TGIF

The Federal Benefits Open Season ends on Monday December 10. Tammy Flanagan on govexec.com offers some guidance to procrastinators.  The FEHBlog's advice is to make sure that your health care providers are in-network if at all possible.

Federal New Network confirms that Congress did pass a two week long extension of the continuing resolution funding certain agencies, including OPM, in the current fiscal year. The new deadline is December 21, 2018.

The Centers for Medicare and Medicaid Services ("CMS") Office of the Actuary issued yesterday its 2017 report on national health expenditures. Health Payer Intelligence observes that

National health spending grew 3.2 percent on a per capita basis last year, compared to four percent in 2016. A descent in the residual use and intensity of goods and services; particularly in hospital care, physician and clinical services, and retail prescription drugs, primarily fueled the overall slowdown, escalating 1.1 percent in 2017, down from 2.1 percent the year before. However, medical price growth slightly up ticked, from 1.3 percent in 2016 to 1.6 percent last year.

The CMS press release explains that "Details from the slower spending growth in these three largest goods and service categories are:

• Hospital spending (33 percent of total healthcare spending) decelerated in 2017, growing 4.6 percent to $1.1 trillion compared to 5.6 percent growth in 2016. The slower  growth for 2017 reflected slower growth in the use and intensity of services, as growth in outpatient visits slowed while growth in inpatient days increased at about the same rate in both 2016 and 2017. 
• Physician and clinical services spending (20 percent of total healthcare spending) increased 4.2 percent to $694.3 billion in 2017. This increase followed more rapid growth of 5.6 percent in 2016 and 6.0 percent in 2015. Less growth in total spending for physician and clinical services in 2017 was a result of a deceleration in growth in the use and intensity of physician and clinical services.
• Retail prescription drug spending (10 percent of total healthcare spending) slowed in 2017, increasing 0.4 percent to $333.4 billion. This slower rate of growth followed 2.3 percent growth in 2016, which was much slower than in 2014, when spending grew 12.4 percent, and in 2015, when spending grew 8.9 percent. These higher rates of growth in 2014 and 2015 were primarily the result of the introduction of new, innovative medicines and faster growth in prices for existing brand-name drugs. Retail prescription drug spending growth slowed in 2017 primarily due to slower growth in the number of prescriptions dispensed, a continued shift to lower-cost generic drugs, slower growth in the volume of some high-cost drugs, declines in generic drug prices, and lower price increases for existing brand-name drugs."

Speaking of Medicare, Modern Healthcare reports that 

When Congress shifted pay models from individual physicians' historical charges to the "relative values" of services [in the early 1990s], that translated to higher reimbursement for new services and a significant increase in the volume of expensive procedures. This has widened the income gap between primary-care physicians and specialists, causing more students to pursue the latter, according to a new white paper from the USC-Brookings Schaeffer Initiative for Health Policy. 

To the dismay of many policy experts and organizations like the Medicare Payment Advisory Commission, updates to the fee schedule have benefited procedure-oriented specialties at the expense of primary-care doctors. 

This problem, which Congress needs to address, is magnified by the fact that private sector networks often base their negotiated pricing on Medicare's fee schedule because doctors are familiar with that schedule.

Healthcare Dive named Amazon the health care industry's disruptor of 2018.  That award hardly requires any background information. As evidence for the validity of that award, Forbes reports that

Walgreens and FedEx are expanding their relationship to launch next-day prescription delivery nationwide. 

The move comes in the wake of online retail giant Amazon’s acquisition of PillPack, an online pharmacy that offers home delivery. Amazon’s distribution network is expected to help PillPack grow dramatically in what could be a major challenge to brick-and-mortar pharmacy giants Walgreens Boots Alliance and CVS Health. 

But Walgreens said its partnership with FedEx will make it the “fastest choice for next-day prescription delivery across the nation.” CVS Health has been rolling out home delivery as well, announcing same-day service in several cities last summer.

Have a good weekend.