KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Kaiser Health News Original Stories

Political Cartoon: 'Flipping The Station'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Flipping The Station'" by Bob Englehart, Hartford Courant.

Here's today's health policy haiku:


Death to Cadillac
Tax, bipartisan snafu,
Hillary et tu?

If you have a health policy haiku to share, please Contact Us and let us know if you want us to include your name. Keep in mind that we give extra points if you link back to a KHN original story.

Capitol Hill Watch

Congress OKs Health Law Tweak To Ease Insurance Rules For Mid-Size Businesses

The White House has signaled that President Barack Obama will sign the measure.

The Wall Street Journal: Bill Waiving Insurance Rules For Midsize Businesses Clears Senate
A bill waiving the federal health law’s insurance rules for tens of thousands of midsize businesses cleared the Senate Thursday in a rare example of congressional agreement to undo part of the 2010 Affordable Care Act. The legislation had already passed the House, and the White House appears open to signing it. ... The Senate used a fast-track process that avoided an up-or-down vote on the measure, which would free companies with 51 to 100 workers from requirements on coverage standards and pricing. ... The issue is separate from another provision in the Affordable Care Act that requires businesses with 50 or more full-time workers to offer them coverage or pay a penalty. (Radnofsky, 10/1)

The New York Times: Health Law Revision Is Approved
At issue is a provision of the health care law that expands the definition of a “small employer” to include companies with 51 to 100 employees, subjecting them to stringent insurance regulation starting Jan. 1. States have historically defined small employers as those with 50 or fewer employees. ... The bill, approved this week in the House and the Senate by voice vote, eliminates a provision of the law that would have imposed tough, potentially costly new requirements on businesses with 51 to 100 employees. (Pear, 10/1)

Also on Capitol Hill, interest in rolling back the health law's "Cadillac tax" is gaining momentum -

The Columbus Dispatch: Portman, Democrats Agree On Killing Obamacare ‘Cadillac Tax’
Sen. Rob Portman welcomed calls from Sen. Sherrod Brown and other Democrats to kill a tax that helps finance the 2010 health law that has extended health coverage to more than 14 million Americans. In a conference call with Ohio reporters on Thursday, Portman, R-Ohio, said that while he always has opposed the law signed by President Barack Obama, he hopes “we can make a bipartisan effort to kill the tax.” (Baedorf, 10/2)

Meanwhile, another congressional budget deadline looms -

The Wall Street Journal: Treasury’s Lew Says Congress Must Raise Debt Limit By Nov. 5
Rep. Mick Mulvaney (R., S.C.) said he had “encouraging conversations” with GOP colleagues over the past month on demanding changes to entitlement programs as part of any debt-ceiling package. “Spending for the sake of spending is going to be a real difficult vote,” he said. Still, it isn’t clear what such a package would look like, and several Senate Republicans who face close elections next year have resisted proposals for big changes to popular programs like Social Security and Medicare. (Timiraos and Peterson, 10/1)

Health Law Issues And Implementation

Program To Help Health Insurers Deal With Risk Comes Up Short On Cash

Administration officials announce that a health law program designed to reimburse insurers who underestimated the cost of covering new patients coming into the marketplace has not collected as much money as insurers requested.

The Wall Street Journal: Health Law’s Program To Ease Insurers’ Risks Has Shortfall
An Affordable Care Act program meant to ease risks for health insurers in the law’s new marketplaces will initially pay many companies less than they expected, likely putting financial strain on some. Federal authorities said that insurers will at first receive only about 12.6% of the money that they requested from the program, known as risk corridors, for 2014, its first year of operation. Insurers have requested approximately $2.87 billion in payments from the program based on their 2014 results. But the pool available to make those payments is just $362 million, which came from collections from other insurers that did relatively well on their marketplace business. (Wilde Mathews and Armour, 10/1)

The Washington Post: Health Insurers To Receive A Fraction Of What They’re Owed Under ACA Program
Health insurers in the marketplaces created by the Affordable Care Act will be reimbursed this year only 13 percent of the money they are owed under a program designed to help cushion the burden of covering large numbers of people who need expensive medical treatment. ... A senior official with the Centers for Medicare and Medicaid Services said the agency would attempt to pay more of what it owes next year and, if necessary, the year after. But the official, briefing reporters on the condition of anonymity, acknowledged that the ability to fully pay hinges on Congress’s willingness to provide additional money. (Goldstein, 10/1)

The Associated Press: Insurers Face Health Overhaul Losses For 2014
The insurance industry was disappointed at what its officials called a significant shortfall. "Stable, affordable coverage" depends on adequate funding of the program, said a statement from Marilyn Tavenner, CEO of America's Health Insurance Plans, the industry lobby. "It's essential that Congress and (the administration) act to ensure the program works as designed and consumers are protected." ... Despite the concerns of insurers, the Republican-led Congress is unlikely to allocate any additional money for the program, a temporary stabilization fund that lasts three years. (Alonso-Zaldivar, 10/1)

In other health insurance news -

Kaiser Health News: Insurers Find Out-of-Network Bills As Much As 1,400 Percent Higher
It’s common knowledge that consumers have to pay more money if they choose doctors or hospitals outside of their insurance plan’s network. But a new analysis prepared by the insurance industry seeks to show just how much more in each of the 50 states. Out-of-network providers charged patients on average 300 percent more than the Medicare rate for certain treatments or procedures, according to the analysis of 2013 and 2014 claims data released Thursday by the America’s Health Insurance Plans. (Gorman, 10/1)

Under Alaska's Medicaid Expansion, 2,000 New Enrollees See Chance For Fresh Start

In other Medicaid expansion news, California's enrollment efforts have been very successful. But the state's health insurance program for low-income people now faces some growing pains in dealing with the health care needs of this ballooning population.

Alaska Public Radio: With Medicaid Expansion, The Chance For A Fresh Start
Alaskans have been able to sign up for Medicaid expansion for one month. Nearly 2,000 people have enrolled during that time. Kenneth Taylor signed up the first week and is anxiously waiting for his enrollment card. Taylor has two types of cancer, in his kidney and his prostate. He’s also trying to manage several chronic conditions, including high blood pressure, diabetes, sleep apnea and asthma. (Feidt, 10/1)

Kaiser Health News: Newly Insured Treasure Medicaid, But Growing Pains Felt
The Affordable Care Act unleashed a building boom of community health centers across the country. At a cost of $11 billion, more than 950 health centers have opened and thousands have expanded or modernized. In San Diego, new clinics have popped up on school campuses and busy street corners. Cramped storefront clinics have been replaced with gleaming, three-story medical centers with family medicine, radiology and physical therapy on site. They are outfitted to care for new immigrants in dozens of languages from Spanish to Somali. (Varney, 10/2)

And on the health exchange front -

The Associated Press: MNsure Health Insurance Rates To Go Up As High As 49 Percent
Health insurance premiums for Minnesota residents buying coverage through MNsure or directly from providers will increase by as much as 49 percent on average next year, state officials announced Thursday, a major jump that the state's top insurance regulator said calls for additional reforms to control costs. The 2016 cost increases range from 14 percent for enrollees on a Medica plan to 49 percent for customers on Blue Cross Blue Shield of Minnesota, the state's largest insurer. All eight companies selling insurance on the individual market posted double-digit percentage rate increases for next year. (Potter, 10/1)

Administration Backs Supreme Court Review Of Legal Challenges To Health Law's Birth Control Mandate

In other news, the American Civil Liberties Union of Michigan sues a Catholic hospital system over its abortion policy.

USA Today/Detroit Free Press: ACLU Sues Catholic Hospital System Over Abortion Policy
A federal lawsuit accuses a Catholic health system with 86 hospitals nationwide of “denying appropriate emergency care to women suffering pregnancy complications.” The American Civil Liberties Union and the American Civil Liberties Union of Michigan filed an amended complaint Friday against Trinity Health, headquartered in Livonia, in U.S. District Court in Detroit. (Anderson, 10/1)

Campaign 2016

On Campaign Trail, 2016 Candidates Advance Health Care Options

One presidential hopeful, Sen. Bernie Sanders, I-Vt., supports allowing some immigrants who are in the country illegally to still get health insurance through the 2010 health law. Meanwhile, Democratic candidate Hillary Clinton discusses expanding the use of an expensive drug that counters a heroin overdose.

The Associated Press: Here They Come Again: Broader Health Care Debate For 2016
After seven years of the political drama known as "Obamacare," you might think voters would be tired of big ideas for revamping health care. If so, the presidential candidates seem to have missed the memo. The 2016 hopefuls in both parties are offering a full spectrum of options, from a system wholly run by the federal government to dialing back Washington's lead role. Much is promised by the candidates, but each approach has pitfalls. (Alonso-Zaldivar, 10/2)

The Washington Post: Bernie Sanders Tells Latino Lawmakers: Undocumented Immigrants Should Benefit From Obamacare
Democratic presidential candidate Bernie Sanders supports allowing some of the nation's undocumented immigrants to obtain health-care coverage under the Affordable Care Act, he told Democratic lawmakers on Thursday. The Vermont senator, who is running a competitive race against Democratic presidential front-runner Hillary Rodham Clinton, made the comments during a 45-minute meeting with members of the Congressional Hispanic Caucus, according to attendees. (O'Keefe and Wagner, 10/1)

The Hill: Clinton Calls For Wider Use Of Costly Heroin Overdose Antidote
Democratic presidential front-runner Hillary Clinton is pledging to vastly expand the country’s use of a costly drug that can reverse the effects of a heroin overdose. “I want it to be in more places than law enforcement. It needs to be on college campuses, it needs to be in workplaces, it needs to be in community centers,” she told a packed crowd at an event in Boston. (Ferris, 10/1)

And for Planned Parenthood, election-year pranks are transforming this campaign into a season of giving -

The Wall Street Journal's Washington Wire: Planned Parenthood Gets Lift From Prank Gifts
It’s the thought that counts. As the 2016 campaign has launched into high gear over the past few months, so has another season: that of prank giving. Planned Parenthood – which provides women’s health services, including abortions — has received over a thousand individual donations in the names of politicians who oppose abortion and have been calling for the defunding of the organization. Sen. Ted Cruz (R., Texas), former Hewlett Packard executive Carly Fiorina, former Florida Gov. Jeb Bush and former Arkansas Gov. Mike Huckabee are among some of the most popular honorees, according to Planned Parenthood. Mr. Cruz is far and away the most popular donor, at 442 donations to Ms. Fiorina’s 83, Mr. Huckabee’s 77 and Mr. Bush’s 70, the group says. (Court, 10/1)


Squirrel Bites & Lamppost Run-Ins: Even Strange Injuries, Conditions Coded Under ICD-10

Doctors' offices are now adapting to a new generation medical coding system, the International Classification of Diseases or ICD-10, that went live this week with nearly 70,000 codes for every medical circumstance from the common to the rare, including crushed by alligator.

The Texas Tribune: New Era For Health Records Drives Demand For Medical Scribes
Starting Thursday, most U.S. health care providers must switch to a new system of computer codes for recording patient ailments — the 10th edition of the International Classification of Diseases. While some doctors worry that the new requirements are an expensive and disruptive set of government mandates, supporters say the new technology is long overdue. They say the upgrade will help keep patients from receiving expensive or harmful medical interventions by making it easier for doctors to share information about patients' histories. (Walters, 10/1)

NBC News: Struck By A Turtle? There's A Code For That
Walk into a lamppost? There's a special code for that. Did someone bite you by accident? There's a code for that, too. There's one code if you're being fitted for an artificial leg on the right side and another code if it's on the left. (Fox, 10/1)


It's A Good Time For Seniors To Evaluate Their Medicare Part D Plan

With drug prices skyrocketing and open enrollment season about top start, The Sacramento Bee reports on the options available to Medicare beneficiaries. In related news, a GAO report finds hospital care to be unaffected by CMS' quality incentive program while a measure for Medicare to help fund end-of-life counseling gets public support.

The Sacramento Bee: Medicare Sticker Shock: Soaring Drug Prices Could Trip Up Seniors
It’s the official start of a once-a-year window when seniors can switch their Part C (hospital/medical care) and Part D (prescription drug) plans. Those who ignore the open enrollment season, which runs Oct. 15 through Dec. 7, could wind up paying hundreds of dollars in unnecessary prescription drug charges next year, especially as some drug prices have soared in recent months, say Medicare experts. It’s also a potentially treacherous period, when scammers and predatory insurance agents ramp up their efforts to steal seniors’ Medicare numbers or entice them into costly, inappropriate coverage. (Buck, 10/1)

CQ Roll Call: Government Payment For End-Of-Life Counseling Draws More Support Than Criticism
Medicare officials received more support than criticism for a plan to pay health care providers for time spent counseling people about their medical options in case of terminal illness or failing health, an approach that was derided in the past as a path toward so-called death panels. About 500 comments submitted on a 2016 Medicare rule for paying physicians supported end-of-life counseling, with most calling on the Centers for Medicare and Medicaid Services to finalize a plan to create a new payment category, CQ Roll Call found in a review of comments posted publicly as of last week. About 100 comments raised objections. Medicare officials will make their final decision as part of the broader rule on payments to physicians, which will be unveiled this month. Powerful lobbying groups, including AARP, the American Bar Association and the American Heart Association, were among those pressing for the creation of the payment.(Young, 10/1)

Veterans' Health Care

Congress Agrees To Pay For Construction Cost Overruns At Denver VA Hospital

The sticker price for the hospital is now $1.6 billion. Also in veterans news, a federal inspector general confirms a whistleblower's claims that Veterans Affairs facilities in St. Louis mishandled records for mental health patients.

The Washington Post: Congress To VA: $1.6 Billion Denver Hospital Will Be Funded … This Time
Despite a last minute fight over funding for the Department of Veterans Affairs vastly over budget hospital in Denver, Congress agreed to fund the rising sticker price of the $1.6 billion medical facility, thought to be one of the most expensive hospitals in the world. Throughout the week, tensions increased over whether Congress would fund the last $625 million needed to finish the complex, whose price tag has ballooned to nearly three times the $604 million the VA originally budgeted for. The project is widely known as “the biggest construction failure in VA history.” (Wax-Thibodeaux, 10/1)

The Associated Press: St. Louis VA Mental Health Records Questioned By Watchdog
A federal watchdog says it has confirmed a whistleblower's claims that Veterans Affairs sites in St. Louis marked appointments for mental health patients as completed before they were seen, effectively boosting the appearance of the sites' productivity. St. Louis VA Health Care System's records from October 2013 and June of last year showed an employee inappropriately marked 60 percent of the 20 consults reviewed as "complete" before those treatments were finished, a VA inspector general's report released Wednesday said. Such misrepresentation "increases the risk that veterans may become lost in the system" if a patient misses a consult appointment or the clinic cancels it, according to the report. (Suhr, 10/1)

State Watch

University Officials Fear Fallout From Planned Parenthood Videos Will Hit Research Labs

Bills in Wisconsin and Ohio would ban research on fetal tissue and university labs elsewhere are concerned that they, too, could be targeted. Other news outlets examine how the video controversy is playing out in South Carolina, and a fact checker looks at the issue of Planned Parenthood and mammography services.

Politico: Planned Parenthood Critics Have New Target — Universities
Officials of the nation’s leading universities have watched with dread as the fallout from the Planned Parenthood sting videos has threatened to engulf labs that depend on fetal tissue for research. Now the abortion wars are raging on their doorsteps as lawmakers in Wisconsin and Ohio try to ban such research and other states limit access to the tissue. More than three dozen of the universities, including Harvard, Yale and Johns Hopkins, have been drawn into the fight despite their traditional deep aversion to an issue that can divide faculties and donors and draw the ire of anti-abortion advocates nationwide. (Norman, 10/2)

The Associated Press: Board Postpones Vote On Another Planned Parenthood Review
South Carolina's Legislative Audit Council postponed voting Thursday on whether to launch another state investigation into Planned Parenthood. Members of the agency's governing board expressed concern about duplicating other investigations. But they said they're still inclined to approve audit requests signed by dozens of House and Senate Republicans. (Adcox, 10/1)

The Associated Press: Conservative Group Pushes Scott On Planned Parenthood Money
[Wis.] Gov. Rick Scott has signed new laws that make it harder for minors to get abortions, require an ultrasound before the procedure and force women to wait 24 hours before ending a pregnancy. He also ordered a state agency to investigate 16 Planned Parenthood clinics that provide abortions. But that's not enough for a conservative group that says Scott can't truly call himself an abortion opponent unless he cuts state money going to Planned Parenthood clinics through combined state/federal health care programs. (Farrington, 10/1)

The Washington Post's Fact Checker: The Repeated, Misleading Claim That Planned Parenthood ‘Provides’ Mammograms
Readers asked us to fact-check Planned Parenthood supporters’ claims that the organization “provides” mammograms. Maloney’s statement above appeared to contradict comments by Planned Parenthood President Cecile Richards’s repeated claim at a Sept. 29 congressional hearing that the organization does not, in fact, offer mammograms or have mammogram machines in its clinics. (Lee, 10/2)

Texas Health Agency Director Promises Less Drastic Cuts To Medicaid Therapy Services For Disabled Kids

Meanwhile, in Connecticut, hospitals may face even bigger payment reductions than originally advanced by Gov. Dannel Malloy, and a Delaware program identifies $11 million in possible Medicaid waste, fraud and abuse.

The Dallas Morning News: It’s Back To Drawing Board On Medicaid Cuts
Texas social services chief Chris Traylor has assured Senate GOP leaders that he gets their message — he’ll squeeze as much savings as he can out of Medicaid spending on therapy but won’t hurt disabled children’s access to services. Responding a day after they told him publicly not to cut rates so deeply that therapy providers drop out of Medicaid, Health and Human Services Commission chief Chris Traylor wrote Lt. Gov. Dan Patrick and Sen. Jane Nelson on Thursday to say he reads them loud and clear. (Garrett, 10/1)

The Texas Tribune: Cuts To Therapy Services For Disabled Kids Softened
Following an outcry from dozens of state lawmakers, Texas’ top health agency announced Thursday it will make less drastic cuts than originally planned to a therapy program for children with disabilities, even if that means spending more than lawmakers budgeted for the program. (Walters, 10/1)

The Connecticut Mirror: Hospitals Could Face Larger Cut
Gov. Dannel P. Malloy cut $192 million in Medicaid funding for hospitals last month, but the actual hit to hospitals could end up being 25 percent higher. The state is holding back additional payments to hospitals that weren’t part of the cut, and a spokesman for the governor’s budget office said decisions about whether to pay them will be “based on whether we have enough money to keep the budget in balance.” (Levin Becker, 10/2)

The Associated Press: Report: $11 Million In Questionable Medicaid Payments
A long-delayed pilot study of Delaware’s Medicaid program has identified more than $11 million in possible waste, fraud and abuse. Officials said in releasing the report Thursday that they are recovering clearly erroneous payments and collecting more information on claims needing further review. (Chase, 10/1)

State Highlights: Pa. Hearing Explores Surprise Medical Bills; Colorado Access Cuts Workforce, Drops Medicare Coverage Options

Health care stories are reported from Pennsylvania, Colorado, California, Maryland and Florida.

The Associated Press: Issue Of Surprise Medical Bills Stirs Debate At Hearing
Advocates for consumers, insurers, hospitals and doctors clashed Thursday at a hearing on surprise bills for expensive out-of-network health care services sent to patients who thought their treatments were covered by their insurance networks. Insurance Commissioner Teresa Miller, who moderated the informational session, said it not only underscored the complexity of the problem but provided ideas for solving it. (Jackson, 10/1)

The Denver Post: Colorado Access Cuts Medicare Coverage, Workforce
Health insurance provider Colorado Access is axing Medicare coverage for the coming year, leaving about 5,500 senior and disabled customers in search of alternatives. The Denver-based nonprofit also will let go 83 employees who worked for Colorado Access Medicare and its subsidiary Access Health Colorado, chief operating officer Matt Case said. An additional 40 openings will go unfilled. (Wallace, 10/1)

California Healthline: Court Rules Blue Cross, Blue Shield May Need To Pay State Health Premiums Tax
A state court ruled last week that two health care service plans may need to pay the state's gross premiums tax because they may qualify as health insurers. The health care service plans -– Blue Shield of California and Anthem Blue Cross -- argued that they were regulated by the Department of Managed Health Care, not the California Department of Insurance, and were not insurers subject to the gross premiums tax. (Gorn, 10/1)

The Baltimore Sun: Johns Hopkins Part Of $100M Initiative To Study The Brain
Johns Hopkins University will participate in what President Barack Obama called “the next great American project,” creating an institute for neuroscience research aimed at mapping the brain and perhaps finding cures for its many mysterious ailments. The institute is one of three that will be opened as part of a $100 million collaborative effort, funded largely by one of the private investors behind the Obama Administration's BRAIN Initiative, aimed at developing a better understanding of how the human brain works. (McDaniels, 10/1)

Los Angeles Times: Why Your Doctor Might Start Asking A Lot More Questions
Many residents of Los Angeles County might soon find they are getting more attention and questions from their doctors. That's because L.A. Care Health Plan -- a public health plan in L.A. County with more than 1.8 million members -- received a $15.8-million federal grant this week to help change the way physicians interact with patients and deliver care. (10/1)

Los Angeles Times: As California Goes... But Will Nation Follow State's Lead On Healthcare For Immigrants?
Like many blue states, California enthusiastically embraced Obamacare, signing up millions for health insurance. Now, it's venturing into a potentially costly and controversial new frontier of health policy: offering medical coverage to hundreds of thousands people living in the country illegally. In a matter of months, the number of California counties committed to providing low-cost, government-run medical care to such residents jumped from 11 to 48. And in June, Gov. Jerry Brown signed a state budget that for the first time funds healthcare for such children. (Karlamangla, 10/2)

The Palm Beach Post: Medicare Fraud Trial For Doc Tied To Sen. Menendez Postponed
The Medicare fraud trial of Palm Beach County ophthalmologist Salomon Melgen has been postponed until next fall. The delay from its scheduled Feb. 22 date to Sept. 19 is partly due to the need to juggle his federal trial here with one in New Jersey. Melgen and his longtime friend, U.S. Sen. Robert Menendez, face bribery charges in New Jersey. (10/1)

Health Policy Research

Research Roundup: Improving Enrollment Assistance; Hospitals And Healthy Communities

Each week, KHN compiles a selection of recently released health policy studies and briefs.

Health Affairs: Navigators And Assisters In The Third Open Enrollment Period
Navigators and in-person assisters continue to play a key role in helping consumers get coverage through the insurance Marketplaces. ... Not only is the consumer-assistance process time- and resource-intensive, but navigators and assisters do not necessarily have the expertise to address some of the new issues they are facing. ... Leveraging relationships with [insurance] brokers can help fill some gaps in consumer assistance and leave time for navigators to focus on the hard-to-reach populations and tough cases. More specific training on the nuances of eligibility determination, immigration, and policy changes would help navigators address some of the hard questions they are facing. (Goodell, 9/28)

Brookings: Hospitals As Hubs To Create Health Communities: Lessons From Washington Adventist Hospital
With today’s emphasis on population health strategies to address “upstream” factors affecting health care, such as housing and nutrition deficiencies, there is growing interest in the potential role of hospitals to be effective leaders in tackling upstream factors ....The [Washington Adventist Hospital] experience highlights several challenges .... Among these: The full impact of a hospital’s community impact – especially beyond health impacts – is rarely measured and rewarded, leading to insufficient incentives for hospitals to realize their full potential. Creative approaches require regulatory and budget flexibility, especially at the state and county level, which is often lacking. Data sharing is needed for effective partnerships, but interoperability problems and privacy laws hamper this. (Butler, Grabinsky and Masi, 9/28)

Urban Institute/Robert Wood Johnson Foundation: QuickTake: Even With Coverage, Many Adults Have Problems Getting Health Care, With Problems Most Prevalent Among Adults With Disabilities
To explore financial and nonfinancial access barriers [to health care] in the wake of the ACA coverage expansions, we used data on a nationally representative sample of nonelderly adults (ages 18 to 64) from the March 2015 round of the Urban Institute’s Health Reform Monitoring Survey .... compared with [insured] adults who did not report a disability, those who [are insured and] reported a disability were significantly more likely to report trouble finding a doctor (7.4 percent versus 3.5 percent) and getting an appointment as soon as needed (20.5 percent versus 9.7 percent). ... adults with disabilities were about three times as likely as other full-year insured adults to report an unmet need for care because a doctor or hospital would not accept their health insurance. (Karpman and Long, 9/24)

Rand Corp./HSR, Health Services Research: Comparing The Health Care Experiences Of Medicare Beneficiaries With And Without Depressive Symptoms In Medicare Managed Care Versus Fee-For-Service
[Researchers sought to] compare patient experiences and disparities for older adults with depressive symptoms in managed care (Medicare Advantage [MA]) versus Medicare Fee-for-Service (FFS). ... Data came from the 2010 Medicare CAHPS survey, to which 220,040 MA and 135,874 FFS enrollees aged 65 and older responded. ... Beneficiaries with depressive symptoms reported worse experiences than those without depressive symptoms regardless of coverage type. For measures assessing interactions with the plan (but not for measures assessing interactions with doctors), the disadvantage for beneficiaries with versus without depressive symptoms was larger in MA than in FFS. ... Efforts are needed to identify and address the barriers these beneficiaries encounter to help them better traverse the managed care environment. (Martino et al., 9/25)

Here is a selection of news coverage of other recent research:

Medscape: Joint Commission Issues Alert On Falls In Hospitals
The Joint Commission (JC) wants healthcare facilities to pay more attention to falls and fall-related injuries and to implement proven prevention strategies. Falls resulting in injury are a "prevalent patient safety problem," and not just among the elderly and frail, the JC notes in a Sentinel Event Alert issued September 28. ... Each year, "hundreds of thousands" of patients fall in hospitals, resulting in injuries in up to half of cases — injuries that often require additional treatment and time spent in the hospital. The average cost for a fall with injury is about $14,000, the JC notes. Falls with serious injury are consistently among the top 10 sentinel events reported to the JC's Sentinel Event database, and most of these falls happen in hospitals. (Brooks, 9/30)

Medscape: US Cervical Cancer Screening Inefficient, Needs Improvement
Current cervical cancer screening practices remain less cost-effective and are linked to less health benefit then they would be if current guideline recommendations were followed, according to a model-based cost-effectiveness study published online September 29 in the Annals of Internal Medicine. Overscreening, underscreening, losing track of women in follow-up, and poor management of care for women with abnormal test results have all contributed to approximately 12,000 new cases and 4000 deaths from cervical cancer annually, report Jane J. Kim, PhD, from the Center for Health Decision Science at the Harvard T.H. Chan School of Public Health, Boston, Massachusetts, and colleagues. (Haelle, 9/28)

Albany Times Union: CDC: Injuries, Violence, Drug Poisoning Cost $700 Billion
Injuries and violence cost Americans $671 billion in medical and work-loss costs in 2013, according to two studied released Wednesday by the U.S. Centers for Disease Control and Prevention. The cost associated with fatal injuries was $214 billion; with nonfatal injuries, $457 billion. Each year, more than 3 million people are hospitalized, 27 million people treated in emergency departments, and more than 192,000 die as a result of injuries. (Hughes, 9/30)

The New York Times: Study Finds Psychotherapy’s Effectiveness For Depression Is Overstated
Medical literature has overstated the benefits of talk therapy for depression, in part because studies with poor results have rarely made it into journals, researchers reported on Wednesday. Their analysis is the first effort to account for unpublished tests of such therapies. Treatments like cognitive behavior therapy and interpersonal therapy are indeed effective, the analysis found, but about 25 percent less so than previously thought. (Carey, 9/30)

Reuters: Cancer Survivor Clinics Linked To Fewer Emergency Room Visits
Specialized clinics for childhood cancer survivors may help reduce the odds these patients will need emergency medical care as adults, a Canadian study suggests. Researchers followed almost 4,000 adult survivors of childhood cancers in Ontario for two decades. Compared with survivors who never used the specialized clinics, patients who went at least once were 19 percent less likely to visit the emergency department, the study found. (Rapaport, 9/30)

The Wall Street Journal: Gene Test Helps Some Breast-Cancer Patients Skip Chemo, Study Says
A gene test used to guide treatment for early-stage breast cancer proved effective in enabling certain women to safely forgo chemotherapy, in a study that illustrates how genomic information is reshaping cancer care. Researchers said the findings provide validation for the test, called Oncotype DX, which is already in use helping women decide whether chemotherapy should be part of their treatment. The test provides a score based on a tumor’s genetic signature that describes the risk that the cancer will recur. (Winslow, 9/27)

The Wall Street Journal: Autism Researchers Seek More Brains to Study
One reason autism research hasn’t made more progress is a shortage of brains available for study. Brain scans can only take researchers so far—they need to work with donated brains to gain a deeper understanding of the condition. That’s why four research institutions have formed the Autism BrainNet to reach out to potential donors. (Sadik, 9/26)

Editorials And Opinions

Viewpoints: Cadillac Tax Defenders Strike Back; Drug Pricing 'Out Of Whack'

A selection of opinions on health care from around the country.

Huffington Post: 101 Economists Sign Letter Defending Obamacare's 'Cadillac Tax'
The experts who brought you the “Cadillac tax” aren’t about to let it go without a fight. On Thursday, 101 economists and other health policy experts signed an open letter defending the controversial levy, which takes effect in 2018 as part of the Affordable Care Act. n the letter, the economists describe the Cadillac tax as an essential, if blunt, tool for controlling health-care costs. They warn that eliminating it could mean higher premiums for people with private insurance and less take-home pay for workers who get benefits from their employers -- unless, somehow, lawmakers find an alternative policy that serves the same purposes. (Jonathan Cohn, 10/1)

The New York Times: Don’t Repeal The Cadillac Tax
Surprisingly, there appears to be one small area of bipartisanship in Washington: the desire to repeal the so-called Cadillac tax. It is a tax on super-expensive health insurance plans provided by some private companies to their employees. The tax would be paid by employers who sponsor these high-cost plans. ... this would be a big mistake, for a number of reasons. In its first eight years, the Cadillac tax will raise some $91 billion. Repeal it and politicians — if they are being fiscally responsible — will have to find other sources of revenue rather than add to the deficit. But more important, the tax makes sense. (Ezekiel J. Emanuel and Bob Kocher, 10/2)

The Wall Street Journal: Two Substantive Sides To Debate Over Obamacare’s ‘Cadillac Tax’
Democratic presidential candidates Hillary Clinton and Bernie Sanders and a bipartisan group from Congress have come out in favor of repealing the Affordable Care Act’s “Cadillac tax.” Debate over the Cadillac tax on employer-provided health-care plans has been framed by some as a matter of good policy (keeping the tax) vs. good politics (repealing it to appeal to business, labor interests, and the Democratic base). As with many issues, things are not that simple. There are strong substantive arguments on both sides. Reasonable people and policy makers could disagree on pure policy grounds. (Drew Altman, 10/1)

The Fiscal Times: Hillary Clinton Is Right: The Obamacare ‘Cadillac Tax’ Is A Lemon
Hillary Clinton upended the delicate consensus on health care policy in the Democratic Party’s upper echelons this week. Clinton reportedly came out against the so-called “Cadillac tax,” adding her voice to a bipartisan call ranging from Bernie Sanders to conservative House Republicans, from business to labor, to repeal the excise tax on high-cost employer health plans (40 percent on every dollar above $10,200 a year for individuals and $27,500 a year for families). The elite pushback has been intense. (David Dayen, 10/2)

The Washington Post: How The ‘Cadillac Tax’ Might Raise Your Income
Pretty much the only people who want the tax to go forward as planned are economists. Which seems likely to make voters hate it even more. But here’s a fun fact that might help turn the tide: This tax would probably help you get a raise. How, exactly? The chain reaction between Cadillac taxes and your paycheck is a little complicated and not terribly intuitive. It all comes down to the fact that, for decades, Congress has been encouraging your employer to give you a dollar more of health insurance rather than a dollar more of wages whenever possible. (Catherine Rampell, 10/1)

USA Today: How To Reduce Drug Prices: Our View
For fresh evidence that prescription drug pricing is out of whack, look no further than the recent case of Martin Shkreli, the hedge fund manager turned pharmaceutical CEO. Shkreli announced that his company would abruptly increase the cost of a 62-year-old drug, used to treat a life-threatening parasitic infection, from $13.50 per pill to $750. (10/1)

USA Today: PhRMA: Don’t Mess With Part D Success
Since 2006, Medicare Part D has been providing affordable prescription drug coverage to seniors and persons with disabilities. The program is exceeding expectations by saving money for beneficiaries and taxpayers and helping seniors live longer, healthier lives. (John J. Castellani, 10/1)

Los Angeles Times: Raw Politics Drives GOP Probes Of Benghazi And Planned Parenthood
It was nice of House Majority Leader Kevin McCarthy to clarify that a primary goal of the Republicans’ never-ending investigations into the Benghazi terrorist attack was to do damage to the leading Democratic candidate for president, Hillary Rodham Clinton. Now, if he would just acknowledge that the current round of hearings “investigating” Planned Parenthood are just another political gambit, McCarthy could be given two gold stars for candor. (David Horsey, 10/1)

Politico: It’s The Abortion, Stupid
Judging by [this week's congressional] hearing, the only thing more painful than watching Republicans not do anything about Planned Parenthood is watching them try to do something about Planned Parenthood. They gave every sign of being underprepared and overmatched. They were like a team of paralegals squaring off with an accomplished mob lawyer. ... If there’s a lesson from the congressional hearing it is that any serious Republican effort to dent Planned Parenthood’s shockingly positive public image must focus on the abhorrent acts at the center of the group’s work. Niggling criticisms are too easily deflected, as Richards attempts to spin away the unspeakable. (Rich Lowry, 10/1)

news@JAMA: The Agency Under Threat That We Need Now More Than Ever
Two decades after a near-death experience, the Agency for Healthcare Research and Quality (AHRQ), the only federal agency devoted to health services research and improving the safety and quality of US health care, is at risk once again. Last June, the House Committee on Appropriations passed a bill that would terminate AHRQ’s funding. Two days later, the Senate Committee on Appropriations voted to cut AHRQ’s budget by 35%, decreasing the AHRQ FY 2015 budget by $128 million. ... The Senate’s position is perhaps understandable, but it is short-sighted, given AHRQ’s function and purpose. The House’s position is just wrong. People should care about how this portion of the budget debate is resolved because AHRQ is important for efforts to improve our health care system. (Gail Wilensky, 9/30)