Tuesday, May 03, 2011

Tuesday's Tidbits

With Congress back in session, the AHIP Hi-Wire offers a helpful status report on FY 2012 budget and related debt ceiling negotiations up on Capitol Hill.

Employee Benefits News reports on the 16th annual Towers Watson / National Business Group on Health survey of employers about purchasing value in health care. The report identifies the following top 12 tactics used by companies that consistently hold their health care cost increase at or below the median:
1. Differentiate cost sharing for use of high-performance networks or centers of excellence.
2. Reward based on biometric outcomes other than smoker, tobacco-use status.
3. Change plan options.
4. Use value-based benefit designs.
5. Reward or penalize based on smoker, tobacco-use status.
6. Audit of medical claim payments.
7. Provide employees with information on provider and/or hospital quality.
8. Use centers of excellence for treatments other than transplants.
9. Reward only those who complete requirements of a healthy lifestyle activity.
10. Require employees to complete the health risk appraisal and/or biometric screening to be eligible for other financial incentives for healthy activities.
11. Reward enrollment in healthy lifestyle activities.
12.Use hard-dollar return-on-investment calculations to support future decisions.
Business Insurance reports today that "large health insurers expect an increase in deals in the industry after last year's U.S. health care overhaul made it tougher for smaller companies to compete." As noted the in the FEHBlog, the Affordable Care Act also is driving up consolidation among health care providers.  It appears that one way or the other we will wind up with a single payer (FEHBlog effort at humor).

The Treasury Department and the Internal Revenue Service yesterday asked for public comment on approaches to implementing the shared responsibility provisions of the Affordable Care Act. These provisions require employers of 50 or more employee to provide health care coverage to their employees or pay a penalty. In the requuest (IRS Notice No. 2011-36), the government describes approaches for determining who is a full time employee. The comment deadline is June 17, 2011.

Finally, on the patient safety front, the AMA News reports about a federal government study finding a rapidly growing number of hospitalizations attributable to adverse medication side effects in a graying population over the period 2004-2008. "Less than a quarter of the drug-related ED visits and less than 10% of inpatient stays were due to mistakes by physicians, pharmacists or patients. The rest were cases in which patients took prescribed medicines as ordered but had side effects severe enough to send them to a hospital." The article notes that electronic prescribing should help remedy this problem by alerting doctor #2 to the prescriptions issued by doctor #1.

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