Weekend Update

The Senate recessed early Saturday morning after joining the House of Representatives in passing a continuing resolution funding the federal government through March 31, 2013 --- the mid-way point of the next federal fiscal year. Here are links to a Hill report and a Govexec report on the resolution.  Now both the House and the Senate like the President are out on the campaign trail until November 6. Congress will return for a lame duck session after the election.

The Federal Times reports on OPM's press release about 2013 FEHBP premiums. The article notes that

OPM is encouraging health insurers to find ways to take better care of their enrollees. OPM wants insurers to reduce hospital readmissions by 20 percent and cut preventable “hospital-acquired conditions,” such as falls, by 40 percent. Foley said those are significant factors driving up the cost of medical care.

OPM also wants insurers to improve maternity and neonatal care and to eliminate early elective delivery of babies before 39 weeks.

While these are worthy goals, the simple fact of the matter is that health plans with the exception of staff model HMOs like Kaiser do not provide patient care; rather they pay for care. Of course, as payors, health plans can influence care to a certain extent that varies with their leverage.  In that regard, NCQA recently issued its insurer rankings which is based on their certification and quality standards. The bottom line, however, is that doctors and hospitals as professionals under the Hippocratic oath and their professional societies must step up their game as illustrated by this article in yesterday's Wall Street Journal.