Federal News Radio reports that OPM has awarded a new seven year long Federal Long Term Care Insurance contract to John Hancock, the incumbent contractor. FLTCI Program coverage is employee pay all. “John Hancock was the only bidder to provide long-term care insurance services to the federal market despite the fact OPM had the solicitation on the street for almost seven months.”

HHS has provided updated information on the Zika virus here.

Kaiser Health News reports on a Health Affairs study concluding that doctors need to speak with their patients about of pocket costs.  That’s more support for the FEHBlog’s idea that health care providers should provide their patients with a summary document about the networks in which they participate and their pricing practices.  Implementing the idea at a minimum would solve the erronoeous provider directory kerfluffle.

On a related note, WBUR points out another Health Affairs study that “looked at the health care shopping habits of 332,255 members of insurer Aetna in 2011 and 2012. The top shopped service was a colonoscopy. Coming in at second and third, respectively: a mammogram and childbirth services” Interesting tidbit.

The Senate is back in session on Capitol Hill this week. The Senate Homeland Security and Government Relations Committee is holding a business meeting tomorrow afternoon to consider various Presidential nominations. However, Beth Cobert is not on the prepared agenda.  The House is holding a district work session for one more week. House sessions resume on April 11.

With respect to the carrier conference last week, the most important thing that the FEHBlog picked up is that last year OPM significantly improved the online FEHB plan comparison tool.  FEHBP enrollees can obtain a lot more comparative information now.  The tool does not provide a link to each Plan’s summary of benefits and coverage which Congress intended to be the principal tool for health plan shoppers.  That would be a helpful addition to the PCT.

Managed Healthcare Executive has a useful article on the valued based payment initiatives that CVS Health and Express Scripts are rolling out for oncology drugs.

For the past day and a half, the FEHBlog has been attending the OPM AHIP FEHBP carrier conference in Crystal City, VA.  OPM has posted the acting Director’s keynote speech. Govexec.com and Federal News Radio have reported on that address.  The FEHBlog’s head is spinning from all of the data and new acronyms that he acquired. Expect more reflections on the conference in the weekend update.

The conference included an informative panel on cybersecurity.  The talk caused the FEHBlog to check up with the Ponemon Institute which recently published a report on the cyberthreats faced by healthcare organizations. The Hill reported today in a bit of good news that “The {Department of Homeland Security told Congress] that 29 [federal’ agencies have reported 321 incidents of ransomware-related activity since last June. But in no case did the agencies have to pay up, as the ransomware was not able to successfully infect the government’s networks.” Evidently a sensible way to protect against ransomware is to back up your data in a way that is protected from the primary server.  

As the Toledo Blade reports, today is the day that the Centers for Medicare and Medicaid Services roll out its mandatory bundled payment program for hospitals in 87 cities across the country. The Blade story explains how hospitals are reacting to the initiative. AHIP Coverage discusses a commercial payer’s bundled payment initiative here.

Tomorrow and Friday morning, the FEHBlog will be attending the annual OPM-AHIP FEHBP carrier conference.

Today the FEHBlog followed a CAQH webinar on its Index product which measures trends in electronic healthcare transactions.  Here is a link to all of the info that was presented.  CAQH, which is financed by health insurers, does a lot of good work for the industry.

Yesterday, the Congressional Budget Office released its analysis of the President’s FY 2017 budget. On page 8 of this spreadsheet that forms part of the analysis, CBO concludes that OPM’s five legislative initiatives for the FEHBP will produce no budget savings.

The FEHBlog noticed today that early last month the CBO released its annual FEHBP overview which is a helpful reference publication.  For example,

The Federal Employees Health Benefits (FEHB) Program is the largest employer-sponsored health insurance program in the country. It provides more than $40 billion in health care benefits annually to employees and retirees of the federal government, the largest employer in the United States. In a typical year, FEHB provides health insurance coverage to about 8.2 million federal employees, retirees, and their dependents. Employees and retirees make up roughly half of that figure, or about 4 million policyholders. Of these, about 50% are retirees. Participation in FEHB is voluntary. About 85% of federal employees participate, and about 90% of retirees participate.

And it’s a managed competition program that works just fine.

Happy Easter! The Senate is out of town for another week and the House of Representatives has left DC for two week. Here is a link to the Week in Congress’s report on last week’s activities on Capitol Hill.

The American Health Information Management Association (“AHIMA”) has isssued a helpful toolkit on consumer engagement which is available here.

Here are a couple of follow-up points on recent posts:

• Health Data Management reports why the addition of 5,600 ICD-10 codes in October may not be a heavy lift for HIPAA covered entities and their business associates. This will be the first regular ICD-10 update in five years. 
• Health Data Management and Healthcare Informatics offer more details on the new round of HIPAA privacy and security rule audits being conduced by HHS’s Office for Civil Rights. This round will affect 200 covered entities and for the first time business associates.  

The Congressional Budget Office issued two significant reports yesterday — updated budget projections and a projection of federal subsidies for people under age 65 — both for 2016 to 2026. On Tuesday March 29, CBO will release its analysis of the President’s FY 2017 budget which will reveal CBO’s projections for the costs or savings associated with OPM’s suggested legislative changes to the FEHBP that were included in the President’s budget.

The FEHBlog has been impressed by the American Medical Association’s President Steven Stack, a young emergency room doctor.  Healthcare Dive offers an interview with Dr. Stack here. Two points from the interview are worth highlighting here:

Late last month, HHS Secretary Sylvia Burwell announced a commitment among the industry, including companies that provide 90% of EHRs used by U.S. hospitals, toward creating a more user-friendly, physician-usable EHR. AMA was one of the organizations that signed the pledge. “Physicians are avid adopters of technology,” Stack said but added, “Health IT is kind of late to the game as far as its sophistication and it’s taken a long time to mature to the point where it’s a helpful tool.” 

Nearly one out of every five dollars in the U.S. economy is spent on healthcare. “In this environment, as the business has escalated in its size and the government has become an ever-larger purchaser of healthcare through programs like Medicare and Medicaid and more involved in efforts like Meaningful Use, the burden of regulations has escalated substantially,” Stack said. “So the politics and the business of healthcare have put extra strain and challenge on the humanism of healthcare, which fundamentally is what most patients rely upon in their moment of deepest need.”

Finally a few quick hits for this Friday afternoon:

• The Wall Street Journal reports today on a recent clinical study finding a strong correlation between calcium levels in breast and coronary arteries. The upshot is that before long mammograms also may help diagnose heart disease in women. Two for the price of one.
• Employee Benefit News provides more background on the application of gaming theories or “gamification” to wellness programs.
• The Centers for Disease Control have refreshed their National Diabetes Prevention Program website.  

On Monday, we learneded that Anthem Blue Cross has sued its prescription benefits manager Express Scripts. According to the LA Times, Anthem is

The House is in session this week while the Senate is out of town.  Here is a link to The Week in Congress’s account of last week’s actions on Capitol Hill.

Interesting Congressional Budget Office (CBO) developments for the coming week:

CBO plans to release its updated 10-year baseline projections of federal spending, revenues, and budget deficits on Thursday, March 24 [at 2 pm ET on cbo.gov). At the same time, CBO will release a separate document detailing its updated estimates of the budgetary effects of the insurance coverage provisions of the Affordable Care Act and of enrollment through health insurance marketplaces (sometimes called exchanges). 

Following up on the TGIF post about Walgreen’s deal with OptumRX, Crain’s Chicago reports that Walgreen’s also is investing

nearly $1.2 billion to build its stake in AmerisourceBergen, a pharmaceutical wholesaler that supplies its drugstores, mail order and specialty pharmaceutical businesses. The nation’s largest drugstore chain says it will own a 15 percent stake after exercising warrants to purchase 22.7 million shares.  Walgreens Boots Alliance started building that stake in 2013, when the companies entered a 10-year supply agreement. Deerfield-based Walgreens still holds warrants to buy another 22.7 million shares in AmerisourceBergen.

Last week, the Centers for Medicare and Medicaid Services (CMS) released “a new interactive map to increase understanding of geographic disparities in chronic disease among Medicare beneficiaries. The Mapping Medicare Disparities (MMD) Tool identifies disparities in health outcomes, utilization, and spending by race and ethnicity and geographic location.  Understanding geographic differences in disparities is important to informing policy decisions and efficiently targeting populations and geographies for interventions.”  This tool may be helpful to FEHBP carriers which cover large cadres of annuitants.

A law school professor warned us against signing petititions or submitting letters to the editor. I generally have followed this advice since 1978.  Today however the FEHBlog signed a petition sponsored by AHIMA which encourages the Obama Administration to

Remove the federal budget ban that prohibits the U.S. Department of Health and Human Services (HHS) from participating in efforts to find a patient identification solution. We support a voluntary patient safety identifier. Accurate patient identification is critical in providing safe care but the sharing of electronic health information is being compromised because of patient identification issues.

This budget item should have been removed when Congress decided to spend $31 billion on electronic medical records, but better late than never.  The FEHBlog is signature #64.  You can sign on here.  

In other healthcare IT news,  Health Data Management reports that last week HHS named 21 members to its healthcare cybersecurity task force which was created the last December’s omnibus appropriations act.  “Six of the members represent providers or health insurers, with the rest representing a range of information technology, governance and security expertise, as well as representatives of HHS, DHS and NIST.” The taskforce is expecte to report to Congress before its charter expires one year from now.

The OPM Director’s blog features the government’s efforts to improve its employees’ eating habits during this National Nutrition Month. Oh, how the FEHBlog wishes that OPM would do a better job coordinating all of the government’s wellness efforts with the FEHBP  The article links to a summer 2015 survey of government wellness programs.  84% of federal worksites offer flu shots and yet OPM hammers the FEHBP carriers to provide the vaccines.

On Monday, OPM’s acting director indicated that David Vargas would be the acting OPM chief informatin officer. Head fake. Yesterday, Federal News Radio reported that “Lisa Schlosser, the deputy federal chief information officer, is heading over to the Office of Personnel Management to be the acting CIO on a short-term detail.”

An email written by OPM Director Beth Cobert, which was obtained by Federal News Radio, said Schlosser also will be a senior adviser as well as acting CIO.
“I worked with Lisa for two years while I was at OMB and can tell you from personal experience that she will bring incredible talent, leadership, and a commitment to public service that will serve this agency well,” Cobert wrote in a note to staff. “I want to thank Dave Vargas for stepping in as acting CIO during this period of transition, and I am glad that he will continue to play a crucial role in OCIO as associate chief information officer. OPM’s CIO team has worked tirelessly and has made significant improvements to our information technology capabilities and security. I applaud their commitment and efforts and look forward to building on our progress in the future. Finally, I am grateful to Lisa for her willingness to continue to serve our nation by joining our talented team on an acting basis. As we work to navigate the National Background Investigations Bureau (NBIB) transition, build on our cybersecurity effort, and find the permanent CIO, Lisa will be a major asset for OPM during her detail with our team.”

OptumRx, a major prescription benefits manager, and Walgreen’s Pharmacies announced a deal yesterday under which beginning in 2017 “eligible” OptumRx members will have ‘the option to fill 90-day prescriptions at home delivery copay levels at any of Walgreens nearly 8,200 pharmacies nationwide or through OptumRx home delivery. ” Good strategic move.

Acting OPM Director Beth Cobert appeared before a House Appropriations subcommittee on Monday afternoon to discuss her agency’s FY 2017 proposed budget.  The hearing, which lasted about 70 minutes, focused on the Obama adminstration’s new approach to conducting background investigations and OPM’s efforts to remediate the massive data breach. Here’s a link to an FCW article on the latter topic.

Last month, CVS Health issued a 2015 prescription drug trends report. Yesterday the other major prescription benefits manager Express Scripts issued its 2015 trend report:

Working collaboratively with our clients, we kept the increase in drug spending to just 5.2% in 2015, roughly half the increase seen in 2014. More importantly, at a time when many plans around the country have been shifting more costs to patients via higher deductibles and out-of-pocket expenses, Express Scripts members’ average copayment decreased 3.2% last year. 

Here’s a link to an Employee Benefits News interview with Express Scripts’ Chief Medical Officer Steve Miller about the report.

Kudos to the Drug Channels blog for expand sharing and expanding on the FEHBlog’s reservations about the Obama Administration’s proposal to control Medicare Part B drug spending.

And here are a few more quick hits:

• HHS’s Office for Civil Rights smacked a Minnesota healthcare provider with a $1.55 million fine for failing to comply the business associate agreement and risk assessment provisions of the HIPAA Privacy and Security Rules.
• Health Data Management reports that CMS plans to roll out thousands of new ICD-10 codes effective October 1, 2016. Oh joy. Most of them are new hospital procedure codes. 
• Modern Healthcare reports that electronic medical record systems begin to bury doctors in electronic messages as interoperability grows. Get used to it, doc.
• Employee Benefits News also interviewed the new CEO of the National Business Coalition on Health (not to be confused with the National Business Group on Health).
• The Minnesota Star Tribune reports about a small United Healthcare subsidiary Harken Health based in Chicago that sells health coverage in competition with its big sister.