Weekend Update

Happy St. Patrick’s Day.  This week will feature the annual OPM AHIP FEHBP carrier conference. The FEHBlog will be in attendance. Congress also will be in session working on budgets and an extension of the continuing resolution funding the federal government through September 30, 2013, the end of the current federal fiscal year. Absent an agreement before March 28, a government shutdown will occur. The House of Representatives already has passed its version of the CR and the Senate will consider its version early this week. The Federal  Times and govexec.com review the impact of these efforts on federal employees and annuitants.

Fierce Health Finance reports that according to an Alarium Institute study health care spending rate is declerating to a level similar to that found in the golden years of managed care / gatekeeper HMOs in the mid to late 1990s. But it’s still going up.  The study credits the weak economy and cost pressures on providers of care for the slowdown.

Contributing to the slowdown according to a Decision Resources study reported in Modern Healthcare is the fact that

Endocrinologists and primary-care physicians use e-prescribing for 76% of their Medicare patients and 79% of their non-Medicare patients.. About 60% of these doctors say that within their e-prescribing program, they have access to their patients’ full lists of medicines, or formularies. As a result, they suggest that they pay closer attention to patient prescription costs. About 80% of these endocrinologists and primary-care physicians say that, if given information about their patients’ formularies and copays, they would prescribe less expensive/better-reimbursed options.

CMS has begun to penalize doctors who don’t use electronic prescribing.

The Hill reports on a House Energy and Commerce Health Subcommittee hearing about the expected impact of the Affordable Care Act on health insurance premiums next year. The FEHBlog’s take is that the Affordable Care Act will increase premiums but consumers who receive premium subsidies in the exchanges (up to 400% of the federal poverty line) will be shielded from the increases to one extent or another (that’s the Affordable part of the ACA).  Consumers who are eligible for employer sponsored coverage can only receive subsidized exchange coverage if there employer sponsored coverage premiums would be 9.5% or more of the employee’s W-2 annual income. If the employer offers a choice of coverage, the employer can select one low cost plan that is open to enrollment by all employees to serve as the benchmark under the IRS rules.

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