- Kaiser Health News Original Stories 3
- Challenges Abound For 26-Year-Olds Falling Off Parental Insurance Cliff
- For Marketplace Customers Who Delay, Auto-Enrollment Could Be Nasty Wake-Up
- Cities, Counties and Schools Sidestep FDA Canadian Drug Crackdown, Saving Millions
- Political Cartoon: 'Moving Right Along?'
- Health Law 2
- McConnell Promised Collins Health Bills Would Pass, But No One Else Seems Eager To Uphold That Deal
- Insurers Could Be On The Hook For CSR Funds They've Already Spent On Low-Income Enrollees
- Capitol Hill Watch 3
- Hospitals, Nursing Homes In Mad Dash To Borrow Tax-Free Funds While They Still Can
- AARP Presses Congress To Exempt Medicare From Cuts To Pay For Tax Bill
- Some Senators Starting To Get Antsy Over Inaction On CHIP Funding
- Public Health And Education 5
- Post-Sandy Hook Behavior Provides Unique Data On Link Between Gun Sales, Accidental Deaths
- The Lost Mothers: African American Women Share Stories Of Severe Maternal Complications
- There Are Hints That Flu Season Is Going To Be Ferocious, So Officials Say Get Your Shot
- Initiative In Ohio Encouraging Innovators To Think Outside The Box To Combat Opioid Crisis
- 'It Always Feels Like The Spanish Inquisition': Putting Off Going To The Doctors Isn't Just About Cost
- State Watch 1
- State Highlights: Mass. Hospital Tackles Patients' Housing Struggles; N.Y. Woman Sues Doctor Saying He Talked On Phone During Surgery
From Kaiser Health News - Latest Stories:
Insurance has often been a tough-sell among these young people because they are often healthy and choosing a plan is complicated. A shorter enrollment and less outreach could dampen enthusiasm. (Carmen Heredia Rodriguez, 12/8)
People who have a plan from the health law’s marketplace and who don’t actively shop for a new one will be auto-enrolled on Dec. 16. But unlike past years, most people won’t be able to change those plans if they don’t like them. (Michelle Andrews, 12/8)
Medicines are up to 80 percent cheaper north of the border and overseas, so U.S. localities are greasing a pharmaceutical pipeline that the feds warn is illegal and possibly unsafe. (Phil Galewitz, 12/8)
Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Moving Right Along?'" by J.C. Duffy.
Here's today's health policy haiku:
MARYLAND MARIJUANA DISPENSARIES ALREADY RUNNING OUT OF POT
Pot sales go straight off the charts!
Snack food sales up too?
- Ernest R. Smith
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.
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Summaries Of The News:
Sen. Susan Collins (R-Maine) threw her support behind the Republican tax bill on the agreement that the Senate would take up the bipartisan health legislation that is aimed at stabilizing the marketplace. But even though she extracted the promise from Senate Majority Leader Mitch McConnell, the rest of the GOP leadership isn't ready with uphold the bargain.
Collins' Obamacare Deal Faces Moment Of Truth
Sen. Susan Collins is barreling toward yet another health care showdown with her own party. But this time, she might not have the leverage to get what she wants. Republicans who watched Collins lead the rebellion over the GOP’s Obamacare repeal effort just three months ago are playing tough on yet another high-stakes bill, wagering they can do without the Maine moderate’s swing vote and still claim a narrow year-end legislative win on tax reform. (Cancryn, 12/8)
Maine’s Susan Collins Was A Health Care Hero, But Now Advocates Are Branding Her A Villain
In an interview, [Susan] Collins said she is puzzled by the strength of the outcry against her vote — though as a centrist she’s used to attracting arrows from both the left and the right. ... She pointed to hard-won promises she extracted from Republican leaders to pass separate legislation that aims to strengthen the health care law’s individual health insurance marketplaces and mitigate premium increases that will result from abandoning the individual mandate. (McGrane, 12/8)
Senator’s Shaky Obamacare Deal Poses Challenge For Tax Overhaul
The three biggest stories in Washington -- a broad overhaul of the U.S. tax structure, a health-care makeover and a spending bill that would avert a government shutdown -- all depend, more or less, on one moderate Republican senator who says she’s got a deal that could deliver them all. The only trouble is, Senator Susan Collins’s deal could unravel fast, putting the Maine lawmaker and her party in a tight spot as GOP leaders seek a major policy win in 2017. (Kapur, 12/8)
The companies may have to return any surplus they used to cover cost-sharing reduction costs since the Trump administration cut off the payments in October.
CMS Could Demand CSR Repayments From Insurers If Congress Doesn't Act
Insurers may be on the hook to pay back the government for funds they have already spent on low-income enrollees through 2017. It's still not clear whether Congress will appropriate cost-sharing reduction payments, as lawmakers race toward a short-term spending agreement before Christmas. This means insurers may have to return any surplus they used to cover CSR costs since the Trump administration cut off the payments in October. An October bulletin from the CMS said insurers would be on the hook for any "overpayments" of CSRs for 2016, but that the agency wouldn't pay any shortfalls. This could be the case for 2017, according to a healthcare attorney who follows the CMS' regulatory actions closely. (Luthi, 12/7)
In other health law and marketplace news —
Q&A: Illinois Insurance Department Head Navigates Obamacare Changes
Jennifer Hammer’s first year as director of the state’s Department of Insurance hasn’t been an easy one. Hammer, who was appointed by Gov. Bruce Rauner and confirmed in February, has overseen the department during a time of tumult and uncertainty over the Affordable Care Act, also known as Obamacare. Hammer, 35, has been at the department’s helm as it reviewed proposed rates for Obamacare plans for next year, worked with insurers to handle changes made by the Trump administration and unveiled a revamped website to help Illinois residents enroll. The deadline for Obamacare enrollment is Dec. 15. (Schencker, 12/7)
Kaiser Health News:
For Marketplace Customers Who Delay, Auto-Enrollment Could Be Nasty Wake-Up
Shopping to update your coverage on the health insurance marketplace may be annoying — didn’t you just do this last year? But letting the exchange automatically renew your coverage instead could be a big mistake. If you don’t like the plan you’re auto-enrolled in this year you may be stuck with it in 2018, unlike previous years when people could generally switch. (Andrews, 12/8)
Kaiser Health News:
Challenges Abound For 26-Year-Olds Falling Off Parental Insurance Cliff
Marguerite Moniot felt frustrated and flummoxed, despite the many hours she spent in front of the computer this year reading consumer reviews of health insurance plans offered on the individual market in Virginia. Moniot was preparing to buy a policy of her own, knowing she would age out of her parent’s plan when she turned 26 in October. (Heredia Rodriguez, 12/8)
Kansas City Star:
One Of The Obamacare Insurers Erroneously Said Children’s Mercy Was In Its Network
During the first four weeks of the Affordable Care Act open enrollment period the website for Ambetter, a new insurer offering plans in the Kansas City area, said that some Children’s Mercy Hospital practitioners were in its network. They were not. (Marso, 12/7)
The borrowing spree is happening as Congress debates whether to do away with long-held tax exemptions on these types of bonds beginning Jan. 1. Meanwhile, lawmakers are mulling what to do about the health law's insurance tax.
The Wall Street Journal:
U.S. Hospitals, Schools Rush To Raise Tax-Free Funds
Hospitals, universities and nursing homes across the U.S. are rushing to borrow money tax-free—while they still can. Last week, borrowers issued more than $4 billion in new so-called private-activity bonds, which allow nonprofits and some for-profit firms to raise money for development projects perceived to have a public benefit. That was triple the amount issued during the same week in 2016, according to a Municipal Market Analytics analysis of Bloomberg data, and one of the highest weekly issuances of the past two years. Prices on private-activity bonds have increased this week alongside other municipal bonds. (Gillers and Evans, 12/7)
House Tax Writers Weigh Plan To Suspend Obamacare Insurer Tax
House Republican tax writers are considering delaying Obamacare's health insurance tax for only limited markets next year, leaving out small businesses and possibly private Medicaid plans, according to sources on and off Capitol Hill. They would suspend it for all markets in 2019. Republicans on the Ways and Means Committee are worried that it will be difficult for the small businesses to send prospective savings from delaying the tax back to consumers. Industry sources, however, say it is possible. (Haberkorn, 12/7)
The tax bill is expected to add $1 trillion to the deficit and that will trigger a mechanism that makes automatic cuts in federal spending. The nonpartisan Congressional Budget Office estimates that would take a $25 billion bite out of the Medicare budget.
AARP: Congress Must Prevent 'Sudden Cut' To Medicare In 2018
The AARP is urging House and Senate leaders to waive congressional rules so the Republican tax bill doesn't trigger deep cuts to Medicare. If Republicans pass their tax bill, which would add an estimated $1 trillion to the federal deficit, congressional “pay-as-you-go” rules would require an immediate $150 billion in mandatory spending cuts to offset the impact. ... Under the bill, according to the Congressional Budget Office, Medicare would be faced with a $25 billion cut in fiscal 2018. (Weixel, 12/7)
And a congressional advisory panel is suggesting changes in Medicare's new payment system for doctors —
MedPAC Finalizes Its Proposed MIPS Replacement
The Medicare Payment Advisory Commission has finalized a recommendation that urges the repeal and replacement of a Medicare payment system that aims to improve the quality of patient care. To avoid penalties under MACRA, physicians must follow one of two payment tracks: the Merit-based Incentive Payment System, or MIPS, or advanced alternative payment models like accountable care organizations. On Thursday, the Commission presented a draft recommendation that will be voted on in January. It asks Congress to eliminate MIPS and establish a new voluntary value program in which clinicians join a group and are compared to each other on the quality of care for patients. (Dickson, 12/7)
Lawmakers are starting to prod leadership about the lack of movement over money for the popular program.
Senators Press Leadership On Children's Health
An increasing number of senators are raising concerns with leadership over delays in funding the Children’s Health Insurance Program since state officials are anxious because a long-term solution still has not been found. Earlier this week, West Virginia GOP Sen. Shelley Moore Capito penned a letter to Senate Finance Chairman Orrin G. Hatch about the state of the Children's Health Insurance Program. Virginia Democratic senators Tim Kaine and Mark Warnerwrote a joint letter to Senate Majority Leader Mitch McConnell of Kentucky and Speaker Paul D. Ryan of Ryan expressing their concerns about the lack of movement on funding renewal as well. (Raman, 12/7)
Clinton Hits GOP Over Lack Of Children's Health Funding
Hillary Clinton is pushing Congress to fund the Children's Health Insurance Program (CHIP), denouncing Republicans for passing tax cuts while the program's authorization has expired. "I’m going to keep tweeting about this, and speaking out every chance I get, until it is fixed," the former Democratic presidential nominee tweeted on Thursday. (Sullivan, 12/7)
The issue of the organization's fetal tissue practices was thrust into the spotlight in 2015 when undercover videos purporting to show Planned Parenthood officials discussing procurement of "intact" and partial fetuses in exchange for compensation for expenses.
The Daily Beast:
Justice Department Moves To Investigate Planned Parenthood’s Fetal Tissue Practices
The Justice Department is taking steps to investigate Planned Parenthood, The Daily Beast has learned. The head of Justice’s office of legislative affairs has sent a letter to the Senate Judiciary Committee asking for documents from its investigation of Planned Parenthood’s fetal tissue practices. The Daily Beast reviewed the letter, which says the requested documents are “for investigative use.” (Woodruff, 12/7)
In other news —
An Effort To Ban State-Funded Abortion Services Didn’t Get Enough Signatures
Backers of a proposed constitutional amendment that would have allowed Massachusetts to exclude abortion services from state-funded health care did not collect enough support by a deadline this week to advance to the next step of the process, according to the treasurer of the ballot group. (Miller, 12/7)
Dignity Health, headquartered in San Francisco, and Catholic Health Initiatives, based in Denver, have signed a merger agreement. The combined system will have 139 hospitals around the country.
Dignity And CHI Sign Definitive Agreement To Merge
After more than a year of discussions, Dignity Health and Catholic Health Initiatives have signed a definitive agreement to merge. The combination will create the nation's largest not-for-profit hospital system by operating revenue. The new health system would have 139 hospitals and a combined revenue of $28.4 billion with more than 159,000 employees, and 25,000 physicians and other advanced practice clinicians. The combined system would have operations in 28 states with no overlap in hospital service areas, which could help expand access and also help from a regulatory perspective, executives said. (Kacik, 12/7)
Colorado Losing A Major Headquarters As Catholic Health Initiatives Merges With Dignity
Catholic Health Initiatives, which jointly operates Colorado’s largest hospital group, Centura Health, has signed a merger agreement with Dignity Health that will create a new nonprofit Catholic health group based in Chicago. CHI, based in Arapahoe County near the Interstate 25 and E-470 interchange, employs about 720 people in the metro area, not counting Centura Health workers, and is one of the largest headquarters in Colorado based on revenue. Dignity Health is headquartered in San Francisco. (Svaldi, 12/7)
St. Luke's Catholic Health Initiatives And Dignity Health Merging
Catholic Health Initiatives, the owner of St. Luke's Health System, and Dignity Health have merged, the two Catholic institutions announced Thursday. The agreement will create the largest non-profit health system in the country. "We are joining together to create a new Catholic health system, one that is positioned to accelerate the change from sick-care to well-care across the United States," Kevin E. Lofton, CEO of Catholic Health Initiatives, said in a statement. (Ackerman, 12/7)
Researchers have always struggled with the correlation between deaths and the presence of guns in homes. But the 2012 tragedy -- and the rush of sales that followed -- allowed them an insight into the ramifications of more Americans owning guns.
The Washington Post:
Surge In Gun Sales After Sandy Hook Led To Spike In Accidental Gun Deaths, Study Says
In the days after the horrific shooting at Sandy Hook Elementary School, gun enthusiasts rushed to buy millions of firearms, driven by fears that the massacre would spark new gun legislation. Those restrictions never became a reality, but a new study concludes that all the additional guns caused a significant jump in accidental firearm deaths. The study, published Thursday in the journal Science, estimates that the 3 million guns sold in the several months after Sandy Hook caused about 60 more accidental gun deaths than would have occurred otherwise. Children were killed in a third of them — some 20 youngsters, the same number as died at Sandy Hook. (Wan, 12/7)
Los Angeles Times:
Add At Least 57 To The Number Of Gun-Related Deaths Tied To The Sandy Hook Mass Shooting
But the aftermath of a mass shooting does not appear to be very good for Americans' safety. New research suggests that the increased availability of firearms after a mass shooting exacts a deadly toll of its own. That toll falls heavily on children, according to the study, which links the spike in gun sales following a mass shooting with an increase in fatal accidents involving firearms. (Healy, 12/7)
Researchers Look For Gun Violence Clues In Google Searches And Background Checks
In Google search data, the team saw spikes in searches including the terms "clean gun" and "buy gun" immediately following the Newtown shooting. The term "clean gun" is, they argue, an indicator that people may be removing guns they already own from storage in order to clean them. In all, the study concludes that increased gun exposure after Newtown led to an additional 66 accidental shooting deaths in the U.S., a third of whom were children. "It's very challenging to estimate empirically," says Studdert. "If we really wanted to understand the health effects of firearm ownership, we would randomize the ownership of weapons in different households and observe their effects over time. Of course, we can't do that." (Hersher, 12/7)
African American women disproportionately experience complications from pregnancy and child birth. ProPublica talks to 10 mothers about their experiences as part of an investigation into why it's happening.
Black Women Disproportionately Suffer Complications Of Pregnancy And Childbirth. Let’s Talk About It.
About 700 to 900 women die each year from causes related to pregnancy and childbirth. And for every death, dozens of women suffer life-threatening complications. But there is a stark racial disparity in these numbers. Black mothers are three to four times more likely to die than white mothers. Nevertheless, black women’s voices are often missing from public discussions about what’s behind the maternal health crisis and how to address the problems. (Gallardo, 12/8)
Black Mothers Keep Dying After Giving Birth. Shalon Irving's Story Explains Why
The researcher working to eradicate disparities in health access and outcomes had become a symbol of one of the most troublesome health disparities facing black women in the U.S. today: disproportionately high rates of maternal mortality. The main federal agency seeking to understand why so many American women — especially black women — die, or nearly die from complications of pregnancy and childbirth had lost one of its own. (Martin and Montagne, 12/7)
So far, the strain that is most common is the one that is less vulnerable to vaccines. But officials say that, even so, it's still worth getting the shot.
Los Angeles Times:
America, It's Time To Get Ready For The Flu
It’s the most wonderful time of the year — the time when the flu makes its presence known in the United States. You may not have given influenza much thought, but that’s OK — health officials at the Centers for Disease Control and Prevention have been doing it for you. They say the virus had been lying low through October, but that’s changed since early November. So far, the dominant strain of influenza here is of a sort that usually produces more misery. It’s also the type that’s less vulnerable to flu vaccines. Even so, health experts recommend that you get your annual flu shot (or nasal mist), if you haven’t done so already. (Kaplan, 12/7)
The Washington Post:
A Mother Got The Flu From Her Children — And Was Dead Two Days Later
The children were the first to get sick. They spent Thanksgiving with sore throats and chills and fevers. By the end of the long weekend, the adults who had gathered for the family’s holiday meal in Phoenix were feeling flu symptoms, too. “We were all together for Thanksgiving, and the little kids got sick, then the adults got sick,” Stephanie Gonzalez told CBS News. “It traveled through our family. Everybody kind of got over it. Everybody was fine.” Everybody but Alani “Joie” Murrieta. (Wootson, 12/7)
The program is distributing millions of dollars to companies to develop solutions such as implants that could someday relieve pain without relying upon opioids and a medication that’s designed to use the body’s natural digestive process to prevent overdoses.
Ohio Tech Fund Awards $10 Million To Develop New Ideas To Curb Opioid Crisis
A recovery app, a therapeutic implant, and a non-narcotic pain drug are among the top ideas that will receive cash from an Ohio tech fund seeking to advance new solutions in responding to the opioid epidemic. Ohio’s Third Frontier Commission, an economic development initiative focused on tech startups, announced Thursday that seven proposals would receive a total of $10 million. It’s part of a broader $20 million effort championed by Ohio Gov. John Kasich as a way to address a crisis that killed more than 4,000 people statewide in 2016. (Blau, 12/7)
Cleveland Plain Dealer:
Northeast Ohio Companies Among Recipients Of $10 Million For Anti-Opioid Technologies
A medical device that releases local anesthetic as an alternative to opioids and a web-based hotline to support people in recovery were among proposals that will receive economic development funds to fight the state's opioid epidemic, a state agency announced Thursday. The Ohio Third Frontier Commission approved $10 million to advance technologies that will battle drug abuse and addiction. Gov. John Kasich, during this year's State of the State address, announced that ultimately $20 million will be made available to combat the drug problem. (Hancock, 12/7)
Even doctors, who know when it's necessary, procrastinate about seeking medical care. The Boston Globe looks at why we do this. In other public health news: gene editing, diabetes, marijuana, suicide, arsenic, smog and more.
Why Do So Many Of Us Avoid Going To The Doctor? Even Doctors.
Most of us put off seeing the doctor on occasion, and there can be consequences. Nobody likes mammograms and colonoscopies, but women over 40 who get annual mammograms see a 40 percent reduction in breast cancer deaths, while if you’re over 50 and don’t get a colonoscopy, you’re skipping a procedure estimated to reduce chances of dying from colon cancer by 60 percent. (Moran, 12/7)
Los Angeles Times:
Scientists Use CRISPR To Turn Genes On Without Editing Their DNA
The revolutionary gene editing tool CRISPR-Cas9 is best-known for helping scientists edit a strand of DNA more precisely and efficiently than ever before. Now, researchers have demonstrated another use for the CRISPR complex: changing what genes are expressed without altering the genome itself. (Netburn, 12/7)
Adults Can Get Type 1 Diabetes, Too
David Lazarus had just moved to Los Angeles to start a new job as a business and consumer columnist for the Los Angeles Times when he suddenly developed some of the classic signs of diabetes: extreme thirst, fatigue and weight loss. He dropped close to 15 pounds in 2 weeks. Lazarus was in his early 40s. "The weight loss was the first big red flag. It happened really fast," he says. He consulted a physician who diagnosed him with Type 2 diabetes and recommended a "monastic" low-carb, macrobiotic diet. (Tucker, 12/8)
The New York Times:
A Comeback For The Gateway Drug Theory?
If you grew up as part of the D.A.R.E. generation — kids of the 1980s and ’90s who learned about drugs from alarmist public service announcements — you know all too well the dangers of so-called gateway drugs. Go to bed with marijuana or beer, you were taught, and risk waking up with cocaine or heroin. Three decades later, scientists and politicians still debate whether using “soft” drugs necessarily leads a person down a slippery slope to the harder stuff. Critics note that marijuana has, in some cases, been shown to actually prevent people from abusing other substances. And even D.A.R.E. now acknowledges that the overwhelming majority of people who smoke pot or drink never graduate to pills and powders. (Quenqua, 12/7)
The New York Times:
Sifting Through A Life After Suicide
During a support-group meeting for people left behind by suicide, Hope Litoff realized she was among a group of collectors. “We all had storage spaces of our dead person,” said Ms. Litoff, a New York film editor whose sister, Ruth, an artist and photographer, committed suicide in 2008 at the age of 42. “We all had the same feelings. We had saved every single thing. The items themselves were too precious to part with, but at the same time, too painful to look at.” (Parker-Pope, 12/7)
The New York Times:
Should You Be Worried About The Arsenic In Your Baby Food?
Rice cereal is often a baby’s first solid food, but it contains relatively high amounts of arsenic, a source of growing concern. Now an advocacy group reports that while the levels of this potentially toxic substance in infant rice cereals have dropped slightly in recent years, rice cereals still contain six times more inorganic arsenic, on average, than infant cereals made with other grains like barley or oatmeal. The new report comes from Healthy Babies Bright Futures, an alliance of scientists, nonprofit groups and private donors that aims to reduce children’s exposures to chemicals that may harm developing brains. (Rabin, 12/7)
Why Your Brain Has Trouble Bailing Out Of A Bad Plan
You're in your car, heading for an intersection. The light turns yellow, so you decide to hit the gas. Then you see a police car. Almost instantly, you know that stomping on the accelerator is a big mistake. But there's a good chance you'll do it anyway, says Susan Courtney, a professor in the Department of Psychological & Brain Sciences at Johns Hopkins University. That's because as one area of your brain is recognizing that police car, other areas have already begun carrying out your original plan to accelerate. (Hamilton, 12/7)
San Francisco Chronicle:
California, 13 Other States Sue EPA Over Smog Levels
California and 13 other states sued the Trump administration’s Environmental Protection Agency on Thursday for ignoring an Oct. 1 deadline to update the nation’s map of areas with unhealthy smog levels, saying the delay is endangering children and people who suffer from lung disease. (Egelko, 12/7)
The Wall Street Journal:
An Unfortunate Memento Of The Total Eclipse: Eye Damage
For millions of people last summer’s solar eclipse was a momentary spectacle, but for one New Yorker the sight of the moon crossing the sun is a vision that may never leave her view, burned as a crescent-shaped scar into her retina. Close-ups of her damaged eye tissue—reportedly the most detailed of their kind—were published online Thursday in the journal JAMA Ophthalmology by solar retinopathy specialist Avnish Deobhakta and his colleagues at the New York Eye and Ear Infirmary of Mount Sinai. (Hotz, 12/7)
Here's What It Looks Like When You Fry Your Eye In An Eclipse
At least one young woman suffered eye damage as a result of unsafe viewing of the recent total solar eclipse, according to a report published Thursday, but it doesn't appear that many such injuries occurred. Doctors in New York say a woman in her 20s came in three days after looking at the Aug. 21 eclipse without protective glasses. She had peeked several times, for about six seconds, when the sun was only partially covered by the moon. (Greenfieldboyce, 12/7)
Georgia Health News:
Agony Of Endometriosis Leaves Many Women Feeling Alone
It’s estimated that more than 6 million in the United States suffer from the condition. Although knowledge of the disease is increasing among the public, due to media reports and celebrity awareness, it is still fairly unknown and often misunderstood. (Thomas, 12/7)
Here is a selection of news coverage of other recent research:
Spillover Effects Of Adult Medicaid Expansions On Children’s Use Of Preventive Services
In our study, we demonstrate that Medicaid expansions targeted at low-income adults are associated with increased receipt of recommended pediatric preventive care for their children. This finding reveals an important spillover effect of parental insurance coverage that should be considered in future policy decisions surrounding adult Medicaid eligibility. (Venkataramani, Pollack and Roberts, 12/1)
Medicare’s Evolving Approach To Paying For Primary Care
Wide differences in incomes for primary care and specialty practitioners contribute to shortages of primary care physicians in many areas of the country. A new analysis, prepared by researchers at the Urban Institute with funding from the Robert Wood Johnson Foundation, explores the two reform methods the Centers for Medicare & Medicaid Services (CMS) is using to address underpayment for primary care in Medicare: new primary care billing codes and demonstrations. New billing codes incentivize specific activities that CMS knows it wants clinicians to engage in, while demonstrations test whether CMS can achieve favorable outcomes by paying for promising new care delivery approaches. (Burton, Berenson and Zuckerman, 12/7)
Mortality Quadrupled Among Opioid-Driven Hospitalizations, Notably Within Lower-Income And Disabled White Populations
Hospitals play an important role in caring for patients in the current opioid crisis, but data on the outcomes and composition of opioid-driven hospitalizations in the United States have been lacking. Nationally representative all-payer data for the period 1993–2014 from the National Inpatient Sample were used to compare the mortality rates and composition of hospitalizations with opioid-related primary diagnoses and those of hospitalizations for other drugs and for all other causes. Mortality among opioid-driven hospitalizations increased from 0.43 percent before 2000 to 2.02 percent in 2014, an average increase of 0.12 percentage points per year relative to the mortality of hospitalizations due to other drugs—which was unchanged. (Song, 12/4)
The Commonwealth Fund:
Big Five Health Insurers’ Membership And Revenue Trends
The five largest U.S. commercial health insurers collectively cover more than two-fifths of the insured population. Over the past decade, these companies’ bottom lines have become increasingly linked to Medicare and Medicaid, with the two programs accounting for 59 percent of revenues in 2016. Access to coverage could be improved if insurers that participate in Medicaid or Medicare were required to also participate in the marketplaces in the same geographic area. (Schoen and Collins, 12/4)
Weapon Carrying Among Victims Of Bullying
Pediatricians should recognize that [victims of bullies], especially those who have experienced 1 or more indicators of peer aggression in conjunction, are at substantially increased risk of weapon carrying. (Pham, Schapiro and Adesman, 12/1)
Media outlets report on news from Massachusetts, New York, Florida, New Jersey, Ohio, Minnesota and Wisconsin.
Boston Medical Center Launches $6.5 Million Initiative To Help House Patients
Boston Medical Center is embarking on a significant new initiative to tackle one of its patients’ most daunting problems: a lack of stable housing. One in four patients admitted to the hospital is homeless, and even more live in unsafe places or are at risk of being evicted — conditions that research shows can exacerbate health problems. (Dayal McCluskey, 12/7)
The Associated Press:
Woman Claims Surgeon Talked On Cellphone During Operation
A suburban New York City woman has sued a doctor, claiming he used his cellphone to take a language test while operating on her. The Journal News reports 70-year-old Mary Edwards, of Port Chester, filed a lawsuit Monday in state Supreme Court against Dr. Eric Fishman and his employer, Westmed Medical Group. The lawsuit seeks unspecified monetary damages. (12/7)
Audit: DCF Failed To Track Seriously Injured Children In Its Care
The Massachusetts Department of Children and Families failed to adequately track and report injuries and abuse of children who were under DCF supervision, a state audit released on Thursday found. Over a two-year period — 2014 and 2015 — DCF was not aware of 260 incidents that involved apparent serious bodily injury to children in its care, the audit found, according to the office of state Auditor Suzanne Bump. (Kelly and Creamer, 12/7)
The Associated Press:
Prosecutors Insist Eye Doc Stole $136 Million From Medicaid
Either Dr. Salomon Melgen is one of the biggest Medicare swindlers ever, stealing more than $100 million from the federal health care program, or a penny ante thief who walked off with $64,000. Those were the widely contrasting arguments made Thursday by prosecutors and Melgen's defense attorneys as they tried to persuade U.S. District Judge Kenneth A. Marra to sentence the Dominican-born, Harvard-trained doctor to 30 years or something significantly less. (12/7)
The Philadelphia Inquirer/Philly.com:
To Lower Infant Mortality In Camden, Neighborhood Women Educate Each Other
Organized by three regional New Jersey women’s health organizations earlier this year and funded by the Horizon Foundation, Trusted Links uses peer education to change health outcomes for women and their babies in Camden, Trenton and Newark. Infant mortality and poverty are ongoing battles in these cities. In each one, Trusted Links recruited 50 women who were given health information and tasked with reaching out to 10 other women or girls to pass on what they had learned. The goal was to reach a total of 500 women statewide, but many of the Trusted Links didn’t stop there. (Giordano, 12/7)
Cleveland Plain Dealer:
University Hospitals Increases Economic Impact In Ohio By $3 Billion
In the past three years, University Hospitals increased its economic contribution to the state by $3 billion, according to a study Silverlode Consulting Corp. completed for UH. The health system contributed $7.7 billion in 2016, up from $4.7 billion in 2013 - the last year studied. (Christ, 12/7)
The Star Tribune:
Mpls. Woman Struggling With Infertility Launches A Social Network For People Who 'Get It'
Seven million women of childbearing age in the U.S. seek treatment for infertility in their lifetimes, according to the Centers for Disease Control and Prevention, and for almost all of them, it can be as much an emotional struggle as it is a medical one. (Jackson, 12/7)
Cleveland Plain Dealer:
UH Richmond Medical Center ER Adds Fast Track Care, Expands, Leading To Quicker Service
The Richmond Medical Center, 27100 Chardon Road in Richmond Heights, has added a fast track emergency room for non-urgent care situations, and is expanding and upgrading its main emergency department area. The changes have resulted in shorter waits for patients at the medical center, where 24,000 ER patients were seen last year. (Pirokowski, 12/7)
Milwaukee Journal Sentinel:
Conditions Were Scary Dangerous In Wisconsin Barrel Plants, Say Workers Hurt On The Job
A Milwaukee Journal Sentinel investigation, published in February, exposed workplace hazards and environmental violations at barrel plants here and around the country and prompted investigations from at least five state and federal agencies. Since then, [Phillip] Leitze and other former Mid-America employees have come forward to tell their own stories of dire working conditions in the plant — ones that echo what other employees had said and underline what inspectors have found. (Diedrich and Rutledge, 12/7)
Cleveland Plain Dealer:
Ohio's Homeless Population Drops Again, But Housing Problems Remain
The number of people in Ohio who were homeless on a January day and night early this year reached a modern low, which suggests advocates, social service agencies and the county and federal government are addressing the problem. (Koff, 12/7)
A selection of opinions on health care from news outlets around the country.
The New York Times:
Please Save Kids’ Health Care
Nearly nine million children across the country receive health care services through the Children’s Health Insurance Program, enacted with bipartisan congressional support in 1997 to provide health care coverage for children from eligible families with low and moderate incomes. In our four states — Massachusetts, Montana, Nevada and Oregon — more than 300,000 children rely on the program, known as CHIP. But any day now, if Congress doesn’t act, these kids could lose the health care they depend on. (Governors Charlie Baker, Kate Brown, Steve Bullock and Brian Sandoval, 12/7)
The New York Times:
The Republican War On Children
The Children’s Health Insurance Program, or CHIP, is basically a piece of Medicaid targeted on young Americans. It was introduced in 1997, with bipartisan support. Last year it covered 8.9 million kids. But its funding expired more than two months ago. Republicans keep saying they’ll restore the money, but they keep finding reasons not to do it .... What’s the problem? The other day Senator Orrin Hatch, asked about the program (which he helped create), once again insisted that it will be funded — but without saying when or how (and there don’t seem to be any signs of movement on the issue). And he further declared, “The reason CHIP’s having trouble is that we don’t have money anymore.” Then he voted for an immense tax cut. (Paul Krugman, 12/7)
Los Angeles Times:
Trump Is Mum On Report Showing How We Can Reduce Sky-High Drug Prices
Hard as it may be to believe, there’s a yawning chasm between Trump’s words and deeds when it comes to drug prices. He’s been a consistent critic of the drug industry since before taking office. He declared a year ago: “I’m going to bring down drug prices. I don’t like what’s happened with drug prices.”... To date, he hasn’t announced a single initiative along these lines. But he has nominated a former drug-company executive, Alex Azar, to serve as health secretary. While head of U.S. operations for Eli Lilly & Co., Azar more than doubled the price of insulin, a life-saving medication for millions of people with diabetes (including me). (David Lazarus, 12/8)
Louisville (Ky.) Courier-Journal:
DEA Should Be Forced To Show Which Drug Distributors Flood Cities With Pain Pills
Congress should demand that the Drug Enforcement Administration release data from its ARCOS system, which monitors the flow of controlled substances from their point of manufacture through commercial distribution channels to point of sale or distribution. This information is critical for local authorities to address the opioid epidemic ravaging our communities. In December 2016, the Charleston Gazette-Mail obtained previously confidential ARCOS records sent by the DEA to the office of the West Virginia attorney general. ... Despite a rising opioid-related death toll during that time, drug wholesalers “showered the state with 780 million hydrocodone and oxycodone pills, while 1,728 West Virginians fatally overdosed on those two painkillers.” In one example, a single pharmacy in a town of just 392 people received 9 million pain pills in just two years. (Mike O'Connell, 12/7)
The New England Journal of Medicine:
Medicaid Coverage For Family Planning — Can The Courts Stop The States From Excluding Planned Parenthood?
In August 2017, the U.S. Court of Appeals for the Eighth Circuit (which includes Arkansas, Iowa, Minnesota, Missouri, Nebraska, North Dakota, and South Dakota) decided Does v. Gillespie, a case involving Arkansas’ efforts to exclude Planned Parenthood from its Medicaid program. The decision focuses on a fundamental, threshold question of law that must be answered before the courts can intervene when unlawful state conduct threatens the welfare of thousands of Medicaid beneficiaries: Can the courts halt the injury before it occurs? In a major departure from other appeals court decisions involving the exclusion of Planned Parenthood, the Does court said “no.” If the U.S. Supreme Court allows Does to stand, other states may try to follow suit at a time of heightened tension over Medicaid funding for Planned Parenthood. (Sara Rosenbaum, 12/7)
The New England Journal of Medicine:
How To Think About “Medicare For All”
In April 1946, President Harry Truman introduced a single-payer health plan and met the same reaction that would greet Senator Bernie Sanders (I-VT) and his colleagues when they proposed “Medicare for All” in September 2017. “It is believed by competent Congressional observers to have little chance of approval,” reported the New York Times back in 1949. ... but 13 years later President Lyndon Johnson signed the Truman revision into law as Medicare, declaring that the United States was finally harvesting “the seeds of compassion and duty” that his predecessor had sown. A proposal with no chance in one era had become law in another. Medicare proved so popular that it came to be a third rail of American politics — dangerous to touch. What lessons does Truman’s success hold for today’s “no chance” Medicare for All? (James A. Morone, 12/7)
The New England Journal of Medicine:
Which Road To Universal Coverage?
Incremental approaches cannot promise to transform the whole health care system. But they do offer a way to chip away at the ranks of the uninsured without upending coverage of more than 90% of Americans. For example, from 1988 through 1993, a succession of individually modest legislative changes in Medicaid, enacted through the efforts of senior congressional Democrats such as Henry Waxman (D-CA) and signed by Republican President George H.W. Bush, supported an 11-million-person increase in Medicaid enrollment. In a similar fashion, extensions of Medicare, Medicaid, and ACA tax credits could expand coverage to many, if not all, of the currently uninsured. (Henry J. Aaron, 12/7)
Congress Moves Backward On Gun Safety
After failing to pass any gun safety legislation for a decade, and after witnessing two of the most deadly shootings in U.S. history in consecutive months, the House of Representatives has finally taken up the issue -- and made matters even worse. The House on Wednesday passed a bill requiring states that permit individuals to carry concealed guns to allow out-of-state residents to do so as well, if they can legally carry in their home state. It's an idea long supported by the gun lobby, and it poses real dangers to the public. (12/6)
The New England Journal of Medicine:
Hepatitis A Outbreak In California — Addressing The Root Cause
On October 13, 2017, Governor Jerry Brown of California declared a state of emergency in response to a hepatitis A outbreak that began in the homeless population in San Diego. ... Homeless people’s often-poor underlying health, high prevalence of risky health-related behaviors, and poor access to nonemergency health care increase their susceptibility to infectious disease and heighten its severity and complicate disease control. In response to the recent hepatitis outbreak, there has been a campaign to vaccinate and educate people at risk and to provide portable hygiene facilities, disinfected with bleach, in areas where homeless people congregate. These responses, though laudable and likely to contain the outbreak, will not alter its underlying causes. (Margot Kushel, 12/6)
The New York Times:
Should Medicine Discard Race?
Professor Yudell belongs to a growing chorus of scholars and researchers who argue that in science at least, we need to push past the race concept and, where possible, scrap it entirely. Professor [Michael] Yudell and others contend that instead of talking about race, we should talk about ancestry (which, unlike “race,” refers to one’s genetic heritage, not innate qualities); or the specific gene variants that, like the sickle cell trait, affect disease risk; or environmental factors like poverty or diet that affect some groups more than others. (Moises Velasquez-Manoff, 12/8)