Healthcare Financial News

A study report released last week by the Center for Studying Health System Change (HSC).suggest that although consumer-directed health plans (CDHPs)--typically a high-deductible health plan accompanied by either a health reimbursement arrangement (HRA) or health savings account (HSA)--are being offered by a growing number of employers, enrollment in these products constituted just 5 percent of total enrollment in employer-sponsored health plans in 2007.

“There’s a lot of window shopping going on with consumer-directed health plans, and there’s a lot of watchful waiting to see how early adopters fare,” said Paul B. Ginsburg, PhD, president of HSC.

The study’s findings are detailed in a new HSC issue brief, Consumer-Directed Health Plans: Mixed Employer Signals, Complex Market Dynamics. Among the issues that might be contributing to the low enrollment in CDHPs, said the report, is the fact that some employers believe that CDHPs, especially tied to HSAs, are difficult for some employees to understand and require extensive employee education when offered. Also, some employers perceive the portability of HSAs as a negative feature, especially in industries with high employee turnover. These employers respond by contributing little or nothing to the account or by offering an HRA instead. Read the issue brief.

A new regulation issued April 2 by the Centers for Medicare and Medicaid Services (CMS) establishes Part D e-prescribing standards for four types of information: formulary and benefits, medication history, fill status notification, and identification of individual healthcare providers.

Prescribers, dispensers, and other providers are not required to implement e-prescribing, but those who do must comply with the new Medicare standards when using e-prescribing to send prescriptions and prescription-related information for covered drugs prescribed for Part D eligible individuals.

The rule will (1) allow physicians and other prescribers to communicate with Part D sponsors about which drugs are covered by a Medicare-eligible individual’s prescription drug benefit plan and which generic prescription drugs might offer lower-cost options for the individual; (2) allow physicians and other providers, as well as dispensers and Part D sponsors, to communicate among themselves about a beneficiary’s prescription history, which should help reduce the number of adverse drug events; (3) allow physicians and other providers to receive e-mail fill status notifications; and (4) require providers, dispensers, and Part D sponsors to use the National Provider Identifier (NPI) to identify individual healthcare providers in Part D e-prescribing transactions.

The new e-prescribing standards will be effective on April 1, 2009. Read the overview.