The fair, which takes place during open enrollment, Nov. 13 to Dec. 11, enables attendees to visit virtual booths for many of the health, dental and vision plan providers available through the Office of Personnel Management Federal Employee Health Benefits offerings to explore their options and talk to representatives from the various providers. The fair also includes webinars throughout open enrollment to give insight into the enrollment process and options.

“Today many of the health care plans have representatives sitting down waiting to answer your questions,” Tammy Flanagan, senior benefits director at the National Institute of Transition Planning, said in one such webcast.

The virtual fair caters to employees that didn’t have access to an in-person fair at their workplace, didn’t see the health care provider they were interested in at such a fair, or wanted to explore their options at home with their family members.

Attendees also have the option to store documents from various providers in their conference “briefcase” for ease of reference and comparison.

To motivate attendees to explore all of their options, the fair also has a scavenger hunt, where compass icons uncover questions about the various providers. Hint: the answer to the question is usually the provider page you’re currently on.

Attendees can also chat with each other about their experiences through the Resource Center’s group chat.

The Federal Employees Health Benefits Program (FEHBP) grants health care to over 8 million federal employees, retirees and their dependents via the Office of Personnel Management. However, the Federal Employees Health Benefits Act of 1959 limits the number of health plans offered in general.

OPM has subsequently proposed the expansion of its health care provider contracting authority as a means to increase the variety of health care plans and to better facilitate market competition between them. The Government Accountability Office then reviewed current FEHBP participation as a means to analyze the possible economic and social impact of OPM’s addition of new health care carriers.

GAO found that from 2008 to 2015, the median of a county’s offered health care plans increased from 19 to 24. Nonetheless, federal employees still tended to go with the biggest provider, namely Blue Cross Blue Shield Association, with median enrollment in that plan going from 58 percent in 2000 to 72 percent in 2015.

GAO had also interviewed both OPM officials and 11 FEHBP stakeholders, ultimately finding a lack of consensus as to the estimated costs of the OPM health care contracting authority expansion. Most of the aforementioned stakeholders supported the authority expansion and those who did not cited concerns about higher premiums and program instability.

“I think the frustration of processing benefits or background investigations or even retirement is unacceptable. We do need to do a better job in doing that,” said Pon.

According to Pon, the technologies to resolve many of these problems already exist in the private sector.

“The technology is not the problem, it’s actually making sure that we execute on putting things together and simplifying things, and making sure that the transactional data, not just paper, but transactional data that you need can actually be transacted in an efficient and effective manner,” Pon said of the backlog in retirement payments.

Pon already has experience managing technology initiatives for federal employee services, as he was the director of eGovernment at OPM from 2003-2005 and managed five of the agency’s human resources IT initiatives. Pon then served as the chief human capital officer at the Department of Energy before leaving federal service to work in the private sector.

When asked whether he would be able to get average hiring times down below three months, Pon responded that he thought three months was even too long, and described an exercise he conducted while working at the Department of Energy, where, with HR commitment and cooperation, they were able to hire several employees within two days of a hiring event.

“That was really to demonstrate a point, that we can do it if we tried,” said Pon. “In terms of hiring, we need to speed things up, we need to make sure that everyone all the way down the line actually understands the authorities that they have. And if they don’t have those authorities, I will talk to you and your constituents and make sure that we can discuss the issues and the challenges of hiring and maintaining the talent that you have.”

Pon’s statements earned him support from the National Active and Retired Federal Employee Association, who applauded his focus on the federal workforce as the key to government success.

“It was encouraging to hear that Dr. Pon is aware of the need to make federal retirement claims processing simpler, quicker and modern. As many retirees are awaiting their full annuity, if confirmed, he should make this a top priority as OPM director. We were also pleased that he committed to improving the hiring process to ensure we are recruiting the best and brightest in a timely manner – and that he expressed his support for modernizing policies affecting the civil service, and how OPM operates,” said NARFE National President Richard G. Thissen. “Dr. Pon’s statements and background indicate he is qualified for the position, and understands the importance of OPM’s role within the federal government. If the Senate approves his nomination, we look forward to working with him.”

Pon also warned of the “inconsistencies” that result from the federal government placing its security clearance resources in many different organizations, such as has been proposed for the Department of Defense to take over clearance investigations from OPM’s National Background Investigation Bureau.

“Proper planning is required currently for looking at whether or not it’s feasible,” said Pon.

He added that his priorities would be for standardization, unification, and simplification in the clearance process.

Both Pon and the nominee for deputy director of OPM, Michael Rigas, said that they would be committed to information security in the agency and preventing events like the 2015 OPM data breach from happening again.

“One of the first things I would do if confirmed would be to work with the internal and external stakeholders involved in the information technology area for OPM – and that would include both the chief information officer and the chief information security officer – to assess what progress has been made to date, what their plans are for ongoing progress and assess if we need to change course or if we are on target to meet the security and data protection needs that I think the federal government demands,” said Rigas.

“On my watch, we will make sure that we not only have the qualified people, but that we have a plan to execute and deter the risks that we have,” said Pon. “It is unacceptable to me to have people that are not trained in the current ways that we protect our data.”

However, Pon was warned that committee chairman Ron Johnson, R-Wis., may hold up his confirmation process in order to get answers about the employer contribution policies for congressional healthcare. Pon stated that though he cannot determine what documents on that topic are available within OPM before taking over the director position, he would personally look into the matter if confirmed.

“OPM has been without a Senate-confirmed director for more than two years. Given the numerous challenges facing the agency, such as a growing retirement backlog and data security still lagging, it is past time for a director,” said Thissen.

“It’s taking resources out of VA and shifting them into the private sector,” said J. David Cox Sr., national president of the American Federation of Government Employees. “It’s voucherizing veterans health care.”

The comments came less than a day after the formal unveiling of the new Coordinated Access & Rewarding Experiences (Vets CARE) Act, proposed by VA leaders as a way to increase patient access to physicians through expanded appointments outside the department’s system.

In a statement, VA Secretary David Shulkin said the new plan puts veterans at the center of all health care plans, instead of bureaucrats.

“We want veterans to work with their VA physicians to make informed decisions that are best for their clinical needs, whether in the VA or in the community,” he said “This bill does just that, while strengthening VA services at the same time.”

The Vets CARE program would replace the three-year-old Veterans Choice program, which allows veterans to seek private sector care at government expense if they face a 30-day wait for a department appointment or a 40-mile trek to the nearest department facility.

Under the new plan — which still needs congressional approval — those options would open to any veteran who faces a wait longer than “a clinically acceptable period.” VA officials could would also be able to authorize outside care for a variety of other reasons, and make it easier for private-sector doctors to get reimbursed for veterans walk-in care.

On Tuesday, officials from the American Legion offered general support for the reforms, saying they are in favor of making VA health care options “more efficient, transparent, and effective.”

But AFGE leaders attacked the proposal, labeling it another effort to slowly undermine and destroy the VA system.

“We’re seeing a constant push to expand ‘choice’ at VA against veterans wishes,” Cox said. “This is another attempt to dismantle VA from the inside out. It’s appalling, and it has to stop now.”

AFGE has been a frequent critic of President Donald Trump’s veterans policies, including legislation he signed into law this summer which made it easier to fire VA workers. In recent weeks, those arguments have centered around the idea that Trump appointees are working to privatize VA health care, an accusation Shulkin has repeatedly refuted.

Cox — whose group represents about 250,000 VA employees — said instead of opting for an expensive expansion of outside care programs, lawmakers should back plans to reinvest in existing VA facilities and more carefully rely on private-sector doctors for specialties the federal workforce lacks.

Shulkin’s vision has instead been focused on offering an expanded network of VA and community physicians. Conservatives on Capitol Hill have backed that idea, with similar promises that they aren’t looking to pull away resources from the department.

Will Fischer, director of government relations for VoteVets, called that approach “death by a thousand cuts.” Their group, which has close ties to the Democratic Party, is working with AFGE to campaign against the new plan.

“They’re promising not to privatize VA, but their actions and words don’t match up,” he said. “Each time one of these vouchers is issued, it’s money that is leaving the VA system.”

House lawmakers are expected to review the plan and their own health care reform proposals at a Capitol Hill hearing next Tuesday.

Meanwhile, officials from Concerned Veterans for America — which AFGE attacked in a press call Tuesday as pro-privatization, Republican activists — called the Vets CARE proposal a good start to the debate over VA’s future.

“There is room for improvement,” said Dan Caldwell, policy director for the group. “One important modification that we believe should be made is that a veteran should be able to choose a primary care physician inside or outside of the Veterans Health Administration within the integrated care network.

“This reform would be an important step towards fulfilling President Trump’s promise to increase health care choice for our veterans.”

“That 4 percent average compares favorably to certain surveys of projected cost increases in private sector employer health group coverage,” said Alan Spielman, director of healthcare and insurance at OPM.

The 6.1 percent increase for 2018 is slightly lower than the 6.2 percent employee contribution increase last year.

That increase results in federal employees paying an average of $5.57 more for self-only plans, $12.55 more for self-plus-one plans, and $12.17 more for family plans.

Premiums will increase 1.26 percent for dental plans and decrease 0.48 percent for vision plans in 2018.

Despite the lower percentage increase on premiums compared with 2017, Richard G. Thissen, president of the National Active and Retired Federal Employees Association, said that the premiums still negatively impact federal employees.

“While the increases in FEHB premiums for 2018 are modest, they continue to cut into federal employees and retirees’ take-home pay, annuity and purchasing power,” he said. “Over the last several years, federal workers have endured a three-year pay freeze and insufficient pay raises that have widened the gap between public- and private-sector pay. During this time, FEHB premiums have steadily increased, as we are witnessing with the 6.1 percent average increase for enrollees in 2018. Decreasing the purchasing power of America’s 5 million strong federal family not only impacts their quality of life, but also has an economic impact on their communities across the country.”

“The premium hikes announced today by the federal government far eclipse any increase in wages or Social Security payments next year,” American Federation of Government Employees national president J. David Cox Sr. said. “These rate hikes mean less take-home pay for current and retired federal workers and another year of difficult decisions by many families on how to pay their bills.”

“Federal employees get the 1.9 percent pay increase, so if you do the math on the average pay level, it comes out comes out to about $60 biweekly. And this average employee [premium] increase comes out to about $9,” said Spielman of the premium to pay ratio.

In addition to premium changes, six providers will terminate their enrollment for 2018, affecting 3,213 people in parts of Illinois, New Mexico, Ohio, Texas, Virginia and Wisconsin. With the addition of one provider in 2018, federal employees will have 262 health plan choices with 15 available nationwide.

“As always, there are some plans, some options, that are terminating,” said Spielman.

For those whose plans are not offering re-enrollment, OPM will be producing a pre-Open Season letter detailing the terminating plans, and providers are required to send a notice to their members advising them of their plan’s termination.

Telemedicine benefits will also be offered on more insurance plans in order to expand access to care.

“It’s important to note that the 6.1 percent increase in enrollee share assumes no movement from where people are enrolled now,” said Spielman, adding that typically 5 to 7 percent of federal employees change their plan every year.

Spielman encouraged employees to evaluate plans on more than just premium increases when choosing their 2018 option. For example, employees enrolled in the family healthcare plan but only have one extra person on their insurance could save money by moving to the self-plus-one plan established in 2016. Though premiums for these plans increased on average by a greater percent than the family plans, most self plus one plans still cost below the family rate on the whole.

According to Spielman, approximately two-thirds of employees eligible for the self-plus-one plan have taken advantage of it so far, with about 400,000 eligible employees still on a Family plan.

Open season for health benefits will be held this year from Nov. 13 through Dec. 11, 2017.

The Department of Defense recently rolled out a promotional video featuring “guru” Robyn, a bubbly benefits counselor who riffs on Disney tunes while serving up basic information on the Blended Retirement System (BRS).

BRS goes into effect in 2018 and service members will have the whole of that year to decide whether to opt into the system. With a polka dot bow in her hair and pictures of her cats to share, Robyn is designed to offer a pain-free introduction to the new benefit option.

The National Defense Authorization Act for Fiscal Year 2016, as amended by the NDAA FY2017, created a new military retirement system. BRS combines elements of the legacy retirement system with a more modern, 401(k)-style plan.

BRS is blended in the sense that it combines the longstanding 20-year military-defined benefit retirement with a defined contribution plan, much akin to the 401(k)-style retirement system, utilizing the Thrift Savings Plan.

“The new modernized retirement system will provide service members a portable government benefit, while maintaining a traditional defined benefit pension for those who serve at least 20 years,” Defense Department spokesperson LTC Paul Haverstick said in written comments to Federal Times.

In tweaking its retirement offerings with a more modernized option, Defense says it will beef up its recruiting and retention capacity. The Department describes this as among the more wide-reaching and significant changes to military pay and benefits in the last 70 years.

“The new plan provides portability and additional options, which will help to attract and manage a military force, which requires ever increasing diverse and technical skills,” Haverstick said. “For the first time, service members will receive automatic and matching government contributions to their retirement and will have control over their own investments.”

For service members, the blended option could mean a significant bump in retirement income. Under the legacy retirement system, 81 percent of service members who leave before reaching 20 years of service received no government retirement benefit, Defense notes. BRS will ensure nearly 85 percent of service members leave the service with government-provided retirement savings, as opposed to 19 percent today in the active component and just 14 percent in the National Guard and Reserve.

Service members will have all of 2018 to opt in, but as the very-perky Robyn points out, the decision to opt in is irreversible once made. Defense officials encourage service members to do their research before making a final choice.

ONC

Security Branch Chief Mikki Smith said that the office is currently working with the National Institute of Standards and Technology an on identity management framework and other framework projects in tandem to drive interoperability.

The use of use cases

When ONC officials asked what stakeholders wanted to see more of in terms of outreach, some called for more use cases to inform developers how they might apply data findings to their apps.

Some stakeholders called for more guidance from the government on the security features developers should include in their apps.

Acting Chief Privacy Officer Deven McGraw said that certain groups, like the HEART Working Group and HIMSS, were already working toward privacy and security specifications for APIs, and the health IT community would be best served to build on each other’s work.

“There lots of sort of pockets of work going on these same issues that we definitely want to connect to so that we are supporting one another and leveraging one another’s learning and not reinventing the wheel,” she said.

“So it’s early,” she said. “People are still, I think, getting up to speed and learning what the rules of the road are. We are getting a lot of feedback that people are starting to understand what they are supposed to do.”

Providers started submitting QPP data on Jan. 1 to help shape their Medicare payment adjustments in 2019 through two payment models: The Advanced Alternative Payment Model and the Merit-based Incentive Payment System.

The MIPS model requires providers to submit data to Medicare if they bill more than $30,000 a year and provide care for more than 100 Medicare patients a year, but will allow physicians to determine their pace of adoption ahead of a March 31, 2018 deadline.

The more data a provider submits, the bigger the Medicare payment they will receive.

For the Advanced APM model, providers who get 25 percent of Medicare payments or see 20 percent of Medicare patients through an Advanced APM in 2017, they have a chance at a 5 percent incentive in 2019, with a potential for 9 percent in 2022.

Goodrich said though providers have been working their way through the new reporting requirements, most are embracing them as a way to move to the more merit-based platform.

“One thing that’s been nice to hear is that a lot of folks really want to try to do more,” she said. “We definitely expect that we will have some folks that will do the minimum amount and they’re just not ready to go beyond that, but even with folks who haven’t participated previously, we are hearing they want to at least try to do more than the bare minimum.”

Goodrich added that CMS will start notifying providers of the status of their MIPS eligibility in the next four to six weeks.

ONC looks ahead

Acting ONC Director Jon White also talked about the office’s goals for 2017 and how it plans to move interoperability forward under the Trump administration and new Secretary for Health and Human Service Tom Price.

“We are collaborating closely with our colleagues in the new administration to deliver IT priorities in areas of focus,” he said. “There are two very clear priorities for us. The first is to reduce the burden of health IT use on providers and the second is to achieve widespread interoperability within health IT.”

White added that those priorities came from Price, but ONC will also focus on implementing the 21st Century Cures Act — a 2016 law that authorizes research using protected health data — in addition to working on its data standards for the Precision Medicine Initiative.

The ONC director added that while interoperability’s stakeholders — both in the tech sector and in the medical field — are fully invested in moving forward to use health IT to move health care toward outcome-based measures, the journey is far from over.

“Nobody wants to go back to paper,” he said. “They all say ‘Look, we see a lot of benefits to this information system, we’ve got data available to us that we’ve not had before.’ They also vent their frustrations.

“This is not a once-and-done deal. This is an ongoing process.”

Congress appropriated $205 million in research funding in 2016, and ONC interoperability efforts will help fuel the secure sharing of health data.

“So we’ve got a really rich source of people’s health care data in certified technology,” he said.

“So when people agree to participate in this research initiative, there’s one of two ways they can come in right now: Either through health care provider organizations that have received cooperative agreements from the National Institutes of Health or there’s going to be an open door for people who are not going to be a part of these organizations.”

White added that having health IT certified by ONC means the information collected will be able to be disseminated and researched through proven compatible formats to see the full picture of the health data.

“We are going to use these [Fast Healthcare Interoperability Resources]-based [application program interfaces] to both recognize that it’s the right person, get their appropriate consent to have their information shared with the research cohort and then deliver the information from certified technology.”

White said that ONC has been working in partnership with industry to develop APIs that will promote the free flow of health information to help populate the PMI pilots.

The agency’s role is central to the PMI because it will ensure that the data can be shared securely so the initiative can disseminate across the research cohort.

“ONC’s role in this is pretty specific,” White said. “We are working to promote and develop data standards that can be used for the Precision Medicine Initiative. We are working to pilot those standards so the technology can move the initiative forward and finally robustly partner with the Office of Civil Rights to address privacy and security policy around people’s data.”

ONC received $5 million of the 2016 PMI funding for the coordination of data standards for the project.