursement for their services, yet they must have the staff and resources to deliver care to all these additional people. High deductibles that have to be paid before an insurer pays also impact healthcare providers, as they sometimes provide services for which they're not paid.
"Cost has just never been more of an issue than it is right now all the way around," Clark said.
The gradual but longstanding shift in insurer reimbursement for healthcare continues, from a fee-for-service to a pay-for-performance payment model. With fee-for-service, healthcare providers are paid for each service they provide. Under this newer scenario, reimbursements are tied to quality metrics to ultimately reduce the total cost of care.
Consolidation of physician practices—physician groups merging with others or selling their practices to larger organizations—has been one result, Murphy said.
"It has moved at a more rapid pace in the last year or so," he added. "We're expecting to see more of that coming down the road."
Another result has been the formation of accountable care organizations (ACOs), voluntary groups of healthcare providers who are reimbursed on a pay-for-performance basis for care given to a specific patient population, such as Medicare enrollees.
One new provider group in Southern Nevada is based on the ACO model with a slight difference. This accountable care network (ACN), called WellHealth Quality Care, contracts with insurers, employer groups, self-insured groups and the Nevada Health CO-OP to provide healthcare.
"We have carefully selected providers on a reimbursement model that incentivizes them for high performance when it comes to clinical and non-clinical quality measures," said Steven Keltie, WellHealth's president of business development and marketing. "ACNs are definitely the model of the future."
Clinical measures include infection rates post surgery, hospital re-admittance rates and others whereas non-clinical ones include aspects of patient satisfaction—wait times, physician communication and the like.
Physicians who fail to reach the established quality benchmarks are expelled from the network. Those who exceed the standards receive bonuses, Keltie said.
WellHealth plans to expand into Northern Nevada in coordination with the Nevada Health CO-OP by year's end.
Due to ACA's requirements, health insurers are assuming more risk. To manage that and costs, many are requiring the insured to pay higher deductibles, as high as about $6,000, Clark said. They've increased or eliminated insured co-pays and lowered co-insurance, the percentage of costs the insurer pays after the deductible is met. These all result in consumers paying more for their healthcare than ever before. These changes also put the onus on providers to collect money from patients before delivering care.
Another insurance company strategy is narrowing coverage networks, decreasing the numbers of medical provider options for consumers, Clark said. Insurers are canceling contracts with many of their providers to obtain greater discounts and control from those remaining in the network. In exchange, they're offering an increase in patient volume to those fewer providers. These fewer providers are incentivized to work to achieve the insurer's goals for controlling costs so the insurer can stay competitive in the marketplace.
The next exchange open enrollment begins November 15. In the meantime, the Silver State's Health Insurance Exchange will keep working to resolve the exchange website and call center problems.
"Our number one goal is customer service," Fisher said. "We want people to enroll in a quick and user friendly manner, to easily access programs available to them and have a good experience going through the process."
Filed Under: Cover Story Tagged With: Affordable Care Act, Anthem Blue Cross, Blue Shield of Nevada, Clark & Associates, Deloitte Consulting, Division of Welfare and Supportive Services, Employer Shared Responsibility, Health Plan of Nevada, Jon Hager, Las Vegas healthcare, Las Vegas insurance, Medicaid, Mike Murphy, Nevada Health CO-OP, Nevada Health Link, Nevada healthcare, Nevada insurance, Obamacare, Patient Protection, Saint Mary's HealthFirst, Silver State Health Insurance Exchange, Silver State's Health Insurance Exchange, Small Business Health Care Tax Credit, Small Business Health Options Program, Steve Fisher, Steven Keltie, Tom Zumtobel, United Healthcare, Valerie Clark, WellHealth, Xerox


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MLB – 1981 – Highlights Special All Star Game – Cleveland Municipal Stadium – With Mel Allen
1980s, 1981 MLB All Star Game, Andre Dawson, Baseball, Bert Blyleven, Bob Gibson, Bruce Sutter, Carlton Fisk, CBS, Dave Winfield, Dog Commentary, Dwight Evans, Fernando Valenzuela, Gary Carter, George Brett, George H. Bush, Goose Gossage, Highlights, Jack Morris, Johnny Bench, Mel Allen, Mike Schmidt, MLB, MLB All Star Game, MLB Hall of Fame, MLB MVP, Nolan Ryan, Ozzie Smith, Pete Rose, Reggie Jackson, Rod Carew, Specials, Steve Carlton, This Week in Baseball, Tim Raines, Tom Seaver, VideosBy L E March 2, 2018 Leave a comment
DOG COMMENTARY: The 1981 Major League Baseball All-Star Game was the 52nd playing of the midsummer classic between the all-stars of the American League (AL) and National League (NL)….as the game was held on August 9, 1981, at Cleveland Municipal Stadium in Cleveland, Ohio…which was the the home of the Cleveland Indians of the American League in 1981.. This was one of only two All-Star Games to be played…

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Category Archive: National
Comets are Ice Hockey's British Masters Champions
August 8, 2014 8:41 am Published by andymack
Cleveland Comets travelled to Nottingham to take part in the British Masters (Over 35) tournament at the weekend and posted an impressive 8 game unbeaten streak to lift the Championship Trophy With a number of former Bombers, Stars and Wasps players in their lineup there was occasions when the games resembled a replay of the… View Article
Washburn Win for Triumphant Teasdale
July 28, 2014 9:12 am Published by andymack
Paddlers from Tees Tigers are celebrating after another successful weekend whilst competing at the UK Slalom Division 1 competition at Washburn in North Yorkshire. 16 year old Ben Teasdale (below) had particular reason to celebrate after he won his K1 race on Saturday which secured his promotion to the sports Premier Division. After an interrupted… View Article
Tees Girls Flying the Flag
July 24, 2014 11:13 am Published by andymack
Once again the Tees Rowing Club is proving it is a hotbed for rowing talent as 3 of their members have been selected to represent England in the Home Internationals Regatta, which is to be held this weekend at the National Rowing Centre in Cork, Ireland. Front to back Charlotte Cook, Beth Bryan, Sara Parfett,… View Article
CHILDREN IN STOCKTON-ON-TEES LEARN LIFE SAVING SKILLS
June 25, 2014 8:55 am Published by andymack
Children from Stockton-on-Tees are being given the chance once again to learn about the dangers posed by open water thanks to a vital life-saving scheme. Due to the success of the first scheme, operated last summer, youngsters are being taught water safety skills as part of Tees Actives School Swimming lessons. All Tees Active's swimming… View Article
Christian Europe Bound
May 28, 2014 1:31 pm Published by andymack
A winter training with World Indoor 60m champion Richard Kilty and international long jumper Chris Tomlinson has seen Gateshead Harrier and Tees Active Sports Academy Sprinter Christian Carson starting the season in impressive style. Early indications of Christians progress were evident in the winter when he ran a personal best indoors in the 60m in… View Article


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Xherdan Shaqiri scored a pair of deflected second-half goals as Liverpool went back into first place with a 3-1 defeat of Manchester United at Anfield on Sunday.
Sadio Mane scored the Reds' other goal, as the leaders moved to 45 points. Jesse Lingard scored for Manchester United, now 11 points adrift of the Top Four.
Jose Mourinho kept Paul Pogba on the bench for the entire 90 minutes.
Mohamed Salah dribbled Ashley Young into the grass with a cutback before earning a corner for Liverpool in the second minute.
Romelu Lukaku was pushed offside by Sadio Mane, making a free kick goal offside because the Belgian's air kick rightly put off Liverpool keeper Alisson Becker.
The first half-dozen minutes were chaotic, with Liverpool claiming for a penalty at one end when Salah hit the deck and Alisson collected a long distance effort from United at the other.
Fabinho rocketed a shot wide with a partial deflection. Young then made a goal line clearance on the ensuing corner as Liverpool ravaged the Manchester United box.
Mane got Liverpool's much deserved breakthrough when Fabinho sent a sensational ball over the top to meet the Senegalese striker, whose technical work in turning it past De Gea was top notch. It was Liverpool's 11th shot attempt of the first 25 minutes.
There was such little danger from United, which makes the equalizer all the more stunning in our story. Lingard started a move to Lukaku, and Alisson couldn't corral an easy ball. Lingard followed it up for 1-1.
Only Bernd Leno and Asmir Begović (3) have made more errors leading to Premier League goals this season than Alisson.
David De Gea made a fine low save and Young blocked Mane's big at a rebound in the 53rd minute, as Liverpool took advantage of a waylaid Eric Bailly.
Liverpool had a pair of corner kicks around the 62nd minute, including a near miss by Dejan Lovren.
Fabinho stung a 30-yard shot at De Gea in the 71st minute, but the United keeper stayed with the swerve for a difficult catch made to look easy.
Mane then set-up the winner by cooking Ander Herrera on the left flank, cutting his effort toward goal. De Gea kicked it back atop the box, where Shaqiri zipped it off Young, then the cross bar, and finally into the goal.
Shaqiri then put it to bed with a second deflected goal, ripping this 81st minute effort off Bailly's ankle and past a flying De Gea.
Liverpool went atop the Premier League table for the moment following a 2-0 win over Fulham at Anfield on Sunday.
Mohamed Salah scored 13 seconds after a Fulham goal was ruled offside, and Xherdan Shaqiri also scored as the Reds moved to 30 points.
That's one point more than Man City, who hosts Manchester United at 11:30 a.m. ET, and three ahead of Chelsea ahead of the Blues 9:15 a.m. ET meeting with Everton.
The first dozen minutes went as expected, as Liverpool mostly did what it wanted in attack. Xherdan Shaqiri was the closest to finding a finish with a 13th minute drive from the top of the box.
Mohamed Salah forced Sergio Rico into an in-tight save in the 16th, as the opener looked certain to arrive any moment. Rico stopped Salah again in the 22nd.
Fulham's Ryan Sessegnon turned Virgil Van Dijk inside out but blasted a shot inches wide of the far post for the Cottagers best chance of the half. Andre Schurrle was stymied by Alisson Becker before the half-hour mark.
Shaqiri missed with a 35th minute bid for the near post.
Then Fulham went from ahead to behind in a flash. Mitrovic headed a cross behind Alisson, and was quickly ruled offside (The margin was thin). Alisson restarted play, and Salah blazed down the right wing for a goal.
The change in fortunes was dramatic, and took 13 seconds.
The Reds got a second goal in the 53rd minute when Shaqiri met a terrific back post cross from Andy Robertson with a composed finish across goal.
Liverpool was very much in control, but failed to add to its goal differential.
Xherdan Shaqiri will not play for Liverpool at Red Star Belgrade in the UEFA Champions League on Tuesday.
Jurgen Klopp and Liverpool have decided against Shaqiri traveling with the squad due to the reception he may get in Serbia's capital city due to his Kosvan-Albanian heritage. Serbia doesn't recognize its former province Kosovo, where Shaqiri was born, as an independent state.
The situation could also be a little more dangerous due to Shaqiri scoring a late winner for Switzerland against Serbia in the 2018 World Cup and then celebrating by making a fluttering eagle symbol with his hands. That symbol was in reference to ethnic Albanians and Shaqiri was fined by FIFA, along with Arsenal's Granit Xhaka and Stephan Lichsteiner, for making the gesture.
With reports that Shaqiri would be the subject of protests in Belgrade, it has been decided he will not travel.
"We have heard and read the speculation and talk about what kind of reception Shaq would receive and although we have no idea what would happen, we want to go there and be focused 100 per cent on football and not have to think about anything else, that's all," Klopp said. "We are Liverpool FC, a big club, a football team but we don't have any message further than that. We have no political message, absolutely not. We want the focus to be on a great game of football, free from anything else.
Liverpool sits atop the Premier League, at least for a few days, after an easy win over Cardiff City on Saturday at Anfield.
Mohamed Salah had a goal and 2 assists, Sadio Mane scored twice, and Xherdan Shaqiri also scored as the Reds ran out 4-1 winners to reach 26 points on the season.
Cardiff remains 17th with five points, and got its goal from Callum Paterson.
Liverpool opened up shop in the Cardiff City end to start the match, and the Bluebirds allowed the Reds three successive shots on target in the 10th minute.
Cardiff blocked two shots and got a piece of Salah's effort that made it 1-0.
The Reds didn't slow down, with Van Dijk hitting the post.
Cardiff backstop Neil Etheridge made an outstanding intervention to deny Salah and clear danger in the 15th.
Adam Lallana had a header cleared off the line at the final breath of the first half.
Cardiff bundled a ball over the line in the 52nd only to be denied by the offside flag.
Mane finally finished another Reds chance, turning twice and losing possession before hitting a left-footed rocket past Etheridge.
Cardiff did find a goal in the 77th minute through Paterson. Junior Hoilett's cross deflected off Virgil Van Dijk and Paterson poked it past Alisson Becker.
Liverpool restored its 2-goal lead when Salah slid in Shaqiri for a classy 84th minute finish, and took it to three through Mane's clever chipped finish of a Salah set-up in the 87th.


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Blackstock Road plaque honours origins of worldwide peace symbol
Gerald Holtom presented his design to fellow peace activists at the offices of Peace News magazine, above Fish & Cook stationers, in 1958
12 October, 2018 — By Emily Finch
Gerald Holtom's daughter Anna Scott, centre, with, from left, Selby Scott, Leo Scott, Hackney councillor Clare Potter and CND's Amy Keegan Photo Credit: Rosie Holtom
A LONG-running campaign to recognise the origins of the internationally-celebrated symbol for peace achieved success on Saturday with a plaque unveiling.
Friends and family of Gerald Holtom, the man who designed the logo in 1958, gathered in the rain as the plaque was unveiled above a stationery shop in Blackstock Road, Finsbury Park.
Designer Mr Holtom created the symbol for the first Aldermaston March against nuclear weapons, organised by the Direct Action Committee against Nuclear War.
He presented it to fellow peace activists at the offices of Peace News magazine above Fish & Cook stationers, where the plaque now sits.
The Blackstock Road shop with plaque above Photo Credit: Rosie Holtom
Rosie Holtom, the artist's great-niece, who lives in Holloway, said the unveiling was "really good". "We had a good turnout, around 20 to 30 people," she added.
"It's so nice to have the plaque. I cycle past it every day and I think the whole family is really proud of the symbol."
The logo was quickly adopted by the Campaign for Nuclear Disarmament (CND) and became popular throughout the world because Mr Holtom did not copyright it.
The campaign to recognise the origins of Mr Holtom's symbol was launched by Guardian journalist and Highbury resident Ian Jack. Mr Holtom was a peace activist until his death, aged 71, in 1985. A conscientious objector, he worked on a farm in Norfolk during World War II.
He came up with the design at his home in Twickenham, where his family hope that another plaque will be installed.
There are varying origin stories for the symbol, which seems to use the semaphore signs for the letters N and D standing for Nuclear Disarmament.
Gerald Holtom
Mr Holtom, who trained at the Royal College of Arts, wrote to Hugh Brock, editor of Peace News, detailing how he came up with the design: "I was in despair. Deep despair. I drew myself: the representative of an individual in despair, with hands palm-outstretched outwards and downwards in the manner of Goya's peasant before the firing squad.
"I formalised the drawing into a line and put a circle round it."
The building with the plaque is on the Hackney side of Blackstock Road. Hackney Council funded the plaque.
Sue Canning: Teacher retires after 45 years at same West Hampstead school
18 July — By Helen Chapman
Lost cat walks into police station
Islington council will not pass private rough sleeper info to the Home Office
Calls to weed out chemical spray used in Islington


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The best phone number to call for information about Student Finance in the UK is 0300 100 0607.
The life of a student is an exercise in delayed gratification. When you're a student, you consume resources: food, time, energy and lastly, money. The rewards of all this expenditure can't be seen until after graduation or until after you get a good paying job. This is why during your school years, you and your parents need all the financial help you can get to push you through. With Student Finance, that's just what you get – a government financial aid to help you reach your goals.
You can call about Student Finance for you or your loved one by dialling their customer enquiries line on 0300 100 0607. They can also be reached by textphone on 0300 100 0622 if you are hard of hearing or if you have a speech impediment.
If you have acute visual impairments and you would therefore prefer to get information and correspondence pertaining to your student finance in braille, then inform them by calling 0141 243 3686.
If you're an EU student and you're studying in the UK, then call 0141 243 3570 locally. Alternatively if you're calling from outside the United Kingdom, then phone their international helpline +44 141 243 3570.
If you would like to lodge an official complaint against Student Finance about their loan or maintainance grants, or a member of their staff then please phone their dedicated complaints team on their local-rate contact number 0300 100 0601.
For those who would like to get correspondence and information in large font or braille, send an email to brailleandlargefonts@slc.co.uk for assistance.
If you have complaints about their assessment of how much money you should receive or the employees you interact with while applying for the benefit then send an email with a full detailed description of what happened to customer_complaints@slc.co.uk.
You can send your enquiries via their social media accounts on Twitter and Facebook.
If you prefer to use Twitter, then send a short tweet @SF_England. You can also send a longer and much more detailed message via Facebook by going to their official page www.facebook.com/SFEngland.


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The Four Records At Stake For Roger Federer In Rotterdam
Friday could see Roger Federer once again rewrite history in men's tennis when he takes on Robin Haase in the quarter-finals of the Rotterdam Open.
The Swiss is just a win away from returning to the top of the rankings in what will be the icing on the cake for a comeback that started 13 months ago when he won the Australian Open. Should Federer win on Friday he won't be breaking one record, he will be breaking four. Further strengthening his position as one of the all-time greats in the sport.
The oldest ever
At the age of 36, he could become the oldest ever No.1 player. The record currently belongs to Andre Agassi, who topped the rankings at the age of 33 years and 133 days. Rafael Nadal is currently the oldest year-end No.1 after finishing 2017 at the age of 31 years and 211 days.
The biggest gap
The last time Federer held the top spot was back in 2012. Should he return to the position next week, it would be five years and 106 days since he last did so. The longest gap between holding the No.1 rank in the history of men's tennis.
14 years since it all began
Never in the history of men's tennis has a player returned to the top of the rankings more than 10 years after they first held the spot. Federer is in line to become the first player to do so. His rise to the top first started on February 2nd 2004. To put this into perspective, world No.4 Alexander Zverev would have been six at the time.
The extension of an all-time record
Federer could increase his record of the most weeks spent as world No.1. The tally currently stands at 302 weeks (five years and 42 weeks). He is the only player so far to break the 300 mark. The next highest is Pete Sampras at 286 weeks.
Federer will take on Haase on Friday evening at the Ahoy Rotterdam. He leads their head-to-head 2-0 and is yet to drop a set. The last meeting occurred in the semifinals of the 2017 Canadian Masters, which the Swiss won 6-3, 7-6(5).
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Stefanos Tsitsipas is still determined to achieve his Grand Slam dream after losing the Australian Open final.
Tony Fairbairn
Stefanos Tsitsipas (@CitiOpen - Twitter)
Stefanos Tsitsipas is remaining determined to achieve his Grand Slam dream after he lost in the Australian Open final to Novak Djokovic.
Playing his second Grand Slam final, Stefanos Tsitsipas was dominated by Novak Djokovic in a 6-3 7-6(4) 7-6(5) defeat with Djokovic claiming his tenth Australian Open title.
The result won't downplay Tsitsipas' impressive start to the season as he will now climb up to world number three when the new rankings are released on Monday.
Even though Tsitsipas' dream of winning a Grand Slam title may not have been realised in Melbourne, the Greek is more determined than before to make it a reality in the future.
Speaking after the match Tsitsipas said he was happy with the two weeks as he looks to win more trophies in the near future, "Look, I'm not thinking about the match anymore," Tsitsipas said in his press conference.
"I'm just happy that I'm in another Grand Slam final. Of course, I was dreaming about the trophy, lifting that trophy. I even dreamt it last night in my sleep. The desire is really there. I really, really want it badly.
"But just dreaming about it won't make it happen. You got to act. You got to do something out there. You got to be present even more and do better. Today I felt like there were moments that I was close, but the tiebreak didn't really show that both ways. Just bad starts. So I'll just eliminate it, take the good things, move on from there.
"It's a long season. It's an exhausting season. I got to be physically ready for the difficult matches that I will have to play this year against the best players in the world."
It's clear that Tsitsipas wants to move onto the future where he will look to improve in winning the biggest titles on the tour.
However the new world number three also reflected on the past and how this year's loss feels in comparison to the one in Paris where he lost from two sets down to Djokovic.
Tsitsipas said the one in Paris was more heart-breaking and has learnt from that experience, "Well, Paris was heartbreaking. I was two sets to love up. I wasn't really thinking that I was two sets to love up. I mean, I was aware of it, but it didn't occupy too much of my thought process," the Greek explained.
"Let's say I did some technical decisions there that were wrong, which I'm pretty sure I'm not going to repeat again in my career. Just pure stubbornness from my side. I can't see or feel the same again, because that was a different final from what we had today.
"That was disappointing, for sure. A lot of not-such-nice things happened for me that day, losing my grandmother the day of the final, not knowing about it but finding out later.
"There was something in the air that day that made it feel that there was something odd about that day. I still remember it. I don't want to remember it because it's not a nice feeling."
Motivated by his two losses in Grand Slam finals, Tsitsipas will now look to have the desire and consistency to achieve his world number one goal.
Concluding his press conference Tsitsipas said that he's not lowering his expectations despite recent results, "I want to max out in what I do in my profession. No. 1 is on my mind. It doesn't come easy, I know that. I got to work harder to make that happen," Tsitsipas claimed.
"What I can say is being on the tour for a few years now, I get a lot of different experiences, I get a lot of different things that I'm faced with.
"It's my time to aim for something like this. I don't see any reason to be lowering my expectations or my goals. I am born a champion. I can feel it in my blood. I can feel it as a competitive kid that I was when I was young. It's
something that is within me.
"I want to harvest that, make it bloom, make it even stronger and fonder, work hard towards those goals."
Australian Open: 'Confident' Elena Rybakina Unfazed By Top Ten Debut
Wimbledon champion Elena Rybakina insisted that her debut in the top ten doesn't change anything ahead of the rest of the season.
Elena Rybakina (marioboc17 - Twitter)
Elena Rybakina has remained unbothered by her upcoming top ten debut and admits her confidence has grown despite her Australian Open final defeat.
The Wimbledon champion was close to winning a second Grand Slam title in Melbourne but fell just short after a three set defeat to Aryna Sabalenka.
Rybakina took the opening set with some blistering tennis and had her chances against the big-serving Belarusian in the final set.
However it wasn't her day as Sabalenka just about held her nerve to secure her first Grand Slam singles title.
Reflecting on the match Rybakina said the turning point was Sabalenka raising her level but admitted it has been a great two weeks, "I think Aryna raise her level in the second set. She played really well, aggressive, a bit less mistakes," Rybakina told the press conference.
"I should have been also more aggressive in some moments. Yeah, I had some chances, for sure, to turn it around. But, yeah, she played really well today. She was strong mentally, physically. Yeah, overall, as I said, it was a good two weeks for me here."
It was an impressive run from Rybakina who managed to beat three former Grand Slam champions in the form of world number one Iga Swiatek, Jelena Ostapenko and Victoria Azarenka to get to the final.
Reflecting on the future Rybakina admitted that this tournament has given her more confidence that Grand Slam finals is where she should be, "Well, if it's going to be like this, it's great. For sure, that's the goal, to be in the second week of all the Grand Slam, to play finals," Rybakina happily claimed.
"Yeah, I mean, now I have more confidence of course even after this final. Yeah, I just need to work hard, same as I did during pre-season and actually throughout the years, be healthy, and for sure the results are going to come.
"Even I would say I'm trying to not think about expectations and everything. Still after a great pre-season like this I was thinking I should show it on the court. Then, of course, the results are going to be there.
"As I said, first few weeks was not that great like maybe the other years I was starting. But, yeah, I think in the end it's just confidence to go forward, to keep on working."
Despite not claiming a second Grand Slam title, it has been a very positive week for Rybakina who will now take her place in the world's top ten.
The Kazakh will be seen as a big threat to the rest of the tour as now she looks to keep performing well at big tournaments.
However Rybakina's top ten debut won't change anything according to the Wimbledon champion, "I don't think tomorrow I'm going to feel different just because of the ranking now," Rybakina boldly stated.
"But, I mean, for sure it's going to be different on the smaller tournaments, I would say. I'm going to be seeded. Maybe in some tournaments I'm not going to play first round. So of course there is some benefits out of this. But for sure I don't really look for the numbers ranking so much."
Rybakina will look to continue to climb up the rankings when she competes in Abu Dhabi, which starts on the 5th of February.


If the original HS operated in the same way as the newer version, the stars were actually given the questions ahead of time so that they could come up with comedic answers (in case they were picked during the game). They were not given the answers as far as I know, but having the questions ahead of time meant they could look much wittier--and help taping go smoother with fewer pauses for thought.
Paul Lynde always cracked me up but I wasn't a HUGE big fan of Hollywood Squares.
I liked Hollywood Squares too. There was a disclaimer at the end of the show during the credits stating that the "stars" were given the questions in advance. They could ask their joke writers to give them a witty answer if they didn't have one of their own. Yes, they were all prepared in case they were called. Not exactly a big secret. This was during the Peter Marshall heyday when it was very popular.
Oh, I remember it. It was a lot of fun, I thought. I liked the "regulars"-- Cliff Arquette, Paul Lynde, and Wally Cox.
Trivia: Charley Weaver is the grandfather to the Arquette family. His real name was Cliff Arquette.
I loved Hollywood Squares in it's heyday. I was young then, I had a crush on Paul Lynde. I thought he was an attractive looking man. It was only when I was older that I knew his "secret". I was sorry to hear when he passed away. Funny man.
80s host John Davidson was good ....whatever happened to him?
Still around at 75 years old.
Even knowing that as I read the OP, I loved reading them. In it's time it was even more racy than Family Feud is today, with Steve Harvey. And more funny.


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blog games things about
Slice & Dice Play Store release!
It's finally out on Google Play! It's been out for a few weeks on itch.io too; huge thanks to all the early players for helping me find bugs & improve things.
History of Slice & Dice
I haven't really kept a dev log and I thought it might be nice to write a bit about it here. Some people ask me how long it took to make Slice & Dice and I can never give a proper answer, maybe this will explain why! I was also working as a programmer for a lot of this time which made it a bit exhausting to continue coding at home.
Event Horizon (2012)
Event Horizon was one of the bigger games I've worked on, though I had only been programming for a couple of years so it was a bit of a mess. It was a ship vs ship card-based combat game; each ship had different weapons and subsystems which provided cards and if they got too damaged then you'd lose their functionality. Peter Queckenstedt did a great job with the art for the game. I was really happy with the gameplay, there were lots of interesting decisions on most turns.
Unfortunately I was too inexperienced to turn it into a proper game. The UI was very complicated, enemy turns were confusing. It was mostly just one-off fights, I started to make a tactical map screen but I couldn't make it fun. I consider Slice & Dice to be a kind of spiritual successor to Event Horizon though, so it's worth mentioning here.
I wanted to make a game where your dice represented people and you could level them up! I did a lot of research around cool 2D ways to represent dice in games, but I couldn't find any that felt good to me. I didn't really want to delve into 3D but I had no choice. It took me a while but I eventually got it working: I could define graphics for sides of a dice and detect which side landed face-up!
I got a basic game working but unfortunately the gameplay didn't quite click. I learnt a lot making it and I knew I could make this dice idea work somehow. 75mb windows download
Dicegeon (2017)
I was really happy with how levelling up the dice felt, so I decided to try turning it into a combat game. Plus now I had a lot more coding and design skill, I thought I'd be able to use Event Horizon's combat system but make it simpler & more streamlined. I was at a friend's house doing a mini boardgame jam when I prototyped the game for the first time. I had some blank dice and drew some shield, sword and magic sides on them. I don't remember the exact rules, though they were very similar to the current game. I could see the game had potential from that, though it was a bit awkward to run the game IRL.
I reused a lot of code from Village and eventually got the game functional again. It was a lot simpler and more fun than Village.
Slice & Dice (2018)
I decided that I was going to finish this game and found a name I liked and reserved it on the Play Store and App Store. I also changed the game to use pixel art; I have a lot more experience with this style of visuals. I created an open beta on the Play Store around this time which turned out really well. I got a lot of emails and feedback from players, it was very motivating to hear that so many people were enjoying it.
One thing that's nice about not having a publisher or deadline is that I'm free to make big gameplay changes. It does have disadvantages: it takes up a lot of time and players who like the old systems will miss it. But I think it's good to rethink things before they get too established, especially if I can see problems with it in the future.
A change I made that was not very popular was the removal of combo abilities. At this time, the spell system was quite different. You had a deck of spells which you drew 3 from each turn, and you had to charge up individual spells with magic. I added some spells that required swords and shields in addition to mana. I also added some special combo-abilities that appear if you have certain combinations of abilities on your heroes! These were fun to make and added a cool sense of excitement and discovery as you played, because even if you've seen all the heroes there may be some combo abilities you haven't seen yet!
My reason for removing it was that it was too complicated. For players, it's unclear exactly how to get them, unclear which ones exist, they took up spell slots randomly which was sometimes annoying, plus the rules around exactly which sides can charge which spells was unintuitive. For me, adding any new sides would dilute things a lot and I'd have to think of new combo abilities. The concept of combo abilities is very cool though, I have a couple of ideas for how to bring it back in a simpler and hopefully more-fun form. We'll see if it works out!
The magic system now is a lot simpler and I'm pretty happy with it! I think mana in general is a bit too strong, but it may be a bit late to change this. We'll see!
Itch Demo (2020)
I quit my job and decided to live cheaply and pursue some projects, including finishing Slice & Dice. I spent about half the year on Slice & Dice and the rest on other misc programming stuff, I had a great time and loved being able to focus properly. I set up an itch.io page for the game and improved the desktop version a lot. I'm a big fan of itch.io, it's very intuitive for developers.
Full Game released (2021)
I created a discord server for the game and it's been fun interacting with the people who enjoy the game. Last month I released the full game on itch. Soon after this, I released on the play store and that's the story up to now.
I have skipped the art from the rest of the story because it's difficult to match up all the dates! The game started off just my terrible programmer art. I have a friend who likes doing pixel art and he offered to make some; it was great having some beautiful pixel art! There were no hero portraits in the game for a long time though.
After I saw the potential in the game, I tried to hire some pixel artists but it didn't really work out with any of them. I eventually decided to do all the art myself and maybe hire someone once the whole game was done.
Then I got an email from a fan who wanted to work on the game. He drew over some screenshots and sent them to me and they looked amazing. I think that working with someone who enjoys and understands the game is a huge plus so I decided to team up.
I've been talking mostly about my end of it in this article because that's what I know most about, but the art for the game turned out really well and, if the game does well, it'll be a huge part of that!
I need a break from gamedev. I don't know how long I'll take but I do have some plans for Slice & Dice in the future. Some of this depends on how successful the game is, and I don't promise anything.
I have a huge list of ideas for how to expand the game. Slice & Dice is a bit of a toybox for me, it's been really fun adding anything and everything to it. I would like to release at least some extra stuff for free this year but we'll see.
An iOS release is quite likely, I have a friend who can build it for his iPhone but I'd like to wait for a bit to fix any remaining bugs so he doesn't have to keep updating it.
On Steam there is already a game called Slice & Dice which probably makes things awkward. I'll look into it at some point probably.
libGDX does not easily export to other platforms though, so this will probably be all that is possible.
Pepeboi 2021-09-18
Thank you for creating this game.
Hamjul 2021-11-16
It was all i want from dice games, thanks. Reslly lookin forward to this one
y4 2021-12-15
how to unlock all the classes? are some classes removed or disabled from demo version? any pages for information or wiki of all heroes and items and achievements?
Julia 2021-12-29
The game is really cool. I wish you creative success.
Lucky 2022-01-07
The game is amazing!! Thank you for creating the game!!
Goblins and Wisps are too strong. And they come in HUGE packs. Make them weaker and/or shrink the sizes of their packs. They should not be as strong as bosses.