TGIF

Yesterday the House of Representatives passed the continuing resolution discussed in last Wednesday’s post. The ball is bouncing around the Senate’s court. The FEHBP will continue on course even in the unlikely event of a lengthy partial government shutdown. Negotiations are continuing over the weekend according to latest reports.

The Senate Finance Committee voted to advance to the Senate floor the President’s nomination of Alex Azar to be Health and Human Services Secretary last Wednesday according to Fierce Healthcare.

Six relevant healthcare organizations including America’s Health Insurance Plans and the Blue Cross Blue Shield Association as well as major provider groups, have issued a consensus statement intended to streamline situations in which the health plan requires prior authorization for coverage of a particular service or supply.  According to the Consensus Statement, these health care leaders will work together to:

  • Reduce the number of health care professionals subject to prior authorization requirements based on their performance, adherence to evidence-based medical practices, or participation in a value-based agreement with the health insurance provider.
  • Regularly review the services and medications that require prior authorization and eliminate requirements for therapies that no longer warrant them.
  • Improve channels of communications between health insurance providers, health care professionals, and patients to minimize care delays and ensure clarity on prior authorization requirements, rationale, and changes.
  • Protect continuity of care for patients who are on an ongoing, active treatment or a stable treatment regimen when there are changes in coverage, health insurance providers or prior authorization requirements.
  • Accelerate industry adoption of national electronic standards for prior authorization and improve transparency of formulary information and coverage restrictions at the point-of-care.

Bravo on the collaborative effort to reduce red tape.

Axios reports that “Four not-for-profit hospital systems that own 10% of U.S. hospitals — Intermountain Healthcare, Ascension, SSM Health and Trinity Health — are banding together to create a new generic drug company. The Department of Veterans Affairs also is helping and has expressed interest as a purchaser.”  The FEHBlog noticed a Modern Healthcare article pooh poohing the idea but the FEHBlog applauds these hospitals banded together to try to fix a national problem — bandit drug manufacturer who hike prices on sole source generic drugs. You have to start somewhere.

In the you can’t please ’em all department, Fierce Healthcare reports that

Hospitals that receive top [clinical quality] marks from U.S. News and World Report don’t always earn the same praise from patients, according to a new analysis.  

Nearly 63% of 2,700 Yelp reviewers gave the top 20 hospitals in the country, as ranked by U.S. News, a score of between one and three stars out of five, according to a study by Vanguard Communications and Healthcare Process Improvement, a healthcare marketing firm.

On average, the top 20 hospitals earned a 3.2 rating, the analysis found. U.S. News ranked a number of big-name providers in its latest list, with a top five that includes Mayo Clinic, Cleveland Clinic, Johns Hopkins Hospital, Massachusetts General Hospital and UCSF Medical Center. 

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