Weekend Update

The Nationals are down two in a best of five series so the FEHBlog has not had a gang buster weekend. Congress remains on the campaign trail, but the Supreme Court’s new session begins tomorrow, the first Monday in October. 

The FEHBlog mentioned a week or so ago that the renewal premium for his family group (wife and two over 18 kids) increased 58% in the ACA/Obamacare era. The FEHBlog has discovered that under the ACA’s pricing scheme there is no difference between individual and small group pricing. Each member of my family group is separately priced based on the family member’s age. What this means is that the FEHBlog will be moving to a high deductible plan, thereby putting his money where is mouth is and then getting his 24 year old daughter who thankfully is happily employed to shift her coverage over to her employer. It’s a brave new world.

This week OPM should announce 2015 FEHB premiums. Business Insurance reports 

Average health care benefit cost increases for active group and pre-Medicare retiree coverage are projected to range between 6.2% and 10.4% depending on the plan type, reflecting flat-to-moderate reductions in cost trend rates in 2014, according to Segal Group’s 18th annual Health Plan Cost Trend Survey, released Thursday.  Segal’s report also predicts an average 8.6% rise in prescription coverage costs in 2015, compared with an average 6.3% increase in the previous year.

We’ll see how FEHB premium changes stack up against this latest projection for all employers.

Kaiser Health News reports on the latest round of potentially avoidable readmission penalties that CMS has imposed on Medicare participating hospitals. The report explains that

As the penalties have played out, an increasing number of prominent experts are voicing concerns that the punishments are too harsh and doled out unfairly. For one thing, Medicare lowers payments to hospitals even if they have reduced their readmission rates from the previous year—so long as their rate is still higher than what the government believes is appropriate for that hospital. Medicare uses the national readmission rate to help decide what appropriate rates for each hospital, so to reduce their fines from previous years or avoid them altogether, hospitals must not only reduce their readmission rates but do so better than the industry did overall.
“You have to run as fast as everyone else to just stay even,” [AHA quality expert Nancy] Foster said. Only 129 hospitals that were fined last year avoided a fine in this new round, the KHN analysis found. 

And of course the safety net hospitals are taking it in the chops. All of these hospitals will increase rates on private sector, including FEHB plans, to recover the losses created by these penalties.

ISACA has a post on the five truths of HIPAA Security Risk Assessments. Risk assessments are write ups on the security threats that keep you up at night. Risk assessments are the starting point for HIPAA Security Rule compliance and it’s incumbent on covered entities and business associates to keep their risk assessments routinely updated.  

In the same vein, Government Health IT weighs in with five tips for managing HIPAA Security Rule risks created by third parties. Congress has in a sense reduced the risk on the covered entity by directly imposing Security rule compliance obligations on business associates. The article concludes with some sound advice:

Healthcare organizations should document their risk management policies and procedures. Documentation needs not be daunting — simply write down what your job entails, and have an independent party review it. This helps organizations identify gaps and avoid future security incidents.
The best way to prevent a breach is to have a robust program to assess how your vendors are managing data risks. That’s the only control you have. These five strategies can help covered entities stay in control of data, whether inside their firewall or in the hands of business associates and subcontractors.

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