Tuesday's Tidbits

The National Business Group on Health issued its 2020 Large Employers' Health Care Strategy and Plan Design Survey today.

The 2020 Large Employers' Health Care Strategy and Plan Design Survey found employers project the total cost of health benefits will rise 5% in 2020, taking cost management initiatives into account. That increase is identical to 2019’s projected increase - but actual costs are coming in lower. Large employers reported the actual increase in 2018 was 3.6%. Including premiums and out-of-pocket costs for employees and dependents, the total cost of health care is estimated to be $14,642 per employee this year, and projected to rise to an average of $15,375 in 2020.  Employers will cover nearly 70% of costs while employees will bear about 30%, or nearly $4,500.  Forty-four percent of employers ranked musculoskeletal issues as the top condition impacting their costs while 85% ranked it among the top three conditions. One in four (25%) employers ranked cancer as the top condition.  

“One of the challenges employers face in managing their health care costs is that health care is delivered locally and change is not scalable.  It’s a market-by-market effort,” said Brian Marcotte, President and CEO of the National Business Group on Health. “Employers are turning to market-specific solutions to drive meaningful changes in the health care delivery system.”

Good point.

Speaking of which, Kaiser Health News reports on 29 Hepatitis A outbreaks across the United States which often follow the path of the opioid crisis.

Dr. Monique Foster, a medical officer in CDC’s Division of Viral Hepatitis, said vaccinating those at highest risk remains the best strategy. “Outbreaks will stop when we have effectively vaccinated the vulnerable people,” she said.

Although the federal government isn’t recommending universal vaccination, several experts said the more people vaccinated, the better. 

“The risk is there. The disease is circulating,” said the University of Kentucky’s Winter. “It’s good for the general public to be vaccinated.” 

With the virus continuing its advance, Penn State’s Haeder said, “it won’t be long before we have it everywhere.”

Meanwhile according to the Wall Street Journal, the U.S. Preventive Services Task Force today "released a draft ["B" level] recommendation that doctors ask their patients about illicit drug use, including opioid painkillers, so they can be directed to treatment." Health plans must cover with enrollee cost sharing final "A" and "B" recommendations when carried out by in-network provider. New USPSTF "A" and :B" level recommendations will be required to be covered without cost-sharing starting with the plan year (in the individual market, policy year) that begins on or after the date that is one year after the date the recommendation is issued / finalized. The Journal's report explains

The group’s draft recommendation, which reverses its previous [2008] stance of not asking about illicit drug use, said it is taking the step in part because 7.5 million people 12 years old and older in the U.S. have been diagnosed with dependence or abuse of illicit drugs in the past year, according to the task force. 

Healthcare Dive reports on healthcare provider suggestions to the Centers for Medicare and Medicaid Services on how to reduce the Medicare administrative burden on them.

Companies took the request for information as an opportunity to air perennial grievances about the highly regulated environment, including inequitable quality measures and reporting requirements, prior authorization that slows down care delivery for patients and problems with interoperability and telehealth.

The FEHBlog dearly wishes that OPM would take a page out of this CMS playbook and apply it to the FEHBP.