Friday, October 30, 2015


Happy Nevada Day!  Health Day reports that "fewer Americans are dying from heart disease, cancer, stroke, diabetes and injuries" according to an American Cancer Society report.

CMS finalized its complicated 2016 Medicare Part B payment to providers rule today. It appears that CMS will begin to star ratings on physician and group practice quality of care based on its Physician Quality Reporting System ("PQRS") beginning in 2017.  CMS already makes negative payment adjustments to providers who fail to satisfactorily report PQRS data. This will be the second shoe to drop.

The EEOC has proposed a rule that would permit "employers that offer wellness programs as part of group health plans [to] provide limited financial and other inducements (also called incentives) in exchange for an employee's spouse providing information about his or her current or past health status."  Basically, the proposed rule would extend the current rules to spouses of plan enrollees. Here's a link to the EEOC's FAQs.

Fierce Healthcare reports that while CMS penalized hospital readmissions have been decreasing since 2011, observation stays have been increasing at similar rates.  "Further study is needed, the [Health Affairs] authors write, to determine whether readmission rates are a reliable measure of how well hospitals reduce complications and coordinate care, and emphasizing readmission rates so heavily may allow hospitals to simply relabel patients rather than actively deliver better care." American ingenuity at work.

The Drug Channels blog assesses the Walgreen's acquisition of Rite Aid announced earlier this week. Of interest to the FEHBlog is the Drug Channel's observation that Walgreen's does not plan, at least immediately, to expand its presence in the prescription benefit manager market place with Rite Aid's EnvisionRx unit.


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