Weekly Edition: January 10, 2020

Reduce Health Costs By Nurturing The Sickest? A Much-Touted Idea Disappoints

Dan Gorenstein and Leslie Walker

Nearly a decade ago, Dr. Jeffrey Brenner and his Camden Coalition appeared to have an answer to remake American health care: Treat the sickest and most expensive patients. But a rigorous study in the New England Journal of Medicine shows the approach doesn’t save money. “We built a brilliant intervention to navigate people to nowhere,” Brenner tells the “Tradeoffs” podcast.

‘An Arm And A Leg’: Watch Your Back — And Your Wallet

Dan Weissmann

Cathryn Jakobson Ramin, author of the book “Crooked,” says chronic low back pain is not a medical condition. Nonetheless, that complaint sends millions of Americans down a path of expensive imaging tests, ongoing therapies and invasive surgery — all with limited effectiveness for many patients. In a conversation with “An Arm and a Leg” podcast host Dan Weissmann, Ramin shares her journey of back pain and recovery.

Hospital Known For Glamorous Patients Opens New Doors To Its Neediest

Anna Almendrala and Harriet Blair Rowan

For years, Cedars-Sinai Medical Center in Los Angeles, one of California’s largest nonprofit hospitals, has been spending less on charity care than other nonprofit hospitals in the state. Now it is expanding eligibility for free and discounted medical care.

High-Deductible Plans Jeopardize Financial Health Of Patients And Rural Hospitals

Markian Hawryluk

Small hospitals and patients in rural areas have been hit hard by the boom in high-deductible health plans. Often when a patient arrives at a rural hospital needing critical care, the person is stabilized and transferred to a larger facility. But bills from the first site of care generally get applied to the patient’s deductible. When patients can’t afford their deductible, the smaller hospital winds up eating the costs.

Family Doctors In Rural America Tackle Crisis Of Addiction And Pain

Bram Sable-Smith, Wisconsin Public Radio

For rural physicians, the burden of responding to the opioid epidemic falls squarely on their already loaded shoulders. For one doctor in a small Wisconsin village, there was no question that she wanted to rise to the challenge.

Effort To Control Opioids In An ER Leaves Some Sickle Cell Patients In Pain

Sam Whitehead, WABE

People with sickle cell disease aren't fueling the opioid crisis, research shows. Yet some ER doctors still treat patients seeking relief for agonizing sickle cell crises as potential addicts.

KHN’s ‘What The Health?’: Democrats Roll Dice On SCOTUS And The ACA

A group of Democratic state attorneys general are betting the Supreme Court will take up the case and overturn a federal appeals court ruling in time for the 2020 elections. In other high-court news, most Republicans in Congress are asking the justices to use a Louisiana law to overturn the landmark abortion-rights ruling, Roe v. Wade. Joanne Kenen of Politico, Stephanie Armour of The Wall Street Journal and Paige Winfield Cunningham of The Washington Post join KHN’s Julie Rovner to discuss this and more. Rovner also interviews NPR’s Richard Harris, who wrote the latest KHN-NPR “Bill of the Month” feature.

Democrats Press High Court To Make Call On ACA. How It Could Play Out At Polls.

Julie Rovner

Democrats have asked the Supreme Court to take up an appeals court ruling that could invalidate some or all of the federal health law. It’s not clear the court will take the case, but the efforts will carry consequences for both Democrats and Republicans.

5 Things To Know As California Starts Screening Children For Toxic Stress

Barbara Feder Ostrov

California now will pay pediatricians to screen Medi-Cal patients for traumatic events known as adverse childhood experiences, or ACEs. The program is based on research showing that children who endure chronic stress have an increased risk of developing serious health problems. Here are five things to know about the new program.

In Massachusetts, Minors Need Permission For Abortion, But That Could Change

Martha Bebinger, WBUR

A parental consent requirement for minors who seek abortions is still on the books in left-leaning Massachusetts, as well as about two dozen other states. But a proposed Massachusetts law seeks to repeal that consent requirement and shore up the right to abortion in case the Supreme Court strikes down the federal right to the procedure.

Fecal Bacteria In California’s Waterways Increases With Homeless Crisis

Anna Almendrala

Some of California’s most prized rivers, bays, beaches and streams are contaminated with levels of fecal bacteria that exceed state limits, threatening human health. While aging sewage infrastructure is largely to blame, homeless encampments are also a probable source of contamination.

Listen: A Renewed Focus On Health Care In 2020

KHN’s Julie Rovner joins Stephen Henderson of “Detroit Today” on WDET, an NPR station, to talk about the pivotal role of health care issues in the 2020 presidential campaign.