Healthleaders Media published a list of top 10 health care quality issues for 2010. Topping the list is imaging scan radiation over-exposure and over-utilization. That issue also tops of OPM's list of quality concerns according to reports made at the annual FEHBP conference the most recent call letter for benefit and rate proposals, and the Inspector General's recommendations in OPM's most recent performance report as discussed in previous FEHBlog entries.
The AMA News reports that the Affordable Care Act and the Medicare Program is boosting the number of house calls made by doctors. The Affordable Care Act creates an Independence at Home program which will be launched in March 2012. "The Medicare program paid for more than 2.3 million house calls in 2009, compared with more than 1.5 million in 1995."
URAC has released revisions to its independent review organization accreditation standards. Independent review organizations will play a leading role in the claim review process for non-grandfathered group health plans outside the FEHBP as a result of the Affordable Care Act. Inside the FEHBP OPM continues to serve as the external review in accordance with the FEHB Act.