Wednesday, March 19, 2014

Mid-week update

The FEHBlog often comments on the fact that the demographics in the FEHBP are lousy which given the FEHBP's success should give hope to the insurers operating in the exchanges. The FEHBlog's point was driven home today by a Washington Post report that "employees younger than 30 make up only 8.5 percent of the federal workforce, compared to 23.2 percent of the U.S. workforce overall, based on data from the Office of Personnel Management."

The Wall Street Journal has a report on a successful IPO by a San Francisco based cloud software company called Castlight. A related Journal analytical report explains that the IPO was successful because there's money to be made in controlling healthcare costs. Castlight advises self-insured employers on this matter. The Leapfrog Group, which was created by the National Roundtable to assess health care quality, just retained Castlight for a big project. Modern Healthcare explains
Castlight, which sells price transparency products and services to self-insured employers' systems, will take its first look at Leapfrog data on early elective deliveries and infections. It will provide an analysis of the survey data nationwide, by region and by each of 28 survey metrics, according to the release. The Castlight analysis, including graphics, will be part of a Leapfrog report this spring evaluating hospitals on quality and safety.  
Why aren't the actuarial consulting services providing this service?

Speaking of improving quality, Modern Healthcare reports on a survey on physician participation in accountable care organizations or ACOs--
The results, published online in the journal Health Services Research, show that roughly 6 of 10 physician groups have so far avoided accountable care, a proliferating payment model that rewards and penalizes hospitals and doctors based on their ability to meet cost and quality targets. Medicare accountable care efforts, launched in 2012 under the Patient Protection and Affordable Care Act, now include more than 350 organizations. Private insurers have entered into more than 600 accountable care contracts, according to estimates by healthcare consultant Leavitt Partners. When measured against an index of 25 measures of care management, patient engagement and quality, the physician practices with no plans to join an ACO scored lowest, the study said. Medical groups already under accountable care contracts ranked highest. One-quarter of survey respondents were in ACOs. The survey included roughly 1,180 medical groups that researchers adjusted to reflect a nationally representative sample. Another 15% planned to join an ACO soon.
Finally, the FEHBlog as a lawyer urges readers who are covered entities or business associates to read this Computer World article that begins

Courts have generally tended to dismiss consumer class-action lawsuits filed against companies that suffer data breaches if victims can't show that the the breach directly caused a financial hit. A federal court in Florida broke the mold by approving a $3 million settlement for victims of a data breach in which personal health information was exposed when multiple laptops containing the unencrypted data were stolen.
The plaintiffs' lawyers argued for restitution on the group that part of the payments that the victims made to AvMed were to cover the cost of securing the data.  That's what we lawyers call precedential or an attention grabber.  .

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