The FEHBlog

Thursday Miscellany

David Ermer–CDC, Federal employment benefits, Rx coverage–

At last year’s OPM AHIP FEHBP Carrier Conference, a Centers for Disease Control scientist announced that the U.S. Surgeon General soon would be issuing a new comprehensive report on tobacco use in the U.S. That report was issued today. It

  • Examines the effectiveness of various smoking cessation tools and resources;
  • Reviews the health effects of smoking and catalogues the improvements to health that can occur when smokers quit;
  • Highlights important new data on populations in which the prevalence of smoking is high and quit rates are low; and
  • Identifies gaps in the availability and utilization of programs, policies, and resources that can improve cessation rates and help smokers quit.

Here’s a link to OPM’s Quit Smoking website which discusses the FEHBP generous tobacco cessation benefits.

The CDC updated the public on its important antibiotic resistance solutions initiative.

CDC’s AR Solutions Initiative invests in national infrastructure to detect, respond, contain, and prevent resistant infections across healthcare settings, food, and communities. CDC funding supports all 50 state health departments, six local health departments, and Puerto Rico and the U.S. Virgin Islands.  Through these investments, CDC is transforming how the nation and world combat and slow antibiotic resistance at all levels.

Good luck.

The FEHBlog has discussed the relatively new, cooperative effort of hospitals to create a public asset, known as Civica Rx, to help solve drug shortages and lower the cost of generic drugs. Today, Civica Rx and the Blue Cross Blue Shield Association announced

their partnership to create a new subsidiary dedicated to lowering the cost of select generic drugs. The subsidiary is being formed in response to the impact of high drug costs on the health of Americans and the overall affordability of health care. Other health plans, employers, retail partners and health care innovators who share the belief that patients and their needs come first are invited to join the initiative.

The subsidiary will acquire and develop Abbreviated New Drug Applications (ANDAs) for select generic drugs and partner with Civica and manufacturing partners to bring more affordable generic drugs to uncompetitive markets in exchange for aggregated volume and multiyear purchasing commitments. Initially, several generic medications identified as having high potential for savings will be prioritized by the partnership and will evolve into a platform that can be used to enhance competition for additional generic drugs.

The new operation expected to start delivering product in early 2022. Strong move.

The American Hospital Association now offers a webpage with updates and resources concerning the Wuhan coronavirus.

Midweek update

David Ermer–Federal employment benefits, Medicare–

CVS announced the following six health trends for 2020

  1. Continued evolution in kidney care 
  2. Greater consumer scrutiny on wellness products 
  3. The need for data stewardship as digital health rolls on 
  4. Pharmacies as a tool to reach underserved populations 
  5. Efforts to mitigate loneliness 
  6. Increased transparency around drug pricing 

The Centers for Medicare and Medicaid Services has decided to extend Medicare coverage to acupuncture for chronic low back pain as an alternative to opioid based pain killers. The CMS decision ” will cover up to 12 sessions in 90 days with an additional 8 sessions for those patients with chronic low back pain who demonstrate improvement.” Previously Medicare excluded acupuncture from coverage.

Retired OPM official Reg Jones discusses survivor benefits related to federal employment in Fedweek. FEHBP survivor benefits are generous if the prerequisites are met:

If your spouse receives an annuity in any amount and was covered under either the self plus one or self and family option of your FEHB plan, he or she and all eligible children may continue coverage. If the annuity amount is less than the premiums required, your spouse will be able to directly make payments to cover the rest of the cost.

Tuesday Tidbits

David Ermer–ACA, CDC, SCOTUS–

This morning without comment, the Supreme Court denied the motion of the petitioners defending the Affordable Care Act to expedite the Court’s review of the Fifth Circuit Court of Appeal’s decision on the ACA’s constitutionality (Nos. 19-840, 841). The FEHBlog has long given up on trying to predict Supreme Court decisions. Now. the respondents seeking to take down the law will have until shortly after the Super Bowl to submit their briefs. The petitioners will have an opportunity to reply, and then the Supreme Court can consider the petitioner in due course, perhaps late March or April. If the Court decides to review the Fifth Circuit opinion, which the FEHBlog assumes is unlikely, the case would be argued next fall. As yet, Federal District Judge Reed O’Connor has not begun the process of reconsidering his vacated decision holding the entire remainder of the ACA inseparable from the unconstitutional ACA individual mandate at least according to the docket sheet available on PACER. The stay order that the Judge Reed entered in December 2018 states in pertinent part that “The parties are directed to notify the Court upon the conclusion of the appeal of the partial judgment within 14 days of any decision.” As the Court is busy, it’s likely that the Judge will tend to other matters until the Supreme Court decides what to do at this stage at least in the FEHBlog’s view.

The Centers for Disease Control (“CDC”) announced today that the agency

is closely monitoring developments around a novel (new) coronavirus first identified in Wuhan, Hubei Province, China. Chinese authorities identified the new coronavirus, which has resulted in close to 300 confirmed cases in China, including cases outside Wuhan City, with additional cases being identified in a growing number of countries internationally. The first case in the United States was announced on January 21, 2020. There are ongoing investigations to learn more.

The Wall Street Journal reported over the weekend that

Nancy Messonnier, the CDC’s director for the National Center for Immunization and Respiratory Diseases, said that as health officials develop diagnostic tests and start testing people with symptoms who have traveled to Wuhan, more cases are likely to be identified around the world, including in the U.S. 

“As we start testing more, I expect that we’re going to see more cases,” she said. 

“I think it’s highly plausible there will be at least a case in the United States.” 

She called the spread a “serious issue,” but added that the CDC has “faced this challenge before.”

“Based on the info CDC has today, we believe the current risk from the virus to the general public is low,” Dr. Messonnier said in a telephonic press conference.

FYI, the Government Accountability Office (GAO) has issued a report on Artificial Intelligence in Healthcare: Benefits and Challenges of Machine Learning in Drug Development. Here’s a link to the GAO’s version of Cliff Notes on the report.

Weekend update

David Ermer–CDC, Congress, Wellness–

OPM directs us to the National & Community Service website for ideas on how to celebrate tomorrow’s Martin Luther King Jr. holiday. The FEHBlog believes that our country is indebted to Dr. King for his bold, essential leadership.

The House of Representatives has a district work period this week, while the Senate will be holding a trial on the House’s impeachment of the President.

Last Friday, the Centers for Disease Control announced updates to its vaping restriction recommendations in light of the subsiding vaping-related lung injury known as EVALI crisis. The FEHBlog appreciates the caution that the CDC has shown in handling this crisis.

Fierce Healthcare recently announced its Fierce 15 of 2019.

Big and small, high-tech and not, we’re honoring this collection of companies across the U.S. that are trying to change the world by changing the healthcare industry. 

The FEHBlog is not familiar with any of these companies but in time?

Healthcare Dive helpfully summarizes five key trends fo providers and payers. The FEHBlog is familiar with all of these.

Kaiser Health News discuss the latest hot item in wellness programs — helping employees sleep.

TGIF

David Ermer–Uncategorized–

The Supreme Court accepted an Affordable Care Act case for review this afternoon but it was not the one that the FEHBlog has been tracking. The Court granted “cert” in a scope of the contraceptive mandate case (No.s 19-431 and 19-454). The FEHBlog will keep an eye out for action the Texas v. United States case (No. 19-840) over the law’s constitutionality.

The Centers for Disease Control issued a report yesterday on adult physical inactivity prevalence by state and race / ethnicity. .

All states and territories had more than 15% of adults who were physically inactive.

In 4 states (Colorado, Washington, Utah, and Oregon) and the District of Columbia, 15% to less than 20% of adults were physically inactive.

In 24 states, 20% to less than 25% of adults were physically inactive.

In 15 states, 25% to less than 30% of adults were physically inactive.

In 7 states (Tennessee, Oklahoma, Louisiana, Alabama, Kentucky, Arkansas, and Mississippi), and 2 US territories (Puerto Rico, and Guam), 30% or more of adults were physically inactive.

The South (28.0%) had the highest prevalence of physical inactivity, followed by the Northeast (25.6%), Midwest (25.0%), and the West (20.5%).

Ruh roh

Govexec reports that early this month the Postmaster General Megan Brennan has delayed her retirement past the scheduled January 31, 2020 date in order to allow the Postal Service authorities more time to appoint her successor.

Thursday Miscellany

David Ermer–Uncategorized–

As the JP Morgan healthcare conference closes, Fierce Healthcare’s reports provide a summary of the highlights.

Employee Benefit News informs us about how CVS Health is leveraging its Aetna acquisition to make gene therapies more affordable to patients.

Healthcare Dive reports that the federal government has today released for public comment a health information technology roadmap for the next five years.

The plan will act as a blueprint for federal agencies like the Department of Defense and the Department of Veteran’s Affairs, along with private sector partners, as they work to make it easier for patients to electronically access health data. Much of the plan focuses on proliferating standardized application programming interfaces and stimulating a new “app economy” in healthcare.

Health Payer Intelligence discusses about a new “path forward” for mental health care.

Launched in November 2019 by the National Alliance of Healthcare Purchaser Coalitions (NAHPC), along with other healthcare partners, the Path Forward for Mental Health and Substance Use initiative aims to strengthen mental health parity through stakeholder collaboration.

“What we have developed is an approach that is thoughtful and comprehensive in terms of how we need to approach rebuilding a health system that can support people with mental health and substance use,” says Michael Thompson, NAHPC president and chief executive officer. 

“It’s basically about making sure that we are taking the same rigor in the treatment of mental health as we would with any other health condition collaborative care, which is providing better support and improving the treatment that is provided through primary care physicians and telebehavioral health.”

Midweek update

David Ermer–Uncategorized–

Fierce Healthcare reporters update us on day 3 of the JP Morgan healthcare conference. CMS Administrator Seema Verma was today’s principal speaker.

Today, about a half dozen groups submitted friends of the court briefs in support of the parties seeking immediate Supreme Court review of the 5th Circuit’s decision on ACA constitutionality. The FEHBlog was impressed by the America’s Health Insurance Plan’s amicus brief.

Over the course of nearly a decade, the ACA has fundamentally reshaped the nation’s health care system. Congress in 2017 chose not to disturb that paradigm shift—including the promise of affordable coverage for those with preexisting conditions—when defanging the individual mandate without repealing any other part of the ACA. Invalidation of the entire ACA would flout Congress’s manifest intent, with profound consequences for our health care system and the hundreds of millions of people it serves. This Court should grant certiorari now to make clear that even if the individual mandate falls, the balance of the ACA will remain in force.

Agreed.

Federal News Network reports that the U.S. Postal Service released to the public their five year strategic plan today. The sooner that Congress considers this report and the legislative issues it raises, and other stakeholder views, the better.

Reg Jones in FedWeek explains in FedWeek on whether deferred and postponed federal annuitants are eligible for FEHBP coverage in retirement. It turns out that postponed annuitants (a CERS feature) can pick up FEHBP coverage in retirement but deferred annuitants (CSRS and FERS feature) cannot.

Tuesday Tidbits

David Ermer–Uncategorized–

Fierce Healthcare’s reporters fill us in on the day 2 doings at the JP Morgan healthcare conference in San Francisco.

In the same vein, Healthcare Dive informs us that “Cigna is partnering with tech-savvy payer startup Oscar Health to jointly sell commercial health plans to small businesses as the Bloomfield, Connecticut-based payer looks to capitalize on Oscar’s simplified strategy to expand its footprint in the small group market.”

About five years ago, the FEHBlog heard the American Medical Association’s then president elect explain that he takes heart disease death statistics with a grain of salt because doctors historically have listed heart disease as the default cause of death for older patients when no autopsy is ordered. This Wall Street Journal article, however, suggests that our country has a serious problem with heart disease.

Americans are dying of heart disease and strokes at a rising rate in middle age, normally considered the prime years of life. An analysis of U.S. mortality statistics by The Wall Street Journal shows the problem is geographically widespread. Death rates from cardiovascular disease among people between the ages of 45 and 64 are rising in cities all across the country, including in some of the most unlikely places.

NPR Shots discusses the current state of concierge medicine and is younger cousin direct primary care in the U.S.

Monday Musings

David Ermer–Uncategorized–

This week the 38th annual JP Morgan healthcare conference is being held in San Francisco. Fierce Healthcare’s reporters provide us with an interesting pastiche of conference presentations.

Beckers Hospital CFO Review reports on a recent Health Affairs analysis on the value of bundled payment arrangements.

Twenty studies reviewed show that the bundled payment models maintained or improved quality while lowering costs for lower extremity joint replacement. This didn’t hold true for other procedures and conditions. Study others added that a significant number of studies didn’t find any effect on healthcare spending, although this varied by clinical episode.

Buyer beware.

The FEHBlog wishes to caveat a point made in his December 2019 “Santa Claus” post. The post accurately explained that Congress has repealed the Affordable Care Act’s medical device, health insurer and high cost plan excise taxes (the latter colloquially known as the ACA’s Cadillac tax.) Katie Keith points out in the Health Affairs blog that

Repeal of the health insurance tax would not take effect until 2021, meaning the tax—which has already been built in to many premiums for the 2020 plan year—will remain in effect for 2020. The Cadillac tax and medical device tax are repealed beginning in 2020.

Weekend update

David Ermer–Uncategorized–

Congress remains in session this week on Capitol Hill.

The Wall Street Journal offers two articles of note:

  • An in-depth article about Google Health’s data analysis arrangements with large health care providers.
  • An article about a new prescription drug manufacturer EQRx, Inc. which claims it plans to offer generics at below market price. The article notes that

The new business is the latest example of how high drug costs have prompted hospital groups, states such as Californiaand now drug-industry insiders to explore alternative models for making drugs at lower prices. 

Govexec.com reports that

The White House is calling on federal agencies to develop new strategies to reduce injuries in the federal workplace and to help those who are hurt to get back to work more quickly, creating a new, governmentwide push to help accomplish the goal. 

The Protecting Employees, Enabling Reemployment (PEER) Initiative will task each agency [including the Postal Service][ with developing specific strategies and goals to slash injuries on the job and time off of work due to injuries, Office of Management and Budget acting Director Russ Vought said in a memorandum dated Thursday. He noted that 107,000 federal employees filed new workers’ compensation claims in 2018 and received $3 billion in payments. 

Health Payer intelligence brings us up to date on budding payer efforts to provide senior members with ride sharing services to healthcare appointments. In the FEHlog’s view, this is a dandy idea.