Weekend update

David Ermer–Uncategorized–

Both Houses of Congress are in session this week. Last week the House of Representatives passed a continuing resolution bill (H.R. 933) that will fund the federal government through the fiscal year end (September 30, 2013) subject to the current sequestration with a few exceptions as the Hill explains

The bill is a continuing resolution for most federal agencies, but for the Defense Department (DOD) and Department of Veterans Affairs, it includes a full appropriations bill. That language gives the DOD some flexibility in dealing with the sequester, by shifting $10.4 billion to the operations and maintenance budget.
The bill tries to cushion the effects of sequestration in some non-military areas. It adds $2 billion for embassy security in the wake of last September’s attacks on the U.S. Consulate in Benghazi, Libya, and provides $363 million more for nuclear security and $129 million more for FBI salaries, among other things.
It also includes other policy mandates, including a prohibition on the use of funds to move Guantánamo Bay detainees to the United States and a freeze on federal worker pay.

According to the Hill’s Floor Watch, the Senate takes up the House bill this week in an effort to avoid the government shutdown that would occur if an impasse occurred. The Federal Times offers more perspective on the Senate’s efforts here.

In the good old days, OPM ran the FEHBP. However, particularly since enactment of the Affordable Care Act, OPM has shares that role with the three ACA regulators, HHS, the Labor Department and the Internal Revenue Service. Hence, it’s worth noting on the FEHBlog that President Obama according to the Washington Post and other sources is prepared to nominate Thomas Perez, the assistant U.S. Attorney General for civil rights, to be the Labor Secretary, replacing Hilda Solis who recently resigned.

In that regard, the FEHBlog further notes that last Friday, the Labor Department issued lucky ACA FAQ XIII which concerns the application of the ACA to expatriate plans.

Finally last week the National Business Group on Health released the 18th annual Towers Watson/National Business Group on Health Employer Survey on Purchasing Value in Health Care.  The survey finds that

The best performers had an average health care cost increase of 1.7% in 2012, less than half the median increase and roughly in line with the general inflation trend. In 2013, this group took a number of significant steps to improve the efficiency of their health care programs. They:

  • Consolidated vendors to improve delivery and coordination of health management programs, while also taking steps to incent providers to invest in new technologies to improve the coordination of care
  • Focused more on communication to help employees make smarter health care decisions, leveraging popular culture technology like social media to make sure they have the best information on health care providers available
  • Stepped up emphasis on transparency in provider prices as well as quality and results
  • Invested in case management to more proactively and effectively manage their high-cost cases
  • Placed more responsibility on employees, tying financial incentives to measurable improvements in their health, and extended incentives to spouses
  • Started implementing new payment methods to providers, placing greater responsibility on them to deliver high-quality, efficient care.

FEHB plans which rank among these best performers use all of these strategies except for placing more responsibility on employees principally because of a statutory and thus inflexible government contribution formula.