Monday, September 03, 2012

Open Season's coming

It's the time of the year on the FEHBP calendar when the focus shifts from benefit and rate negotiations for 2013 (which should be concluded) to the impending Open Season which runs this year from November 12 through December 10, 2012. Here's a link to an OPM list of Open Season resources.

Historically but not recently, OPM would issue its press release about the following year's government contribution and the employee share of the large plans shortly after Labor Day. Over the last decade, that announcement is made in late September. The FEHBlog expects that OPM will adhere to the recent schedule this year.

Modern Healthcare announced its list of 2012 Most Influential People in Healthcare. The top five include four government officials and a health insurance executive Mark Bertolini of Aetna (at #2). The next five include four health plan / health insurance executives and the HHS Secretary. Health care provider executives start to show up at number 12, with a dialysis company executive. Surprisingly to the FEHBlog at least, the OPM Director was not included on the list.

Modern Healthcare named Chief Justice John Roberts to be the most influential person. If the FEHBlog were in charge, he would have named the American voter as the greatest influence on healthcare this year.

The Health Affairs blog has an interesting piece on "Seizing the Opportunity to Improve Medication Adherence"  The authors encourage, among other things
more commitment *** by public and private payers to include adherence quality measures as a basis for reimbursement or bonus payments for providers and pharmacists. Adherence-related quality measures and bonus payments can be expanded within Medicare to cover more beneficiaries (e.g., those in Stand-Alone Prescription Drug Plans), and similar policies can be adopted by Medicaid and commercial payers.  Finally, further innovation and testing is needed of interventional strategies that combine effective approaches for targeting patients at the highest risk of non-adherence with efforts to personalize effective interventional strategies that work best for each patient.

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