- KFF Health News Original Stories 2
- Consumers’ Satisfaction With Coverage Linked To Out-Of-Pocket Expenses
- Having A Baby? Big Differences Noted In Hospital Quality Across Mass.
- Political Cartoon: 'Subpar?'
- Marketplace 2
- The Deal Is Done! Anthem To Buy Cigna In Latest Health Insurance Merger Deal
- Cancer Drug Costs Skyrocket, Create Tension Between Doctors, Drug Makers
- Capitol Watch 1
- Anti-Abortion Activists View Controversial Videos As Stepping Stone To Ban On Federal Funding For Planned Parenthood
- Veterans' Health Care 1
- Congress May Act Soon To Shore Up VA Budget With $3B Injection, VA Secretary McDonald Says
- State Watch 1
- State Highlights: Calif. Judge To Rule On Right-To-Die Lawsuit; Cleveland Stops Providing Family Benefits For Unmarried Couples
From KFF Health News - Latest Stories:
KFF Health News Original Stories
Consumers’ Satisfaction With Coverage Linked To Out-Of-Pocket Expenses
People with traditional health insurance plans are happier with their coverage than those with high-deductible plans, but the groups also say the quality of their coverage is similar. (Michelle Andrews, )
Having A Baby? Big Differences Noted In Hospital Quality Across Mass.
WBUR compiles a database for pregnant women to compare hospitals in Massachusetts. (Martha Bebinger, WBUR, )
KFF Health News provides a fresh take on health policy developments with "Political Cartoon: 'Subpar?'" by Roy Delgado.
Here's today's health policy haiku:
BIG INSURERS GET BIGGER, MARKET GETS SMALLER
Another merger...
Anthem buys Cigna. And now
What was five is three.
- Anonymous
If you have a health policy haiku to share, please Contact Us and let us know if we can include your name. Haikus follow the format of 5-7-5 syllables. We give extra brownie points if you link back to an original story.
Opinions expressed in haikus and cartoons are solely the author's and do not reflect the opinions of KFF Health News or KFF.
Summaries Of The News:
The Deal Is Done! Anthem To Buy Cigna In Latest Health Insurance Merger Deal
Anthem's acquisition of Cigna will create the health insurance industry's biggest company by enrollment and shrink the number of major players in the sector.
Los Angeles Times:
Anthem Clinches Deal To Buy Rival Cigna For $54 Billion
Anthem Inc. has agreed to acquire rival Cigna Corp. for $54 billion, creating the health insurance industry's biggest company by enrollment. The agreement announced Friday caps weeks of frenzied dealmaking in the healthcare sector. Aetna Inc. reached a $37-billion deal for Humana Inc. this month. And Woodland Hills insurer Health Net Inc. agreed to be acquired by Medicaid insurer Centene Corp. for $6.8 billion. (Terhune, 7/24)
The New York Times:
Anthem To Buy Cigna In Deal Valued At $54.2 Billion
The deal would shrink the number of major health insurers in the United States and comes just weeks after Aetna agreed to acquire Humana, the smallest of the big five insurers, for $37 billion in cash and stock. A combined Anthem-Cigna would have estimated revenue of about $115 billion and serve more than 53 million people with medical coverage. (Bray, 7/24)
The Wall Street Journal:
Anthem Agrees To Buy Cigna For $48 Billion
Anthem Inc. agreed to buy Cigna Corp. for more than $48 billion in a transaction that, along with a previously proposed combination of rivals, could reshape the U.S. health industry. ... The tie-up of Anthem and Cigna would accelerate the rapid-fire reconfiguration at the top of the U.S. managed-care industry. The biggest companies are seeking more cost efficiency and scale as the health-care landscape changes because of the Affordable Care Act and other factors. ... Of the five largest health insurers, only UnitedHealth Group Inc., the largest by revenue, is sitting out the merger wave, at least so far. (Mattioli, Wilde Mathews and Dulaney, 7/24)
CNN Money:
Another Insurance Mega-Merger: Anthem To Buy Cigna For $54 Billion
The health services companies said that Anthem, Inc. (ANTM), a Blue Cross and Blue Shield insurer, would buy all of Cigna Corp.'s (CI) shares in a cash and stock transaction. The latest step in a striking consolidation of the insurance industry would leave only three major players. (Smith, 7/24)
Cancer Drug Costs Skyrocket, Create Tension Between Doctors, Drug Makers
IMS Health, which tracks the market, estimates an increase in 2014 costs of about 10.3 percent. Meanwhile, some physicians are developing a database to score cancer medicines based on how they will work and how much they cost.
CBS News:
Rising Cancer Costs Pit Doctors Against Drugmakers
Spending on cancer drugs is skyrocketing and shows no signs of slowing. IMS Health, which tracks the market, estimates that spending on these medications hit $100 billion worldwide in 2014, an increase of 10.3 percent, bringing the compound annual growth rate to 6.5 percent over the past five years. That's expected to rise to 6 percent to 8 percent through 2018, when total global spending is forecast to hit between $114 billion to $147 billion. (Berr, 7/24)
The Fiscal Times:
As Drug Prices Soar, Doctors Voice Outrage
Recent breakthroughs in cancer treatment come with a hefty price tag. In 2014, virtually every new cancer-treatment drug approved by the Food and Drug Administration was priced at more than $120,000 a year, according to a new study. And the cost for each additional year lived by a patient as a result of new drugs soared from $54,000 in 1995 to $207,000 in 2013. (Pianin, 7/23)
NPR:
Doctors Plan Database On Cancer Drugs, Showing Effectiveness And Cost
A group of cancer doctors is trying to create a database on cancer drugs. It would give a score for each drug, reflecting how well the drug works, and also how much the drug costs. (Kestenbaum, 7/24)
In other news, The Wall Street Journal writes about the latest bid to alter the prescription-drug pricing landscape in the U.S. by having the federal government negotiate with drug makers for Medicare Part D medicines -
The Wall Street Journal's Pharmalot:
U.S. Could Save Up To $16B If Medicare Part D Prices Are Negotiated: Paper
In the latest bid to alter the prescription-drug pricing landscape in the U.S., a new paper argues that the federal government could save between $15.2 billion and $16 billion annually if it negotiated with drug makers for Medicare Part D medicines and obtained the same prices that are paid by Medicaid or the Veterans Health Administration. (Silverman, 7/23)
Many Taxpayers Overpaid Obamacare Penalty, Report Finds
CBS News reports that more than 300,000 Americans overpaid the IRS on the Individual Shared Responsibility Payment, according to a report by the National Taxpayer Advocate. Meanwhile, the Colorado nuns who have been challenging the Obama administration on the health law's birth control mandate announced they will appeal the most recent ruling to the Supreme Court.
CBS News:
Did You Overpay The Obamacare Tax Penalty?
More than 300,000 taxpayers have overpaid the IRS because they incorrectly indicated that they owed the Individual Shared Responsibility Payment (ISRP), the tax penalty related to the Affordable Care Act, on their 2014 tax return. This was discovered and outlined in a annual report by the National Taxpayer Advocate. When it sampled IRS tax return data, the NTA found that a large number of taxpayers didn't owe the penalty that they incorrectly indicated on their tax returns. (Martin, 7/24)
The Associated Press:
Colorado Nuns Appeal Birth Control Ruling To Supreme Court
A group of Colorado nuns said Thursday they will go to the U.S. Supreme Court to appeal a ruling that allows their employees to receive birth control from a third party under the Affordable Care Act, fueling a combustible argument over contraception and religion ahead of next year's presidential election. Attorneys for Little Sisters of the Poor and four Oklahoma Christian colleges said last week's ruling from the 10th Circuit Court of Appeals in Denver violates their religious freedom, in an argument that goes beyond last year's Hobby Lobby case. (Riccardi, 7/23)
The Wall Street Journal reports on how some health law gambles are paying off big -
The Wall Street Journal:
Fund Boss’s Gamble On Health Law Pays Off Big
Glenview Capital Management LLC made a bold decision when President Barack Obama’s health-care overhaul was rolling out: Bet on it. The result has been one of the most successful hedge-fund wagers in recent years. New York-based Glenview has realized and paper gains of more than $3.2 billion since it started making investments in hospitals and insurers four years ago, according to a Wall Street Journal analysis of securities filings. (Benoit, 7/23)
And in terms of recent developments regarding states and Medicaid expansion -
The Associated Press:
Hearing On Challenge To Arizona Medicaid Plan Rescheduled
A hearing for arguments on the constitutionality of a fee collected from hospitals to pay for an expansion of Arizona's Medicaid program has been postponed. The hearing had been scheduled for Friday in Maricopa County Superior Court but Judge Douglas Gerlach has reset it for July 30. The hearing is for arguments on motions for a pretrial judgment in a lawsuit filed by Republican legislators. They lost a 2013 legislative battle over expansion of coverage provided by the Arizona Health Care Cost Containment System. (7/23)
Activists increasingly believe the goal of cutting off federal support for the organization is now achievable. The related outrage has spread from the halls of Congress, where members are calling for investigations, to the campaign trail and to some state houses.
The Wall Street Journal:
Planned Parenthood Federal Funds Challenged By Surreptitious Videos
Videos of Planned Parenthood staffers discussing how they gather fetal tissue during abortions for use in medical research are stirring antiabortion activists’ hopes of converting the controversy into a ban on federal funding for the organization. Cutting off federal funds for Planned Parenthood has emerged as one of the short-term moves that activists believe is most achievable in the wake of the release of two videos in the past two weeks. (Radnofsky and Peterson, 7/23)
CQ Healthbeat:
Planned Parenthood Videos: Members Call For Dueling DOJ Probes
In the wake of the release this week of another undercover video of Planned Parenthood officials discussing fetal tissue, lawmakers on both sides of the aisle are calling for a Department of Justice investigation — but that’s where any bipartisan agreement ends. Republicans want Attorney General Loretta Lynch to probe whether the nation’s largest provider of abortions is illegally harvesting and selling fetal organs and tissue, while Democrats want the Justice Department to look at whether the anti-abortion activists behind the videos went too far with their secretive recordings. (Khurshid, 7/23)
Politico:
GOP States Push Planned Parenthood Probes
At least eight Republican-led states are starting investigations or trying to stop funding Planned Parenthood — and they may be able to get results more easily than the outraged Republicans in Congress or on the GOP presidential campaign trail. The red states may be better placed to slash funds than Congress, where Senate Democrats can likely block GOP efforts to defund the organization, which gets millions in state and federal financing each year for providing health care services ranging from breast cancer screening to birth control, often for low-income women. (Haberkorn, 7/24)
Politico:
Hillary Clinton Comes Out In Defense Of Planned Parenthood
Hillary Clinton on Thursday came out in defense of Planned Parenthood for the first time since the organization got swept up in a scandal involving videos that allege it sells fetal tissue. “Planned Parenthood has apologized for the insensitivity of the employee who was taped, and they will continue to answer questions for Congress and others,” Clinton said during a campaign stop in South Carolina. (Karni, 7/23)
The Associated Press:
Clinton Backs Planned Parenthood, Hails Battle Flag Removal
Hillary Rodham Clinton praised South Carolina leaders for removing the Confederate flag from Statehouse grounds but said the country must "dig deeper" against racial injustice. Separately, she defended Planned Parenthood against attacks from her Republican counterparts who are using an edited video to accuse the women's health care and abortion provider of profiting from the sale of fetal tissue to researchers. She accused Republicans of a "concerted effort" to undermine a woman's constitutional right to terminate a pregnancy. (Barrow, 7/23)
Congress May Act Soon To Shore Up VA Budget With $3B Injection, VA Secretary McDonald Says
The Department of Veteran Affairs' $2.5 billion budget shortfall has raised the risk of some VA hospitals closing as well as employee furloughs. The beleaguered agency has also made little progress decreasing vets' wait times for health care or in hiring for 41,500 open medical positions.
The Associated Press:
VA Secretary Optimistic Congress Will Plug VA's Budget Gap
Veterans Affairs Secretary Robert McDonald said Thursday he's confident that Congress will act soon to address a looming budget crisis that could force his agency to shut down some VA hospitals, freeze hiring and take other belt-tightening steps. During a visit to the Richard L. Roudebush VA Medical Center in Indianapolis, McDonald expressed optimism that by the end of next week Congress will endorse transferring up to $3 billion from the Veterans Choice program to close the Department of Veterans Affairs' budget gap. (Callahan, 7/23)
Fox News:
VA Hospitals In Danger Of Closing Unless Lawmakers Fix Newest Funding Mess
A new multibillion-dollar funding crisis has surfaced at the Department of Veterans Affairs that threatens the health care of thousands of America’s military members if not immediately fixed. Members of Congress lambasted the VA on Wednesday for hiding the details of a $2.5 billion budget shortfall that could force some VA hospitals to shut their doors as soon as next month -- leaving hundreds of American military members without a place to go for their medical needs. (Pergram, 7/23)
The Center For Investigative Reporting:
VA Struggling With Promise To End Long Benefits Waits This Year
The U.S. Department of Veterans Affairs has reduced its chronic backlog of veterans’ disability claims – deemed unacceptable by President Barack Obama when he campaigned for office – but so far, the agency is struggling to meet its self-imposed deadline of eliminating long wait times by 2015. (Glantz, 7/23)
USA Today:
VA Has 41,500 Unfilled Medical Jobs, Forcing Vets Into Costly Private Care
The Veterans Health Administration has 41,500 job vacancies for doctors, nurses and other medical professionals across its sprawling health care system while it struggles to provide timely medical care for veterans, according to records obtained and analyzed by USA TODAY. (Hoyer and Zoroya, 7/23)
Jeb Bush Defends Campaign Trail Comments On Medicare
At a Wednesday forum, the GOP presidential hopeful made statements about phasing out Medicare. On Thursday, he defended his comments, saying they were taken out of context and that a "grown-up" conversation is needed regarding Medicare and budget issues.
The Wall Street Journal's Washington Wire:
Jeb Bush Learns Perils Of Medicare Overhaul Proposal
Jeb Bush learned Thursday that it’s still politically treacherous to talk about entitlement reform, even though an overhaul of Social Security and Medicare has become widely accepted in Republican circles. At a forum Wednesday in Manchester, N.H., organized by Americans for Prosperity, a leading conservative group, Mr. Bush said he wanted to “phase out” Medicare in its current form for the entitlement program’s future beneficiaries, while protecting it for people receiving benefits now. (Reinhard, 7/23)
Politico:
Jeb Bush Hits Back At Criticism Over Medicare Comment
Jeb Bush defended comments he made Wednesday night in which he seemed to advocate the “phasing out” of Medicare, after he was confronted during a town hall here Thursday afternoon by an elderly woman who said she was worried about losing benefits. (Stokols, 7/23)
USA Today:
Bush, After 'Phase Out' Comment, Says Medicare Needs Reform
Jeb Bush, under fire from Democrats for saying he would “phase out” Medicare, said Thursday the program has to be reformed because of unsustainable costs in the long run. “It’s an actuarially unsound health care system,” Bush told the crowd at a town hall in New Hampshire, adding that “$50 trillion dollars of debt has been accrued and if we do nothing, that’s the burden that we’re going to place on your children and grandchildren.” (Jackson, 7/23)
CNN:
Jeb Bush Defends Medicare Comments
Bush said the attacks underscore the real problem. "It took less than a day for me to be attacked for the very thing that I predicted would happen and that's just ridiculous. We need to have a grown-up conversation about these issues," Bush said to reporters after the town hall. Bush promised he would not seek to change benefits for people who already have them, and that pushing for reforms is the only way to save the system from crumbling under mountains of debt for future generations. (Spodak, 7/24)
Health care stories are reported from California, Ohio, Illinois, Florida, Arizona, Georgia, Washington, Iowa, Colorado, Nebraska and Massachusetts.
The Associated Press:
California Judge To Rule On Right-To-Die Lawsuit
A single mom given only months to live and other California right-to-die advocates are hoping a court will do what the Legislature did not: allow doctors to prescribe fatal medication for terminally ill people who want it. A San Diego Superior Court judge is expected Friday to hear a motion to dismiss a lawsuit against the state by Christy O'Donnell, two other terminally ill Californians and a San Diego doctor seeking such a right. The plaintiffs are backed by Compassion and Choices, an advocacy group that has supported legislative efforts and similar lawsuits in various states. (7/24)
The Associated Press:
Cleveland Abolishes Family Benefits For Unmarried Couples
City employees with domestic partners are now expected to marry if they want to continue receiving benefits, officials said. Cleveland City Council on Wednesday ended the program extending family benefits to employees’ domestic partners, Northeast Ohio Media Group reported Wednesday. The council also introduced legislation to terminate the city’s domestic partner registry. (7/23)
Los Angeles Times:
Legislator Vows To Seek More Healthcare Coverage For Immigrants
Healthcare advocates in California this year successfully pushed for medical coverage for kids who are in the country illegally. But they say they're not satisfied. At a news conference Thursday, state Sen. Ricardo Lara (D-Bell Gardens) outlined his efforts to further expand coverage to Californians who entered the country illegally. (Karlamangla, 7/23)
The Chicago Tribune:
Federal Judge Orders Rauner To Keep Medicaid Money Flowing In Cook County
Another pressure point in the Springfield stalemate was relieved Thursday when a federal judge ruled that payments owed to many Cook County health care providers who serve the poor must be made despite the absence of a state budget. The ruling opens the spigot for much of an estimated $8 billion in state taxpayer contributions to the Medicaid program to go out without delay while Republican Gov. Bruce Rauner and Democrats who control the General Assembly remain locked in a political fight that has stalled agreement on a spending plan for the budget year that began July 1. (Geiger and Venteicher, 7/23)
The Associated Press:
Florida Medicaid Plans Seek Raise From State Amid Losses
Insurers participating in Florida's new Medicaid managed care program say they've lost $542 million through 2014 and want the state to raise their rates. But after losing major federal funding for hospitals, Gov. Rick Scott doesn't want to use any more state money for the Medicaid program. Scott and the insurers are locked in intense negotiations that could undermine the fledgling program that gives federal funds to private health insurance companies to oversee medical care for poor and disabled people instead of reimbursing doctors and hospitals for each service. (7/23)
The Miami Herald:
Governor's Health Care Commission Urges Price, Quality Transparency
Hospital profits have crept up over the past decade, thanks in part to taxpayer support, yet patients continue to struggle to find price and quality information — issues the governor’s healthcare commission vowed to tackle during its meeting in Miami Thursday. “We’ve got to make the costs for procedures available to consumers,” said Carlos Beruff, president of a home building company and chairman of the Commission on Healthcare and Hospital Funding created by Florida Gov. Rick Scott. “But that needs to be in conjunction with quality.” (Chang, 7/23)
Arizona Republic:
Insurance Company Health Net Fined Nearly $350,000 For Enrollment Miscues
Private health insurance company Health Net gave the wrong information to nearly 14,000 Medicare customers in Arizona during open enrollment last fall, a miscue that prompted the federal government to fine the health insurer nearly $350,000. (Alltucker, 7/23)
Georgia Health News:
WellStar In Talks To Buy Tenet's Hospitals In State
WellStar Health System, fresh from abandoning a proposed deal with Emory Healthcare, has now landed a new potential partner. The Marietta-based WellStar is beginning negotiations with Tenet Healthcare to buy Tenet’s five hospitals in Georgia — all in greater metro Atlanta. (Miller, 7/23)
The Associated Press:
Ruling: Washington Can Require Pharmacies To Dispense Plan B
Washington state can force pharmacies to dispense Plan B or other emergency contraceptives, a federal appeals court said Thursday in a long-running lawsuit brought by pharmacists who said they have religious objections to providing the drugs. The unanimous decision Thursday by the three-judge panel of the 9th U.S. Circuit Court of Appeals overturned a 2012 ruling by U.S. District Court Judge Ronald B. Leighton, who had found that the state's rules violated the religious freedom of pharmacy owners. It was the second time the appeals court reversed Leighton in the case. (Johnson, 7/23)
California Healthline:
Evaluation Trumps Incarceration In L.A. Police Dept. Mental Health Efforts
In the Los Angeles Police Department manual, the section addressing contact with persons who have a mental illness says the goal is to provide a humane, cooperative, compassionate and effective law enforcement response, reduce the potential for violence, and assess services available to the person involved. That's easier said than done when an officer encounters a person who's irrational, disconnected from reality, and threatening himself or someone else -- maybe even the officer. (Stephens, 7/23)
The Associated Press:
Los Angeles DA Recommends Diverting Mentally Ill From Jails
Los Angeles County District Attorney Jackie Lacey is presenting a plan to divert low-level mentally ill offenders from jail and toward treatment. Among the recommendations: expanding law enforcement training to raise sensitivity and more effectively interact with the mentally ill; adding more urgent care centers to determine what services are needed; and establish detox centers for those with substance abuse issues. (7/23)
The Associated Press:
Iowa, Federal Rules Differ Over Marijuana Oil Extract
A Dubuque mother says a wrinkle in Iowa’s cannabis oil program is forcing her to take her young son out into the parking lot of his care facility for his twice-daily dose of the medicine. Jennifer McFadden jumped through all the hoops to obtain a new state cannabis oil card. The permit is supposed to allow her to possess the oil for treatment of her 12-year-old son, Liam, who has severe epilepsy. To get the card, McFadden found a University of Iowa neurologist willing to sign a state form giving approval of the treatment. She then found a Colorado firm willing to send her the oil. But the agency that runs the facility where Liam lives says it can’t allow the oil into the place. McFadden said the agency, Hills & Dales, noted that even though state law allows her to possess the oil, federal authorities still consider it a strictly controlled marijuana product. (Leys, 7/23)
The Associated Press:
Coalition To Give Voice To Medical Marijuana Patients
More than a dozen groups have formed a statewide coalition to make sure patients can get access to medical marijuana under Illinois' new pilot program.
Organizers have announced the formation of the Cannabis Patient Advocacy Coalition. They say it will seek to remove barriers to care and make sure policymakers hear patients' personal stories. The coalition will also push for Gov. Bruce Rauner to approve recommendations to add 11 health conditions, including post-traumatic stress disorder, to the state's medical marijuana program. (7/23)
Health News Colorado:
Fixed-Price Surgeries Come To Colorado Retirees
The costs for basic hip and knee surgeries were staggering, but even more confounding were the wild variations in charges for these common procedures. When analysts at Colorado PERA, the Public Employees Retirement Association, tracked exactly what they and their younger retirees had paid for knee and hip replacement surgeries in 2013, they found stunning variations. (Kerwin McCrimmon, 7/23)
The Associated Press:
Winnebago Hospital Loses Medicare Funding For New Patients
Medicare funding for new patients ended Thursday at a troubled Nebraska hospital where, according to a federal report, inadequate treatment resulted in one death this year and harm to at least nine other patients. Spokesman Bob Moos for the Centers for Medicare & Medicaid Services said payments may continue for up to 30 days for current patients at the Winnebago Indian Health Service Hospital in Winnebago. (7/23)
Kaiser Health News:
Having A Baby? Big Differences Noted In Hospital Quality Across Mass.
When women prepare to give birth, their choice of a hospital is usually dependent on how close it is to their home, where their doctors practice or where their insurance coverage sends them. What they might not realize is that there are often big differences in quality. In Massachusetts, with a little effort, the 70,000 women who give birth each year can check on those measures that set hospitals apart on a tool developed by Boston public radio station WBUR. (Bebinger, 7/24)
The Associated Press:
From Highways To Health Care, Challenges Confront Governors
Money to repair highways, rising health care costs and controversies surrounding attempts to combat global warming are among topics the nation's governors plan to tackle when they gather this week in West Virginia. The National Governors Association summer meeting, which runs Thursday through Saturday at The Greenbrier resort in White Sulphur Springs, comes as states find themselves grappling with an array of issues that defy easy answers. Those include long-range funding for infrastructure upgrades, the effects of prolonged drought, and adequately funding public schools and colleges. (7/23)
Research Roundup: Retail Clinics; Medicaid And Access To Doctors; Mental Health Coverage
Each week, KHN compiles a selection of recently released health policy studies and briefs.
The New England Journal of Medicine:
Convenient Ambulatory Care — Promise, Pitfalls, And Policy
Both retail clinics and urgent care centers are part of the rapidly growing “convenient care” industry .... This article aims to ... examine the evidence of their effect on cost, quality, access, patient navigation, and continuity of care; to discuss existing standards and regulatory approaches; and finally to lay out the key policy considerations in balancing support for these new care models while ensuring essential protections for patients. ... Convenient ambulatory care poses a double-edged sword for policymakers. On one hand, assisting their growth could help address the imperative to reduce cost while increasing access to care. On the other hand, concerns about quality, the potential to mislead patients in need of higher levels of care, and fragmentation of care call for regulatory safeguards for patients. (Chang, Brundage and Chokshi, 7/23)
JAMA Pediatrics:
Geographic Variation In Hospitalization For Lower Respiratory Tract Infections Across One County
Bronchiolitis and pneumonia are leading causes of pediatric hospitalizations. Identifying geographic patterns in hospitalization rates across small geographic areas could be particularly relevant to targeted patient-level and population-level health care. ...We calculated bronchiolitis and pneumonia hospitalization rates for Hamilton County [Ohio] and for each of 222 in-county census tracts [between January 1, 2010, and December 31, 2013]. ... Bronchiolitis and pneumonia hospitalization rates varied considerably in ways that were related to underlying socioeconomic conditions. Clinical and public health interventions, targeted accordingly, could improve patient-level and population-level management of acute conditions at a reduced cost. (Beck et al., 7/20)
Health Affairs:
Primary Care Appointment Availability For New Medicaid Patients Increased After Medicaid Expansion In Michigan
We conducted a simulated patient (or “secret shopper”) study to assess primary care appointment availability and wait times for new patients with Medicaid or private insurance before and after implementation of Michigan’s Medicaid expansion in 2014. The expansion, which was made possible through a section 1115 waiver, has a unique requirement that new beneficiaries must be seen by a primary care provider within 60–90 days of enrollment. During a period of rapid coverage expansion in Michigan, we found that appointment availability increased 6 percentage points for new Medicaid patients and decreased 2 percentage points for new privately insured patients, compared to availability before the expansion. Wait times remained stable, at 1–2 weeks for both groups. (Tipirneni et al., 7/22)
GAO:
Behavioral Health: Options For Low-Income Adults To Receive Treatment In Selected States
GAO was asked to provide information about access to behavioral health treatment for low-income, uninsured, and Medicaid-enrolled adults. ... GAO also selected [to review] four non-expansion and six expansion states ....Behavioral health agencies (BHA) in four selected non-expansion states offered various treatment options for low-income, uninsured adults, focusing care primarily on those with the most serious behavioral health needs. ... [They] established priority populations of those with the most serious behavioral health needs [and] in three of the four states maintained waiting lists for adults with less serious behavioral health needs. [In the six states that expanded Medicaid] ... officials reported increased availability of behavioral health treatment, although some access concerns continue. Four of the six selected states explicitly chose separate contractual arrangements for behavioral health and physical benefits. (7/20)
Psychiatric Services/Rand Corp.:
Noncommissioned Officers' Perspectives On Identifying, Caring For, And Referring Soldiers And Marines At Risk Of Suicide
Noncommissioned officers (NCOs) in the U.S. Army and U.S. Marine Corps were surveyed to identify their ability and willingness to identify, intervene on behalf of, and refer fellow soldiers and marines at risk of suicide. ... Thirty-seven percent of marines and 40% of Army soldiers reported that they could use more suicide prevention training. Compared with trained civilians, NCOs reported greater efficacy to intervene with at-risk peers, but they also reported relatively more reluctance to intervene. Close to 40% of NCOs believed that they would be held responsible for a service member’s suicide if they had asked the service member about suicidal thoughts before the suicide occurred. Chaplains were the preferred referral source, primarily because of the confidentiality they afford. (Ramchand et al., July, 2015)
Georgetown University Health Policy Institute/NORC at the University of Chicago/The Kaiser Family Foundation:
To Switch Or Be Switched: Examining Changes In Drug Plan Enrollment Among Medicare Part D Low-Income Subsidy Enrollees
Low-income [Medicare] beneficiaries who receive premium and cost-sharing assistance through the Part D Low-Income Subsidy (LIS) program have a subset of premium-free [prescription drug plans] PDPs (benchmark plans) available to them, but can also choose to enroll in a non-benchmark plan and pay a premium. ... When PDPs lose their premium-free status, the Centers for Medicare & Medicaid Services (CMS) automatically reassigns many of their LIS enrollees to another premium-free PDP; however, CMS does not reassign LIS enrollees who have chosen a plan other than their assigned PDP. ... The CMS policy for determining which LIS enrollees will be automatically reassigned ... has shielded many low-income beneficiaries ... but as our analysis shows, it has the potential to reduce the financial protection available ... for the share of LIS enrollees who have chosen their own plans. (Hoadley et al., 7/17)
Here is a selection of news coverage of other recent research:
The New York Times:
Chemotherapy May Worsen End-Of-Life Quality, Study Finds
It is an excruciating question for cancer patients with a prognosis of only months to live. Should they try another round of chemotherapy? ... Now, a new study suggests that even those stronger patients may not benefit from end-of-life chemotherapy — and that for many their quality of life may worsen in their final weeks compared with patients who forego last-ditch treatment. “It worsened quality of life for those that are relatively healthy, and those are the ones that the guidelines support treating,” said Dr. Charles Blanke, a medical oncologist at Oregon Health and Science University, who was not involved in the study. “Chemotherapy is supposed to either help people live better or help them live longer, and this study showed that chemotherapy did neither.” (Belluck, 7/23)
NPR:
With Pap Tests Less Common, Women May Miss Out On STD Tests
Changes in how women are screened for cervical cancer mean they're getting Pap tests less often. But that may also mean young women are not getting tested for chlamydia, the most common sexually transmitted disease. As the number of teens and young women getting annual Pap tests declined, so did the number getting screened for chlamydia, according to a study published Monday in Annals of Family Medicine. (Yang, 7/21)
The Wall Street Journal:
Pregnant Women Get More Ultrasounds, Without Clear Medical Need
In 2014, usage in the U.S. of the most common fetal-ultrasound procedures averaged 5.2 per delivery, up 92% from 2004, according to an analysis of data compiled for The Wall Street Journal by FAIR Health Inc., a nonprofit aggregator of insurance claims. Some women report getting scans at every doctor visit during pregnancy. But medical experts are now warning that frequent scans in low-risk pregnancies aren’t medically justified. A joint statement in May 2014 from several medical societies, including the American College of Obstetricians and Gynecologists, calls for one or two ultrasounds in low-risk, complication-free pregnancies. (Helliker, 7/17)
Medscape:
Antibiotic Use Climbs For Acute Respiratory Infections
Antibiotic use, particularly of macrolides, increased among veterans with acute respiratory infections over the course of 6 years, according to a retrospective, cross-sectional study. Moreover, providers accounted for nearly 60% of the variation in prescription rates. The authors note that their findings, published in the July 21 issue of the Annals of Internal Medicine, mirror similar findings in other national studies, including ones using data from the National Ambulatory Medical Care Survey. (Haelle, 7/21)
Reuters:
Families On Medicaid Make More Incorrect Assumptions About Antibiotics
Parents of children insured by Medicaid, the U.S. health program for the poor, are more likely to incorrectly assume antibiotics can treat colds and flu and seek these drugs when kids don’t actually need them, a study suggests. Parents surveyed in Massachusetts reported using antibiotics for their kids on average less than once a year, the study found. But when asked if antibiotics should be used for colds of flu, only 44 percent of the Medicaid parents correctly said “no,” compared with 78 percent of parents with private coverage. (Rapaport, 7/20)
Reuters:
Effect Of Poverty On Brains May Explain Poor Kids' Lower Test Scores
The effect of poverty on children’s brains may explain why poor youngsters tend to score lower on standardized tests compared to wealthier students, a new study suggests. ... [Seth] Pollak, from the University of Wisconsin-Madison, and colleagues report in JAMA Pediatrics that about 20 percent of the gap in test scores between poor children and middle-class children may be a result of poor brain development in the upper-front and side regions of the brain known as the frontal and temporal lobes, respectively. The researchers examined brain images and standardized test scores from 389 children and young adults, ages four to 22, participating in a study by the U.S. National Institutes of Health between 2001 and 2007. (Seaman, 7/20)
The New York Times:
Not Telling Your Doctor You Use Acupuncture And Chiropractic
People with chronic back, neck or joint pain commonly seek acupuncture and chiropractic care for relief, but many don’t tell their doctors about it, a new study reports. Researchers said they were surprised to find that of some 6,068 chronic pain patients who responded to a questionnaire, 47 percent reported using chiropractic care, 32 percent said they used acupuncture, and 21 percent used both. (Rabin, 7/23)
The Associated Press:
Report: Teen Use Of Morning-After Pill Is Climbing
More than 1 in 5 sexually active teen girls have used the morning-after pill — a dramatic increase that likely reflects that it’s easier now for teens to buy the emergency contraceptive. A report released Wednesday shows teen use of the morning-after pill rose steadily from a decade earlier, when it was 1 in 12. Now, all teens can buy it without a prescription. The finding comes from a Centers for Disease Control and Prevention survey that’s considered the government’s best source of information on teen sex and contraception use. (Stobbe, 7/21)
Reuters:
Many Vietnam Veterans Have PTSD 40 Years After War
Decades after the end of the U.S. war in Vietnam, more than one in ten American veterans from the conflict still experience at least some symptoms of post traumatic stress disorder (PTSD), according to a new study. One third of veterans with PTSD also suffer from major depressive disorder, the research team reports in JAMA Psychiatry. (Rapaport, 7/22)
Viewpoints: Jeb Bush's Confusing Statements On Medicare; The Clash Over Fetal Tissue
A selection of opinions on health care from around the country.
Bloomberg:
Jeb Bush's Struggle To Say What He Means Continues
During a forum sponsored by Americans for Prosperity, the influential conservative group backed by David and Charles Koch, Jeb Bush told the audience that he wants to "phase out" Medicare. ... here the trouble is of Bush's own causing. The "new program" he was talking about may well have been Medicare with more means testing, and a higher retirement age. But that language is at best imprecise, particularly for a debate, as Bush himself noted, that easily can be distorted. (Michael C. Bender, 7/24)
The Washington Post:
The Price Of Fetal Parts
Planned Parenthood’s reaction to the release of a clandestinely recorded conversation about the sale of fetal body parts was highly revealing. After protesting that it did nothing illegal, it apologized for the “tone” of one of its senior directors. ... The Planned Parenthood revelations will have an effect. Perhaps not on government funding, given the Democratic Party’s unwavering support and the president wishing it divine guidance. Planned Parenthood might escape legal jeopardy as well, given the loophole in the law banning the sale of fetal parts that permits compensation for expenses (shipping and handling, as it were). But these revelations will have an effect on public perceptions. (Charles Krauthammer, 7/23)
The Chicago Tribune:
Planned Parenthood's Awkward Clash
If the reason for the sting was unease about how fetal tissue is obtained at Planned Parenthood clinics, then there are reasons for concern. In the videos, there are hints that abortion procedures might be altered to obtain particular tissue and there is some unseemly haggling over the processing fees. The solution to these concerns is to reaffirm that Planned Parenthood clinics are getting sound consent from women who donate, that procedures are being done solely with the health and safety of women in mind and that fees are clearly set every year, reasonable for the work involved and not subject to negotiation. Of course that is not the point of the sting. The point of the sting is to bring enough shame onto Planned Parenthood so that it is defunded, so that it cannot offer elective abortions. (Arthur L. Caplan, 7/23)
The Wall Street Journal:
Bristol-Myers’ Pricey Pipeline
Bristol-Myers Squibb’s cancer pipeline is the envy of the industry. But drug-pricing pressures—especially from health-insurer consolidation including the expected Anthem deal for Cigna—could keep shareholders from reaping its full benefits. (Charley Grant, 7/23)
The Chicago Tribune:
For People With Disabilities, 25 Years Under ADA Has Opened A New World
One day when I was 23 years old, back in 1977, I was hanging out at Lake Michigan when my friend's dog knocked my shoes in the lake. I dove in to retrieve them and broke my neck, leaving me paralyzed from the chest down. It didn't take long to realize my world had changed. People immediately treated me differently because of my wheelchair — I lost my job as a nurse, I lost my home, I lost my health insurance. I couldn't use public transit, and I couldn't get into many public places without entering through the service entrance — that happened more times than I care to remember. America in 1977 was a completely different country for those with disabilities. (Marca Bristo, 7/23)
The Washington Post:
Why I Wrote The Americans With Disabilities Act
The ADA was a response to an appalling problem: widespread, systemic, inhumane discrimination against people with disabilities. In 1971, a New York judge described people with disabilities as “the most discriminated [against] minority in our nation.” Large numbers of children with disabilities were systematically excluded from American public schools. ... State residential treatment institutions for people with disabilities were generally abysmal. ... Most public transportation systems made few, if any, accommodations for persons with disabilities, resulting in a transportation infrastructure that was almost totally unusable by people with mobility or visual impairments. ... People with disabilities were routinely denied rights that most members of our society take for granted, including the right to vote. (Robert L. Burgdorf Jr., 7/24)
USA Today:
Reeve: Disabilities Battle Is Not Over
Civil rights issues have dominated headlines this year, each deserving of attention. But there is one issue that tends to be overshadowed year after year — one that impacts the largest minority group in the U.S., the disability community. For many decades, entire cities and communities were inaccessible, from restaurants to public transportation and even sidewalks. The world was full of obstacles that restricted independent living for millions of Americans. I witnessed this world from a young age. (Will Reeve, 7/23)
The Wall Street Journal:
A Win For Vaccines, But Worries Remain
In a growing number of states, parents can no longer refuse to immunize their children due to conflicting “personal beliefs”—at least not if they want their children to attend school. California recently joined West Virginia and Mississippi in requiring a medical exemption from a physician to permit a child to enter school without being immunized. Gov. Jerry Brown signed the controversial bill, SB277, last month. Most of us rejoice, yet there is still reason to worry that exemptions will proliferate along with preventable diseases. Particularly if doctors feed their patients’ fears and offer easy exemptions with few questions asked. (Nina Shapiro, 7/23)
The New England Journal of Medicine:
Shifting Vaccination Politics — The End Of Personal-Belief Exemptions In California
It's not often that California, West Virginia, and Mississippi are politically aligned, but that unlikely trio formed on June 25, 2015, when California Governor Jerry Brown signed into law Senate Bill (SB) 277, substantially narrowing exceptions to school-entry vaccination mandates. With that law, California becomes the third state to disallow exemptions based on both religious and philosophical beliefs; only medical exemptions remain. The move represents a stunning victory for public health that affects not only California schoolchildren but also the prospects for strengthening vaccination requirements nationwide. (Michelle M. Mello, David M. Studdert and Wendy E. Parmet, 7/22)
Los Angeles Times:
Will The Legislature Inadvertently Invite More Medical Tourists?
California is already a magnet for birth tourism. Now, health analyst Robert Laszewski writes, the California Legislature could make the state a magnet for medical tourists who sign up for insurance, get an expensive procedure done at one of the state's famous medical centers, then drop their coverage and head home. It's a powerful critique, but Laszewski downplays one important fact: Foreign nationals can do that already, and not just in California. (Jon Healey, 7/23)
The New York Times:
Choosing How We Die
In 1975 Shirley Dinnerstein, a 64-year-old Massachusetts woman, learned she had Alzheimer’s disease. Three years later she was in an “essentially vegetative state,” according to her case records, and a court was deciding whether to honor her previously expressed wish not to be resuscitated if she died. The court ruled in her favor, establishing, for the first time, that patients’ care choices at the end of life could be officially documented in the medical record without being validated in court. (Theresa Brown, 7/24)
The New England Journal of Medicine:
The Expansion Of Retail Clinics — Corporate Titans Vs. Organized Medicine
In a tumultuous era of change propelled by public health policies and private entrepreneurial activity, the spread of retail clinics offering basic primary care, walk-in visits, extended hours, and lower prices than a doctor's office or emergency department is unsettling the medical profession, especially family physicians and pediatricians. Most U.S. retail clinics are owned and operated by vast corporate enterprises and staffed by advanced practice nurses and physician assistants. Although relatively few assessments have been conducted of the quality of care in such clinics, some peer-reviewed studies indicate that they deliver their circumscribed set of services at least as well as physicians' offices do. Nevertheless, primary care physician groups have raised concerns about both the care at these clinics and their potential for disrupting patients' continuity of care. (John K. Iglehart, 7/23)
JAMA:
Treatment Decision Making And Genetic Testing For Breast Cancer
Rates of genetic testing for women with diagnosed breast cancer appear to be increasing substantially. More than one-fourth of patients diagnosed today undergo testing, multiple-gene sequencing panels are replacing testing limited to BRCA1/2 mutations, and genetic counselors report ordering more tests. Within the next few years it is likely that most patients with newly diagnosed breast cancer will undergo genetic testing to inform their risk of developing a subsequent cancer. There is already a widening gap between the availability of more expansive genetic testing and the relative importance of results to treatment decisions. (Steven J. Katz, Allison W. Kurian and Monica Morrow, 7/23)