TGIF

David Ermer–Uncategorized–

In the last weekend update, the FEHBlog noted that the House Oversight and Government Reform Committee would be holding a hearing on enhancing cybersecurity of third party contractors and vendors.  Here is an FCW report on the hearing for those interested.

Two months ago today, the FEHBlog watched an online webinar about population health management (promote longevity – compress morbidity) presented by the National Diabetes Education Program which is part of NIH. Here are links to the slides and the script for that webinar. Very worthwhile.

Here’s an interesting perspective on last week’s HIMSS conference from Michael Arrigo, an advisor on disruptive healthcare regulations.  Five trends to follow.

OPM is encouraging FEHB plans to offer incentivized wellness programs.  Here’s an Employee Benefit Advisor report about an Optum survey of larger employers about their wellness program incentives.

  • The most prevalent incentive mechanisms include company contributions to HSAs, HRAs or HIAs (38%); health premium reductions (34%–jumping from 27% in the prior year survey); and gift cards (29%).
  • Only 16% of employers use cash incentives.
  • The average value of incentives is $414, although 24% offer incentives in the $500-$999 range, and 11% provide incentives worth $1,000 or more.
Finally, here is a CMS report on physician participation in the Medicare Physician Quality Reporting System (“PQRS”) and Electronic Prescribing Incentive Program. PQRS is the flip side of the HEDIS quality measures applied to health plans. Suprisingly, at least to the FEHBlog, a large cadre of physicians opted for a financial penalty from Medicare for failing to participate in PQRS.  

  • In 2013, 641,654 eligible professionals participated either as individuals or as part of PQRS group practices, through at least one reporting mechanism, a 47 percent increase from the 435,931 who participated in 2012. Approximately 51 percent of the 1.25 million professionals who were eligible to participate in 2013 participated in PQRS. The 2013 PQRS incentive payments totaled $214,551,741. 
  • 469,755 eligible professionals were subject to a 2015 PQRS negative payment adjustment. Based on 2013 PQRS reporting, 469,755 eligible professionals are subject to a reduction of 1.5 percent of their 2015 Part B Medicare Physician Fee Schedule allowed charges. Of those professionals subject to the adjustment, 98 percent did not attempt to participate in PQRS. In addition, 43 percent of the professionals subject to the payment adjustment treat 25 or fewer Medicare beneficiaries a year.
Greater physician participation in PQRS likely would boost health plan HEDIS socres.