The Washington Post reports this afternoon that

Office of Personnel Management Director Katherine Archuleta resigned under pressure on Friday, a day after Obama administration officials announced that two major breaches last year of U.S. government databases holding personnel records and security-clearance files exposed sensitive information about at least 22.1 million people.”  

The report further explains that

The White House announced that Beth Cobert, deputy director for management at the Office of Management and Budget, will take over the personnel agency in an acting role until President Obama appoints a permanent replacement. OPM has not had a deputy director since 2011; the president’s nominee for the  No.2  job [retired Navy Admiral Earl L. Gay] has been held up in Congress for many months.

Here is Ms. Cobert’s CV from the White House OMB website:

Beth Cobert is the Deputy Director for Management. She was confirmed on October 16, 2013. Cobert previously served nearly thirty years at McKinsey & Company as a Director and Senior Partner. During her tenure, she worked with corporate, not-for-profit and government entities on key strategic, operational and organizational issues across a range of sectors, including financial services, health care, legal services, real estate, telecommunications, and philanthropies. She led major projects to generate performance improvements through process streamlining, enhanced customer service, improved deployment of technology, more effective marketing programs and strengthened organizational effectiveness. Within McKinsey, Cobert held multiple leadership roles in people management including recruiting, training, development and performance management of staff. She has been a champion for professional development and initiatives to support women’s advancement to leadership positions. Cobert also previously served as a board member and chair of the United Way of the Bay Area and as a member of the Stanford Graduate School of Business Advisory Council. Cobert received a bachelor’s degree in economics from Princeton University and a master’s degree in business administration from Stanford University. She and her husband Adam Cioth have two children. 

Quite a resume.

Fierce Health Payer reports today that Cigna and Anthem now are making progress on their merger negotiations after a hiccup in those negotiations occurred a couple of weeks ago.

On the regulatory front, CMS issued a proposed rule Wednesday on Medicare Part B payments to physicians for 2016. This is the first Part B rule released since Congress repealed and replaced the sustainable rate of growth formula earlier this year. “Through the proposed rule, CMS is beginning implementation of the new payment system for physicians and other practitioners, the Merit-Based Incentive Payment System (MIPS), required by the legislation.” It appears quite complicated like everything in Medicare.  CMS must have made the hospitals’ day yesterday by announcing a new bundled payment pilot for hip and knee replacement surgeries.

Under this proposed model, the hospital in which the hip or knee replacement takes place would be accountable for the costs and quality of care from the time of the surgery through 90 days after—what’s called an “episode” of care.
Depending on the hospital’s quality and cost performance during the episode, the hospital would either earn a financial reward or be required to repay Medicare for a portion of the costs. This payment would give hospitals an incentive to work with physicians, home health agencies, and nursing facilities to make sure beneficiaries receive the coordinated care they need with the goal of reducing avoidable hospitalizations and complications. Hospitals would have additional tools – such as spending and utilization data and sharing of best practices – to improve the effectiveness of care coordination.
By “bundling” these payments, hospitals and physicians have an incentive to work together to deliver more effective and efficient care.  This model would be in 75 geographic areas throughout the country and most hospitals in those regions would be required participate. 

The ACA regulators today announced a final rule on the ACA mandate for women’s preventive health care which must delight religious employers.

OPM has been pressing FEHB plans to help reduce hospital readmissions.  Fierce Healthcare reports that the leading causes of readmissions are heart attacks, congestive heart failure, and flying somewhat below the radar screen sepsis.

For 30-day readmissions, sepsis accounted for 20.4 percent of cases. The rates for congestive heart failure were 23.6 percent and for heart attacks, 17.7 percent. UCLA estimated the annual cost of sepsis-related readmissions in California during the study period was $500 million, whereas congestive heart failure accounted for $229 million and heart attacks cost the system $142 million.  “Sepsis is a leading contributor to excess healthcare costs due to hospital readmissions,” the researchers concluded. “Interventions at clinical and policy levels should prioritize identifying effective strategies to reduce sepsis readmissions.”

On a related note, the Leapfrog Group released the results of its annual hospital transparency survey

Key findings from this report include:

Never events policy compliance remains low. The rate of hospitals meeting Leapfrog’s standard has remained at 79 percent from 2012 to 2014, meaning one in five hospitals won’t commit to apologizing to the patient and waiving all costs associated with the event if a Never Event, such as a foreign object left in after surgery or an air embolism, occurs at their facility.
Rates of certain hospital-acquired conditions remain a problem. One in six Leapfrog reporting hospitals have higher infection rates than expected for central line infections (CLABSIs) and one in ten perform poorly in preventing catheter-associated urinary tract infections (CAUTIs).
Hospitals are struggling to comply with safe practices. Urban hospitals continue to outperform rural hospitals: about 20% more urban hospitals met Leapfrog’s standard for safe practices and showed greater year-over-year improvement in meeting the requirements.
More hospitals with intensive care units are complying with Leapfrog’s ICU Physician Staffing standard. Studies show that meeting the standard can reduce ICU mortality by 40%.

Have a good weekend.