Monday, December 26, 2016

Holiday update

The FEHBlog has enjoyed a great Christmas holiday with his family. He hopes that his readers had the same experience.

The House of Representatives and the Senate have posted their 2017 legislative calendars. The party split favors the Republicans in both Houses of Congress -- in the Senate 52 Republicans to 46 Democrats plus 2 Independents who caucus with the Democrats and in the House 241 Republicans to 194 Democrats.  Both Houses convene next Tuesday January 3, 2017.

The New York Times had an interesting story on a troubled accountable care organization ("ACO"), Cornerstone Health Care, in Sunday's business section.   The physician lead bought into the Affordable Care Act initiative to base Medicare reimbursement on quality of care rather than number of services.  Cornerstone's effort initially bore fruit but the effort stumbled as a result of competition for doctors, lawsuits, and a heavy debt burden caused by a technology investment. Cornerstone was purchased by a hospital, Wake Forest Baptist Health, last year.  The article concludes
It may be that * * * the Cornerstone accountable care model were simply ahead of their time. Dr. Brian Caveney, the chief medical officer for the Blue Cross plan in North Carolina, said being out front came at a cost. “It’s more complicated than flipping a switch,” Dr. Caveney said.
Speaking of Medicare, Modern Healthcare reports
While Medicare Advantage plans added nearly 900,000 members in 2016, enrollment is growing at a slower pace. Still, experts say the future of Medicare Advantage will be lucrative for insurers. “It's the only safe game in town, in all of health insurance,” said John Gorman, a former CMS official who is now a healthcare consultant in Washington.
Enrollment in Medicare Advantage, the private, managed care version of the federal health program for seniors, reached nearly 18.7 million as of Dec. 1, according to the latest federal data.

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