Happy Veterans Day

David Ermer–Uncategorized–

Happy Veterans Day! 90 years ago today the guns fell silent on the Western Front. Thanks to everyone who has served in our Nation’s military services.

  • AIS offers the perspective of various FEHBP carriers on the current Open Season. AIS also provides various viewpoints on how consumer driven health care will fare in the next Administration.

  • The Justice Department reported on False Claims Act recoveries during the government fiscal year that ended on September 30, 2007.

  • The Midwest Business Group on Health released its 2008 National Benchmarking Survey of Employers and Regional Focus Groups of Employees and their respective Readiness to adopt Value-based Benefits Strategies. Not surprisingly to me at least, the Group found that “The premise of value-based benefit design programs for health care – higher quality care at a lower cost – is counterintuitive to employees’ perception of the consumer marketplace. Employees perceive higher quality health care equals higher cost.” The Group recommends more employee education.

  • The Wall Street Journal featured today an article on the impending ICD-10 code set conversion. The ICD provides the codes that all providers use to classify providers diagnoses and that hospitals use to classify the care that they provide to patients. (Doctors use the AMA’s CPT). “The new system of 155,000 codes includes 68,000 codes describing diagnoses, up from 13,000 currently, and 87,000 codes for different medical procedures, compared with 3,000 in the current system.” The Journal summarizes the pros and cons as follows:
  • The new codes can offer more detail on patients’ conditions.
  • Doctors complain that changing to the new system will eat up time and money.
  • Hospitals could get higher payments for performing more-advanced surgeries.
  • Consumers may see more billing errors as the new system rolls out.

    • Actually everyone agrees on the need to convert, the disagreement is over the length of time necessary for a smooth conversion. Hopefully, cooler heads will prevail, and HHS will set October 1, 2013 as the conversion date.