Pre-Thanksgiving Musings

  • Mercer has issued its annual survey of employer sponsored health plans. Cost increases have been relatively stable around 6% for three years. Employers are saving money with consumer driven health plans. In 2007, health savings account based plans cost $5,679 per employee annually; health reimbursement account plans cost $6,224 per employee, and traditional PPO plans cost $7,352. See OPM chart for distinctions between HSA and HRA plans.
  • House and Senate negotiations over the mental health parity bill are continuing while the House leadership tries to figure out how to resolve the pay-go issues associated with the bill. According to BNA, the major issue confronting the negotiators is whether to accept the House bill’s use of the American Psychiatric Association’s DSM-IV to define mental illnesses. OPM currently uses the DSM-IV to define the scope of the FEHB Program’s mental health parity program. However, while it would be a simple administrative matter for OPM to change definitions, it would take a lot more effort to make such a change if the DSM-IV were enshrined in law.
  • BNA reports that Senate Finance Committee members favor a two year fix (2008 and 2009) of the Medicare physician reimbursement issue because it would be less expensive in total. There is no timetable for consideration of the Medicare package. Absent a legislative fix, Medicare reimbursement to doctors will be cut by about 10% on January 1, 2008.
  • reports that the Senate could not pass the Wired for Healthcare bill by unanimous consent due to objections from the American Medical Association (not enough money, etc.) and privacy zealots.
  • New York State Attorney General Andrew Cuomo concluded doctor ranking agreements with United Healthcare and several other health plans this week.
  • Last week, I blogged about a lawsuit between CaremarkPCS, the prescription benefits manager, and Walgreen’s, the pharmacy chain. Walgreen’s had terminated on short notice a contract with CaremarkPCS in Illinois and Wisconsin affecting four employer plans. CaremarkPCS sought a temporary restraining order which Judge Mark Filip granted. President Bush just nominated the Judge to be Deputy Attorney General.
  • The Blue Cross Blue Shield Association’s National Council of Physician Executives is supporting the CMS “never events” policy of limiting reimbursement of treatment of hospital errors. This may lead individual Blues plans and other insurers to adopt the CMS policy, which takes effect October 1, 2008.