Wednesday, November 18, 2015

Midweek update suggests the best ways that federal and postal employees and retirees can obtain assistance with their Federal Benefits Open Season decisionmaking.

Avalere Health has concluded not surprisingly that health insurance premium changes reflects consumer spending on healthcare.

The prescription benefit manager ("PBM") trade association informs us on the battles between PBMs and independent pharmacies that are being waged on Capitol Hill.

According to Medpage Today, the Centers for Medicare and Medicaid Services is pushing ahead with its initiative to create a new quality based payment model for joint replacement surgeries performed on Medicare beneficiaries.  "Known as the Comprehensive Care for Joint Replacement (CCJR) rule, the new regulation requires bundled payments for joint replacements to the lower extremities over a 90-day "episode of care" in 67 metropolitan areas." The mandatory pilot takes effect April 1, 2016.

Finally Modern Healthcare reports that "Hospital and physician groups are cautioning the CMS that it needs better [quality] measures before it ties physician pay to quality and outcomes." The FEHBlog expects that payers appreciate the providers' concern.

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