Midweek update

Yesterday, the House of Representatives began consideration of the American Health Care Act. House Speaker Paul Ryan explains that House consideration of the bill will be a multi step process leading to consideration on the House floor.

This week, the Energy and Commerce Committee and Ways and Means Committee are holding markups to consider their portions of the bill.  Next [after the Congressional Budget Office score is released], the work of these two committees will go to the Budget Committee to be considered as one bill. After that, the legislation will go to the Rules Committee [before reaching the House floor]. 

The Speaker emphasizes that the bill has been under development for over a year. Prof. Timothy Jost dissects the bill in Health Affairs.  The FEHBlog who appreciates the Goldilocks story takes heart in the Washington Post's subheadline this morning that the bill is under attack from the left and the right.

OPM in its 2017 and 2018 call letter for benefit and rate proposals encouraged FEHBP carriers to adopt telehealth and value based insurance design. For that reason the FEHBlog calls readers attention to recent studies on those topics:

• A Health Affairs study "on the impact of a value-based pharmacy benefit on medication adherence found that offering free chronic disease medications maintained patients’ levels of adherence even after switching to a health plan with a deductible."
• Another Health Affairs study on telehealth services finds that the services at this stage at least are a convenience and do not bend the cost curve down.  This comes as no surprise to the FEHBlog. Nevertheless Healthcare Finance identifies some useful conclusions from the study

Since telehealth services save patients costs on travel time, payers may be able to raise patient costs to reduce the impact of increased utilization.

For some patient populations, greater utilization may provide more of a cost benefit than it does to the population in the study, particularly for undertreated conditions. “An increase in utilization for patients with diabetes or mental illness might be perceived as a net positive,” the authors note. 

As telehealth becomes a more widespread, payers may need to look at ways to limit the potential for unnecessary use of the service.