Friday, October 14, 2016


The FEHBlog didn't make it home until 2:30 am this morning following attendance at the Washington National's 4-3 loss to the LA Dodgers. (Go Cubs!).  And the FEHBlog had to be up as usual at 6:30 am so the FEHBlog my friends is weary.

Contrast that with HHS which today issued a nearly 3,000 page final rule implementing the new MACRA law for reimbursing doctors and allied health providers under Medicare Part B beginning as early as January 1, 2017.  The FEHBlog is skeptical of these massive rulemakings.  Becker's Hospital Review posts 10 things to know about the rule. HHS has created a snazzy new website to help doctors with MACRA implementation.

How does this impact the FEHBP you ask? The large number of annuitants with primary Medicare Parts A and B coverage help moderate premiums for everyone due to the FEHBA's sensible approach of using a single risk pool for each plan option.  OPM has been trying to encourage new annuitants to pick up Medicare Part B for that reason. The MACRA rule on top of the PHSA Section 1557 rule and other ACA innovations may be the straw that breaks the camel's back by causing more and more doctors and annuitants to leave Medicare Part B. Time will tell.  HHS indicates that it plans to continue tweaking the rule.

In this regard, the FEHBlog took note of this Fierce Healthcare article about a study concluding that commercial accountable care organizations are larger and more efficient than Medicare ACOs. That makes sense to me because commercial carriers tend to be more flexible than CMS in developing these new networks. Also the commercial ACOs are based on voluntary contracts rather than imposed laws.

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