Wednesday, May 14, 2014

Mid-week update

UPI reports that HHS Secretary nominee Sylvia Mathews Burwell sailed through her Senate Finance Committee confirmation hearing this afternoon with flying colors. 

The non-profit Health Care Cost Institute announced today that beginning next year it will make available to the public a free web-based health care cost and quality transparency tool based on claims data provided by Aetna, Humana, and United Healthcare (and hopefully others). Forbes reports that
“Consumers, employers and regulatory agencies  will now have a single source of consistent, transparent health care information based on the most reliable data available, including actual costs, which only insurers currently have,” David Newman,  the Health Care Cost Institute’s executive director said in a statement issued this morning.
There will be three tiers of information provided. In one tier, any consumer will get average price information for an “episode of care” such as a knee replacement or heart surgery based on complex coding and claims data submitted to and analyzed by the Institute.
In another tier, consumers with coverage from Aetna, Humana or UnitedHealth Group will get more detailed price information given the health plan subscribers in their plans already have a relationship with the companies and therefore more specific information on their network of medical care providers that are part of the data set used by the Institute.
Meanwhile, employers will have access to even more “granular” information to help them customize information for employees, Newman said.
Continuing the FEHBlog's focus on healthcare costs,
  • Kaiser Health News reports on Medicare's struggles with the expensive new Hepatitis C drugs. 
Researchers estimate that 3 to 5 million Americans carry the insidious hep-C virus. The biggest concentration is among those born between 1945 and 1965.
Many got hep-C from injecting street drugs in their youth. Other baby boomers got the virus from transfusions before 1992, a period when blood wasn't screened. Some got it from sharing razors or toothbrushes, or from contaminated tattoo needles or hospital equipment. For some, transmission was sexual, although fortunately this isn't the highest-risk route.
The timing of these infections spells trouble for Medicare, which insures Americans over 65 [and the FEHBP which is 50% annuitants] Hepatitis-C is a slow-acting virus. Over a period of 20 to 40 years, it causes liver damage in about 70 percent of people it infects.
A growing number of people who got infected in the 1960s through the 1990s have now "used up" the infection's latency period, notes Dr. Camilla Graham of Beth Israel Deaconess Hospital in Boston, "which is why we're now seeing this dramatic increase in the number of people developing complications and dying of hepatitis. And we expect this to continue to increase for the next 10 years."
  • Reuters reports that the new low dose CT scans for persons with a history of heavy smoking recommended by the U.S. Preventive Services Task Force will cost Medicare $9.5 billion over five years in unanticipated testing and early treatment costs. As the FEHBlog has noted the Medicare program may not pay for these tests, but the ACA requires FEHB plans to do so with no cost sharing beginning next year.
The FEHBlog is for helping people. His point is that there is no such thing as a free lunch. 


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