Wednesday, July 16, 2014

Midweek update

The House has been debating this week the appropriations bill for the financial services and general government operations (HR 5160), and this afternoon the House passed the bill in a vote along party lines. This is the bill that funds the Office of Personnel Management and the FEHBP. 

On Monday, the Congressional Budget Office released its report on the Senate Postal Service reform bill, S. 1486. That bill would establish a Postal Service health plan within the FEHBP. This new plan would have mandatory integration with Medicare Parts B and D for annuitants. CBO projects that this approach will save the Postal Service $1 billion over 10 years.

The Commonwealth Fund has created an initiative looking at ways to improve provider incentive programs. The "initiative recognizes that a wide range of factors influence providers’ choices, beyond financial rewards or penalties, including intrinsic motivation and medical professionalism, organizational influences, and policy." An example of a non-financial reward is
Leveraging providers’ innate desire to do a better job. Psychological research also demonstrates that nonmonetary motivators, such as peer comparisons, may strengthen people’s inherent desire to perform well. The introduction of quality report cards for cardiac surgeons across Pennsylvania had a four times larger effect on surgeons’ performance than profit incentives.
Speaking of quality report cards, U.S. News and World Report has released its 2014-15 Best Hospital rankings according to the Fierce Healthcare website. The rankings include an Honor Roll of the top 10 hospitals. The closest top 10 hospital to Washington DC is Johns Hopkins in Baltimore. Johns Hopkins health system has taken over a number of suburban DC hospitals in Maryland and Virginia.

Finally, the Seattle Times reports on health plan efforts to expand coverage of telehealth services. The article discusses the debate over the proper form and role of telemedicine.
It’s a debate that has included the American Medical Association (AMA), which last month offered new guidelines to shape telemedicine’s development; state licensing boards that agreed on their own draft policy in April; five of the nation’s top publicly traded health insurers; and a small group of closely held telemedicine companies convinced their time has come as concerns about medical cost and access rise.
The discussion promises to escalate as patients become increasingly sophisticated in their online pursuits, delays in making doctor appointments grow longer, and the cost of services provided by medical centers increases.
“More and more patients are comfortable seeing a physician online,” said Jonathan Linkous, CEO of the American Telemedicine Association.
“It’s an adoption process. They understand it, and use it,” Linkous said.

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