Weekend update

Congress remains out of session for the next two weeks and the national legislature will have to implement the continuing resolution deal upon its return as the current federal fiscal year ends on September 30.

The FEHBlog read a Washington Post article this morning about the growing trend of hospital systems to become health insurers.

[T]he North Shore-LIJ Health System, with 16 hospitals and more than 300 outpatient centers in Long Island and New York City, is laying the groundwork to be an insurer, as well as a provider of health care. Like other hospital chains across the country, it’s under intense pressure from public and private insurers, as well as employers, to accept flat-rate payments for care, rather than reimbursements for every service. And that puts pressure on hospitals not just to manage costs, but to keep people well – in short, to act more like insurers.

As the article explains, many health care providers accepted risk  in arrangements with health plans in the 1990s and lost their shirts. This time around the providers expect that improved technology and greater experience with clinical algorithms will avoid the pitfalls of the 1990s. However, from the FEHBlog's viewpoint, medicine remains as much as art as it is a science.

Speaking of technology, the Department of Health and Human Services last week proposed the second round of meaningful use standards that providers must use a condition to receiving federal funding for their electronic health technology. There still is no free lunch.  HHS also finalized the regulation that adopts a health plan identifier standard for electronic transactions and allows the one year extension in the compliance date for the mandatory use of the ICD-10 code set in those transactions.  The FEHBlog never ceases to be amused by the HHS press release crowing about the savings created by this rule that was authorized by a law -- HIPAA -- passed over 15 years ago. It just points out the silliness of embedding technology standards in federal law.

Also HHS unveiled an update to its medicare.gov website.