Studies and some other news

Health Affairs Blog previewed a Health Care Cost Institute study of employer sponsored heath plan costs over the period 2007 through 2016.

The authors found that total enrollee spending (not including premiums) on health care goods and services increased by 44 percent over the decade—from $3,752 to $5,394 per person—which was an average annual increase of 4.1 per cent. They also observed that growth rates slowed after 2009 but increased between 2014 and 2016.

The study also found that enrollee out of pocket spending kept pace with total spending, up 43% over the same period.

Forbes reports on Mercer consulting's preliminary projection  that large employer health plan costs will rise 4.1% next year and Avalere consulting's projection that ACA exchange plan premiums will increase 3.1% in 2019. Plansponsor.com digs into some employer sponsored plan trends identified in the Mercer report.

Becker's Hospital News summarizes a fascinating, detailed Wall Street Journal story about how big health systems use their leverage to create exclusive contracts with various payers, thereby impairing competition. According to the Journal,

Dominant hospital systems use an array of secret contract terms to protect their turf and block efforts to curb health-care costs. As part of these deals, hospitals can demand insurers include them in every plan and discourage use of less-expensive rivals. Other terms allow hospitals to mask prices from consumers, limit audits of claims, add extra fees and block efforts to exclude health-care providers based on quality or cost.

The Wall Street Journal has identified dozens of contracts with terms that limit how insurers design plans, involving operators such as Johns Hopkins Medicine in Maryland, the 10-hospital OhioHealth system and Aurora Health Care, a major system in the Milwaukee market. National hospital operator HCA Healthcare Inc. also has restrictions in insurer contracts in certain markets.

 No bueno.

Today, the Surgeon General spotlighted government efforts to alleviate the opioid crisis.

The federal government has been working with key stakeholders to address this problem and is seeing real progress. This week, HHS disbursed more than $1 billion in opioid-specific funding for states, which includes State Opioid Response grant programs administered by SAMHSA to support a comprehensive array of prevention, treatment, and recovery services. Additional funding from the Health Resources and Services Administration (HRSA) went to community health centers to increase access to substance abuse disorder and mental health services, to increase  the number of professionals and paraprofessionals who are trained to deliver integrated behavioral health and primary care services as part of health care teams in HRSA-supported health centers as well as to rural grantees to increase services and develop plans to implement evidence-based opioid use disorder prevention, treatment and recovery interventions.  There are signs that efforts to stem the opioid crisis are having success, with the use of medication-assisted treatment growing significantly and the number of Americans initiating heroin use dropping significantly from 2016 to 2017.

Bueno.

Earlier this week, the Centers for Medicare and Medicaid Services announced "a proposed rule to relieve burden on healthcare providers by removing unnecessary, obsolete or excessively burdensome Medicare compliance requirements for healthcare facilities. Collectively, these updates would save healthcare providers an estimated $1.12 billion annually. Taking into account policies across rules finalized in 2017 and 2018 as well as this and other proposed rules, savings are estimated at $5.2 billion."  The FEHBlog is a big fan of deregulation and would be pleased to see OPM catch the deregulation bug.