Yahoo Finance offers an interview with Aetna’s former CEO Mark Bertolini.  The FEHBlog values Mr. Bertolini’s insights. Here’s the piece of the interview that struck home with the FEHBlog —

Presently, health care in the U.S. is like a “warranty system” that waits until people are “broken” to fix them, according to Bertolini. “It’s a warranty system today,” Bertolini said. “You get a warranty card when you join a health plan. If you get broke and present yourself to the nearest dealer, we’ll fix you at some cost. It’s not free. And so we have to change that model to what are we doing in the community.”

“This is why we did the CVS deal. We got to do something in the community where we can get people into the stores, have the stores reach out to the community as a way of finding better ways to take care of people, keeping them away from the system,” Bertolini said.

All forms of insurance are warranty systems. The FEHBlog agrees that the old warranty model is outdated. But how can either the new community model work or the old warranty model work with personal responsibility for one’s wellbeing being at the forefront?

The Centers for Medicare and Medicaid Services, which enforces the HIPAA electronic transaction standards and code set rules, announced their findings from a voluntary study of health plan and healthcare clearinghouse compliance with those standards.

Ten organizations met the criteria for participation in the Optimization Pilot. Of these, four clearinghouses and one health plan completed the pilot. All but one of these entities underwent a corrective action plan as part of the pilot. Each participating entity received an acknowledgement stating their participation and compliance. By participating in the pilot, covered entities assisted HHS with streamlining the compliance review process, including review tracking, coordinating and communicating with participating entities, and assessing violations.

CMS advises health plans and clearinghouses to look forward to “a future Information Bulletin for details about full implementation of the Compliance Review Program.”

In Thursday tidbits, the FEHBlog called attention to Choosing Wisely Campaign flyers that can be shared with patients and plan members. The FEHBlog noticed today that the Choosing Wisely campaign also offers a free smartphone app.

The Wall Street Journal reports that while current flu season has not been as severe as last year, it is lasting longer. Thankfully Spring arrived yesterday so the flu can’t hang around much longer.