The Office of Personnel Management released today its 2019 report on the outcome of Health Care Quality, Customer Service, and Resource Utilization measures (“QCR”) applied to the FEHB plan carriers. The good news is that “A significant number of FEHB carriers demonstrated improvement across a number of QCR measures showing that efforts to improve care and customer service are producing positive results.” The FEHBlog can tell you that carriers put a lot of effort into boosting these scores.

The chart from this report that most impressed the FEHBlog is the chart on page 5 showing steady improvement in the diabetes type 2 control measure. In the FEHBlog’s view, credit for that improvement principally belongs to the plan members who confront this disease by following their doctor’s advice and health plan input.

The FEHBlog also wants to readers to know that yesterday’s FEHBlog tirade was directed at the CMS civil monetary penalty proposal and not at the FEHB plans members with primary Medicare A and B coverage. Those members go along way toward controlling everyone’s FEHBP premiums by picking up Part B. Coordination of benefits with Medicare is a major and necessary part of the carrier’s workload and in the FEHBlog’s experience they pay close attention to it just like the QCR scores.

Express Scripts has issued its annual 2019 Drug Trend report. Fierce Healthcare reports that “[Cigna’s] pharmacy benefit manager found that medications for inflammatory conditions such as psoriasis and rheumatoid arthritis drove 43.7% of spending, by far the highest among the different classes.” This report always is interesting reading.

It’s also worth calling readers’ attention to HHS’s Agency for Healthcare Research and Quality’s (“AHRQ”) TAKEheart Initiative which was launched in the Spring of 2019.

Currently, only 1 in 5 of eligible patients with serious cardiac conditions enroll in cardiac rehabilitation (CR), which has been shown to improve health and prevent hospital readmissions. TAKEheart takes aim at these missed opportunities by spreading two evidence-based practices shown to boost rates of CR referral of eligible patients. These strategies involve automatically referring patients to CR through electronic health record prompts and ensuring that a staff member or lay navigator helps coordinate the patient’s referral process.

Recently, TAKEheart reached an important milestone. We’ve recruited the first of two waves of 50 hospitals and have begun the training and support needed for implementing automatic electronic referral to CR as well as care coordination.

That good news to hear in American Health Health MonthP.