Reducing Costs at FEHBP, Civil Service Reform and More

The Office of Personnel Management is encouraging insurers to find ways to reduce costs for plans in the health care program for federal employees.

In its annual letter to Federal Employees Health Benefits Program carriers on Jan. 23, OPM suggested a number of ways that insurers could change their offerings, or provide new types of plans.

“The Office of Personnel Management has developed an agency strategic objective to improve the quality of health care received by enrollees in FEHB plans, increase the affordability of FEHB plans, and enhance the portfolio of available FEHB plans to increase the proportion that offer high quality at an affordable cost,” wrote Alan Spielman, OPM’s director of health care and insurance. “[Effective] plan design is key to providing high-quality, cost-effective health care.”

Among the ideas OPM floated were adjusting cost-sharing for high-value and low-value benefits “to help ensure members are getting the most value,” implementing tiered provider networks including options with reduced cost sharing, and reducing cost sharing when members act to manage chronic conditions or obtain higher-quality care through “creative provider or vender partnerships.”

OPM also suggested insurers employ online portals and other communication tools to improve enrollee engagement and support with decision-making, and to explore new techniques for cost management, including evidence-based utilization management.

The letter also stressed that FEHB providers must enhance efforts to prevent opioid misuse, and said proposals for 2019 must include detailed information about insurers’ efforts to combat the prescription painkiller epidemic.

“We expect all FEHB carriers to strengthen their efforts to prevent opioid misuse and treat addiction,” Spielman wrote. “[Additional] data regarding utilization of key services related to opioid prescribing, pain management, addiction care, and naloxone rescue agent dispensing will be required as part of each carrier’s response to the automated data collection.”

The agency also told insurers that it is exploring the expansion of its high deductible health plans. High deductible FEHB plans currently cap health reimbursement arrangement and health savings account amounts at 50 percent of such a plan’s deductible, but Spielman wrote that OPM is “seeking proposals” for plans that allow HRAs and HSAs to exceed that threshold.

Meanwhile, President Trump traveled to Capitol Hill Tuesday to deliver his first State of the Union address, in which he urged Congress to move forward with civil service reform.

As Charles S. Clark reports, Trump said lawmakers should “empower every Cabinet secretary with the authority to reward good workers—and to remove federal employees who undermine the public trust or fail the American people.”

Although federal workers routinely say they want better rewards for strong performance, efforts to make it easier to fire employees are controversial, with Democrats and labor leaders decrying such proposals as a potential erosion of feds’ due process protections.

On Tuesday night, National Treasury Employees Union National President Tony Reardon lambasted Trump for targeting federal employees. Next month, the White House is expected to propose a pay freeze for all civilian federal workers as part of its fiscal 2019 budget request.

“It is unfortunate that the president chose to single out our world-class civil service tonight, leaving the impression that federal employees are not dedicated to public service, committed to the missions of their agencies and honorable Americans,” Reardon said. ”[Federal] employees must retain existing protections that stop unfair and arbitrary management practices, along with political favoritism and retaliation. Our workforce is non-partisan and merit-based and any reduction in due process protections is a step backward for our country.”