Monday Miscellany

• The FEHBlog schedule has gotten offtrack because my wife and I enjoyed a weekend off in Connecticut.
  
• The Tier 4 controversy continues. Sen. Barack Obama (D Ill) sent OPM Director Linda Springer a letter last week requesting by April 30 a report on "skyrocketing copayment costs for prescription drugs." USA Today followed the New York Times in opining against the growing practice of increasing cost sharing on biologic or specialty drugs. AHIP President Karen Ignani presented a counterpoint to the USA Today's editorial -- urging Congress to create a pathway to biogenerics and "a national institution to compare the effectiveness of new and existing therapies, and provide patients and doctors with data about which are safest, work the best and are most cost-effective."
• I ran across two interesting articles in the AMA News. One discussed a healthcare marketplace website -- www.carol.com -- that according to the about us page on the siete allows Twin Cities (Minneapolis / St. Paul MN) consumers to compare health care services, practitioner credentials, quality dimensions, and costs—with or without insurance. Carol works with insurance companies to verify membership and provide cost estimates for care packages." The AMA News provides this background information on Carol:

  Carol's founders include Tony Miller, co-founder and former chief executive officer of Definity Health, one of the first companies to offer consumer-driven health plans such as health savings accounts. United bought Definity, its fellow Minneapolis-area company, in December 2004. Miller then formed Lemhi Ventures, which put $25 million into the startup of Carol. For now, Carol's reach extends only to the Minneapolis-St. Paul vicinity, though the company says talks are under way with physicians and hospitals in Seattle and Cincinnati to offer services there.

  On a related note the Wall Street Journal reported managed care company earnings for the first quarter of 2008 appear to be unhealthy. However, according to the Journal's report

  Health insurers have been cushioning problems in their core commercial health-insurance market by expanding into new areas, such as offering plans to Medicare beneficiaries and developing health-information tools and capabilities that might help employers and individuals better control their own costs.
  
  Some analysts say, for example, that Aetna's successful packaging of medical-cost and disease-management tools in recent years is one reason it hasn't seen the same enrollment shortfalls as its competitors. Last year, among the top four carriers -- including WellPoint, UnitedHealth and Cigna Corp. -- Aetna was the only one that didn't see a decline in people it charges a premium to insure.

• The other AMA News article of note was an interview with the AMA's President Ron Davis, MD, who recently has been diagnosed with pancreatic cancer. Dr. Davis, who clearly is a brave man, blogs about his illness at carepages.com, a Revolution Health social website that "connects family and friends during illness or injury."