Midweek update

Today, OPM issued its annual list of significant changes to the FEHBP and FEDVIP. Here are links to the OPM cover letter and the list of changes. Again, no new carriers have joined the FEHBP. The most important point for enrollees is the following:

Employees in terminating plans (Table 1 [of the list]) or service area reductions with terminating enrollment codes (Table 2) must enroll in a new health plan during Open Season. If they do not enroll in a new plan, they will be enrolled in the Standard Option of the GEHA Benefit Plan (the lowest-cost nationwide plan option for 2018 as determined by OPM). 

New Coverage:  Coverage under an enrollee’s new health plan will be effective the first day of the pay period beginning on or after January 1, 2018; for most employees this will be Sunday, January7,2018.Enrollees will remain covered and receive the 2017 benefits of the old plan until coverage under the new plan becomes effective.

In other big news, the large Blue Cross licensee, Anthem, announced “it is establishing a new pharmacy benefits manager to be named IngenioRx. IngenioRx will begin offering a full suite of PBM solutions starting in 2020, which coincides with the conclusion of the company’s current PBM contract [with Express Scripts]. Anthem’s press release further explains that

IngenioRx will serve customers of Anthem affiliated health plans, as well as non-Anthem customers, with a seamless, integrated experience by taking Anthem’s new model to the national marketplace. The IngenioRx pharmacy leadership team combined has more than 100 years of experience in the PBM industry, which will be invaluable in helping to ensure a seamless transition for members. 

Anthem has signed a five-year agreement with CVS Health, for services beginning Jan. 1, 2020. IngenioRx will combine its member and provider engagement initiatives and market leading pricing with CVS’ expertise in point-of-sale engagement, such as member messaging and Minute Clinic. CVS will also provide prescription fulfillment and claims processing services.

Finally, Health IT Analytics reports that  “The distributed ledger methodology known as blockchain is piquing interest in the healthcare industry as organizations search for more secure and trusted strategies for managing big data.”  A recent Harvard Business Review article explains:

The technology at the heart of bitcoin and other virtual currencies, blockchain is an open, distributed ledger that can record transactions between two parties efficiently and in a verifiable and permanent way. The ledger itself can also be programmed to trigger transactions automatically.  * * *  

True blockchain-led transformation of business and government, we believe, is still many years away. That’s because blockchain is not a “disruptive” technology, which can attack a traditional business model with a lower-cost solution and overtake incumbent firms quickly. Blockchain is a foundational technology: It has the potential to create new foundations for our economic and social systems. But while the impact will be enormous, it will take decades for blockchain to seep into our economic and social infrastructure. The process of adoption will be gradual and steady, not sudden, as waves of technological and institutional change gain momentum.