Friday, July 18, 2014


Following up on Wednesday's post about the House passage of the financial services and general government appropriations bill, Federal News Radio points out that
The bill is silent on the issue of a federal pay raise, but that's actually good news for federal employees. In the absence of specific legislative language, President Barack Obama has the authority to order a pay raise for federal workers. In his fiscal 2015 budget proposal, Obama signaled his intention to award federal employees a 1 percent pay raise. 
The White House has expressed opposition to this House bill because it would slash funding to the IRS.

The Congressional Budget Office issued a report on the causes of projected growth in spending for Social Security and Major Health Programs, which is worth a look. CBO projects that
the anticipated growth is expected to come from the government’s major health care programs (Medicare, Medicaid, the Children’s Health Insurance Program, and subsidies offered through [the ACA's] health insurance exchanges): CBO projects that, under current law, total outlays for those programs, net of Medicare premiums and certain other offsetting receipts, would grow much faster than the overall economy, increasing from just below 5 percent of GDP now to 8 percent in 2039.
Speaking of the ACA, the ACA regulators just issued FAQ XX which concerns the Supreme Court's Hobby Lobby decision.  An FEHBP angle of this issue is that Congress has allowed faith based FEHB plans to opt out of contraceptive coverage since it implemented a contraceptive coverage mandate for the FEHBP in the late 1990s.

Leapfrog Group released a Castlight analysis of its annual hospital survey for 2013 which was loaded with good news:
More hospitals are adopting computerized physician order entry (CPOE) to reduce medication errors, with 616 hospitals fully meeting Leapfrog’s standard, a 65 percent increase from 2012. But some problems with performance of the systems persist, such as failure to alert on potentially fatal medication errors.
• Dramatic improvement in areas of maternity care – especially in reducing early elective deliveries, with the average rate of early elective deliveries declining from 11.2 percent in 2012 to 4.6 percent in 2013. However, too many high-risk babies are being delivered at hospitals that aren’t optimally equipped to care for them. In 2013, less than 24 percent of hospitals fully met Leapfrog’s high-risk delivery standard, a decline from 37 percent in 2011.
• Surprisingly high variance in predicted survival rates for high-risk procedures across hospitals, as well as in hospital-acquired injury and infection rates. For example, the predicted mortality rate varies five-fold for esophagectomies; six-fold for abdominal aortic aneurysm (AAA) repair; and 131 out of 1,302 reporting hospitals have hospital-acquired injury rates of over one in 1,000, which is considered alarmingly high.
• Better compliance with ICU physician staffing standards, shown to decrease mortality by as much as 40 percent. Notably, 41.7 percent of reporting hospitals fully meet this standard in 2013, compared to 39 percent in 2012.
• Strong adoption of Leapfrog’s Never Events policy, with 80 percent of hospitals committing to abide by Leapfrog’s five principles when a Never Event occurs in their facility. 
OPM has encouraged FEHB plans to undertake efforts to support reduction of early elective deliveries and never events.

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