TGIF

David Ermer–Uncategorized–

Following up on yesterday’s leading items, Federal News Radio breaks down the Trump’s administration’s legislative proposal to dismantle OPM and Avik Roy offers some observations on CMS’s Medicare Advantage and Part D drug pricing final rule.

In the examples of how federal law impacts healthcare department —

  • The Boston Globe reports on a recent study finding a substantial increase in mental health are claims over the past decade, a good thing which the FEHBlog attributes to the 2008 federal mental health parity law among other factors, and 
  • The American Medical Association reports that “2018 marked the first year in which there were fewer physician owners (45.9 percent) than employees (47.4 percent), not so good thing for professionals which the FEHBlog attributes to the Affordable Care Act. To that end, “more than half of physicians, 54.0 percent in 2018, continue to work in practices that are wholly owned by physicians, sometimes referred to as “private practice.” This share is statistically lower than that of 2012 (60.1 percent) and 2014 (56.8 percent), but not that of 2016 (55.8 percent). More than half of the 2012 to 2018 shift away from physician- owned practice occurred during the first two years of that period.
The FEHBlog over the past couple months has been learning about APIs. An API is it the part of the [computer] server that receives requests and sends responses. An example of an API is Medicare’s Blue Button which allows for Medicare claims data to be transmitted to a beneficiary’s phone or table app. Modern Healthcare informs us that Dr. Donald Rucker, the chief of the Office of National Coordinator for Health Information Technology said in an interview that 

If all these [electronic health record interoperability] APIs [such as HL7’s Da Vinci] work, the whole reporting of quality measures will, over time, eventually go away”  Dr. Rucker suggested that one day payers could access data from a provider through an API, and apply machine learning to extract quality measures. That would eliminate the need for clinicians to generate these measures “in a one-off kind of way,” he said.

A win-win for payers and providers.