The Internal Revenue Service has granted self-funded large employers and insurers including FEHB plans, a 30 day grace period (from January 31, 2019, to March 4, 2019) for distributing Forms 1095-B and 1095-C to employees / plan enrollees. These forms document the enrollees compliance with the ACA’s individual shared responsibility mandate and the large employer’s compliance with the ACA’s employer shared responsibility mandate. The IRS did not extend the reporting entity’s deadline to submit the forms to the IRS. The IRS will have to revisit these forms for the next reporting year when the individual mandate penalty starts to be zeroed out.
CNBC interviewed Express Scripts’ chief medical officer Steve Miller, MD.
Dr. Miller sees a potential watershed moment in the year ahead when it comes to drug pricing in Washington. He thinks the administration could find allies on both sides of the aisle in the incoming Congress to move even further with reforms which seemed unthinkable just a couple of years ago.
“I never would have thought I’d have a Republican president in Donald Trump who’s advocating for international price controls, that I would have the former head of Lilly, Alex Azar HHS, advocating for low prices and low rebates, and Scott Gottlieb who’s been spectacular at the FDA accelerating approvals of generics, accelerating approvals of the 2nd and 3rd in class per drug. It’s really an incredible moment,” Dr. Miller said.
With respect to the drug pricing issue, Healthcare Dive reports that
After years of delay, HHS finalized a rule Thursday that will impose a ceiling price to limit how much drug manufacturers can charge hospitals participating in the 340B drug discount program for their products, as well as civil monetary penalties for manufacturers charging above the ceiling.
While this is good news for tertiary care hospitals in particular, it probably means that the drug manufacturers will be seeking to make up lost ground with other customers.
Health Payer Intelligence discusses a recent customer satisfaction survey of health plan consumers that Newsweek arranged. Humana, Blue Cross, and Aetna topped the results.
Tailored experiences and a personal touch are in extremely high demand, said Nancy Cooper, Newsweek Global Editor in Chief, especially as automation threatens to fundamentally alter the way consumers interact with large corporate entities.
“As we examined the larger, impersonal forces that are transforming retail, it seemed like a good time to recognize a more personal factor in business success: the ways in which many companies nurture their relationships with consumers,” she said.
“The automated future is already upon us, and the hope is that we—as a nation and as individuals—can shape it to our advantage.”
Healthcare payers are certainly trying to balance the efficiencies of automation with the individualized customer service their beneficiaries expect.
By combining advanced data analytics and artificial intelligence with personalized outreach and tailored communications, payers are creating innovative new opportunities to increase satisfaction and adherence to recommended treatment pathways.