Check out the Peterson-KFF series of charts on how U.S. healthcare spending has changed over time, which was posted on December 20, 2019. The website explains

This chart collection explores recently released National Health Expenditure (NHE) data from the Centers for Medicare and Medicaid Services. These data offer insight into changes in health spending over time as well as the driving forces behind spending growth.

Yes indeed. 

As Americans return to full work weeks following the holiday season, Congress begins the second session of the current 116th Congress here in the Nation’s capital.

On Friday, according to the Volokh Conspiracy, the intervenor defendant, appellant States and House of Representatives filed separate requests for expedited review of the Fifth Circuit’s decision in the Texas v. United States decision holding the Affordable Care Act’s individual shared responsibility provision / mandate unconstitutional.  As you will recall, the Fifth Circuit directed the lower court — Northern District of Texas — to carefully reevaluation its December 2018 decision that the ACA is inseverable from the unconstitutional individual shared responsibility responsibility. The petitioners seek to short circuit this step by taking the case to directly to the Supreme Court. For what it’s worth, the FEHBlog expects the Supreme Court to decline this request in order to allow the record to more mature before high court review.

Govexec.com reports that

In a report dated Dec. 19 and released on the Office of Personnel Management’s website last week, the President’s Pay Agent, which is a board comprised of Labor Secretary Eugene Scalia, Office of Management and Budget Acting Director Russell Vought and OPM Director Dale Cabaniss, greenlit a series of recommendations from the advisory Federal Salary Council. Chief among them were the creation of a new Des Moines, Iowa, locality pay area, and the addition of Imperial County, Calif., to the Los Angeles locality pay area.

The inclusion of these new regions is “subject to rulemaking,” meaning OPM must act over the course of the next year to finalize the additions. The pay agent also approved the salary council’s recommendation that officials should consider human capital indicators when weighing regions’ requests to be granted a locality pay area despite not meeting the established criteria for inclusion.

The Wall Street Journal reports today that while antibiotic manufacturers have adequate government funding to research superbug antibiotics, the commercial market for these drugs is insufficient to support manufacture.

Washington has taken notice of the problem, but near-term action remains unlikely. The Disarm Act, short for Developing an Innovative Strategy for Antimicrobial Resistant Microorganisms and introduced in Congress in 2019 (HR 4100 and S 1712), would have Medicare pay for certain antibiotics in full. Despite bipartisan support for the bill, executives worry its progress could be hindered by impeachment proceedings and the coming election.

Disappointing.

Fierce Healthcare offers a bunch of snippet forecasts on the future of healthcare in 2020. For example

We have a lot of hospital beds in brick-and-mortar institutions and
we’re going to move to community- and home-based sites of care, which is
more convenient for the patient. Consumers are demanding easier access
to services.

The telehealth capabilities and sensors that we can put into the home
now, these devices are not just gadgets but good enough for diagnosis
and treatment. And we’re going to see more security risks so we need to
redouble our efforts to make sure data is protected and data integrity
as well. If data is altered, that can be worse than if the data were
deleted.”

— John Halamka, M.D., president, Mayo Clinic Platform

The Wall Street Journal reports today that 

More than 60 [prescription] drug makers raised prices in the U.S. on Wednesday,
according to an analysis from Rx Savings Solutions, which sells software
to help employers and health plans choose the least-expensive
medicines. The average increase was 5.8%, according to the analysis,
including increases on different doses for the same drug. The average is just below that of a year ago, when more than
50 companies raised the prices on hundreds of drugs by an average of more than 6%, according to the analysis.

The CPI-U increased by 2.1% over the period November 2018 to November 2019.

Healthcare Dive informs us that

• Hospital consolidation is associated with poorer patient experiences and doesn’t improve care, according to a study published Thursday in the New England Journal of Medicine, refuting a common provider justification for rampant mergers and acquisitions.
• The study funded by HHS’ health quality research division, the Agency for Healthcare Research and Quality, found that acquired hospitals saw moderately worse patient experience, along with no change in 30-day mortality or readmission rates. ​Acquired hospitals did improve slightly in clinical process, though that can’t be directly chalked up to the results of an acquisition, researchers found.
• It’s further evidence that bigger isn’t always better when it comes to hospitals, and adds onto a heap of previous studies showing provider mergers lead to higher prices for commercially insured patients.

West Georgia Ambulance, Inc. (West Georgia), has agreed to pay $65,000 to the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS) and to adopt a corrective action plan to settle potential violations of the Health Insurance Portability and Accountability Act (HIPAA) Security Rule. West Georgia is an ambulance company that provides emergency and non-emergency ambulance services in Carroll County, Georgia.

West Georgia stepped into hot water when it reported a data breach to OCR as required by law.

The FEHBlog is pleased to announce that the name of his law firm has changed from the Ermer Law Group PLLC to Ermer & Suter, PLLC.  Jason Suter has been the FEHBlog’s partner since 2014 and it’s high time that he got due recognition. Soon the FEHBlog will be available on our renamed firm’s refreshed website (which should be launched in the new few days.)  Our staff is writing a TPRS Blog on our refreshed Third Party Recovery Services site, which is up and running.. 

When the decade began, we were enmeshed in Congressional actions which lead to the enactment of the Affordable Care Act in March 2010. From a health policy perspective, this has been the ACA’s decade for better or for worse.

The FEHB Program celebrated its 60th anniversary in 2019. The FEHBP which was once a fairly uncomplicated program, was burdened — like other group health plans — with ACA obligations and uniquely with new OPM initiatives, such as the agency’s plan performance system. The decade ended with a ray of sunshine created by the repeal of the ACA’s health insurer and Cadillac taxes and a well deserved raise for federal employees.

Will the FEHBP see its 70th anniversary or will be it folded into a Medicare for All arrangement in the 2020s?  Time will tell, but the FEHBlog bets that the FEHBP will see 2030. Let’s hope that we all do.

For a longer trip down memory lane, check out this Becker’s Hospital Review article.

Fun fact to know and tell, as CNBC reports, the 2010s were the only decade in American history without an economic recession.

Happy New Year.

The Affordable Care Act created, and required health insurers and plans to fund, a Patient Centered  Outcomes Research Institute.The FEHBlog thinks that the PCORI duplicates the work of existing government agencies, such as AHRQ.  He also cannot understand why the cost of PCORI was not spread over other segments of the health care industry. The ACA provided PCORI with health plan / insurer funding through this year. Some thought that this meant the annual PCORI funding obligation would end. Those observers must not work inside the Beltway like the FEHBlog does. So the FEHBlog was not surprised to learn today that the FY 2020 final spending bills extended the current funding system for PCORI over the next ten years. As the same bills repealed the ACA’s health insurer and Cadillac taxes, this is a small price of health plans and insurers to pay. Hopefully, the fruits of the PCORI will be on display in the next decade.

Congress remains out of town until next week.

Readers may recall that the health insurer trade associations had requested the Department of Health and Human Services to extend by at least 90 days the comment period o the proposed out of pocket cost transparency rule applicable to health plans. Fierce Healthcare reports that the Department has granted a 15 day extension through January 29, 2020.

Health Payer Intelligence brings us up to date on health insurer efforts to take social determinants of health into account. The FEHBlog expects this effort to continue to grow over time.

The percentage of adults living with diagnosed and undiagnosed diabetes varied significantly by race/ethnicity and among Hispanic and non-Hispanic Asian subgroups. Broadly, the age-sex-adjusted percentage of adults living with diagnosed or undiagnosed diabetes was 22% in Hispanics, 20% in non-Hispanic blacks, 19% for non-Hispanic Asians and 12% for non-Hispanic whites.