Weekend Update

Congress is in session this coming week. Here’s a link to a report on last week’s work on Capitol Hill.  Modern Healthcare predicts that Congress will pass another extension of the Medicare Part B patch that prevents the statutory sustainable rate of growth formula from cutting reimbursements to doctors by 21.2%. The deadline for Congressional action is the end of this month.

Modern Healthcare also reports that Blue Cross of Massachusetts, a member of the value based care vanguard, lost $119 million from operations last year due to Hepatitis C drug costs and ACA and local taxes. The operating loss for this non-profit insurer was on “$6.5 billion in revenue, a -1.8% operating margin. When factoring
in investments and other income, the insurer posted an $8 million
surplus in 2014.”

Federal News Radio reports that “Just over 9,200 federal employees filed for retirement benefits in the shortest
month of the year, enough to swell the government’s backlog of retirement claims
to its highest point in more than 18 months.”  The point here is not to knock OPM but rather to illustrate FEHB demographics which skew toward an older demographic.

Kaiser Health News reports on the serious problem that has arisen due to the fact that the government spent $30 billion on electronic medical record systems that don’t communicate with each other electronically. Health Data Management reports that the Senators are not impressed by the government’s roadmap to interoperable electronic medical records. The FEHBlog is placing his bets on private sector organization like the eHealth Initiative and CAQH CORE to solve the problem.

Drug Channels offers an intriguing analysis of CVS’s SEC reports.  Here are a tidbit:  “CVS Health’s Caremark pharmacy benefit management (PBM) business
accounted for a record 35% of CVS retail pharmacies’ prescription
revenues. That’s much higher than Caremark’s overall market share.” The article focuses on the marvelous synergies of CVS’s Maintenance Choice program for both CVS and payers.

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