Almost Friday

The FEHBlog has been out of town this week.  He wants to fit in the end of week message before heading back to DC tomorrow.  Here’s a link to the Week in Congress’s report on this week’s activities on Capitol Hill.

A commenter asked the FEHBlog for details about the Inovalon study mentioned in the Wall Street Journal article about rural health care costs.  The FEHBlog did discover that Inovalon had acquired the health care consulting firm Avalere but he couldn’t find the study in question.  He has written to the article’s author. In the meantime, the National Rural Health Care Association offers a litany of rural health care problems.   On the bright side, Health Day reports that

Having a commonplace surgery — such as a gallbladder removal — may be safer when done in a rural hospital compared to a suburban or city hospital, a new study finds. “This study gives credence to what rural surgeons long suspected — that well-done rural surgery is safe and cost-effective,” study author Dr. Tyler Hughes said in a University of Michigan news release. Hughes is one of only two surgeons at McPherson Hospital in rural McPherson, Kan., and a director of the American Board of Surgery.

Go figure.

Forbes reports on a new Blue Cross study finding that  “the high cost of specialty drugs like the new hepatitis C pills, saying they contributed another $87 annually in [2013 – 2014] costs per enrollee whether they used the expensive medicines or not.” That adds up to a lot of money.

Also on the Rx front, the Minneapolis Star Tribune reports that United Healthcare’s PBM OptumRx beat out CVS Caremark and Express Scripts for the enormous CALPers prescription drug benefits contact.  The five year long contract is worth $4.9 billion. That is a lot of money.  It also indicates that OptumRx has formed a big three of PBMs with CVS and Express Scripts.

Stat reports on efforts by naturopaths to get reimbursed by health insurers.  Their efforts are spurred on by the ACA’s Public Health Service Act Section 2706(a) and vitamin manufacturers. Everyone wants a piece of the pies.

Finally Health Day reports about health care pricing transparency problems.  

The out-of-pocket price for a standard chest X-ray, CT scan or ultrasound can vary by hundreds of dollars, depending on where the imaging is done, new research reveals.
“The lack of price transparency is certainly not isolated to the field of radiology alone,” said study co-author Dr. Mindy Licurse, a diagnostic radiology resident with the University of Pennsylvania Health System. For example, a 2014 analysis by the Health Care Incentives Improvement Institute in Connecticut and Catalyst for Payment Reform in California revealed that most states lack laws making health cost information available to consumers.
“Our study certainly contributes to the underlying hypothesis that pricing information within health care, specifically imaging in this case, may be difficult to obtain depending on the setting, and therefore comparison-shopping by patients is limited,” she added.

This is a problem that healthcare providers can and should fix in cooperation with insurers.