Wednesday, April 12, 2017

Midweek update

Today, the Office of Management and Budget ("OMB") ended the temporary federal hiring freeze implemented upon the President's inauguration. Federal News Radio reports that OMB has replaced the hiring freeze with a detailed structure for reorganizing government agencies.

Last week, OMB issued in depth guidance on the President's one rule in, two rules out Executive Order 13,771.  The FEHBlog is suprised that to date he has not noticed any HHS roll back of ACA rules, such as the onerous Public Health Service Act Sec. 1557 rule, or sub-regulatory guidance, such as the ACA FAQs. that would loosen the choke chain that the ACA placed on health plans. That is the third leg of the Republican House leadership's health care reform strategy. The FEHBlog must remain patient.

Federal News Radio also reflects on the fact that it's been nearly two years since OPM announced its large data breaches.  The article observes that
the biggest harm from the OPM breaches has been the public’s erosion of trust in the agency and in government at large to protect personal data, said Charlie Phalen, director of the National Background Investigation Bureau (NBIB).
“It’s a big deal in the sense that we need to renew the faith of the American public that we can protect that information,” he said during an Apr. 10 discussion of the long-term impacts of the OPM data breaches at the Intelligence and National Security Alliance’s Counterintelligence Threats Summit in Arlington, Virginia. “By and large, that’s the biggest piece. It is less of a big deal holistically in terms of dangers to people. The problems that will be encountered will be individuals in the wrong place at the wrong time if this is exploited in some shape or form.”
AHRQ posted the results of study which supports ongoing Congressional efforts to reduce the state law malpractice burden on physicians, e.g., H.R. 1215. In sum,
Medical malpractice law is intended to foster high quality care and discourage negligence among health care providers. This observational study took advantage of differing malpractice laws by state and examined the extent to which the malpractice environment is associated with hospital quality. Investigators assessed quality using several measures: validated processes-of-care measures, such as whether evidence-based actions were appropriately taken for common conditions like myocardial infarction, pneumonia, heart failure, and surgical care; patient experience as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems; imaging efficiency as reported by Medicare's Hospital Compare website; AHRQ Patient Safety Indicators; and 30-day readmission and hospital mortality rates. There were no associations between any of these quality outcomes and the rate of paid claims per 100 physicians. Areas with a higher malpractice geographic cost index had lower 30-day mortality but higher readmission rates, and higher malpractice costs were correlated with more inefficiency in some types of imaging. The authors conclude that malpractice environment does not appear to be associated with quality, but higher malpractice costs may lead to overtreatment.

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