The FEHBlog hopes that everyone enjoyed the long holiday weekend. The FEHBlog certainly did.
Congress returns to Washington this week. The Arizona Republic projects that Congress has about 30 days remaining before the election to take legislative action.
The Washington Post published a primer for health care investors today that was quite informative. On Thursday, the FEHBlog linked to a Beckers Hospital Review projection of non-profit hospital revenues for 2014. The Post adds that
[R]oughly 80 percent of hospitals are still nonprofit, according to the American Hospital Association. But those who want to invest increasingly need to choose mega hospital networks as more hospitals merge to cope with the higher costs. Eighty-five hospitals and health systems merged or were acquired in 2013 — up from the 50 deals in 2009, according to Irving Levin Associates, a health research firm. In all, 283 hospitals changed hands last year, the firm’s Lisa Phillips says.The Dallas Forth Worth Healthcare Daily published an interesting interview with Cigna's regional CEO, LaMonte Thomas. Here's the punchline:
What do you see the future of the company and the role of the insurer going forward?NCQA announced last weeks its 2015 changes to the HEDIS quality measures that are applied to health providers and plans, including FEHB plans. Here's one sensible change that the FEHBlog noticed:
I think as healthcare continuously evolves, the role that we’ll play is conveners: Conveners of the stakeholders as we continue to evolve and continue to grow and adjust as we learn more amid technology changes. There will be different access to information, to resources as the medical field evolves. So we’ll be conveners for employers, for hospital systems, and for those that are consuming healthcare.
We’ll provide and continue to provide coaching, we’ll continue to provide management and medical management services that we provide today. I don’t think that model changes much. For us at Cigna, since most of our business is self-funded, we’ll be serving greater resources for employers to help them in their efforts to continue to push their employees closer to the physician.
Our role for the physician is to provide data and resources to make it easy and helpful for both of those parties as they move closer together. In an ideal situation, if there’s risk and you’re paid on results rather than activity, then you’re incentivized to guide that person to the high quality place for the most cost efficient. You’re incentivized to write prescriptions for generics instead of name brand. So that role as navigator and transparency goes closer and closer to the physician, more so than companies like Cigna or other companies out there building models around transparency.
So you’ll be more of an intermediary between the two.
Absolutely, with us getting away from the middle of that relationship.
Plan All-Cause Readmissions: To improve this measure’s accuracy, NCQA revised it to allow readmissions to serve as potential index admissions and added an exclusion for planned readmissions.Finally the FEHBlog got a big kick out of a letter that a Florida doctor sent to the Wall Street Journal in response to its editorial about the Supreme Court's Hobby Lobby decision last week:
What has corrupted the debate over this issue is that we have abandoned the principle of individual responsibility and have transformed the idea of medical insurance into a concept of free medical care.
Amen, Dr. Stanley Spatz.