- Kaiser Health News Original Stories 3
- Tainted Scope Infections Far Exceed Earlier Estimates
- Rise In Oncologists Working For Hospitals Spurs Higher Chemo Costs: Study
- Most Doctors Unsure How To Discuss End-of-Life Care, Survey Says
- Political Cartoon: 'Pick Your Poison?'
- Administration News 2
- CDC Confirms Zika Can Be Transmitted Through Anal Sex
- In Effort To Prevent Devastating Birth Defects, FDA Will Allow Folic Acid To Be Added To Corn Flour
- Health Law 2
- Taxes For Employer Health Plans Getting Renewed Attention On The Hill
- Arkansas Senate Fails To Pass Bill To Fund Medicaid Expansion
- Women’s Health 2
- Couple Sues Sperm Bank Saying It Misrepresented Donor Touted As Healthy PhD Student
- Lawyers: Jury Exceeded Its Authority In Indictment Of Man Behind Planned Parenthood Videos
- Public Health 2
- The Opioid Crisis: For People Who Don't Understand, She's 'Just Another Statistic'
- Doctors, Breaking With AMA, Form Group To Support Legalization Of Marijuana
- State Watch 3
- Ohio, Mass. Officials To Offer Changes In Medicaid Programs
- West Virginia Medical Centers Agree To Settle Antitrust Lawsuit
- State Highlights: Fla. Gov. Signs Law To Protect Consumers From Surprise Medical Bills; Ohio Steps Up Suicide Prevention Efforts
From Kaiser Health News - Latest Stories:
House panel concludes inquiry on superbug outbreaks; one member prepares legislation “to make sure these situations don’t happen again." (Chad Terhune, )
Researchers found that the facility fees hospitals and their clinics routinely add to the bill helps drive the price increases. (Michelle Andrews, )
They recognize the responsibility, but some may need training. (Barbara Feder Ostrov, )
Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Pick Your Poison?'" by Ralph Hagen.
Here's today's health policy haiku:
A SHORT-TERM COVERAGE CONVERSATION
Time to drain the pool.
When overspending is vogue.
The duct tape won't hold.
If you have a health policy haiku to share, please Contact Us and let us know if we can include your name. Haikus follow the format of 5-7-5 syllables. We give extra brownie points if you link back to a KHN original story.
Opinions expressed in haikus and cartoons are solely the author's and do not reflect the opinions of KHN or KFF.
Summaries Of The News:
Officials do not know how long the virus can live in semen. In other Zika news, experts are divided over what to tell women looking to get pregnant in affected areas, the White House gets an unlikely champion in its funding efforts and infections are confirmed in Florida and Ohio.
The New York Times:
Zika Virus Can Be Transmitted Through Anal Sex, C.D.C. Says
The Zika virus can be transmitted by anal sex as well as vaginal sex, according to a report issued on Thursday by the Centers for Disease Control and Prevention. The agency described a case of man-to-man sexual transmission in January. The case, which was previously disclosed by health officials in Texas without identifying the genders of the partners, was the first known case of sexual transmission of Zika within the United States in the current epidemic. It involved a Dallas resident who became infected with Zika through a mosquito bite while visiting Venezuela and then infected his male partner through unprotected sex upon his return. Both had relatively mild symptoms, and blood was not detected in either man’s semen. (McNeil, 4/14)
The Wall Street Journal:
CDC Confirms Sexual Transmission Of Zika Virus Involved Two Men
Semen samples from both patients showed no evidence of the virus, so it is still unclear how long the virus persists and how it is shed from semen, said John T. Brooks, a co-author of the report and a medical epidemiologist in the Division of HIV/AIDS Prevention at the CDC’s National Center for HIV, Hepatitis, TB and STD Prevention. Dr. Brooks said the case study should encourage doctors to report any suspected cases of Zika to health officials. “Every piece of data we have helps,” he said. (Long, 4/14)
Zika Virus Can Be Transmitted Through Anal Sex, Too
During a previous outbreak, the virus was detected in the semen of one man two months after his fever had set in. In a more recent case, researchers found the virus in the semen of a French traveler two weeks after he'd been sick (there was a lot more virus in semen than there was in blood or urine, leading them to wonder if the virus can replicate in the male genital tract). (Bichell, 4/14)
The New York Times:
Health Officials Split Over Advice On Pregnancy In Zika Areas
As the Zika virus bears down on the United States, federal health officials are divided over a politically and ethically charged question: Should they advise American women to delay pregnancy in areas where the virus is circulating? Some infectious disease experts are arguing that avoiding conception is the only sure way to prevent the births of deformed babies, according to outside researchers who serve on various advisory panels. Women’s health specialists, on the other hand, counter that the government should not tell women what to do with their bodies. (McNeil, 4/14)
White House Finds Ally In Rubio
The White House has found an unexpected ally in its fight to get Congress to approve $1.9 billion in emergency funding to fight the Zika virus: former Republican presidential contender Marco Rubio. (Haberkorn, 4/14)
White House, GOP Play Blame Game On Zika
The White House and GOP leaders are pointing fingers over the stalled effort to increase funding for the fight against the Zika virus. The Obama administration has ramped up attacks on Republicans this week, accusing them of holding up billions of dollars needed to prevent a widespread outbreak of the disease. But House leaders say the Obama administration has actually delayed the funding by ignoring recent letters and refusing to answer questions about what one lawmaker called a $2 billion "slush fund." (Ferris, 4/14)
The Miami Herald:
New Zika Virus Infections Confirmed In Miami-Dade
Florida health officials, contending with the greatest number of Zika virus infections in the nation, confirmed two new cases in Miami-Dade on Thursday, raising the statewide total to 87 people affected by the infectious disease since February. Among the 15 counties identified as having had Zika virus infections, Miami-Dade has experienced the most, with 35 cases. Nearly all of Florida’s cases were acquired by people traveling outside the country, except for one case of sexual transmission in Polk County. (Chang, 4/14)
The Cleveland Plain Dealer:
Summit County Resident Infected With Zika Virus, Health Department Says
A Summit County resident has tested positive for the Zika virus after traveling to a Zika-infected country, the Summit County Public Health department said Thursday. (Farkas, 4/14)
Critics say the decision was long overdue.
Health Advocates Score A Major Victory With Folic Acid
The Food and Drug Administration announced Thursday that it would allow folic acid to be added to corn flour in order to prevent certain types of birth defects. The decision was a major victory for health advocates around the nation, who credit the additive with preventing some 1,300 birth defects per year. (4/14)
The Seattle Times:
FDA To Allow Folic Acid In Corn Masa To Stop Birth Defects
In a move critics said was long overdue, federal regulators agreed Thursday to allow folic acid to be added to corn-masa flour, possibly preventing devastating birth defects such as those affecting families in Central Washington. (Aleccia, 4/14)
House Ways and Means Committee Chairman Kevin Brady, R-Texas, raises concerns about the health law's Cadillac tax at a hearing Thursday. Also, insurers' are complaining about problems they encounter in the health insurance marketplaces.
Both Parties Will (At Least) Discuss Employer Health Taxes
The tax treatment of employer-sponsored health insurance under Obamacare is one of the few provisions of the law that Congress has touched since passage. It’s also clear that members on both sides of the aisle think the topic needs more work. ... Employees pay for their premiums under employer-provided health insurance with “pre-tax dollars,” which leads to about 30 percent savings for the typical worker. There are several critiques of this system. First, it’s very expensive for the federal government. (Owens, 4/14)
Insurers Warn Losses From ObamaCare Are Unsustainable
Health insurance companies are amplifying their warnings about the financial sustainability of the ObamaCare marketplaces as they seek approval for premium increases next year. Insurers say they are losing money on their ObamaCare plans at a rapid rate, and some have begun to talk about dropping out of the marketplaces altogether. (Sullivan, 4/14)
The issue is not yet decided, however, because House members are putting pressure on the Senate and the governor has threatened a veto of the state Medicaid bill if it doesn't include funding for the expansion program.
Arkansas Medicaid Funding Bill Fails In Senate
The Arkansas Legislature’s fiscal session ground to a temporary halt Thursday, its second day, after the Senate rejected a bill to fund the state Medicaid program and the House rejected a bill that the Legislature is required to pass before it passes any other bills. House and Senate leaders said those bodies would not convene again until Tuesday following Thursday’s failed votes, which grew out of clashes over whether to fund Gov. Asa Hutchinson’s Medicaid expansion plan, titled Arkansas Works. (Lyon, 4/14)
Medicaid Vote Short In Senate
Senate Bill 121 failed to clear the Senate on Thursday, falling two votes short of the 27 required for approval in the 35-member chamber. The bill would grant the Department of Human Services' Medical Services Division $8.4 billion in spending authority, including $1.7 billion for Medicaid expansion, during fiscal 2017, which starts July 1. ... In the 2013 and 2014 sessions, legislation reauthorizing the use of Medicaid funds for the expansion program failed several times in the House before it ultimately won the required 75 votes for approval. (Wickline, Fanney and Willems, 4/14)
The Associated Press:
GOP Senators Block Arkansas Medicaid Funding
A spokesman says Arkansas Gov. Asa Hutchinson is prepared to use his line-item veto authority if lawmakers send him a budget bill that defunds the state's hybrid Medicaid expansion. Hutchinson spokesman J.R. Davis said Thursday the governor has told Democrats and Republicans he would use the authority if lawmakers approve a Medicaid budget bill without the program's funding. (4/14)
In its first guidelines for managing simultaneous operations, the American College of Surgeons says "the patient needs to be informed" that the doctor will be in more than one operating room. News outlets also look at variety of other developments that affect patients.
Surgeons Must Tell Patients Of Double-Booked Surgeries, New Guidelines Say
The world’s largest surgeons’ organization has issued its first-ever guidelines for surgeons managing simultaneous operations, saying the controversial practice is broadly permissible, within limits, but that “the patient needs to be informed” whenever a doctor runs more than one operating room at a time. Such notice to patients is not now routine or required at many hospitals. The new standards from the American College of Surgeons, issued Wednesday, also aim to bar surgeons from handling cases in which the “critical or key” parts of surgeries overlap. (Abelson and Saltzman, 4/13)
Kaiser Health News:
Tainted Scope Infections Far Exceed Earlier Estimates
The number of potentially deadly infections from contaminated medical scopes is far higher than what federal officials previously estimated, a new congressional investigation shows. As many as 350 patients at 41 medical facilities in the U.S. and worldwide were infected or exposed to tainted gastrointestinal scopes from Jan. 1, 2010, to Oct. 31, 2015, according to the Food and Drug Administration. A separate Senate investigation released in January found 250 scope-related infections at 25 hospitals and clinics in the U.S. and Europe. That probe looked at a narrower period, from 2012 to 2015. (Terhune, 4/15)
Nurses Say Stress Interferes With Caring For Their Patients
Nursing has long been considered one of the most stressful professions, according to a review of research by the National Institute for Occupational Safety and Health at the Centers for Disease Control and Prevention in 2012. Nurses and researchers say it comes down to organizational problems in hospitals worldwide. That includes cuts in staffing; some California nurses struck last month for a week over low staffing and wages. But some researchers say that just hiring more people won't fix things. Other proposed solutions include restructuring hospitals so that administrators pay more attention to what nurses have to say about patient care and work flow, and training programs to help nurses relieve their stress and deal with ethical dilemmas. (Yu, 4/15)
Kaiser Health News:
Most Doctors Unsure How To Discuss End-Of-Life Care, Survey Says
Doctors know it’s important to talk with their patients about end-of-life care. But they’re finding it tough to start those conversations — and when they do, they’re not sure what to say, according to a national poll released Thursday. Such discussions are becoming more important as baby boomers reach their golden years. By 2030, an estimated 72 million Americans will be 65 or over, nearly one-fifth of the U.S. population. (Feder Ostrov, 4/14)
A new report tries to quantify the problem of inaccurate health records and finds that incompatible electronic record software can miss checkups, emergency room stays and hospital admissions. In other information technology news, a doctor creates an online tool to help patients with end-of-life wishes, while an artist uses murals to channel her anger with the digital health system.
The Government May Want A Refund For Its $30 Billion Investment In Electronic Medical Records
The federal government has invested more than $30 billion in electronic medical records. The idea is that these records will let doctors and hospitals improve patient care – and potentially lower costs – by tracking all the treatment a person receives. The government may want its money back. (Gorenstein, 4/14)
New Jersey Doctor Creates Online Patient Resource To Improve End-Of-Life Care
A New Jersey doctor has created a new tool to help patients and doctors fill out POLST forms. That's short for Practitioner Orders for Life-Sustaining Treatment. Without it, Dr. David Barile said, patients at the end stages of life may get too much of the wrong kind of care. (Gordon, 4/14)
This Artist Is Trying To Transform Digital Health, One Painting At A Time
Just six days after Regina Holliday's husband died, she started painting a mural on the side of a gas station, off a busy street in Washington, D.C. "Fred's in the center of the painting," Holliday says. "I started with Fred because I wanted to have him back so desperately." (Gordon, 4/14)
The couple thought they were getting sperm from a musically gifted, well-educated donor, but later found out he was actually a man who suffered from schizophrenia and narcissistic personality disorder, had no university degrees and had been charged with residential burglary.
The Washington Post:
This Couple Says Everything They Were Told About Their Sperm Donor Was A Lie
Eight years ago, Angela Collins and Elizabeth Hanson thought they had found the one — the man whose sperm would help them have their first child. ... According to his profile, Donor #9623 boasted an IQ of 160. He held Bachelor’s and Master’s degrees in neuroscience, and was in the midst of pursuing a Ph.D. He had practically no health problems to speak of, but for the fact that his father was colorblind. ... Donor #9623 was not as he appeared. Some Internet research revealed to Collins that her baby’s father was in reality a man, James Aggeles, who suffered from schizophrenia, narcissistic personality disorder and other mental illnesses. (Wang, 4/15)
In other assisted reproduction news, a study highlights the benefits of expanding plans to cover single embryo in vitro fertilization —
The Denver Post:
CU Study: Insurance For Single Embryo In Vitro Fertilization Preferred
Expanding insurance coverage to cover a type of in vitro fertilization known as elective single-embryo transfer could lead to improved health outcomes and lower health care costs, according to a new study that included researchers from the University of Colorado School of Medicine. (Osher, 4/14)
David Daleiden's attorneys have filed court documents to try to get the indictment dismissed. They also argue that the district attorney on the case colluded with Planned Parenthood.
The Texas Tribune:
Anti-Abortion Activist Wants Charges Tossed
An anti-abortion activist who wound up facing criminal charges himself after making undercover recordings of a Houston Planned Parenthood facility is asking a Harris County judge to dismiss his indictments. (Ura, 4/14)
The Associated Press:
Defense: DA Colluded With Planned Parenthood On Indictment
An anti-abortion activist who made undercover videos at Planned Parenthood clinics claims a Texas district attorney colluded with the provider to obtain an indictment accusing him of falsifying records to make his secret recordings. Attorneys for David Robert Daleiden filed court documents Thursday seeking dismissal of the indictment. The Houston Chronicle reports Daleiden's attorneys also contend that the Harris County grand jury that indicted the Davis, California, man wasn't empaneled properly. (4/14)
Meanwhile, Hillary Clinton asks moderators why there were no abortion questions during the Democratic debate, and Ted Cruz sidesteps a question about personhood legislation —
Clinton: Why No Abortion Questions In Dem Debates?
Hillary Clinton at Thursday's Democratic presidential debate chastised moderators for not asking a single question about women’s reproductive rights, during a time in which she says abortion rights are under attack from Republican presidential candidates and governors. (Zanona, 4/14)
Cruz Dodges Chuck Todd's Questions On Personhood
Ted Cruz refused to say if he would support so-called personhood bills in an interview with MSNBC's Chuck Todd, according to a partial transcript released by the network ahead of Thursday's broadcast. (Collins, 4/14)
And, in Iowa Republicans go after Planned Parenthood funding, while in Missouri lawmakers are summoning a Planned Parenthood head to explain why she shouldn't be held in contempt —
The Associated Press:
Iowa Republicans Propose To Defund Planned Parenthood
Planned Parenthood in Iowa would have no state funding under a budget bill advanced Thursday by some House Republicans, but the proposal is not expected to have enough support in the Democratic-majority Senate. (Rodriguez, 4/14)
The Associated Press:
Senators Summon Planned Parenthood CEO Over Subpoena
Missouri lawmakers in a rare move Thursday voted to summon the CEO of a regional Planned Parenthood to explain why she should not be held in contempt of the state Senate for defying a subpoena that demanded documents on how the organization handles fetal remains. The 24-8 party-line Senate vote follows Republican outcry over undercover videos released last summer that alleged Planned Parenthood was illegally selling fetal tissue for profit. The organization has denied the allegations in the videos, which reference its St. Louis clinic, the state's only abortion provider, and Democratic Attorney General Chris Koster found no evidence of wrongdoing in Missouri. (4/14)
The mother of a woman who died of a heroin overdose spoke out about her daughter's struggle in hopes of reaching just one other family who was going through what she had. She ended up touching thousands.
The Boston Globe:
A Mother’s Depiction Of Daughter’s Overdose Touches Thousands
When Kathleen Errico of Haverhill found her 23-year-old daughter dead of a heroin overdose on April 2 — slumped over in bed, lips white, television turned on at 3:45 a.m. — a devastating, years-long struggle had ended. The demons of opioid addiction finally took the life of Kelsey Endicott, the mother of a toddler who would soon turn 2. But Errico’s heart-rending discovery in the still of night also marked a remarkable beginning. (MacQuarrier and Farragher, 4/14)
In other news, a poll shows that 3 out of 10 people in Ohio know someone who is abusing prescription drugs —
The Cleveland Plain Dealer:
Opiate And Heroin Crisis Affecting More Ohioans, Poll Shows
About three in 10 Ohio adults now know someone who abuses prescription pain relievers, and of these, 40 percent know someone who has overdosed on these medications, according to a new Ohio Health Issues Poll released today. (Zeltner, 4/14)
Doctors for Cannabis Regulation says the prohibition and criminalization of marijuana use does more harm to the public than good. In other news, researchers wonder if parasites can actually help treat diseases.
The Washington Post:
More And More Doctors Want To Make Marijuana Legal
A group of more than 50 physicians, including a former surgeon general and faculty members at some of the nation's leading medical schools, has formed the first national organization of doctors to call on states and the federal government to legalize and regulate the use of marijuana in the interest of public health. The group — which is announcing its formation Friday, under the name Doctors for Cannabis Regulation (DFCR) — is endorsing the legalization of marijuana for adult recreational use, a break from the position of the American Medical Association, the largest organization of doctors in the country. (Ingraham, 4/15)
When Parasites Could Be The Treatment Instead Of The Illness
Could swallowing the eggs of a parasitic worm help treat a disease? It might just work in some cases, according to the work of P'ng Loke and Ken Cadwell, two researchers at New York University who study parasites and the immune system. Several years ago, Loke got an intriguing phone call from a man with inflammatory bowel disease. The man told Loke that he had become so desperate that he had undergone a risky treatment in Thailand. It involved swallowing worm eggs and letting the worms, or helminths, hatch in his gut. (Sofia, 4/14)
Ohio will soon release details of a plan to require some Medicaid enrollees to make payments toward the cost of their insurance, and Massachusetts is finishing up a draft of an overhaul that will change how doctors and hospitals are paid.
The Associated Press:
Ohio To Post Plans To Require Cost-Sharing In Medicaid
State officials are set to release proposed details of an effort to require more than 1 million low-income Ohioans to pay a new monthly cost for Medicaid. House Republicans inserted the idea for the so-called Healthy Ohio Program into the state budget last year. It would require federal approval. (4/15)
The Boston Globe:
Overhaul Planned For MassHealth Insurance Model
Governor Charlie Baker’s administration has drafted plans for the biggest overhaul of the state’s Medicaid program in two decades, changing the way doctors and hospitals are paid in an effort to rein in soaring costs. (Dayal McCluskey, 4/15)
And in other Medicaid news from New Mexico and Massachusetts —
Panel Proposes Rate Cuts To Medicaid Providers
New Mexico hospitals, dentists, doctors, long-term care facilities and behavioral health providers would see their Medicaid reimbursement rates slashed under a recommendation that could save the state up to $114 million in total funds but potentially hurt staffing numbers and the level of care available. The proposed rate cuts are a fallout of the state’s budget crunch – specifically a $417 million Medicaid shortfall over the next 15 months – and were mandated by the Legislature in a $6.2 billion budget passed during this year’s 30-day legislative session. (Boyd, 4/14)
The Associated Press:
Boston Medical Center Settles Improper Billing Claims
A federal prosecutor says Boston Medical Center and two of its physician practice organizations have agreed to pay $1.1 million to resolve allegations that the hospital improperly billed Medicare and Medicaid. (4/14)
In related news, federal antitrust regulators are taking a hard look at the cost impact a proposed Chicago-area merger between two hospitals could have on consumers.
Justice Department Alleges Two West Virginia Hospitals Illegally Divvied Up Territories
St. Mary's Medical Center in Huntington, W. Va., and Charleston (W. Va.) Area Medical Center have agreed to settle an antitrust lawsuit accusing them of illegally coordinating marketing campaigns for various services in the markets where they compete. (Schencker, 4/14)
Crain's Chicago Business:
FTC Expert Warns Of $45 Million Cost Increase In Merger Trial
Consumers along the North Shore would end up paying about $45 million more a year for health care if two of the biggest Chicago-area hospital networks merged, an expert for federal antitrust regulators testified yesterday. That's based on Advocate Health Care and NorthShore University HealthSystem gaining better bargaining power at the negotiating table with insurers if they combined and created a 16-hospital system, the largest in Illinois and among the biggest in the nation. (Schorsch, 4/14)
News outlets report on health issues in Florida, Ohio, Georgia, Michigan, Missouri, Minnesota, California, North Carolina and Colorado.
Florida Governor Signs Law Shielding Patients From Surprise Medical Bills
The movement to protect consumers from surprise medical bills won a major victory Thursday when Florida Republican Gov. Rick Scott signed a bipartisan bill that will exempt patients from having to pay balance bills from out-of-network providers in certain situations. (Meyer, 4/14)
The Associated Press:
Ohio Governor Announces Suicide Prevention Initiatives
State officials are hoping more research, access to around-the-clock crisis hotlines and efforts to end the stigma of suicide will help reduce the hundreds of lives lost when people kill themselves each year in Ohio. (Welsh-Huggins, 4/14)
Georgia Health News:
Regulators Scrutinizing More Nursing Homes In New Beginnings Probe
More Georgia facilities run by a financially troubled nursing home operator are under federal and state regulatory scrutiny, a state health care agency said Thursday. Clyde Reese, commissioner of the Department of Community Health, made the disclosure during an interview with GHN. He did not specify the number or location of the nursing homes operated by New Beginnings Care that are being reviewed. (Miller, 4/14)
The Associated Press:
High Copper Or Lead Levels Seen In 19 Detroit Schools' Water
Detroit's hard-pressed school system has found elevated levels of lead and copper in nearly a third of its elementary schools, contamination that one expert says could be found nationwide, wherever school authorities spend the time and money to look. The news gave parents in the 46,000-student district yet another reason to worry, and prompted the teachers' union to appeal for help from autoworkers, who trucked bottled water to a school where some students were drinking from bathroom sinks after the water fountains were shut down as a precaution. (4/14)
St. Louis Post-Dispatch:
No One Seems To Want The Top Job At St. Louis VA
The Department of Veterans Affairs continues to struggle to permanently fill the top position at the St. Louis VA medical system, with the second potential candidate over the last nine months leaving federal service before the job could be filled. The position of medical center director has been open for almost three years, filled by temporary administrators who rotate through every few months. Last summer, a top candidate for the job withdrew for personal reasons. More recently, one under consideration left public service before an offer could be made, according to Huntley. (Raasch, 4/14)
Minnesota Public Radio:
Low-Income Minnesotans Less Likely To Get Cancer Screenings, Study Says
Low-income Minnesotans on Medicaid are much less likely to receive cancer screenings than people with other health coverage, new research has found. Minnesota nonprofit MN Community Measurement found that a little more than half of Medicaid recipients got recommended colorectal cancer screening, while three-quarters of people with other coverage were screened. (Zdechlik, 4/14)
Discounted Surgeries Bring The Uninsured New Hope In California
As a young surgeon, Dr. Jorge A. Enriquez watched his peers fly across the ocean to do charity work in far-flung places. But he was struck by the needs of his own community here amid the agricultural lands of the Central Valley. (Leigh Brown, 4/14)
North Carolina Health News:
Mental Health Crisis Center To Serve Caldwell, Alexander & McDowell Counties
A new comprehensive mental health care center will provide 24-hour mental health and addiction urgent care, outpatient behavioral health treatment and beds for people in crisis. (Sisk, 4/14)
The Denver Post:
Catalyst Signs Three Big-Name Tenants For RiNo Health-Tech Campus
A health-tech innovation campus planned for Denver's River North neighborhood has snagged three big names in health care as tenants — University of Colorado Anschutz Medical Campus, Terumo BCT and the American Diabetes Association. (Rusch, 4/14)
North Carolina Health News:
NC To Mandate ‘Environmental Justice Reviews’ Of New Coal Ash Dumps
To better shield poor people and racial minorities from excessive impacts from Duke Energy’s statewide coal ash clean up, North Carolina will require “environmental justice” reviews of any landfills the state permits. The reviews, to be evaluated by outside environmental-justice experts, will explore adverse socioeconomic, environmental and health risks from the facilities on these groups. (Clabby, 4/14)
Each week, KHN compiles a selection of recently released health policy studies and briefs.
JAMA Internal Medicine:
Association Between The Centers For Medicare And Medicaid Services Hospital Star Rating And Patient Outcomes
[Medicare's 5-star hospital rating system] depends solely on patient experience ... and currently, it does not include measures of quality of care or patients’ health outcomes. ... critics worry that the star rating system may mislead patients into thinking that 5-star hospitals are superior in quality. Therefore, we investigated whether hospitals with more stars have lower risk-adjusted 30-day mortality and readmissions than hospitals with less stars. ... We found that the number of stars was inversely associated with risk-adjusted mortality rate. ... 5-star hospitals [had] the lowest mortality rate of 9.8% ..., followed by 4-star hospitals with a rate of 10.4% .... Higher CMS star ratings were also associated with lower adjusted readmission rates, with 5-star hospitals having the lowest readmissions rate of 18.7%. (Wang et al., 4/10)
The New England Journal of Medicine:
Two-Year Costs And Quality In The Comprehensive Primary Care Initiative
The 4-year, multipayer Comprehensive Primary Care Initiative was started in October 2012 to determine whether several forms of support would produce changes in care delivery that would improve the quality and reduce the costs of care at 497 primary care practices .... Support included the ... care-management fees, ... shared savings, and ... data feedback and learning support. ... During the first 2 years, initiative practices received a median of $115,000 per clinician in care-management fees. The practices reported improvements ... in areas such as management of the care of high-risk patients and enhanced access to care. ... However, at this point these practices have not yet shown savings in expenditures for Medicare Parts A and B after accounting for care-management fees, nor have they shown an appreciable improvement in the quality of care or patient experience. (Berg Dale et al., 4/13)
The New England Journal of Medicine:
Early Performance Of Accountable Care Organizations In Medicare
[W]e compared changes in [Medicare] spending and in performance on quality measures from before the start of ACO contracts to after the start of the contracts between beneficiaries served by the 220 ACOs ... in mid-2012 (2012 ACO cohort) or January 2013 (2013 ACO cohort) and those served by non-ACO providers (control group) .... In 2013, the differential change ... in total adjusted annual spending was −$144 per beneficiary in the 2012 ACO cohort as compared with the control group ... consistent with a 1.4% savings, but only −$3 per beneficiary in the 2013 ACO cohort as compared with the control group .... our findings extend evidence of small but meaningful reductions in spending, with unchanged or improved quality of care, early in the Medicare ACO programs and suggest that progress toward net savings ... may be slow. (McWilliams et al., 4/13)
The Urban Institute/Kaiser Family Foundation:
Medicaid Spending Growth Compared To Other Payers: A Look At The Evidence
[T]his issue brief examines evidence from over 40 methodologically rigorous studies related to Medicaid program spending. Key findings show: Per capita spending in the Medicaid program is lower compared to private insurers after adjusting for the greater health needs of Medicaid enrollees. ... Medicaid spending growth primarily has been driven by rising Medicaid enrollment .... Lower payment levels in Medicaid have contributed to its relatively low costs. ... Recent federal budget proposals include provisions to reform Medicaid financing .... given Medicaid’s already lower payment rates that contribute to lower per capita spending, such proposals could result in reductions in utilization and/or enrollment as well as additional pressure on states to lower provider payment further. (Clemans-Cope, Holahan and Garfield, 4/13)
The Commonwealth Fund:
Medicaid Expansion In Texas: What's At Stake?
Texas is one of nearly 20 states yet to expand its Medicaid program under the Affordable Care Act (ACA), and is home to the largest number of uninsured Americans of any state in the country. For many of the state’s 5 million uninsured, this decision has left them without an option for affordable health insurance. A comparison with other Southern states that have expanded Medicaid shows how this decision has left many low-income Texans less able to afford their medical bills, to pay for needed prescription drugs, and to obtain regular care for chronic conditions. These problems have been compounded by the state’s opposition to outreach and enrollment assistance for many Texans who are eligible for coverage under the ACA. (Sommers, 4/7)
Here is a selection of news coverage of other recent research:
Mixed Results With Readmission Reduction Program
A readmission reduction program for high risk, newly discharged seniors helped lower 30-day hospital readmission rates, but the effect was small and did not reach national goals, researchers reported. Among 10,621 high-risk Medicare fee-for-service patients, ages 64 and older, 30-day readmission rates decreased from 21.5% to 19.5%, compared with a 0.1% reduction in the control group (21.1% to 21.0%), for a relative reduction of 9.3%, after implementation of a transitional care program, according to Leora I. Horwitz, MD, of New York University School of Medicine, and colleagues. (Wickline Wallen, 4/11)
Healthcare Providers In Cath Labs May Be Harmed By Radiation
Healthcare workers in labs where patients undergo heart procedures guided by X-rays may be at higher risk for cataracts, skin lesions, bone disorders or cancer than other healthcare workers, according to a new study. Procedures in the “cath lab” -- named for the catheters threaded into the heart -- are done for all forms of cardiac disease, like congenital heart defects, ischemic heart disease or heart arrhythmias, said lead author Maria Grazia Andreassi of the CNR Institute of Clinical Physiology in Pisa, Italy. ... But staff members, too, are exposed to radiation. In particular, for the cardiologists and electrophysiologists who work near the patient and the radiation source, “the cumulative dose in a professional lifetime is not negligible,” Andreassi said. (Doyle, 41/2)
Doctors Say Aspirin Lowers Heart Attack Risk For Many Adults
Many adults who have never had a heart attack or stroke should take aspirin every day to keep it that way, new U.S. guidelines say. People in their 50s with risk factors for cardiovascular disease -- including high blood pressure, high cholesterol or a history of smoking -- may benefit from starting a daily aspirin regimen and staying on it for at least a decade, according to the U.S. Preventive Services Task Force (USPSTF), a government-backed panel of independent physicians. (Rapaport, 4/11)
The Washington Post:
This Study 40 Years Ago Could Have Reshaped The American Diet. But It Was Never Fully Published.
It was one of the largest, most rigorous experiments ever conducted on an important diet question: How do fatty foods affect our health? Yet it took more than 40 years — that is, until today — for a clear picture of the results to reach the public. The fuller results appeared Tuesday in BMJ, a medical journal, featuring some never-before-published data. Collectively, the fuller results undermine the conventional wisdom regarding dietary fat that has persisted for decades and is still enshrined in influential publications such as the U.S. government's Dietary Guidelines for Americans. (Whoriskey, 4/12)
Editorial writers take in-depth looks at the current state of knowledge about the Zika virus as well as the congressional reaction to it.
The New York Times:
On Zika, Congress Is Failing To Do Its Job
The Centers for Disease Control and Prevention has concluded that the Zika virus causes brain damage in babies born to infected women, which adds to the growing evidence that the virus is a major public health emergency. Yet Republicans in Congress are refusing to appropriate the money needed to respond to this crisis. (4/14)
Los Angeles Times:
Now That We Know Zika Causes Birth Defects, Will Congress Stop Bickering About Emergency Funding?
The Centers for Disease Control and Prevention on Wednesday officially blamed the Zika virus for causing birth defects in infected mothers. It's something that everyone believed to be true, but everyone has been wrong before. (Remember that flat-Earth thing?) This pronouncement is based on study of existing data and comes just two days after the CDC's Dr. Anne Schuchat said: "Everything we look at with this virus seems to be a bit scarier than we initially thought." (Mariel Garza, 4/14)
Zika Risks Are Small: Column
South Korea last month joined the growing list of countries with a confirmed case of Zika virus. Since the World Health Organization declared the virus a global public health emergency in early February, public fear has also spread. While it's the duty of public health officials to warn the public of outbreaks and how to prevent them, they also need to allay the public's fears to prevent reactions that cause unintended negative consequences. (Merceditas Villanueva and Joan Cook, 4/14)
The Zika Virus Is Worse Than We Thought
With summertime mosquito season approaching, the Zika virus is beginning to get mighty scary. In recent years, we’ve had to deal with other insidious threats, including another mosquito-borne disease, the West Nile virus. But Zika is truly sinister. It’s most vulnerable targets are pregnant women and the fetuses they carry, which the virus attacks. On Wednesday, the U.S. Centers for Disease Control and Prevention confirmed Brazilian doctors’ initial suspicions — that had become widely accepted — that the Zika virus causes babies to be born with abnormally small heads, a condition called microcephaly, usually accompanied by brain defects. (4/14)
A selection of opinions from around the country.
Obamacare Shows Why Health Insurers Should Be More Like Southwest Airlines
For competition to revolutionize the insurance market, enrollees have to actually force insurers to compete for their business. Happily, that's exactly what enrollees did. (Ezra Klein, 4/14)
Health Affairs Blog:
Today’s Most Attractive National ACO Model Is Offered By…CMS
A large national payer recently announced the opportunity for Accountable Care Organizations (ACOs) to share in 100 percent of the savings they create for the payer’s largest book of business. Providers will have complete autonomy in how they manage the health of their population, and the payer will ensure the timely flow of datasets needed to support care improvement activities. The payer will pre-define the ACO’s population and its spending benchmark, which will be adjusted for the risk of the ACO population. Consumers aligned to the ACO will be offered supplemental benefits and financial incentives to seek care from the ACO’s network. (Chris Dawe, Nico Lewine, and Mike Miesen, 4/15)
The Wall Street Journal:
How The 15-Minute Doctor’s Appointment Hurts Health Care
How would you react if you sent your sputtering car to the auto mechanic, and they stopped trying to diagnose the problem after 15 minutes? You would probably revolt if they told you that your time was up and gave back the keys. Yet in medicine, it’s common for practices to schedule patient visits in 15-minute increments—often for established patients with less complex needs. Physicians face pressure to mind the clock while they examine you. (Peter Pronovost, 4/15)
Why Aren't Millions Of Americans Getting Preventive Care?
We were recently involved in a new report that analyzed prevention measures across all 50 states. It looked at prevention through the lenses of access to health care, immunizations, and efforts to prevent chronic disease. The final report, United Health Foundation’s America’s Health Rankings Spotlight: Prevention, released in partnership with the American College of Preventive of Medicine, revealed troubling disparities in access to recommended preventive care. (Reid Tuckson and Daniel S. Blumenthal, 4/15)
The Des Moines Register:
Let Medicare Negotiate Prices For Prescription Drugs
In newspaper ads across America, an entity calling itself the American Action Network encourages seniors to call their congressmen and voice their opposition to a bill that would, supposedly, harm Medicare beneficiaries. The American Action Network is not a grassroots of organization of seniors, although you might think that from the ads, one of which has appeared in The Des Moines Register. They depict seniors and use the phrase, “Don’t Cut Our Medicare!” (4/14)
U.S. News & World Report:
A Grand Bargain To Help The Poor Live Longer
The United States should be a land of opportunity in which every child born into poverty has a fair chance to succeed in life. Yet a major study published in the Journal of the American Medical Association provides insight into why there is a growing gap between a person's income and life expectancy. Even with these findings, the report can guide how future health care policies address these inequalities. (Ezekiel J. Emanuel and Topher Spiro, 4/14)
Compromise Is A Losing Battle For The Supreme Court
The briefs are in -- and the Supreme Court’s extraordinary effort to bring about a compromise in a contraceptive care case looks like a bust. Instead of finding a mutually agreeable solution, religious groups and the federal government appear to have only hardened their positions. (Noah Feldman, 4/13)
The Kansas City Star:
Physicians Who’ve Had Success Motivating Patients Can Help With Parenting, Too
As much fun as it is to start fiddling with a new gadget right out of the box without looking at the manual, it’s nice to know there is a manual if I just can’t get the thing to do what I want. Kids, though. Eesh. My wife and I are blessed with boys we can take just about anywhere, but there are still times they won’t do what we want. They draw on the wisdom of “Star Wars” to explain what’s wrong when the other one isn’t minding: “He has a bad motivator.” Indeed. And unlike an R2 unit, the boys didn’t come with manuals that say how we might get them moving. (Richard Espinoza, 4/14)
Children's Cancer Research Is Often Ignored. Make It A Moonshot Priority.
Cancer is the leading disease-related cause of death in children in the United States. Yet pediatric cancer is often left behind when it comes to funding research and developing new drugs. Not only does this give short shrift to children with cancer, but it also threatens to rob us of advances that could benefit cancer patients of all ages. (David Williams, 4/14)
Objects Left In Patients And Health IT Issues Among Top Safety Woes
Hospitals continue to struggle with long-standing patient safety issues, such as leaving sponges and towels inside of patients having surgery and failing to create a culture where staffers speak up about mistakes. That's according to the third annual report on the year's top patient safety issues from the ECRI Institute, a not-for-profit health research agency. (Sabriya Rice, 4/13)