The agency that manages health benefits and other benefits for federal employees — the U.S. Office of Personnel Management (OPM) — wants to find a way to pay for health benefits based partly on health plan performance.
The FEHB program is similar in some ways to the Patient Protection and Affordable Care Act (PPACA) public exchange program. Insurers apply for a chance to sell coverage to federal employees through the programs. The employees in a given community can choose from a wide menu of plans supplied by the providers who have been approved to sell coverage in that community.
If OPM goes ahead with the new payment approach, performance-based assessments would start in 2016.
OPM would begin making payments based on performance data in 2017.
Comments on the proposal will be due 30 days after the official publication date.
Although the proposal would have a direct effect only on federal employees, it could have an indirect effect on how other employers buy benefits.
See also: FEHB To Pay For Substance Abuse Screening.
For more about the proposal, read on.
1. OPM would use a different approach to measuring clinical quality
Today, OPM has contracting officers rate “experience-based” plans — plans with charges that vary with enrollees’ claims — based on six factors: contractor performance, contractor cost, federal socioeconomic programs, cost control, independent development and capital investments. OPM officers rely heavily on contractor performance when reviewing charges, officials say.