Weekend Update

Both Houses of Congress are in session this week, and the Supreme Court is poised to issue the most significant decisions of its current term which will be completed at the end of this month. None of those decisions as far as the FEHBlog knows will have a significant impact on the FEHBP. Nevertheless he will be checking in with scotusblog

The St. Louis Business Journal notes that Humana is considering the sale of its prescription benefits management business valued at $7.1 billion and Express Scripts, which is based in that fair city, would be a likely bidder.

The Motley Fool reports that Aetna, Cigna, and United Healthcare are jumping on the smartphone app revolution in order to connect to their customers. Smart move.

Finally, Kaiser Health News reports that surgeons are not yet playing a major role in accountable care organizations.

That’s according to a case study and survey published this week in the journal Health Affairs. The authors conducted case studies at four ACOs in 2012 and sent a survey to all 59 Medicare ACOs in the first year of the program, with 30 responding.
“I’m a surgeon, so I was really curious as this model probably continues to gain steam, what’s this going to mean for me?” said lead author James M. Dupree, a urologist at Baylor College of Medicine. “We found that thus far, very little of the strategic attention seemed to be devoted to surgical care and the integration of surgeons into the ACO.”

That’s odd.  The article explains

“Dermatologists, endocrinologists, all the different specialties want to know how they fit in, but generally ACOs are not prioritizing the specialties. They’re focusing on the lowest hanging fruit, and generally the specialties aren’t the lowest hanging fruit.” It’s easier to focus first on things like reducing expensive hospital admissions by managing the care of patients with chronic illnesses, including diabetes.
Another reason, [Dr. Dupree] ys, is that it’s hard for an ACO to figure out how to share savings with specialists like surgeons. With a primary care physician, it’s relatively easy to figure out their share of the ACO’s savings by factoring in the number of patients they see. “It’s harder with specialists who may only see a handful of patients a week,” he said

Rome of course was not built in a day.

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