Tuesday Tidbits

The FEHBlog listened to the House Oversight and Government Reform Committee hearing on postal reform this morning.  The stars certainly aligning for passage of H.R. 756 which would create a separate Postal Service Health Benefits Program within the FEHBP. The PSHBP would be fully integrated with Medicare, and because all enrollees will be placed in a single risk pool like any sensible health insurance plan the PSHBP premiums should be lower than traditional FEHBP premiums. That’s the Postal Service’s objective as Congress in its infinite wisdom decided a decade ago to require the Postal Service to pre-fund the costs of its retiree coverage. It was pleasant to listen to a hearing where people were willing to compromise for a good cause.

Express Scripts, one of the big prescription benefit managers, issued its annual prescription drug trend report yesterday.  Medscape has a good summary of the report here.

Healthcare IT News reports on a new IBM study on cyberattacks on healthcare entities.

Fierce Healthcare reports on a trip to Capitol Hill by leaders of five large provider groups.

In the meetings with senators and their staff members, the organizations outlined five priorities:

  • Do not increase the number of uninsured patients
  • Protect the healthcare safety net
  • Ensure patients are protected from excessive insurance costs
  • Maintain premium subsidies
  • Protect small insurance markets

Healers try healing yourself.  

The FEHBlog was interested in reading a Wall Street Journal article about a new device called MarginProbe that improves the efficacy of breast cancer surgery.  The article explains that

The cost of the device, which is being used in about 100 medical centers around the U.S., remains a stumbling block. Each breast surgery requires a new MarginProbe, at $1,000 each, which isn’t typically covered by insurance.

Now let’s clarify this point. Health plans cover the surgeon’s and the surgicenter’s bill but the providers are supposed to cover the cost of these devices under their price.  The bottom line is again according to the article that

Second surgeries cost a lot more—$9,000 to $16,000 and up—but hospitals and surgery centers are reimbursed for them. Dr. [Alice] Police [a cancer surgeon who uses the device in her practice]  says health-care economics have created a strange incentive favoring re-excisions, no matter the costs to the health system. She credits the device for lowering her re-excision rate to 3% from 15%. But she worries about hospitals balking: “You have to tell a hospital, it is going to cost you $1,000 and we are going to take away your second operation.”

You’re telling the FEHBlog that the hospital can’t find savings to offset the cost of MarginProbe?  That my friend is a problem that should be addressed.  The provider groups should add this issue to their list.

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