Sunday, September 21, 2014

Weekend Update

As the FEHBlog mentioned on Friday, Congress is out on the campaign trail now, but in addition to passing a continuing resolution, Congress passed a law regulating hospices according to this Washington Post report. The bill requires more frequent federal inspections of hospices which have become a large portion of Medicare spending. 

The New York Times lead business section story today was about the 34 year old CEO of a company called Zenefits which is eating the lunch of health insurance brokers with a smartphone app. The article discloses that one of the authors of the Affordable Care Act, Bob Kocher MD has cashed in by investing in this company. The article explains
The Affordable Care Act also called for the creation of state-run insurance exchanges aimed at small businesses; those have been delayed, but eventually they, too, may streamline the way small businesses buy health care. But because the exchanges will allow firms to use brokers, the Zenefits business would still work under that model.
In the long run, such efficiencies could help keep down the costs of health care. “When you can see all the plans online, people tend to choose narrower-cost ones — and that has the effect of pushing doctors and hospitals to try to get into those lower-cost plans,” Dr. Kocher said.
As the FEHBlog has noted, consumer groups empowered by the ACA have strongly objected to narrow networks. In in ironic twist, the lead article in today's New York Times is about doctors who fly the pirate flag by slyly proving out of network services as assistant surgeons or surgical consultants. It's a rather sad story because the patients tried to control their expenses but failed to do so because the doctors did not provide transparent pricing. It's too bad that the ACA did not hold the primary surgeon or other doctor responsible for the prices charged by the other team members.

Business Insurance reports that a study of more than 1,500 data breaches in 2013 and 2014 by a unit of Beazley P.L.C. reveals that the two most common sources of breaches are misdirected emails and faxes and the physical loss of paper records, mostly by health care providers. The FEHBlog thought that the lead cause was theft of records. Update your risk assessments according.

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