Midweek update

For the past couple of days, the FEHBlog has been visiting St. Michael’s MD on the Eastern Shore. Lovely place. The town’s website recounts

During the War of 1812, St. Michaels gained its name as “the town that fooled the British”. The residents of St. Michaels, having been forewarned that British barges were positioned on the waters to attack with cannon fire, hoisted lanterns into the trees above the city. This first successful “blackout” fooled the British into overshooting the town’s houses and shipyards. Only one house, forever since known as Cannonball House, was struck. 

Ah, American ingenuity. But time marches on.

Yesterday, the Centers for Medicare and Medicaid Services announced, no doubt to the relief of hospitals and doctors, that it is proposing to roll back the Obama Administration’s mandatory joint reduction payment pilot and cancelling two other pilots scheduled to begin next year — the Episode Payment Models (EPMs) and the Cardiac Rehabilitation (CR) incentive payment model.  The CMS press release explains

Changing the scope of these models allows CMS to test and evaluate improvements in care processes that will improve quality, reduce costs, and ease burdens on hospitals,” said CMS Administrator Seema Verma. “Stakeholders have asked for more input on the design of these models. These changes make this possible and give CMS maximum flexibility to test other episode-based models that will bring about innovation and provide better care for Medicare beneficiaries.”
Moving forward, CMS expects to increase opportunities for providers to participate in voluntary initiatives rather than large mandatory episode payment model efforts. The changes in the proposed rule would allow the agency to engage providers in future voluntary efforts, including additional voluntary episode-based payment models.  

Today CMS announced the launch of its Hospice Compare website.  “The Hospice Compare site allows patients, family members, caregivers, and healthcare providers to compare hospice providers based on important quality metrics, such as the percentage of patients that were screened for pain or difficult or uncomfortable breathing, or whether patients’ preferences are being met. Currently, the data on Hospice Compare is based on information submitted by approximately 3,876 hospices.”

Finally, the Minneapolis Star Tribune reports that earlier today United Healthcare announced that its CEO, Stephen Hemsley, “is leaving the job next month and will be succeeded by Dave Wichmann, the company’s president.”

During Hemsley’s tenure, [which began in 2006] UnitedHealth’s workforce grew from 58,000 to more than 260,000, including 17,000 in Minnesota. Revenue grew from $71.5 billion to an estimated $200 billion this year. At the end of June, more than 49 million people had health insurance coverage from UnitedHealth Group.
Before taking the top job, Hemsley was chief operating officer and guided the company’s reorganization into the two key businesses it operates today — the legacy health insurance business called UnitedHealthcare and the fast-growing health services business called Optum.