KHN Morning Briefing

Summaries of health policy coverage from major news organizations

First Edition: March 29, 2011

Today's headines include reports about ongoing congressional talks about the budget impasse and policy issues related to the health law.

Kaiser Health News: Insuring Your Health: Demand Grows For Palliative Care
In her latest Kaiser Health News consumer column, Michelle Andrews writes: "If you've never heard of palliative care, you're not alone. In a recent survey, only 24 percent of people said they were familiar with the term. Palliative care isn't nearly as well known as, say, hospice care; in fact, people often confuse the two. Its use is growing fast, however, and 59 percent of hospitals with more than 50 beds now have palliative care programs. Hospitals like this type of care because it appears to be cost-effective and may improve health outcomes. Patients -- once they know about it -- like it because it may make them feel better" (Andrews, 3/29).

Kaiser Health News: Study Finds Raising Medicare Age Would Shift Costs
Kaiser Health News staff writer Mary Agnes Carey reports: "Raising Medicare's eligibility age by two years would save the federal government $7.6 billion but those costs-and more-would shift to others, according to a report out today" (Carey, 3/29).

Kaiser Health News: Health On The Hill: Lawmakers Return To Wrangle Over Health Law, 1099 Repeal Funding
Kaiser Health News staff writer Mary Agnes Carey talks with Politico Pro's David Nather about developments on the Hill. Watch the video.

Kaiser Health News Column: The RUC – Providing Valuable Expertise To The Medicare Program For Twenty Years
In this Kaiser Health News column, Dr. Barbara Levy, the chair of the AMA/Specialty Society Relative Value Scale Update Committee, writes: "Today, much of the dialogue related to Medicare payment refers to the need to infuse value into the system. Medicare beneficiaries and American taxpayers deserve the best care possible, while conserving limited resources to ensure the long-term viability of the program. Confusion persists, however, regarding how values are assigned to physician services under the current Medicare payment system, as well as the impact that this process actually has on payment levels for physicians of different specialties" (3/28).

Kaiser Health News: Palliative Care Can Help Children And Families Navigate Bewildering Medical Terrain
Reporting for Kaiser Health News, in collaboration with the Boston Globe, Joanne Kenen writes: "PACT - the Pediatric Advanced Care Team at Children's Hospital Boston and the Dana-Farber Cancer Institute -- has worked with the Norton family for nine years. The doctors, nurses, and social workers, trained in the relatively new specialty of pediatric palliative care, manage complex pain and symptoms while supporting families as they navigate bewildering medical terrain, set goals of care, and make tough decisions that match those goals" (Kenen, 3/28).

Kaiser Health News: Health Care Expands For Ex-Offenders In California
Reporting for Kaiser Health News, in collaboration with the Bay Area News Group, Rick Schmitt writes: "Expanded indigent-care is expected to help many of the 130,000 former inmates discharged every year in the state, as well as the mainly impoverished communities where they move upon release. The newly freed arrive home in neighborhoods in Oakland and Hayward, Richmond and Antioch, bringing high rates of chronic and communicable disease and serious mental illness" (Schmitt, 3/28).

The Washington Post: With 'Time Short,' Congress Still At Impasse On Shutdown Talks
Still unsettled among the aides is what to do with dozens of policy prescriptions on contentious social and regulatory issues that were attached to the House legislation (Kane, 3/28).

The Wall Street Journal: Government Shutdown Grows Likelier
Talks between congressional leaders and the White House on a deal to fund the government for the rest of the year appear to have slowed, with Democrats and Republicans loudly bickering over the fate of their negotiations. … The coming days represent a crucial stage in the negotiations if both sides are to avert a government shutdown. Last week, Vice President Joe Biden played a role in keeping the talks on track after a session broke up in acrimony. But he has been trying to keep a low profile, said one Democrat familiar with the negotiations, out of concern that Republicans would rather not be seen as making a deal with the White House. … Another stumbling block: conservative-backed amendments contained in the House bill that would cut off funding for the health-care law and other administration priorities (Lee and Hook, 3/29).

Politico: Keeping ACA Affordable – For Feds
Starting in 2014, all health plans offered through the state health insurance exchanges will have to offer the "essential health benefits package" - a set of minimum services all individuals and small businesses are supposed to have in their coverage. That package will have a direct impact on the cost of the law, because people will get subsidies to help them buy coverage if they can't afford it on their own (Nather, 3/29).

The Associated Press/Washington Post: Virginia Files New Court Papers Arguing Federal Health Care Law Is Unconstitutional
Virginia's attorney general has filed additional court papers arguing that the Obama administration's health care reform law is unconstitutional. The 69-page brief filed Monday urges the 4th U.S. Circuit Court of Appeals to strike down the entire law. The court will hear oral arguments in May (3/28).

The Wall Street Journal: Medicare Records Reveal Troubling Trail Of Surgeries
A Medicare database analyzed by The Wall Street Journal reveals that Dr. Makker has had an unusual propensity for performing such multiple surgeries on the spine. The data show that in 2008 and 2009, Dr. Makker performed spinal fusions on 61 Medicare patients. In 16 of those cases, he performed a total of 24 additional fusions. That gave him an overall rate of 39 additional fusions per 100 initial fusions, the highest rate in the nation among surgeons who performed spinal fusions on 20 or more Medicare patients during those two years. For the past year, the Journal has been mining Medicare's claims databases to expose how some doctors potentially defraud the taxpayer-funded health program for the elderly and disabled and game its reimbursement system (Carreyrou and McGinty, 3/29).

Los Angeles Times: Hospital Executives Occupy Top Tier Of California's Public Workers
Three hospital district executives have emerged as among the highest-paid public employees in California, according to a state report, including an official in San Diego County who made more than $1 million in 2009 (Allen, 3/29).

Los Angeles Times: Nurses To Play A Greater Role In Healthcare
California is among 23 states that allow nurse practitioners to act as primary care providers without a doctor's supervision, a move aimed at stemming a shortage of physicians and reducing costs. Now the nurses are poised to take on an even greater role as Los Angeles County and other health systems develop "medical home" models of care that expand the number of primary care providers, including nurses, to meet the requirements of national healthcare legislation, reduce unnecessary hospital visits and cut costs (Hennessy-Fiske, 3/29).

The Washington Post: Critics Slam Cost Of FDA-Approved Drug To Prevent Preterm Births
The list price for the drug, Makena, turned out to be a stunning $1,500 per dose. That's for a drug that must be injected every week for about 20 weeks, meaning it will cost about $30,000 per at-risk pregnancy. If every eligible American woman were to get Makena, the nation's bloated annual health-care tab would swell by more than $4 billion (Stein, 3/28).

Politico: Drug Poses Political Dilemma
If anything is too expensive for Medicare, it just might be a prostate cancer therapy that costs $93,000 and gives men, on average, an extra four months to live. But then again, maybe that's not where the program will draw the line. The decision is due March 30, when the Centers for Medicare & Medicaid Services is set to rule on whether Medicare will pay for Provenge, an immunotherapy drug that drew special scrutiny from the agency and could cause political headaches whichever way the decision goes (Nather, 3/29).

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