TGIF

Earlier this year, Congress appeared to be poised to enact a postal reform bill that would create a separate Postal Service Health Benefits Program within the FEHBP. The bill had a lot of other moving parts but this one concerned the FEHBlog. In April the President created a task force to offer recommendations for reforming the Postal Service. Congress put its bills on simmer while waiting for the task recommendations. The task force submitted its recommendations to the White House on August 10 as directed. The President decided to take some time to review the recommendations before making the report public. Reuters reports that the Senate Homeland Security and Governmental Affairs Committee cancelled a hearing on postal reform scheduled for next Tuesday because the task force reports remains under wraps. Govexec based on its sources indicates that the report will be kept under wraps until after the mid-term election. Time will tell. 

Mercer consulting tells us that most large group health plans offer telehealth services. That is the case with the FEHBP. Mercer goes on to identify best practices on how to get enrollees interested in using the new service. 

A closer look at our survey data shows that higher utilization is associated with lower copays. Among employers reporting utilization rates of 10% or higher, the median copay for telemedicine was $15. But in the group with below-average utilization rates -- 6% or less -- the median copay was $30. You might be surprised that a relatively small difference in cost would affect whether or not someone chooses to use telemed, given that consumers are not terribly price-sensitive when it comes to selecting a PCP (for example). But consumers know that a possible outcome of the call is being told that an office visit is necessary after all – in which case the telemed visit is an additional cost.

Interestingly, waiving the copay entirely doesn’t significantly increase utilization over a low copayment. Only 18% of large employers that offer telemed charge nothing for a telemed visits. Among this group, the average utilization is 11%.

But reducing or even waiving the copay alone won’t work if employees aren’t aware of the telemedicine benefit, don’t know how it works or what to expect, or don’t know how to access it. Here are a few tips on communication that works:

• Testimonials.

• Real-life examples from how a peer benefited from the service can help boost awareness and thus utilization

• Time-specific notifications. Look at communication materials that address how the service can be utilized during specific times of the year – for example, winter communications about the flu and how the telemedicine service can be beneficial, spring communications about allergies and the pollen season, etc.

• Utilize the employer’s existing wellbeing portal to help promote the service.  

• If there if there is an incentive program in place, consider a way to “reward” members for completing the telemedicine pre-use application form.

Congress wisely has suspended the ACA's onerous health insurance tax for 2019. United Healthcare engaged Oliver Wyman actuarial consulting to project the impact of resurrecting that tax for 2020 and beyond.

We estimate that the tax on health insurance will increase premiums by 2.2% in 2020 and in subsequent years when the amounts collected in taxes is mandated to increase at the same level as premium growth. In 2020, this amount equates to $196 per individual in the non-group market, $154 per single contract and $479 per family contract in the small group market, $158 per single contract and $458 per family contract in the large group market, $241 per Medicare Advantage member (including Special Needs Plans and Employer Group Waiver Plans), and $157 per Medicaid managed care enrollee. Over the next ten years, this amount equates to $2,473 per individual in the non-group market, $1,873 per single contract and $5,824 per family contract in the small group market, $1,921 per single contract and $5,558 per family contract in the large group market, $3,052 per Medicare Advantage member, and $1,988 per Medicaid managed care enrollee. Furthermore, we estimate that about 142 million consumers and/or their plan sponsors (in the case of Medicaid and subsidized exchange plans) could be impacted by the tax on health insurance.

In the FEHBP, the tax impacts insurer products like Blue Cross FEP and the HMOs. The House of Representatives has passed a bill that would extend the tax suspension through 2021. We will soon find out whether the Senate takes up this bill which would make high deductible plans with health savings accounts more attractive to consumers.

Finally, here's an interesting blockchain in healthcare article from Health Data Management. The article identifies several long hanging fruit type products that could benefit from the new technology.