The FEHBP Carrier Conference is Over

David Ermer–Uncategorized–

It’s been a busy week for the FEHBlog topped off by the 27th OPM AHIP FEHBP carrier conference. Here are some things that the FEHBlog learned from the conference:

  • Michael Thompson from the National Alliance of Healthcare Purchaser Coalitions (formerly the National Business Group on Health) spoke about a form of health reimbursement account known as medical episode spending allowances. 
  • Dr. Daniel Knecht, Vice President, Clinical Strategy & Policy, Aetna expressed his opinion medication assisted treatment is the gold standard for opioid use disorders.  MAT produces a 50% reduction in mortality compared to non-MAT treatment, but only 1 in 5 affected people receive MAT. Aetna is trying to address that problem.
  • Dr. Knecht also mentioned that Exparel is a safe alternative to opioids for oral surgery pain. Oral surgeon can administer the product during surgery. Aetna has been promoting this drug.  Other health and dental plans should take note because at the height of the opioid crisis opioids dispensed due to oral surgery lead to a lot of unnecessary addiction.
  • Finally Dr. Knecht noted that Aetna uses a the Alosa Health group from Boston to meet with doctors about evidence-based guidelines.   
  • Dr. Julie Kessel from Cigna explained that in order to cover more genetic / genomic tests with less cost and more quality outcomes. Cigna partnered with Informed DNA.  A few years ago, Cigna adopted a claims policy requiring genetic counseling for breast and colon cancer with no member cost share.  Cigna agreed to cover the genetic counsellor’s recommendation. Cigna soon expanded the program to all hereditary cancers. In 2018 Cigna removed the counseling barrier for members who urgently need surgical treatment. 
  • Christa-Marie Singleton, MD, MPH, Senior Medical Advisor, Office of Health Systems Collaboration, CDC discussed the Centers for Disease Controls’ Six [Conditions] Eighteen [Interventions] Program.  This Program offers assistance to healthcare providers and payers on chronic illnesses. 
  • Katherine E. Fleming-Dutra, MD, Deputy Director, Office of Antibiotic Stewardship, Division of Healthcare Quality Promotion, CDC explained that while antibiotics have saved millions of lives and they underpin modern medicine, antibiotic use is a major driver of antibiotic resistance. For that reason we need to use antibiotics properly.  85 to 95% of antibiotic use occurs in the outpatient setting. Thirty percent of outpatient prescriptions are unnecessary. Unnecessary antibiotic prescription can harm the patient. One of the six conditions  (issues} covered by the Six Eighteen Program is proper antibiotic use. 
  • Keith Fontenot from AHIP noted that the blockbuster specialty drug Humira is covered by over 100 patents which interfere with efforts to create biosimilar versions of the drug.