Friday, January 23, 2015


Federal News Radio reports that for the second fiscal year in a row the Office of Management and Budget has concluded that no additional sequestration-required budget cuts will occur in FY 2015 which ends on September 30, 2015.  "'OMB estimates that discretionary appropriations are at the defense cap, while non-Defense appropriations are nearly $3.7 billion below the budget authorizations set in the [Budget Control Act],' OMB wrote in the report."  The President's FY 2016 budget is expected to proposed to bust these caps by 7%.

The FEHBlog has analogized the relationship between health care providers and  health plans to the feuding Hatfields and McCoys.  Modern Healthcare reports that "value based case" likely will not end these "financial spats."
Experts largely agree that value-based contracting will not be a panacea for healthcare payment spats, and these types of disagreements will persist in a value-based reimbursement setting. What will change will be the sticking points between insurers and providers—issues such as per-member per-month fees and performance measures, for example.

Following up on a couple of items that have interested the FEHBlog --

  • The Des Moines Register reports that the State of Iowa will be liquidating the ACA created consumer owned health care cooperative serving Iowa and Nebraska known as CoOppotunity Health.  
  • The ProPublica and the New York Times report that CMS's Open Payments website is error riddled.  
"Amid much anticipation and after a lengthy delay, the government in September unveiled its Open Payments database, saying it would bring transparency to relationships between physicians and the drug and medical device industries. But this openness has been clouded by numerous errors that detract from its usefulness."
The government and industry expect that the errors will get cleaned up over time. ProPublica discovered the errors in the course of preparing its own database that allows consumers to find out whether their health care professionals received drug company money. Mine didn't. 

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