Speaking of AMA clout, ihealthbeat reports that last week a federal judge in New York City approved a plan to distribute the $350 million that United Healthcare agreed to pay in a settlement with the AMA over the Ingenix usual reasonable and customary fee schedule that insurers used to price out of network claims. It took three years for the doctors to agree on how to split up the money. $50 million went to the lawyers.
Here's a link to the Office of Personnel Management section of the President''s FY 2013 budget proposal that was released yesterday. The budget includes OPM's proposal to "streamline" FEHBP prescription benefit contracting, a change that requires Congressional approval.
Business Insurance reports that
The president's budget proposal for fiscal year 2013 seeks a total of $364 billion in health care savings over 10 years, which the White House hopes to achieve by cutting Medicare and Medicaid payments to health care providers, raising costs on future Medicare beneficiaries and cracking down on waste and fraud.Unfortunately, these cuts generally shift costs onto private sector insurers, including FEHB plans.
The Wall Street Journal reports on two health insurer technology initiatives involving "big data":
UnitedHealth Group Inc.['s Optum unit] plans to launch a new cloud-computing platform aimed at health-care providers and insurers, one of a growing number of efforts to allow more sharing of medical data among industry players. * * * Optum plans to take another page from technology firms' books by opening up its cloud environment to outside developers, which will be able to offer "apps" in much the same way they can through Apple Inc.'s well-known app store.
In another move, a group of insurers [lead by Independence Blue Cross] and a health-technology company said they will buy a digital network that is currently used mostly to send administrative and financial communications between providers and health plans. The companies—Highmark Inc., Horizon Blue Cross Blue Shield of New Jersey, Independence Blue Cross and Lumeris Corp.—plan to use NaviNet Inc.'s network to help doctors and hospitals integrate different health data. One goal will be to allow health insurers to more closely tie doctors' and hospitals' reimbursement to quality and cost measures.Good luck with these initiatives that have the potential to bend the cost curve down.