Happy Super Sunday

The Super Bowl is less than three hours away. The FEHBlog does not care for either team, but as an American and an NFL fan he feels duty bound to watch the game.

Congress will be in session again this week. Last week, the Senate Homeland Security and Government Oversight Committee, which is responsible for OPM and the FEHBP, announced its subcommittee chairs for the new Congress.  Sen. James Lankford (R Okla) will chair the Subcommittee on Regulatory Affairs and Federal Management.  Here is a link to This Week in Congress’s latest update.

Tomorrow, the President will release his FY 2015 budget proposal. Here is a link to the Hill’s report on five things to watch for in the budget. Ed Lorenzen, a senior advisor to the Committee for a Responsible Federal Budget, “”pointed out that the president’s budget serves a useful purpose for appropriators in Congress each year because it contains line-by-line details of agencies’ needs.” That;s why the FEHBlog will be taking a look at the budget documents.

Forbes reports that the budget will include additional funding for personalized medicine, which is good news. The Republicans in Congress are expected to be receptive to this Administration initiative. Personalized or precision medicine builds on the human genome project.

The Wall Street Journal reports that many hospitals and doctors, who are sick of voluminous, detailed quality measures, want to move to global measures that look at patient health outcomes. But there are other views too.

On Friday, the National Quality Forum, a nonprofit advisory group, submitted recommendations on 199 performance measures for Health and Human Services to consider in 20 federal programs. Christine Cassel, the group’s president and chief executive, said many of the proposals seek to better align measures among various programs and replace narrow process-oriented metrics with “measures that matter.” For example, one recommendation would replace individual metrics on the percentage of diabetes patients who get foot exams, eye exams and blood-glucose checks with a composite measure of diabetes control.
But some doctors question whether the measures that exist can adequately measure quality. And there is little agreement on what measures matter most or are more likely to produce good value. “In many areas of patient care, we do not yet have high-quality outcome measures with enough specificity to drive improvement,” American Medical Association Executive Director James L. Madara wrote in a letter to the quality forum earlier this month.
Some doctors complain that whether patients get better is often out of their control; that outcomes measures take more work, not less; and that being held accountable for outcomes could prompt doctors to avoid treating the sickest patients.

This problem is even more acute for insurers that are judged by the health care quality measures but generally are much more removed than doctors from the healthcare decision making. In any event, the flip side of the coin illustrated in this article from today’s New York Times, is how to assess whether, and steer patients away from, doctors are engaged in ordering unnecessary tests care.