Wednesday, December 07, 2011

Mid-Week Update

Well, the clock continues to tick down to the end of the current continuing resolution on December 16. With so many issues up in the air, as Federal News Radio reports, Your guess about the income is as good as the FEHBlog's.

In this year's call letter for benefit and rate proposals, OPM encouraged FEHB plans to utilize the patient centered medical home ("PCMH") concept which financially rewards primary care providers for pro-actively managing the care of their chronically ill patients. AIS reports that two large Blue Cross plans, Independence Blue Cross ("IBC") and Blue Cross and Blue Shield of Tennessee ("BCBSt"), have found success with their patient centered medical home pilots.
PCMHs have proven so successful that BCBST is contemplating expanding them into other therapy areas next year, such as behavioral health, oncology and cardiology. IBC already has an oncology practice acting as a PCMH.
Two items reminded the FEHBlog that there are some important rules that should be finalized soon. AIS reports that a Senate Committee flogged the head of the HHS Office for Civil Rights because the rules implementing various provision of the HITECH Act, amending HIPAA's privacy, security, and enforcement provisions. The GAO issued a report on the efficacy of the 2008 mental health parity act which notes that the regulators needs to issue a final implementing rule for that law too.

AHIP discussed  a recent longitudinal state by state study of health care spending by the CMS Actuary. Not surprisingly the report finds wide variations in spending.
The states with the highest per capita spending tended to be older in population with higher per capita incomes. The lowest per capita states reflected areas with younger populations, lower per capita incomes and higher numbers of uninsured.
What did surprise the FEHBlog is an AMA news report that the use of antibiotics varies widely from state to state. You would think that this particular medical practice would be more standardized given the public health focus on avoiding antibiotic use for viral infections. Apparently a greater effort is needed.

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