Wednesday, March 21, 2012

Midweek Update

On Monday, the Affordable Care Act regulators issued their eighth set of Frequently Asked Questions about the law, which is celebrating its second anniversary. These FAQs provide helpful and suprisingly flexible guidance to health plans about the new summary of benefits and coverage requirement. The new requirement made the FEHBlog think -- wouldn't it be nice if providers provided patients with standard information about their billing practices and networks in which they participate?

In that regard, the AMA News reports on readily available resources to improve health care literacy.

The FEHBlog noticed that the HHS rule on health insurance exchanges creates a role for paid "navigators."  Not surprisingly, health insurance agents who have been squeezed by the minimum loss ratio rule, see this as a bone. More interestingly to the FEHBlog, the AMA News is reporting that health insurers are hiring companies that provide health system navigation services to consumers. "Most notably, Highmark, a Pittsburgh-based Blue Shield plan that has nearly 5 million members, will provide a call-in service. Highmark hired Health Advocate, based in Plymouth Meeting, Pa., to provide myCare Navigator, a service available to all members." Highmark's press release is here.

Modern Healthcare reports on a WEDI study on the state of ICD-10 code set implementation which according to MH suggests that delaying implementation beyond October 13, 2013, is a good call.

Finally, the FEHBlog noticed a Fierce Health article about the unnecessary costs of using general anesthesia with gastroenterological diagnostic procedures like colonoscopies and endoscopies. This is where public health cost estimates get so slippery. Yes those procedures could be done under local anesthesia. But if local anesthesia is required, how may patients would opt out of routine procedures which might avoid a deadly colon cancer. The FEHBlog would think twice.

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