The Trump Administration is apparently poised to test national health-care initiatives with the federal workforce.

The administration has contacted insurance vendors that participate in the Federal Employees Health Benefits Program, informing them that they will be expected to address general health insurance cost containment, prescription drug costs, genetic testing and opioid abuse in the health plans they offer for next year.

These measures were outlined in the federal Office of Personnel Management’s annual call letter to insurers. While the letter essentially echoed objectives cited by the Obama Administration, its directives for the 2019 coverage year underscored the fact that such issues have become both nonpartisan and national.

Among the actions the letter asked the carriers “to carefully consider” were:

Identify “innovative models that include other cost management techniques, such as new evidence-based utilization management in medical or specialty pharmacy.”
Focus on solutions for curbing hypertension and diabetes, since these are the most common chronic conditions referenced by carriers.
Make recommendations on ways to tap the potential for genetic testing to “speed time to diagnosis, optimize treatment, improve health outcomes, and avoid costs associated with adverse drug effects.”
Strengthen their efforts to prevent opioid misuse and treat addiction.

The letter stipulated new requirements for combatting the opioid crisis, including more restrictions on prescribing them and better access to addiction treatment. However, it noted that, with respect to opioid addiction and deaths, progress has already been made due to the national focus on it. “We are encouraged that preliminary FEHB data reveals a declining trend in opioid utilization, both in number of prescriptions and quantity dispensed per prescription,” the letter said.

The call letter officially opens the period of negotiation between the parties on terms and rates for 2019 for federal employees. Generally, final terms and rates are announced in September.

Instant Insights /

2019 federal insurance priorities: Cost containment, genetic testing, opioids

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