Tuesday Tidbits

David Ermer–Uncategorized–

The Boston Globe’s STAT reports that “New federal data released Tuesday found the number of new diabetes diagnoses fell to about 1.3 million in 2017, down from 1.7 million in 2009.” The article observes that

Increasingly, more doctors have been diagnosing “prediabetes,” a health condition in which blood sugar levels are high but not high enough to hit the diabetes threshold. Physicians typically push such patients into exercise programs and urge them to change their diet. “Prediabetes is becoming a more accepted diagnosis” and may be causing an increasing number of patients to improve their health before becoming diabetic, said Dr. Tannaz Moin, a UCLA expert.

This is exactly what should be happening.

The Society for Human Resource Management, of which the FEHBlog is a proud member, called attention to the fact that the Internal Revenue Service had issued 2020 inflation adjustments for high deductible insurance plans and related health savings accounts.  And always remember that according to the IRS

A high deductible health plan that is a group health plan will generally be subject to both the out-of-pocket maximum for high deductible health plans under Section 223 and the out- of-pocket maximum for group health plans under Section 1302(c)(1) of the Affordable Care Act (via Section 2706(b) of the Public Health Service Act). If two different out-of-pocket maximum levels apply to a plan, the plan complies with both if it complies with the lower out-of-pocket maximum. Thus, in the case of a high deductible health plan subject to the maximum out-of- pocket limit under Section 223 and the maximum out-of-pocket limit under Section 2706(b) of the Public Health Service Act, the plan must comply with the lower amount. In any event a high deductible health plan must satisfy the maximum out-of-pocket limit under Section 223 in order to be a high deductible health plan supporting an HSA.

Fierce Healthcare informs us about a UnitedHealth Group study concluding that “Price variation leads to gross overspending for many consumers, even for common health care services such as diagnostic tests, which play an important role in the diagnosis, monitoring and treatment of disease.”  The report finds that

Significant price variation is not primarily driven by differences in the underlying cost or quality of care. The complex and fragmented health care delivery system, which includes opaque cost structures and varying treatment protocols, makes it challenging for providers to determine the actual cost of treating their patients.

  • Geographic cost differences have relatively little impact on actual provider price variation.
  • Prices are not predictive of provider quality or patient outcomes.
  • Rather than cost or quality primarily driving price variation, a more likely reason is that health care providers generally are incentivized to use their market power to increase prices, often resulting in overpriced services.

Perhaps health plans and Medicare Part B should stop making geographic adjustments to their negotiated prices.

Employee Benefit News discusses an interesting approach that employers have been adopting — making mental health first aid available to employees.  “[M]ental health first aid [is[ a relatively new system of providing employees with basic training on spotting signs of emotional distress and engaging with the troubled individual in what could be a potentially crucial intervention to help the person find treatment.”