May Day

Ah, it’s the first of May.  The beginning of the three best months of the year (weather-wise) here in Washington, DC.

Two other insurers, Cigna and Humana as well as the two big prescription benefit managers, CVS Health and Express Scripts, have reported their first quarter results. The winter weather did not adversely impact healthcare companies.

The Federal Times reports that the reconciled FY 2016 budget moving through Congress does not include any express federal employee benefit cuts. However, the resolution does direct the Congressional committees to reduce civil service spending which in turn could lead to reductions. Specifically, according to the Washington Post, “The joint budget agreement calls for cutting that amount over 10 years from programs under the House Oversight and Government Reform Committee,” which of course has jurisdiction over the FEHBP and other federal employee benefit programs. .Defense spending would be increased.

Yesterday, CMS released details on $103 billion of Medicare spending on prescription drugs in 2013. The Administration trumpets this action as evidence of its transparency and the action certainly has attracted press attention as illustrated by this Kaiser Health New collection of articles. However, the FEHBlog thinks that OPM’s “small ball” request made in the 2016 call letter that FEHBP carriers offer a webtool that allows consumers and their healthcare providers to see consumers would pay for prescription drugs pushes the transparency ball down the path further than this HHS move.

Health insurers and employers have been funding a Patient Centered Outcomes Research Institute (“PCORI”) to the tune of millions of dollars since the ACA’s enactment. The FEHBlog has wondered what the PCORI has accomplished other than spending the money on research studies. The FEHBlog is gratified that Modern Healthcare is asking the same question.

The Affordable Care Act created an independent organization to support research that assesses which healthcare interventions are most effective. But three years after it started funding studies, there’s no central repository of results or a clear strategy for making sure the knowledge reaches the clinicians it’s intended to influence.
The Patient-Centered Outcomes Research Institute distributed grants worth $30 million to its inaugural round of 50 projects. About 30 are complete and more results are anticipated this summer, PCORI leaders told Modern Healthcare.
It’s not clear, however, when or where those results can be found. PCORI says grantees are expected to have a plan for sharing their findings but also that it does not set timelines for completing studies.
As of last week the group said it had not been notified by project leaders of the completed research whether or not they have submitted manuscripts to peer-reviewed journals. The institute also said it does not have a central database where results can be shared, and researchers are not required to submit manuscripts to journals for publication. 

This problem could have a quicker fix than the electronic medical record interoperability problem. Time will tell.