- Kaiser Health News Original Stories 3
- President Trump Wouldn’t Have To Wait For Congress To Undo Much Of The Health Law
- Got Zika? For Pregnant Women, Lab Constraints Mean It’s Often Hard To Know
- Rehab For Addiction Usually Lasts 28 Days. But Why?
- Political Cartoon: 'Didn't Say Boo'
- Capitol Hill Watch 1
- GOP Lawmakers Enthusiastic About Passing 21st Century Cures Bill In Lame Duck Session
- Marketplace 1
- Iowa Survey Finds Employers Not Dropping Workers' Health Coverage, Despite Rising Costs
- Public Health And Education 4
- Hospitals Stock Up, Close Doors As Hurricane Matthew Barrels Toward U.S.
- White House Mulls Limits For Well-Known Carcinogen In Chewing Tobacco
- Women Are Dying From Pregnancy, Childbirth At Alarming Rates -- And It's Only Getting Worse
- As Traditional Genome Sequencing Becomes Obsolete, Scientists Find New Ways To Tell 'Human Story'
- State Watch 1
- State Highlights: Mass. Health Spending Higher Than Initially Thought; Fla. High Court Hears Medical Records Case
- Health Policy Research 1
- Research Roundup: Insurance Churning; Hospital Readmission Rates; Teen HPV Vaccinations
From Kaiser Health News - Latest Stories:
Since President Barack Obama has used executive authority many times to help stabilize the law, Donald Trump could likely reverse those decisions and undermine the law. (Julie Rovner, 10/7)
Testing people — especially pregnant women — who may have been exposed to the virus is an integral part of the response strategy, but it’s putting a strain on this part of the nation’s public health infrastructure. New congressional funding could change that. (Shefali Luthra, 10/7)
A month's stay in a rehab facility became the standard of care for alcoholism. But there's little research to support that length of stay for people addicted to opioids. (Ben Allen, WITF, 10/7)
Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Didn't Say Boo'" by Dave Granlund.
Here's today's health policy haiku:
HOW LONG SHOULD INPATIENT REHAB TAKE?
So … 28 days …
Is that the magic number?
Or just a habit?
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:
California health officials took deliberate steps — such as expanding Medicaid — to ensure the Affordable Care Act changes were successful in their state. “What has been lost in all the rhetoric and the politics is that the system can work,” says Dr. J. Mario Molina, chief executive of Molina Healthcare Inc, an insurer that has done well under the law.
Los Angeles Times:
Obamacare Is No Disaster. California Is Proving Why
Even as turmoil in insurance markets nationwide fuels renewed election-year attacks on the Affordable Care Act, California is emerging as a clear illustration of what the law can achieve. The state has recorded some of the nation’s most dramatic gains in health coverage since 2013 while building a competitive insurance marketplace that offers consumers enhanced protections from high medical bills. (Levey, 10/7)
The Wall Street Journal:
Molina Outperforms Rivals In ACA Marketplaces
When Elizabeth Wolfe switched her insurance to Molina Healthcare Inc. earlier this year, her coverage changed dramatically. She had to stop going to her old doctors because they didn’t accept Molina. Her new health-maintenance-organization plan didn’t include some of the highest-profile hospitals in the Los Angeles area, where she lives. Losing her old doctors and switching to a no-frills clinic “was a big concern, but when we had to make the first premium payment, we got over that quickly,” she says. (Wilde Mathews, 10/6)
In other health law news —
Patient Groups Praise HHS For Plans To Standardize Insurance Plans
In a letter sent to HHS Secretary Sylvia Burwell on Thursday, 153 patient groups said they were encouraged by the department’s plans to extend standardized options plans into 2018, with the assumption that patients will be able to more easily compare plans across insurers. The groups encouraged HHS to go a step further and require issuers to offer the standardized plans in 2018. (McIntire, 10/6)
The Associated Press:
Delawareans Facing Higher Premiums Under Affordable Care Act
Delawareans are again facing steep price increases for health insurance next year under the Affordable Care Act. Insurance Commissioner Karen Weldin Stewart has approved an average rate increase of 32.5 percent in the individual market for Highmark Blue Cross Blue Shield of Delaware, which has the vast majority of the individual market share in Delaware. That follows an average premium increase of 22.4 percent for individual Highmark plans this year. (Chase, 10/6)
Donald Trump's recently updated plan mirrors many traditional conservative ideas for health reform. Other news outlets report on changes a President Trump might make to Medicaid and the health law.
Trump’s Updated Health Plans Are Still Conservative Ideas, Still Lack Details
Republican presidential nominee Donald Trump’s updated health care proposals narrow what the Republican presidential nominee had previously proposed regarding health care, but his campaign still has not offered details about how such reforms would work. Trump’s health care proposals ... say he would replace the Affordable Care Act with health savings accounts if elected to the presidency. He’s previously said people should be allowed to use health savings accounts that are tax-free and can accumulate .... Trump’s updated proposals also say he would work with Congress to create a patient-center system focused on choice, quality and affordability, and would work with states to establish high-risk pools to ensure continued coverage for individuals, a new idea for the campaign. (McIntire, 10/6)
Presidential Race Holds Implications for Medicaid, Trump Adviser Says
The result of the presidential election, more than gubernatorial elections, will decide whether more states expand their Medicaid programs, an adviser on Republican nominee Donald Trump’s presidential transition team said Oct. 5. Hillary Clinton, if elected president, would push more states to expand Medicaid, Mike Leavitt, who served as secretary of the Department of Health and Human Services under George W. Bush and was named a key adviser to the Trump campaign’s transition team, said. ... Under a Clinton administration, governors and lawmakers in states that haven’t expanded their Medicaid programs are likely to take advantage of a little-known ACA provision set to begin in 2017 that allows states to waive many of the law’s requirements—such as individual and employer mandate—if they provide similar coverage, Leavitt said. (Ruoff, 10/6)
Kaiser Health News:
President Trump Wouldn’t Have To Wait For Congress To Undo Much Of The Health Law
Republicans have been vowing for six years now to repeal the Affordable Care Act. They have voted to do so dozens of times, despite knowing any measures would be vetoed by President Barack Obama. But if elected, a President Donald Trump wouldn’t have to wait for lawmakers to once again pass repeal legislation to stop the health law from functioning. Indeed, he could do much of it with a stroke of a pen. (Rovner, 10/7)
Congressional leaders say the bill, aimed at promoting medical research and developing innovative medical solutions, will be one of their top priorities during the four-week session after the election. In other news from Capitol Hill, Congress is urged to lift a ban on developing a national patient identifier, experts warn not to expect significant legislation on drug prices and Democrats want the National Hockey League to take steps to reduce head injuries.
Government Funding and Medical Research to Dominate Lame-Duck Session
Last week, lawmakers raced to find a funding deal to avert a government shutdown, and they’ll be back in a few weeks to do it all over again. ... Spending fights will likely take up much of the time before the 114th Congress wraps up. But the GOP leaders in both chambers also expressed interest in passing a 21st Century Cures Act during the lame-duck. The measure is aimed at promoting medical research and developing innovative medical solutions. The bill “could end up being the most significant piece of legislation we pass in the whole Congress,” [Senate Majority Leader Mitch] McConnell said. (Bowman, 10/6)
AHIP, BCBS Push Congress To Lift Ban On Patient Identifier
The leaders of nearly two dozen healthcare industry organizations want Congress to continue to push for lifting an 18-year-old ban that prevents HHS from developing a national patient identifier. ... Providers and other users of electronic health records now often use a technique called probabilistic matching. It matches patients to their electronic records using mathematical algorithms that take basic demographic data in those records, such as first and last names, date of birth and sex, and calculates the probability the patient's records being queried belong to the patient seeking care. (Conn, 10/6)
Congress Likely To Take Only Small Steps On Drug Prices
Federal lawmakers will continue to rail against the high cost of prescription drugs in the next few years, but their most likely actions will be limited to relatively small steps such as the enactment of measures intended to approve more generics. “There is not going to be a magic bullet," said Douglas Holtz-Eakin, a former director of the Congressional Budget Office who now leads the conservative American Action Forum. “There are a bunch of little levers they can pull.” (Dooley Young, 10/6)
House Dems Call For NHL To Reduce Head Injuries
House Democrats on Thursday wrote to the National Hockey League to press the organization to take steps to reduce head injuries in the sport. The lawmakers pointed to studies showing the danger of head injuries due to physical contact in the normal course of a hockey game and that such hits to the head can have long-term effects like chronic traumatic encephalopathy, a brain disease more commonly known as CTE. (Sullivan, 10/6)
The survey of businesses finds that nearly all employers with more than 51 workers are offering coverage and the percentage of smaller employers offering coverage is rising. In California, a new tool aims to help consumers find out more information about their plans.
Des Moines Register:
Rising Cost Doesn't Dissuade Employers From Offering Health Insurance
Iowa employers continue to face rising health-insurance premiums, but they’re not dropping coverage of their workers, a new survey shows. “We’re not seeing an exodus at all,” said David P. Lind, a Clive health care analyst who oversees the annual survey. In fact, he said, slightly more employers are offering coverage this year than last. An estimated 1.6 million Iowans, who make up more than half the state’s population, receive health insurance via an employer. Most of the rest buy their own policies or obtain coverage from a government program, such as Medicare or Medicaid. (Leys, 10/6)
Everything You Wanted To Know About Your Health Plan (But Were Afraid To Ask)
It can be well worth the effort to go up against your health plan if it denies you treatment you think you need. That’s just one of the many lessons consumers can glean by using a new online tool unveiled today by the Department of Managed Health Care. It shows that last year, nearly two-thirds of Anthem Blue Cross enrollees who filed an appeal with the department to challenge a denial of-care ended up getting the medical services they requested. (Ibarra, 10/6)
For more than 24 years, the Department of Veterans Affairs was banned from covering the costs of IVF because of conservative opposition to assisted reproduction. Sen. Patty Murray (D-Wash.), the author of the new legislation, said the law was outdated.
The Washington Post:
Veterans Affairs Will Begin Covering IVF And Adoption Costs For Wounded Veterans
The Department of Veterans Affairs will begin covering costs for in vitro fertilization and adoptions for combat-wounded veterans struggling with infertility because of their injuries, giving thousands of young veteran families fresh hope at starting a family, advocates say. President Obama signed a bill last week that allows the agency to pay the costs for the next two years from existing VA health-care funds. The provision was authored by U.S. Sen. Patty Murray (D-Wash.), who said she is also pushing to fund the services permanently. (Wax-Thibodeaux, 10/6)
Meanwhile, a California VA clinic is pushing back against criticism over its spending —
The Mercury News:
VA Palo Alto Respond To Concerns Over Art Expenses
Members of the U.S. House of Representatives’ Committee on Veterans’ Affairs and some of the Peninsula’s top political leaders have questioned why VA Palo Alto spent $6.3 million on artwork and related consulting in the past 10 years at a time when medical care languished at other VA hospitals. The artwork debacle followed revelations that many veterans across the country had to wait exceedingly long periods for treatment and some died before ever seeing a doctor. Long patient wait times have not been an issue at the Palo Alto system’s facilities, however. (Lee, 10/6)
According to the figures for 2014, Medicare spends $11,393 on average for each beneficiary for 70 days of care, Modern Healthcare reports. The numbers, however, vary by state. Also, The Hill reports on concerns about Medicare's move to bundled payments.
CMS Posts Hospice Payment Data. But How Reliable Is It?
In 2014, Medicare spent more than $15 billion on hospice care for 1.3 million of its beneficiaries. More precise breakdowns of where those dollars went, however, have not always been publicly available. A new data set the CMS released Thursday is likely to change that, even as some raise concerns about the accessibility and reliability of other spending data provided by the agency. The Hospice Utilization and Payment Public Use File contains privacy-protected information on the services of 4,015 hospice providers to Medicare beneficiaries. (Whitman, 10/6)
Providers: Too Soon To Expand Medicare Bundled Payment Models
Hospital and nursing home advocates say a new Medicare payment model for heart attack patients should be halted until more evidence that it will work is available. The comment period for a proposed rule establishing a cardiac payment bundle and expanding a hip replacement model closed Monday. Advocates claim CMS hasn’t gauged the success of the knee and hip replacement model, before duplicating it for cardiac patients. The rule would also expand the joint replacement model, which launched in April, to include hip and femur fracture treatment. (Ayala, 10/6)
WellCare, which has Medicaid operations in Florida and Georgia, is purchasing Care1st Health Plan of Arizona.
WellCare Enters Arizona Medicaid Market With Care1st Acquisition
WellCare Health Plans, a publicly traded insurer that voiced its hunger for transactions earlier this year, has agreed to acquire Care1st Health Plan of Arizona for $157.5 million. The deal, expected to close in the first quarter of next year, marks WellCare's entrance into the Arizona Medicaid managed-care market. WellCare had 2.43 million Medicaid members as of June 30, and more than half of that total resided in Florida and Georgia, two states that did not expand Medicaid under the Affordable Care Act. Arizona is one of 31 states that have expanded Medicaid eligibility to more low-income people. (Herman, 10/6)
Wellcare's $158M Deal Signals Medicaid Shift
While health plans struggle to make profits off individuals buying commercial coverage on public exchanges under the Affordable Care Act, the insurance industry still sees promise in the law’s Medicaid expansion. Take Wellcare Health Plans’ announcement that it has signed a deal to buy the Arizona operations of Care1st Health for $157.5 million in a deal that will add 114,000 Medicare and Medicaid beneficiaries in the state’s largest market, Maricopa and Pima counties. “Our acquisition of Care1st Arizona provides us with an opportunity to expand our footprint into Arizona’s growing Medicaid and Medicare markets,” said Ken Burdick, WellCare’s chief executive officer. (Japsen, 10/6)
In other Medicaid news —
The Associated Press:
NY Auditors Cite Progress Limiting Medicaid Drug Payments
New York's comptroller says state health officials have installed measures to block Medicaid payments to pharmacies providing narcotics and other controlled substances that exceed legal limits. Following up on a February 2015 audit report, the comptroller's office says the health department has since instituted controls that resulted in denying about $3.3 million in claims through July. (10/7)
In other health technology news, Massachusetts teachers launch a new suicide prevention website, and an Ohio medical practice suffers a data breach.
Atlanta Journal Constitution:
Remedy: A Startup Trying To Solve Your Medical Bill Problems
With 1-in-5 working-age Americans reporting they had trouble paying their medical bills in the past year, according to a Kaiser/Times survey released in January, it’s no wonder some entrepreneurs want to offer solutions. Among them, a Bay Area startup called Remedy launched its website last week in hopes of helping consumers fight medical billing errors and overcharges. In some cases, said chief executive and co-founder Victor Echevarria, the company will even negotiate down balances. (Krasny, 10/7)
New Website Launched By Mass. Organization Teaches How To 'Stop A Suicide Today'
The Stop A Suicide Today site is intended to give people a sense of urgency — to know they can and should intervene when they're concerned a friend or family member might be suicidal, and treat it as a medical emergency — just as if the loved one were having a heart attack. In 70 percent of cases, a suicidal person makes actual statements indicating what he or she is thinking — sometimes obvious, sometimes more subtle, according to Jacobs. (Jolicoeur, 10/6)
Urology Data Breach Affected 300,000
Central Ohio Urology Group put a number to the size of its data breach August — 300,000. The Gahanna-based health-care provider submitted a report to the U.S. Department of Health and Human Services, which tracks such breaches and has an online database dating to 2009. The urology group's breach is the eighth-largest in the country this year among healthcare providers and is the biggest among Ohio-based providers in the federal database. (Malone, 10/6)
Eight hospitals in Florida evacuated this week because of their coastal locations, while inland hospitals prepared to face the storm.
Hurricane Matthew Challenges Providers On Southeast Coast
Governors in Florida, South Carolina, North Carolina and Georgia declared states of emergency, ordered mass evacuations of coastal areas and called in thousands of National Guard members. President Barack Obama declared a federal state of emergency in both Florida and South Carolina on Thursday, directing aid to those states. Eight hospitals in Florida evacuated this week because of their coastal locations, while inland hospitals prepared to face the storm, stocking up on supplies and coordinating staff to quickly respond once the Category 4 hurricane hits. (Rubenfire and Livingston, 10/6)
Florida Hospitals Brace For Hurricane Matthew, Some Close
Florida hospitals prepared Thursday to get hit by the monster storm Matthew, with many facilities altering their normal operations, and a number of facilities closing and evacuating patients. Jackson Health System, a major hospital operator in the Miami area, said it "will continue normal operators at all Jackson facilities, with the exception of its primary care clinics, the ambulatory care centers and rehab outpatient clinic, which will all be closed Thursday and Friday." (Mangan, 10/6)
The Campaign for Tobacco-Free Kids says the chemical is one of the most troublesome cancer-causing agents in smokeless tobacco as well as in cigarette smoke. Meanwhile, California is tightening rules on a common pesticide because of its health risks, an extra screening for women with dense breast tissue may be needed and the National Institutes of Health faces congressional scrutiny over its funding of a World Health Organization cancer agency.
White House Weighs Rule On Cancer-Causing Chemical In Chewing Tobacco
The White House is reviewing a proposal from the Food and Drug Administration (FDA) that apparently would require lower levels of a well-known carcinogen in chewing tobacco. While it has not yet been made public, the proposed rule under review by the White House's Office of Management and Budget is listed as a tobacco product standard for N-nitrosonornicotine levels in finished smokeless tobacco products. The Campaign for Tobacco-Free Kids said the chemical has long been known as one of the most troublesome cancer-causing agents in smokeless tobacco as well as in cigarette smoke. (Wheeler, 10/6)
Beyond Mammograms, Screening Choices Are Far From Clear
Mammography can prevent deaths from breast cancer, but it's not a perfect test. It misses some cancers, especially in women with dense breast tissue, and flags abnormalities for follow-up tests that turn out to be benign, among other issues. So there's a lot of interest in additional tests that might make screening more accurate in women who have dense breasts. (Hobson, 10/7)
The Associated Press:
California Tightens Rule On Popular Pesticide, Citing Health
California will tighten rules on how much farmers can use a common pesticide listed by the nation's most productive agricultural state as a chemical known to cause cancer, regulators said Thursday. The change doesn't ban the pesticide Telone but creates a uniform rule for its application each year. The rule is drawing criticism from farmers who call it a key way to fight pests and fear the crackdown could lead to rising food prices. (Smith, 10/6)
U.S. Lawmakers To Investigate Funding Of WHO Cancer Agency
Officials from the U.S. government's health research agency are to be questioned by a congressional committee about why taxpayers are funding a World Health Organization cancer agency facing criticism over how it classifies carcinogens. An aide to the U.S. House Committee on Oversight and Government Reform told Reuters that National Institutes of Health officials have agreed to give an in-person briefing to the committee after questions were raised by lawmakers over its grants to the International Agency for Research on Cancer (IARC), a semi-autonomous part of the WHO based in Lyon, France. (Kelland, 10/6)
And in other news —
Bay Area News:
UCSF Researchers Seeking Pancreatic Cancer Patients For Study
UCSF gastrointestinal oncologist Dr. Margaret Tempero is among colleagues at 200 other medical centers around the world participating in the clinical trial called HALO-301. As part of the 420-patient Phase 3 clinical study, Tempero is evaluating the efficacy of an investigational therapeutic called PEGPH20. Tempero is looking for patients with untreated Stage IV pancreatic cancer, and patients whose cancers have high levels of a sugar called HA (hyaluronic acid), which impacts 35 percent to 40 percent of Stage IV pancreatic cancer patients. (Seipel, 10/6)
Kansas Health Institute:
Olathe Medical Center Breaks Ground On $25M Cancer Center
As part of an ambitious $100 million-plus expansion plan, Olathe Medical Center broke ground Thursday on a new $25 million cancer center. The 25,000-square-foot facility, expected to be completed next year, will consolidate the hospital’s currently fragmented cancer outpatient services in one place. It’s the latest project in a frenzy of construction at the hospital’s 250-acre medical campus near 151st Street and Interstate 35. The last year has also seen the opening of a new hospice house and the start of construction on a neonatal intensive care unit. (Margolies, 10/6)
Fatality rates are on par with Iran, and the prognosis that the trend will improve is not positive. In other women's health news, long turnaround times for Zika tests add to pregnant women's anxiety, an appeals court weighs in on a case involving invasive ultrasounds and an anti-abortion campaign makes a stop at an Ohio Planned Parenthood.
Pregnant Women In America Die More Often Than In Iran, And It’s Getting Worse
The rate at which American women are dying from causes related to pregnancy or childbirth is on par with Iran, China, and some nations that made up the Soviet bloc. The difference is that in those countries, the prognosis is for improvement. In America, it’s not. The disturbing trend is a counterpoint to global progress on healthy childbirth, according to a comprehensive new study. More than 275,000 women died worldwide last year in pregnancy, childbirth, or complications from it, most of the deaths preventable. In the U.S. these deaths have increased about 2.7 percent a year since 2000, to 26.4 deaths for every 100,000 live births, or 1,063 total, last year. (Roston, 10/6)
Kaiser Health News:
Got Zika? For Pregnant Women, Lab Constraints Mean It’s Often Hard To Know
Houston-based Legacy Community Health Services, a federally qualified health center, is trying hard to fight the Zika virus. It’s screening pregnant women and following federal guidelines to test people at risk. But despite best efforts, there’s a problem, says Legacy’s chief medical officer, Dr. Ann Barnes. Women who could be infected usually have to wait as long as a month to know if their pregnancy is at risk. That’s the turnaround time from the state public health lab, where blood samples are sent for testing. (Luthra, 10/7)
Health News Florida:
Court Reverses Ruling In Invasive Ultrasound Case At Valencia
A federal appeals court has ruled in favor of three former Valencia College students who alleged their constitutional rights were violated in a training program that included students performing invasive ultrasound procedures on each other. A three-judge panel of the 11th U.S. Circuit Court of Appeals on Tuesday overturned a lower-court judge's decision to dismiss the case. The panel's ruling sent the case back to the lower court, with the dispute focused on whether the former students' First Amendment rights were violated and whether two of them were subjected to unconstitutional searches. (10/7)
40 Days For Life Protests Mt. Auburn Planned Parenthood
Anti-abortion protesters through the nationwide 40 Days for Life campaign made a stop at the Planned Parenthood in Mount Auburn Thursday evening. The 40 Days for Life vigil, prayer and rally campaign bus tour moving through 50 states – with stops at 125 cities in 40 days – desires to put an end to the "abortion crisis," according to a news release. Steve Karlen, the director of the North American campaigns, said on a podium by the bus that this is the largest mobilization of anti-abortion demonstrators in history. (Milam, 10/6)
It's becoming clear that the original method is prone to mistakes, so researchers are thinking of different ways to map the human genome.
Scientists Are Assembling A New Picture Of Humanity
Sixteen years ago, two teams of scientists announced they had assembled the first rough draft of the entire human genome. If you wanted, you could read the whole thing — 3.2 billion units, known as base pairs. Today, hundreds of thousands of people have had their genomes sequenced, and millions more will be completed in the next few years. But as the numbers skyrocket, it’s becoming painfully clear that the original method that scientists used to compare genomes to each other — and to develop a better understanding of how our DNA influences our lives — is rapidly becoming obsolete. (Zimmer, 10/7)
In other public health news —
NASH, A Stealthy Liver Disease, Is Subject Of New Attention
[Wayne] Eskridge felt fine, and he didn’t drink alcohol or have hepatitis C like many people with liver disease. Instead, the cause was non-alcoholic steatohepatitis, or NASH, which is what leads to cirrhosis in one-quarter of people with the condition. It is increasingly common, for reasons that are unclear, and there is no known cure. Eskridge isn’t alone — people with NASH usually have no symptoms. It’s estimated that roughly 2 percent to 5 percent of adults in the United States have the disease, and that another 10 percent to 20 percent may have its milder cousin, non-alcoholic fatty liver disease, or NAFLD, according to the National Institute for Diabetes and Digestive and Kidney Diseases. NASH is expected to become the most frequent reason for liver transplants by 2020. (Bond, 10/6)
What Makes Teenagers Impulsive May Also Help Them Learn
The teenage brain has been characterized as a risk-taking machine, looking for quick rewards and thrills instead of acting responsibly. But these behaviors could actually make teens better than adults at certain kinds of learning. "In neuroscience, we tend to think that if healthy brains act in a certain way, there should be a reason for it," says Juliet Davidow, a postdoctoral researcher at Harvard University in the Affective Neuroscience and Development Lab and the lead author of the study, which was published Wednesday in the journal Neuron. (Ross, 10/6)
Kaiser Health News:
Rehab For Addiction Usually Lasts 28 Days. But Why?
A month’s stay is typical for people who go to an inpatient facility to treat drug or alcohol addiction. But why? “As far as I know, there’s nothing magical about 28 days,” said Kimberly Johnson, director of the Center for Substance Abuse Treatment at SAMHSA, the federal agency that studies treatment services. (Allen, 10/7)
Outlets report on health news from Massachusetts, Florida, California, Ohio, Colorado, Pennsylvania, Minnesota and Wisconsin.
State Revises 2015 Health Spending Higher On Harvard Pilgrim Error
Turns out health care spending in Massachusetts was actually worse than we thought last year. The state’s Center for Health Information and Analysis, or CHIA, said Thursday that statewide medical spending increased 4.1 percent last year, up from the 3.9 percent rate the agency previously reported. CHIA said Harvard Pilgrim Health Care, one of the state’s largest insurers, noticed an error in the figures it submitted to the agency. After Harvard Pilgrim turned in new data, CHIA ran the numbers again. (Dayal McCluskey, 10/6)
Health News Florida:
Florida Supreme Court Hears Arguments About Medical Record Access
Though the parties reached an eleventh-hour settlement, the Florida Supreme Court on Wednesday plunged into a dispute that could have implications for medical-malpractice cases across the state. Justices heard more than 45 minutes of arguments about an issue rooted in a 2004 constitutional amendment that was aimed at expanding access to records in malpractice cases. Plaintiffs' attorneys heavily backed the voter-approved amendment, as records held by hospitals and other medical providers can play a key role in pursuing malpractice claims. (10/7)
Los Angeles Times:
Los Angeles County Now Plans To Require Hospitals To Report Superbug Infections
Los Angeles County plans to require hospitals to begin reporting when patients are infected with a certain superbug so lethal that it can kill half its victims, health officials said Thursday. Unlike two dozen other states, California has not required hospitals to report when patients are sickened with the lethal bacteria, which federal officials warn is one of the nation’s most urgent health threats. (Petersen, 10/6)
Los Angeles Times:
UC Irvine Health Laying Off 175 Employees
U.C. Irvine Health began laying off 175 employees this week as part of a plan to ensure efficiency of its medical center's clinical and educational operations, the university-based care provider said. Those being let go — many of whom are in management or administrative and support positions — are being notified individually, according to UC Irvine Health spokesman John Murray. The layoffs will not include faculty, which includes doctors, he said. (Chan, 10/6)
Cleveland Plain Dealer:
Western Reserve Hospital Seeks Artists To Help Promote Healing
Western Reserve Hospital has partnered with Collide: Cuyahoga Falls and ArtsNow of Summit County to introduce artwork from the local creative community to patients at their Cuyahoga Falls facility. The partnership's goal is to enhance the environment for oncology patients. (Jackson, 10/6)
Welltok Figures Out How To Motivate People To Get Healthier — And Attracts Another $33.7 Million From Investors
By mixing artificial intelligence and machine learning with custom health plans and financial rewards, Welltok figured out a way to help people get healthier — and attract even more investors. The Denver digital-health company will announce Thursday that it added $33.7 million from new and existing investors. That brings Welltok’s funding to $163 million to date. (Chuang, 10/6)
The Philadelphia Inquirer:
Jefferson Medical School Meets Design School, Resulting In Drones, ER Heat Maps And Innovation
This week, as part of the 10-day DesignPhiladelphia event series, a 20-foot-tall monument occupies the plaza at 10th and Locust Streets on the Thomas Jefferson University campus. Called the Beacon, it's made of laser-cut steel and light-emitting yarn, with an outer skin to be woven by a pair of drones performing a nightly 30-minute ballet choreographed based on how visitors respond online to questions about urban regeneration. This futuristic totem is, on one level, a symbol of an idea that's recently become trendy among medical school administrators: bringing creativity and, with it, empathy back into medical education. (Melamed, 10/6)
St. Paul MN Boys Group Homes Close, Multiple Violations Cited
After reviewing clients’ medical records, state officials believe a resident ran out of lithium, a prescribed anti-psychotic medication, and went without it for eight days. Another boy spent five days without trazodone, a prescribed anti-depressant. The treatment plan for a boy admitted in mid-March called for a mental health referral. By early May, there was still no evidence he had received one. On Monday, [the Department of Human Services] ordered the Vintage Place and Vintage Place North to close, citing more than 30 state licensing violations. If they hope to stay open, the group home administrators have 10 days to file an appeal with the department. (Melo, 10/6)
Milwaukee Journal Sentinel:
City Receives $75,000 For Water Filters
The city has received $75,000 to buy water filters for low-income Milwaukee families with young children. Mayor Tom Barrett announced the grant Thursday, one month after he urged owners and residents of Milwaukee homes built before 1951 to install faucet filters capable of removing lead from drinking water. The money was donated by the United Way of Milwaukee and Waukesha County and a group that includes Aurora Health Care, Children's Hospital of Wisconsin, Ascension Wisconsin, and Froedtert and the Medical College of Wisconsin. (Spicuzza, 10/6)
Cleveland Plain Dealer:
Who's On The Ohio Medical Marijuana Advisory Committee? See The List.
Ohio's new medical marijuana law required Gov. John Kasich and legislative leaders from both parties to appoint 14 members to the Ohio Medical Marijuana Advisory Committee within a month of the law taking effect Sept. 8. The panel will make recommendations to the three state agencies writing the rules for the program: The Ohio Department of Commerce, Ohio State Medical Board and Ohio State Board of Pharmacy. (Borchardt, 10/6)
Each week, KHN compiles a selection of recently released health policy studies and briefs.
Insurance Churning Rates For Low-Income Adults Under Health Reform: Lower Than Expected But Still Harmful For Many
Changes in insurance coverage over time, or “churning,” may have adverse consequences, but there has been little evidence on churning since implementation of the major coverage expansions in the Affordable Care Act (ACA) in 2014. We [surveyed] 3,011 low-income adults in Kentucky, which used a traditional expansion of Medicaid; Arkansas, which chose a “private option” expansion that enrolled beneficiaries in private Marketplace plans; and Texas, which opted not to expand. We also compared 2015 churning rates in these states to survey data from 2013, before the coverage expansions. Nearly 25 percent of respondents in 2015 changed coverage during the previous twelve months—a rate lower than some previous predictions. We did not find significantly different churning rates in the three states over time. (Sommers et al., 10/4)
Rethinking Thirty-Day Hospital Readmissions: Shorter Intervals Might Be Better Indicators Of Quality Of Care
We examined risk-standardized thirty-day risk of unplanned inpatient readmission at the hospital level for Medicare patients ages sixty-five and older in four states and for three conditions: acute myocardial infarction, heart failure, and pneumonia. The hospital-level quality signal captured in readmission risk was highest on the first day after discharge and declined rapidly until it reached a nadir at seven days, as indicated by a decreasing intracluster correlation coefficient. Similar patterns were seen across states and diagnoses. The rapid decay in the quality signal suggests that most readmissions after the seventh day postdischarge were explained by community- and household-level factors beyond hospitals’ control. (Chin et al., 10/4)
Achieving High Adolescent HPV Vaccination Coverage
Despite national recommendations for adolescent human papillomavirus (HPV) vaccination, rates have lagged behind those of other adolescent vaccines. ... Denver Health is an integrated urban safety net health system serving >17 000 adolescents annually. The process for achieving high vaccination rates in our health system includes “bundling” of vaccines, offering vaccines at every visit, and standard orders. ... In 2013, HPV coverage of ≥1 dose was 89.8% (female subjects) and 89.3% (male subjects), compared with national rates of 57.3% and 34.6%. Rates of HPV coverage (≥3 doses) were 66.0% for female subjects and 52.5% for male subjects, versus 37.6% and 13.9% nationally. ... Female subjects, Hispanic subjects, non-English speakers, and teenagers <200% below the federal poverty level were more likely to have received 3 doses of HPV. (Farmer et al., 10/5)
The New England Journal of Medicine:
The Health Effects Of Electronic Cigarettes
It is clear that the use of e-cigarettes has biologic effects and possibly health-related effects on persons who do not smoke conventional tobacco products. Although some studies suggest that smoking e-cigarettes may be less dangerous than smoking conventional cigarettes, more needs to be learned. A particular challenge in this regard is the striking diversity of the flavorings in e-cigarette liquids, since the effects on health of the aerosol constituents produced by these flavorings are unknown. At present, it is impossible to reach a consensus on the safety of e-cigarettes except perhaps to say that they may be safer than conventional cigarettes but are also likely to pose risks to health that are not present when neither product is used. ... e-cigarette use is growing among minors and young adults and may promote nicotine addiction in these age groups. (Dinakar and O’Connor, 10/6)
Annals of Internal Medicine:
Trends In Prevalence Of Chronic Kidney Disease In The United States
The unadjusted prevalence of stage 3 and 4 [chronic kidney disease] CKD increased from the late 1990s to the early 2000s. Since 2003 to 2004, however, the overall prevalence has largely stabilized (for example, 6.9% prevalence in 2003 to 2004 and in 2011 to 2012). There was little difference in adjusted prevalence of stage 3 and 4 CKD overall in 2003 to 2004 versus 2011 to 2012 after age, sex, race/ethnicity, and diabetes mellitus status were controlled for (P = 0.26). Lack of increase in CKD prevalence since the early 2000s was observed in most subgroups and with an expanded definition of CKD. (Murphy et al., 10/4)
Designing A Medicare Buy-In And A Public Plan Marketplace Option: Policy Options And Considerations
Presidential candidate Hillary Clinton has indicated interest in a Medicare buy-in option for those ages 55 to 64 and a public plan option for the Affordable Care Act’s Marketplaces as mechanisms for increasing the affordability of insurance outside employer-sponsored insurance. Medicare is an attractive basis for developing insurance alternatives (either a direct buy-in or a public option based in Medicare rates) since the program generally has lower provider payment rates and lower administrative costs than private insurers. This paper explores the design issues raised by these proposals and their implications for costs and benefits to different age groups. (Blumberg and Holahan, 9/29)
The Kaiser Family Foundation:
The Gap In Medigap
Medicare provides coverage for a wide array of medical and drug benefits, but, with its deductibles, cost-sharing requirements, and lack of an annual out-of-pocket spending limit, many people on Medicare purchase Medigap supplemental insurance to help cover their out-of-pocket costs. ... Thanks to a 1990 federal law, people age 65 and older are able to buy a Medigap policy when they sign up for Medicare, but younger Medicare beneficiaries with disabilities are not granted the same right unless they live in a state that requires it. Today, Medicare covers 9 million people under 65 with disabilities. ... a much smaller share of beneficiaries under 65 with disabilities than seniors have a Medigap policy (2% versus 17%, respectively), and a much higher share have no supplemental coverage whatsoever (21% versus 12%). (Neuman and Cubanski, 9/27)
And one news outlet's report on recent research --
Study: ObamaCare Enrollees More Likely To Have Checkups
People who gained ObamaCare coverage in 2014 were more likely to have a regular doctor and an annual checkup than people who remained uninsured, a new study finds. The study, published in Health Affairs, finds that 27 percent of people who were uninsured in 2013 and gained coverage through ObamaCare’s marketplaces in 2014 went from not having a usual source of care to having one. That is significantly higher than the 11 percent of people who remained uninsured who gained a regular doctor. (Sullivan, 10/5)
A selection of opinions on health care from around the country.
The New England Journal Of Medicine:
Past As Prologue — Presidential Politics And Health Policy
All presidential campaigns are unique, and the current one, as George Orwell might have said, seems more unique than most. When it comes to health care, however, there is continuity between the 2016 presidential contest and past elections, reflecting deep underlying political forces and historical experiences with health care politics and policy. (David Blumenthal and James Morone, 10/6)
The Wall Street Journal:
Clinton Vs. Clinton On ObamaCare
When Bill Clinton emerges as an ObamaCare critic and even President Obama admits in a recent interview that his entitlement has “got real problems,” the discipline of the law’s apologists must be fading. The question now is whether Republicans can capitalize to improve U.S. health care from its ObamaCare bottom. For years liberals have depicted the law as an end-of-history achievement, dismissing genuine problems as partisan inventions. ObamaCare remains as unpopular today as when Democrats rammed it through Congress in 2010, but they claimed it could never be repealed or changed. (10/6)
The Wall Street Journal:
Trump’s ObamaCare Silence
There is such a thing as a political goof. It should not be confused with a cosmic political error, mind-boggling in its inanity, inexplicable on any level, the electoral equivalent of stuffing your opponent’s ballot box. An example of the latter is Donald Trump’s failure to jump on ObamaCare as an excellent path to the White House. (Kimberley A. Strassel, 10/6)
The Washington Post:
Archbishop Desmond Tutu: When My Time Comes, I Want The Option Of An Assisted Death
Now, as I turn 85 Friday, with my life closer to its end than its beginning, I wish to help give people dignity in dying. Just as I have argued firmly for compassion and fairness in life, I believe that terminally ill people should be treated with the same compassion and fairness when it comes to their deaths. Dying people should have the right to choose how and when they leave Mother Earth. I believe that, alongside the wonderful palliative care that exists, their choices should include a dignified assisted death. (Desmond Tutu, 10/6)
The New York Times:
Your Surgeon Is Probably A Republican, Your Psychiatrist Probably A Democrat
We know that Americans are increasingly sorting themselves by political affiliation into friendships, even into neighborhoods. Something similar seems to be happening with doctors and their various specialties. New data show that, in certain medical fields, large majorities of physicians tend to share the political leanings of their colleagues, and a study suggests ideology could affect some treatment recommendations. (Margot Sanger-Katz, 10/6)
The Baltimore Sun:
Evergreen Needs To Do More Than Stay In Business
For the sake of competition in Maryland's Obamacare marketplace — particularly for those who buy insurance as individuals, not through their employers — Evergreen Health needs to survive. CareFirst BlueCross BlueShield had 80 percent of Maryland's individual insurance market in 2014, according to the Kaiser Family Foundation, up from 74 percent three years before. Evergreen, with nearly 40,000 members and growing fast, is expanding in the state at a time when other carriers are pulling back. (10/6)
WRAL (Raleigh, N.C.):
Transcend Petty Partisan Politics And Expand Medicaid
Nowhere is there greater evidence of the depths of petty partisan politics than in North Carolina’s stubborn refusal to expand Medicaid. Voters must elect legislators who WILL EXPAND Medicaid. Any legislator seeking re-election, who opposed expansion in the past and won’t publically promise to back it now, should not be re-elected. (10/6)
Sioux Falls (S.D.) Argus Leader:
The Truth About Medicaid Expansion
I recently noticed some billboards pushing Medicaid expansion which, like the (Un)Affordable Care Act (a.k.a. Obamacare), is basically another form of socialized medicine. Like Obamacare, the goal of Medicaid expansion and its proponents is not to provide care, but to create an ever increasing dependence upon government. Socialized medicine does not, and never has, benefited the patient. (Marianne Gasiecki, 10/6)
St. Louis Post-Dispatch:
Loss Of Federal Funding Raises Concerns About Women's Health Care
Women’s health care advocates in Missouri are bracing for potentially severe reproductive care consequences as the state patches together plans to fund the Women’s Health Services Program. Some other states that rejected federal money in an effort to punish Planned Parenthood saw a rise in maternal mortality rates, unintended pregnancies and HIV transmission. (10/7)
Digital Health Entrepreneurs Raising More Capital Than Ever (Probably)
A trio of new reports shows the fundraising landscape for new digital health ventures remains promising. New York’s Startup Health, an investor and accelerator, has released its report on the digital health venture market for the third quarter. Startup Health estimates $6.5 billion has been invested in digital health deals in the first three quarters of 2016, more than the $6.1 billion invested in all of 2015. (John Graham, 10/6)
New Orleans Times-Picayune:
Medicare Choices On Table For Senior Adults, Beginning Oct. 15
This fall, as Americans make their choices in a host of local, state and national elections, including 2016 presidential, gubernatorial and congressional races, seniors and those eligible for Medicare in the New Orleans area must pay special attention to the decisions they face during another important election— the Medicare Annual Election Period (AEP). During this year's Medicare AEP, which lasts from Oct. 15 to Dec. 7, it's important for people with Medicare to understand that the choice they make can affect their health throughout 2017. As with any major decision, thoughtful research will go a long way toward making the best care coverage choice that maximizes value based on your individual health needs. (Laura Trunk, 10/6)
The Washington Post:
Giving Cancer A First-Person Voice
I finished reading a remarkable book on the subject called “When Breath Becomes Air,” written by Dr. Paul Kalanithi and completed by his wife, Lucy. ... It is a vivid picture of a driven and accomplished professional — a neurosurgeon — on the verge of a brilliant career, facing a disease that humbles and then kills him. It is a situation we sometimes see from a distance. It is a gift to be given an honest account from inside. (Michael Gerson, 10/6)
San Antonio Press Express:
Vaccines Save Many Lives
One in 5 Americans believe that immunizations cause autism and that vaccines fall into the category of a medical conspiracy contrived by physicians and governmental officials whose motives are purely suspect. That was the conclusion of a study in JAMA Internal Medicine two years ago. These individuals share a distrust of science, not unlike those who are convinced the FDA is hiding homeopathic cures for cancer to protect drug company profits or that health officials know cellphones cause cancer but are doing nothing to stop it. (Bryan Alsip, 10/6)
Effective Opioid Recovery Is Unobtainable For Many: Urgent Action Is Needed
Drug overdoses have surpassed car crashes as the number one cause for accidental death in America, with a staggering 47,000 lives lost to addiction in 2014 alone. However, the systems largely responsible for combatting the disease of opioid addiction – public policy, insurance and criminal justice - are just beginning to publicly address the problem, and in some cases, even hinder the pursuit of safe and effective treatments. (Newt Gingrich, Patrick J. Kennedy and Van Jones, 10/6)