KHN Morning Briefing

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Summaries Of The News:

Marketplace

Senators Want Mylan To Justify 400-Percent Cost Increase For EpiPen Pack

Sen. Chuck Grassley, R-Iowa, asks Mylan labs for pricing data on the auto-injected devices used to reverse potentially deadly allergic reactions. Meanswhile, Sen. Amy Klobuchar, D-Minn., asked the Federal Trade Commission and Senate Judiciary Committee to investigate the company's "outrageous" price hike for the medication.

Stat: Senators Press Mylan Labs Over 'Outrageous' EpiPen Pricing
Responding to the high cost of the EpiPen auto-injector for reversing life-threatening allergic reactions, Senator Chuck Grassley (R-Iowa), who chairs the Senate Judiciary Committee, on Monday wrote Mylan Laboratories asking for pricing data on the device. At the same time, Senator Amy Klobuchar (D-Minn.) asked the US Federal Trade Commission and the Senate Judiciary Committee to investigate price hikes taken by Mylan. Klobuchar happens to be the ranking member of Senate Judiciary Antitrust Subcommittee. And Senator Richard Blumenthal (D-Conn.) also wrote the company for data about assistance programs to patients and first responders. And he also demanded that Mylan lower its price. (Silverman, 8/22)

Morning Consult: Senate Democrat Compares EpiPen Cost Increases To Scrutinized Drugmakers
In a call for the Federal Trade Commission to investigate the increased price of EpiPen packs, Sen. Amy Klobuchar (D-Minn.) compared the rising cost of the device to companies such as Turing and Valeant hiking up the prices of rare pharmaceuticals. Mylan, the company that acquired EpiPens in 2007, has increased the cost of the allergic reaction reversal treatment from $100 per pack in 2008 to $500 currently, Klobuchar wrote in a letter sent Monday to the FTC. According to Klobuchar, the increases don’t seem to be justified because the company doesn’t need to recover the cost of developing the treatment, and the higher price is forcing some patients to maintain expired EpiPens because they can’t afford to update theirs annually. (McIntire, 8/22)

Morning Consult: Grassley Presses EpiPen Company On Price Hikes
The chairman of the Senate Judiciary Committee is seeking information on Mylan’s decision to increase the price of EpiPens since acquiring the treatment in 2007. Sen. Chuck Grassley (R-Iowa) asked Mylan’s CEO to explain the price increases that have occurred over the past few years, which have come under scrutiny. The price of the drug has increased by 400 percent and has put financial pressure on families and schools, he says. (McIntire, 8/22)

The Hill: Grassley Presses EpiPen Maker On 400 Percent Price Increase 
Senate Judiciary Committee Chairman Chuck Grassley (R-Iowa) is asking the maker of EpiPens to explain sharp increases in the device's price. Grassley wrote a letter to Mylan, the company that makes EpiPens, asking for an explanation of a 400 percent increase in the price since 2007. (Sullivan, 8/22)

Year-Long Study Leads Health-Services Company To Revamp Its Employee Wellness Program

Meanwhile, MedCity News details how hospitals are struggling to figure out how best to use social media to engage patients.

MedCity News: How To Effectively Engage Patients On Social Media
By now, most hospitals know they should be on social media, but they still struggle to understand where the value lies for them. Consider this: More than 40% of consumers say that information found via social media affects the way they deal with their health. Social media offers hospitals the opportunity to impact health outcomes on a large scale. (Simon, 8/22)

Medicaid

Iowa Governor Dismisses Criticism Of Private Medicaid Managed Care Firms

Gov. Terry Branstad says the state's move this year to have three private firms run the Medicaid program is saving Iowa "significant" money, and he scoffs at concerns that the companies are not treating health care providers fairly.

The Des Moines Register: Branstad Scoffs At Criticism Of Medicaid Managed Care
Gov. Terry Branstad dismissed criticism of his move to privatize management of Iowa's Medicaid program, saying Monday the change is eliminating fraud and abuse and saving taxpayers millions of dollars. Medicaid health insurance, which serves 560,000 low-income Iowans at a cost of about $4.2 billion annually, has had its management shifted to three private companies after previously being operated by the government. (Petroski, 8/22)

Iowa Public Radio: Branstad: Some Companies "Not Following" Medicaid Privatization Rules
Gov. Terry Branstad confirmed on Monday that the for-profit companies now managing Iowa’s multi-billion dollar Medicaid program did not follow the rules in the first two months of operation. But the governor also says the state issued no warnings or fees, in spite of complaints of late payments to health care providers and delayed care to patients.  (Russell, 8/22)

The (Cedar Rapids) Gazette: Branstad: 'Significant' Savings From Iowa's Privately Managed Medicaid
Gov. Terry Branstad on Monday defended the state’s switch to privately managed care for Iowa’s Medicaid recipients, saying the new system is saving the state “significant” money by rooting out fraud and abuse that previously had gone undetected. Meanwhile, two of the three insurance companies tasked with managing the Medicaid system saw losses in the tens of millions of dollars during the first six months of the year, according to financial statements filed with the Iowa Insurance Division. (8/22)

The Des Moines Register: Medicaid Managers Report Millions In Iowa Losses
Two of the three private companies managing Iowa’s Medicaid program say they’ve lost tens of millions of dollars so far, new reports filed with the state show. AmeriHealth Caritas reported last week that it ran a $42.6 million deficit on its Iowa operations in the first six months of 2016. Amerigroup reported it lost $66.7 million. The third Medicaid management company, UnitedHealthcare, did not break out its Iowa results in its report. (Leys, 8/22)

And in Medicaid news from Texas —

Dallas Morning News: Texas Owes The Medicaid Program $57.8 Million, Report Says 
The state of Texas received nearly $58 million from the federal Medicaid program for health services that did not qualify for reimbursement — and it may be asked to return part of the money. Payments made to six facilities within the University of Texas academic health system were calculated in a way that did not meet federal and state requirements, according to an audit released this month by the Department of Health and Human Services' Office of the Inspector General. (Rice, 8/22)

Campaign 2016

Clinton To Propose Expanded Tax Credits To Help Small Businesses Provide Workers Health Insurance

According to The Wall Street Journal, the proposal would simplify an underused tax credit created by the Affordable Care Act and expand it to companies with up to 50 workers. Meanwhile, Bloomberg reports that some Republicans suggest that a Hillary Clinton presidency could shift the health care debate from efforts to kill it to those that would tweak it.

The Wall Street Journal: Clinton To Offer Plan For Small Businesses
Democratic presidential nominee Hillary Clinton is proposing a package of ideas aimed at helping small businesses, including a new standard deduction that could simplify tax filing and improvements to a little-used tax credit for companies that offer workers health insurance. (Meckler, 8/23)

Bloomberg: Clinton Win Could Pressure GOP To Heal, Not Repeal, Obamacare
Republicans in Congress have insisted the only way to fix Obamacare is to repeal it. But with Barack Obama about to leave the White House, several Republicans sound willing to tweak it rather than kill it. These Republicans suggest that a Hillary Clinton presidency could shift the debate over the Affordable Care Act just enough to work on improvements with someone who isn’t the law’s namesake.  (Wayne and House, 8/23)

On late night, Clinton and Jimmy Kimmel joke about her health "issues" —

Politico: On Kimmel's Show, Clinton Mocks ‘Failing Health’ Conspiracies
Hillary Clinton poked fun at the Donald Trump’s repeated claims that her health is failing Monday night, jokingly asking ABC’s Jimmy Kimmel to take her pulse while they spoke on his late-night TV show. The Democratic nominee’s physical well-being has been a topic of discussion on the campaign trail ever since Trump claimed she "lacks the mental and physical stamina to take on ISIS" last Monday. The allegation, a staple of right-wing media critiques of Clinton, was quickly denounced by her campaign, which pointed to a doctor’s letter released last year that pronounced her health “excellent.” (Lima, 8/23)

Public Health And Education

Zika's Wide-Ranging Impact: From Mixing Up Abortion Debate To Creating Business Opportunities

In other Zika-related news, Miami-Dade Country receives $5 million from the state to help fund the fight against the virus. Also, Florida students return to classrooms within the Zika zone while Gov. Rick Scott is targeted by a consumer advocacy group for his response to pregnant women's concerns.

Politico: How Zika Could Change The Politics Of Late-Term Abortion
For years, most Americans have opposed abortions late in pregnancy. Zika could change that, potentially undermining support for a national ban on abortion after 20 weeks of pregnancy as more women infected with the virus find themselves in the crosshairs of the abortion wars if they choose to end their pregnancies. (Haberkorn, 8/22)

The Baltimore Sun: For Some Companies, Zika Means Business
The Zika threat has led to economic opportunities for some businesses in Maryland and elsewhere as the state and federal governments have launched efforts to prevent spread of the virus. Millions have already been spent or committed in Maryland, and that's just a fraction of the billions Zika is expected to cost the United States, as well as Central and South America, where there have been far more cases. (Cohn, 8/22)

News Service Of Florida: Miami-Dade Gets $5 Million For Zika Fight
Gov. Rick Scott said Monday the state is sending $5 million to Miami-Dade County to help in the ongoing effort to stem an outbreak of the Zika virus. As part of $26.2 million in emergency state funding authorized by Scott, the governor said Miami-Dade would receive the money for additional mosquito-control staff, mosquito spraying and community outreach. (8/23)

CBS News: Florida Students In Zika Zone Begin School Year Amid Outbreak
More than 7,000 students in Miami-Dade County started the new school year Monday in a Zika zone. The reopening of school came with more than the usual first-day jitters. With mosquito-spread Zika infections in the area up to 37 now, parents worried about the kids they sent out the door and off to class. The science of the mosquito-borne virus was part of the first day’s lesson plan at a middle school in Wynwood, CBS News correspondent David Begnaud reported. (8/22)

Naples Daily News: Group Targets Rick Scott On Medicaid Expansion And Zika
A consumer’s advocacy group is calling out Gov. Rick Scott for telling pregnant women concerned about Zika to contact their doctors, because that won’t work for 300,000 women who don’t have doctors due to Florida not expanding Medicaid coverage. The Florida Health Alliance, with more than 100 organizations in various medical fields, began asking members Monday to send letters to Scott and Florida lawmakers demanding they expand Medicaid in light of the growing Zika threat. (Freeman, 8/22)

Pharmaceuticals

FDA Complains That Drugmakers Abuse Petition Process To Try To Hold Up Drug Approvals

Regulators tell Congress that many citizen petitions submitted do not raise valid health concerns and waste time because the Food and Drug Administration must review each one. FDA officials say pharmaceutical companies use them as a ruse “aimed at blocking generic or biosimilar competition.”

Stat: Drug Firms Still Abuse Citizen Petitions, FDA Tells Congress
Once again, the US Food and Drug Administration filed an annual report to Congress about citizen’s petitions that can be used to ask the agency to refrain from approving a generic drug or a biosimilar. And once again, FDA officials reiterated complaints that many petitions generally do not raise valid scientific concerns and appear to have been filed to delay approval of competing medicines. This is actually a long-standing issue for agency officials, despite having released new guidelines five years ago that were intended to limit such petitions. (Silverman, 8/22)

And drug companies Advaxis, Pfizer and Medivation are in the news —

Stat: Small Biotech Advaxis, On The Brink Of Ruin, Resurrects Itself
Three years ago, a small New Jersey biotech called Advaxis was on the brink of ruin. Its cancer drug AXAL was in the middle of clinical trials, but the company was out of money and trading as a penny stock.Today, Advaxis is on the upswing. In the past few weeks, the company has earned two big wins — its cancer drug has been fast-tracked for approval to treat cervical cancer by US Food and Drug Administration and the company has inked a valuable partnership with Amgen for another tumor-killing technology. The rapid resurrection of Advaxis is the work of both man and microbe — chief executive officer Daniel O’Connor, who was hired at the company’s rock bottom, and a bacterial species called listeria that’s best known for causing food poisoning. (Weintraub, 8/22)

The Associated Press: Pfizer Spends $14B On Medivation In Cancer Fight
Pfizer will pay about $14 billion to buy cancer drug developer Medivation in a cash deal aimed at fortifying its hold in one of the hottest and most lucrative areas of medicine. The New York drugmaker said Monday that the acquisition will stock its product portfolio with leading treatments for the most common cancers in men and women by adding Medivation's pricey prostate cancer treatment Xtandi to a lineup that already includes the breast cancer drug Ibrance. (8/22)

State Watch

Critics Question NYC Mayor's Staffing Plan To Fix Budget Crunch At Public Hospitals

State and federal aid for 11 New York City hospitals is projected to drop by almost $1 billion by fiscal year 2020. News organizations also report on developments at facilities in Texas and New Hampshire.

Bloomberg: New York Hospitals In Critical Condition As Deficit Looms 
New York City’s public hospitals are in critical condition with rising costs and plummeting revenue. There’s no dispute about that diagnosis. The problem is with Mayor Bill de Blasio’s proposed cure, according to health policy makers, hospital administrators and budget watchdogs. As NYC Health + Hospitals President Ram Raju describes it, the largest U.S. municipal-healthcare provider is an ailing system of 11 hospitals that’s losing revenue because of increased competition from non-profit hospitals for Medicaid patients and drastic cuts in federal and state aid for indigents.  (Goldman and Braun, 8/22)

Houston Chronicle: Kindred To Close Another Local Hospital 
For the second time this month a Houston-area Kindred hospital has announced it will close. The Kindred Hospital at 2130 W. Holcombe Blvd., near the Texas Medical Center, will shutter in October, and all 204 positions will be eliminated, according to a letter sent to the Texas Workforce Commission last week. The health care company confirmed the news Monday. Earlier this month, the Kindred Hospital in Baytown also announced its closing and the elimination of 33 jobs, the Workforce Commission reported. (Deam, 8/22)

New Hampshire Times Union: Staffing Agencies Say Exeter Hospital Has Invalid Claim Against Them 
A judge will hear arguments later this month from lawyers representing two medical staffing agencies who say their clients should be excluded from contributing toward legal settlements paid to 188 patients who tested negative during a hepatitis C outbreak. Exeter Hospital filed a lawsuit in January 2014 against a half dozen staffing agencies, saying the agencies are responsible for allowing former technician David Kwiatkowski to remain working in the medical field while knowing about his drug habit. (Kimble, 8/22)

New Hampshire Times Union: State Likely To OK Hospital Contract For Psychiatric Services 
The Executive Council on Wednesday is expected to approve a $36.5 million contract for Dartmouth-Hitchcock to provide psychiatric services at New Hampshire Hospital and other state institutions, despite continued concerns over changes in staffing. Those concerns were heightened after a recently discharged New Hampshire Hospital patient committed suicide in Nashua. Republican gubernatorial candidate and Manchester Mayor Ted Gatsas has asked the council to hold off on the vote. (Solomon, 8/22)

And, Stat reports from a Boston hospital on what a successful arm transplant procedure takes —

Stat: Grueling Work Required To Make Arm Transplants Succeed
(Will) Lautzenheiser, one of about 80 people worldwide with transplanted arms, can’t fathom what another American recipient told People Magazine last month — that he had considered getting his transplants removed. ... Patients go into their surgeries fully aware that the procedure is experimental and might not succeed, though 95 percent of the transplanted limbs have had good outcomes, said Dr. Vijay Gorantla, administrative medical director of the Reconstructive Transplant Program at the University of Pittsburgh. Fewer than 10 of the transplants have had to be removed. (Weintraub, 8/23)

Lower Vaccination Rates In Iowa Raise Concerns For State Health And School Officials

Other public health stories from the states cover dental care for kids, connecting low-income women with doulas, mental health services for trauma victims and the dangers of lead paint.

Iowa Public Radio: Health Officials Concerned About Drop In Vaccination Rates As School Starts
Schools across Iowa are beginning classes this week amid concerns from public health officials about the drop in vaccination rates. At many schools, the percentage of students fully vaccinated is below 90 percent, and at a few around the state, it's below 50 percent. State Epidemiologist Dr. Patricia Quinlisk says more families are seeking exemptions from vaccinations for a variety of reasons.  (Moon, Kieffer and Dillard, 8/22)

Georgia Health News: Huge Numbers Of Georgia Children Can’t Get Dental Care, Researcher Says
A Georgia Tech researcher said Monday that hundreds of thousands of Georgia children have problems getting access to a dentist in the state. Nicoleta Serban, an industrial and systems engineering professor, told state lawmakers that there are more than 500,000 Georgia children who are not eligible for the public insurance programs Medicaid and PeachCare, but whose parents cannot afford dental care. (Miller, 8/22)

Atlanta Journal Constitution: Georgia Dental Hygienists, Dentists At Odds Over Program For Kids
The state of Georgia could save millions of dollars a year and serve thousands of children from low-income families by increasing access to basic dental care, researchers told key lawmakers Monday. But one suggested solution appears to be stalled in the kind of fight between health care professionals that often eats up weeks of every General Assembly session. Dental hygienists say the dentist lobby — a big campaign contributor to lawmakers — held up legislation earlier this year that would have allowed hygienists to do basic cleaning and preventive care at so-called “safety-net settings,” qualified health centers and school-based health clinics, without a dentist present. (Salzer, 8/22)

The New York Times: New York City Strives To Connect Poor Expectant Mothers With Doulas
The experience highlighted some of the hurdles facing a fledgling New York City health program to give low-income women free access to a resource that hospitals and insurers alike have long treated as a luxury for wealthy women seeking boutique births. Most doulas are present at delivery and later help the new mother care for her baby and give advice on breast-feeding. In 2015, the City Council and New York state started earmarking about $468,500 annually for the free program, called Healthy Women, Healthy Futures, as part of a broader initiative to address high rates of infant and maternal mortality among black New Yorkers as well as those women living in the city’s poorest neighborhoods. (Sharp, 8/22)

The California Health Report: Most Survivors Want More Rehab, Less Punishment For Victimizers
The survey also found that repeat crime victims are rarely able to access even basic services and support for recovery. Two out of three survivors reported anxiety, stress, difficulty sleeping and other symptoms resulting from the traumatic effects of their victimization, but few reported receiving treatment. Most were unaware of the full spectrum of victim services that are available, a finding that holds true nationally, too. (Dayton, 8/23)

The California Health Report: Confronting Child Sex Trafficking On The Central Coast
Five years ago, when Lisa Conn became a mental health provider for juvenile justice in Santa Barbara County, she noticed a disturbing trend: A large number of the incarcerated girls were displaying symptoms of complex trauma and, in particular, sex trauma. ... “Their symptoms were beyond what we would typically see with sexual assault,” she said. Conn noticed the young women had an intense loyalty to the men she suspected were their abusers; they seemed almost brainwashed. “Not all of them would even say they were being raped, but they had the telltale signs of trauma.” (Bartos, 8/23)

State Highlights: Fla. Regulators Weigh Insurance Rate Hikes; Opioid Overdoses Rise In Ohio

Outlets report on health news from Florida, Ohio, New York, Massachusetts and Michigan.

Health News Florida: Insurance Regulators Take Up Major Rate Requests
Florida’s insurance regulators are considering two major rate increases.  The moves would raise rates for workers compensation insurance and property insurance with the state-backed company Citizens. Court rulings and water claims are driving the rate hikes insurers say, and across two days of public hearings they worked hard to make their case before the office of insurance regulation. The meetings mark the first major undertakings in the tenure of David Altmaier, the new head of OIR. (Evans, 8/22)

Cincinnati Enquirer: ODs Rise, Naloxone Doesn't Work Well
Be on alert: A spike in overdoses in Hamilton County emergency rooms coupled with a lack of effectiveness of the antidote naloxone is leading health officials to believe that deadly opioids are getting to heroin users. The Hamilton County Heroin Coalition issued the warning Monday after Hamilton County Public Health noted a surge in hospital overdose cases. The emergency department-visit surveillance system detected the increase over the weekend, beginning on Friday, health officials said. (DeMio, 8/22)

WBUR: High-Demand Local Labs Draw Increased Foreign Investments 
Perhaps one of the unintended consequences of the U.K.'s "Brexit" vote earlier this summer is an influx of foreign investments in a local market: high-tech biomedical laboratory space. According to reporting today by The Boston Globe's Robert Weisman, roughly half of last year's $46 billion in commercial real estate sales were made by foreign investors. And with area lab space in short supply, what does this mean for the biomedical industry in the Boston area? (Bologna and Becker, 8/22)

Detroit Free Press: Nurses Don't Want Wayne Co. To Privatize Jail Services
A company named in a federal lawsuit in the 2014 death of a Macomb County jail inmate could be in line to take over medical services at Wayne County's jails and juvenile detention facility...But many staffers say that privatizing medical care is not the solution for Wayne County's jails. Several nurses and social workers who attended a commission meeting Thursday predicted that many current staffers would leave, exacerbating the county's staff-retention problems, although the administration said the goal is to improve care and retention. (Lawrence, 8/22)

Orlando Sentinel: Orlando Dermatologist Finds Success In Buying Practices 
Advanced Dermatology is now one of the largest dermatology practices in the United States, with 155 offices in 13 states, including 30 offices in Central Florida. "In our model, we purchase [physicians'] practices, and they can practice as long they want," said Leavitt, CEO and chief medical officer of the group. "We make it easier by giving them resources, so they can enjoy being doctors again."  (Miller, 8/22)

Editorials And Opinions

Marketplace Debate: Can Exchanges Survive Aetna Withdrawal, Other Problems?

Commentators look at the issues surrounding the insurance marketplaces that are central to the federal health law.

The Washington Post: To Save Obamacare’s Exchanges, Learn From Their Critics
All but the most hardened partisans understand that the Affordable Care Act’s insurance exchanges are in serious trouble. In 2010, the Congressional Budget Office predicted that 21 million people would have exchange-based coverage in 2016; the real number was about 12 million. As insurers head for the exits, the gap between initial hype and final reality will widen. (Avik Roy, 8/22)

The Huffington Post: Fixing Obamacare: The Democrats Have To Talk About It
Last week Aetna, one of the country’s largest insurance companies, announced that it was cutting back its participation in the health care exchanges created by the Affordable Care Act (ACA). With several other major insurers also cutting back their participation, there will be very limited competition in many markets. This prospect has supporters of the ACA worried and opponents gleefully looking forward to the day when millions may lose their insurance. (Dean Baker, 8/22)

The Hill: ObamaCare Is The Last Chance For Private Health Insurance 
[The ACA] is based on the free market, for-profit healthcare system of both insurance companies and healthcare providers. Indeed, it has empowered them both, swelling enrollment by millions and sending their profits soaring. Even as Aetna pledged last week to drop out of the healthcare exchanges in eleven of fifteen states, citing anticipated losses, their Q2 earnings topped $780 million. There is nothing anti-capitalist about the ACA. It works in conjunction with the free-market healthcare system which has existed here since the beginning. It is also the very last chance that system has to prove it can work. (Patrick Tomlinson, 8/22)

Dallas Morning News: Obamacare Customers In Dallas Are On The Outside, Looking In 
Here’s another cruel irony for Obamacare.Two new health care models that aim for better outcomes at a lower price are taking hold in North Texas, but they won’t be offered on HealthCare.gov next year. That’s because the insurers participating in the efforts, Aetna and Scott & White Health Plan, said last week that they would exit the exchange business in the state. (Mitchell Schnurman, 8/22)

The Des Moines Register: Government Should Not Rely On Private Insurers
Aetna announced last week that it was reducing participation in health insurance exchanges created by the Affordable Care Act. It will sell plans in only four states next year, including Iowa, down from 15 this year. This follows similar market exits from UnitedHealth Group and Humana. This is yet another reminder of why government should not rely on private companies to deliver health insurance to Americans. History has repeatedly shown this is a costly, dangerous and unsustainable idea. Yet politicians refuse to listen to history. (8/22)

The Huffington Post: Why A Single-Payer Healthcare System Is Inevitable
The best argument for a single-payer health plan is the recent decision by giant health insurer Aetna to bail out next year from 11 of the 15 states where it sells Obamacare plans. Aetna’s decision follows similar moves by UnitedHealth Group, the nation’s largest health insurer, and by Humana, another one of the giants. All claim they’re not making enough money because too many people with serious health problems are using the Obamacare exchanges, and not enough healthy people are signing up. (Robert Reich, 8/22)

Viewpoints: Improve Medicare's Drug Payment Test; Have Scientists Judge Biotech Patents

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

Morning Consult: A Path Forward On Medicare Payment Reform For Physician-Administered Drugs
The recent proposal for a large-scale test of payment reforms for Medicare Part B “physician-administered” drugs has generated broad opposition from many patient groups, physician specialty societies and pharmaceutical companies. While many consumer organizations that represent Medicare beneficiaries have expressed support, the future of the proposed reforms is unclear. (Peter Bach and Mark McClellan, 8/23)

The Des Moines Register: Iowa's Fighting Medicaid Fraud, But At What Cost?
Gov. Terry Branstad on Monday brushed off like an annoying mosquito questions about health-care providers going out of business or having to borrow money because the state’s Medicaid program isn’t paying them on time. ... we still have no real idea whether or how much the state is saving by moving to managed care. So the governor is discounting the reports from providers who say they are struggling to stay afloat amid managed care red tape in favor of expectations of savings that we still can’t actually document. (Kathie Obradovich, 8/22)

The Wall Street Journal: Patent Judges Should Be Scientists, Too
Patents are the lifeblood of biotechnology, the force that motivates companies to develop innovative medical treatments and bring them to market. The trouble is that these patents must be enforced in a court system that isn’t set up to adjudicate highly technical matters—resulting in rulings that seem arbitrary or even scientifically suspect. (Alex Berezow and Neal Mody, 8/22)

The Hill: Zika Funding Held Back By Politics 
To date, nearly 2,000 Zika cases have been reported in the United States. In Miami alone, roughly 30 people have contracted Zika after being bitten by mosquitos, including a tourist who took the virus back with him to Texas. The Centers for Disease Control and Prevention (CDC) has taken the unprecedented action of issuing a travel warning for a community in the United States. Sadly, Congress has yet to act. (Dr. Thomas Gellhaus and Dr. Didi Saint Louis, 8/22)

The New York Times' The Upshot: The Life-Changing Magic Of Choosing The Right Hospital
There’s an exceedingly simple way to get better health care: Choose a better hospital. A recent study shows that many patients have already done so, driving up the market shares of higher-quality hospitals. A great deal of the decrease in deaths from heart attacks over the past two decades can be attributed to specific medical technologies like stents and drugs that break open arterial blood clots. But a study by health economists at Harvard, M.I.T., Columbia and the University of Chicago showed that heart attack survival gains from patients selecting better hospitals were significant, about half as large as those from breakthrough technologies. (Austin Frakt, 8/23)

Stat: Why All Findings From Clinical Trials Need To Get Published
New research suggests that nearly half of all clinical trials involving kids go unfinished or unpublished — either because the researchers lose interest in the work or take up more pressing projects, or, in some cases, because the companies that funded the studies don’t want the results to get out. That news won’t come as a surprise to anyone who has followed the fate of studies in general. But it should catch the notice of the FDA: The pharma industry currently gets a special bonus, in the form of extended exclusive marketing rights, for testing their drugs in kids — a rule that was implemented to accelerate research into childhood ailments. (Ivan Oransky and Adam Marcus, 8/19)

Stat: Learning From The Yellow Fever Vaccination Campaign
The massive yellow fever vaccination campaign that got underway this month in Angola and the Democratic Republic of Congo (DRC) will help save lives in those countries. It is also serving as a dress rehearsal for how all nations can best cope with vaccine shortages, something we could see a lot more of in the years ahead. (Seth Berkley, 8/22)

Stat: In A New Era Of Terrorism, Examining The Science Of Mass Hysteria
Last week, loud popping sounds triggered a frightening chain of events at J.F.K. Airport. ... Incidents of mass panic or hysteria depend on the mood of the crowd at the time an episode occurs. Over the past 30 years, I have studied many outbreaks of mass panic and hysteria. In all of them, the common denominator is a backdrop of anxiety and stress. Fear and anxiety can spread from person to person like a contagious disease. (Gary W. Small, 8/23)