Tuesday’s Tidbits

In last Friday’s Federal Register, the Internal Revenue Service published an Affordable Care Act rule that further delves into the topics of whether health plan coverage provides minimum value or is affordable for ACA purposes. A Health Affairs blogger offers a good post on the proposed rule.  The public comment deadline is July 2.

An Employee Benefits News blogger offers an entertaining post arguing that return on investment principles should not be applied to wellness programs. The FEHBlog agrees that the use of strict ROI rules to meaure soft dollar benefit savings misses the point of these programs.

The FEHBlog discussed prescription drug wastage in a recent post. The FEHBlog therefore noted with interest an iHealthBeat story that CVS pharmacies are terminating their prescription refill reminder service out of a concern that their drug manufacturer compensation for the service may be inconsistent with the Hitech Act omnibus rule that takes effect on September 23.

The FEHBlog notes that late last month the U.S. Preventive Services Task Force (“USPSTF”) approved two new “A”   level recommendations:

The USPSTF recommends that clinicians screen for HIV infection in adolescents and adults ages 15 to 65 years. Younger adolescents and older adults who are at increased risk should also be screened.
The USPSTF recommends that clinicians screen all pregnant women for HIV, including those who present in labor who are untested and whose HIV status is unknown.

The decision triggers on obligation on FEHB plans and other health plans to cover these screenings without cost sharing when performed in-network beginning next year. [CORRECTION — This change will take effect in 2015 under the ACA rules.]  Currently, this mandate is limited to patients who are considered at risk.

Kaiser Health News reviews a bevy of new studies looking at whether the recent slow down in health care spending was tied to the Great Recession or reflects structural changes. The FEHBlog was struck by this statement in the article:

“On this front, history is not encouraging,” wrote John Holahan and Stacey McMorrow, researchers at the Urban Institute, in the paper released by the Robert Wood Johnson Foundation. “Health spending growth has rebounded after every major attempt at cost containment and this creates understandable skepticism that the most recent slowdown will be lasting.”

Time will tell.

Among structural changes are the retail clinics that have popped up a pharmacies and other retailers. Modern Healthcare reports that

The industry’s Convenient Care Association estimates nationwide there are now more than 1,400 health clinics inside retail chain stores, double the number from six years ago. Industry leader CVS Caremark Corp. now operates 650 MinuteClinics in 25 states and Washington, D.C., and plans to open 150 new clinics in the coming year on its way to having 1,500 in 35 states by 2017. Walgreen, the second-largest player, is planning double-digit growth in 2013 as it expands its Take Care clinic roster of 372 stores. 

The FEHBlog closes this evening with a link to an ACA Burden Tracker developed by the House majority based on agency estimates under the Paperwork Reduction Act. Right now the burden on businesses and the general public stands at about 190,000,000 hours annually.