Weekend update

The FEHBlog is back from a relaxing vacation just as Congress headed out of DC for its Fourth of July recess which will end on July 7.  Here is a link to last week’s Congressional news.

Tomorrow is the last day of the current U.S. Supreme Court term. The Court has two more decisions to release before heading out on its summer vacation. In anticipation of the Hobby Lobby decision due tomorrow,  HHS on Friday released a report which includes the following findings

IMS estimated that the total number of prescriptions for oral contraceptives with no co-pay increased by more than four-fold from 6.8 million in 2012 to 31.1 million in 2013 (an increase of 24.4 million) in part due to the Affordable Care Act’s zero-cost sharing provisions for certain preventive services.

This increase in oral contraceptive prescriptions dispensed with no co-pay contributed to a reduction in out-of-pocket costs estimated by IMS at $483.3 million that would have been spent in 2013 had women bought the same mix of oral contraceptives as those purchased in 2012. 

But few things in life are free. The half billion dollars were not avoided. Those costs were shifted onto other insureds. The ACA’s reforms principally add (25 million prescriptions) and shift costs (here half a billion dollars) from one group to others. The law reflects political decisions, but it does not hold down health care costs. 
The Washington Post and the Wall Street Journal reported this weekend on Anne Wojcicki, the estranged wife of Google’s CEO who runs a DNA screening company for John and Jane Doe called 23andme. House Energy and Commerce Committee Chairman Fred Upton and President Obama hosted Ms. Wojcicki a different events here in DC last week. Some months ago, the Food and Drug Administration shut down her company’s consumer operation for lack of testing on her company’s consumer product, which TIME magazine trumpeted a few years ago. According to the article, Ms. Wojcicki thinks that this is just a disconnect between advanced technology and bureaucracy. Her observations on the health care system are worth reading.  
Also on the technology front, the New York Times reports today on the University of Pittsburgh Medical Center’s health insurance arm, which participates in the FEHBP.  UPMC is trying to apply consumer shopping data to its member analytics.  

The Pittsburgh health plan, for instance, has developed prediction models that analyze data like patient claims, prescriptions and census records to determine which members are likely to use the most emergency and urgent care, which can be expensive. Data sets of past health care consumption are fairly standard tools for predicting future use of health services.

But the insurer recently bolstered its forecasting models with details on members’ household incomes, education levels, marital status, race or ethnicity, number of children at home, number of cars and so on. One of the sources for the consumer data U.P.M.C. used was Acxiom, a marketing analytics company that obtains consumers’ information from both public records and private sources.

With the addition of these household details, the insurer turned up a few unexpected correlations: Mail-order shoppers and Internet users, for example, were likelier than some other members to use more emergency services.

Of course, buying furniture through, say, the Ikea catalog is unlikely to send you to the emergency-room. But it could be a proxy for other factors that do have a bearing on whether you seek urgent care, says Pamela Peele, the chief analytics officer for the U.P.M.C. insurance services division. A hypothetical patient might be a catalog shopper, for instance, because he or she is homebound or doesn’t have access to transportation.

 What next? 

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