Kaiser Health News - Health IT

HHS Report Finds Uptick In Doctors' Use Of Electronic Health Records

Thu, 23 May 2013 13:32:50 GMT

Also in the news, the Pentagon is in search of a new system for veterans' health care while San Francisco is "leading the way" in new health data applications.

USA Today: Incentives Push Doctors To Electronic Medical Records
More than half of doctors' offices and 80 percent of hospitals that provide Medicare or Medicaid will have electronic health records by the end of the year, the Department of Health and Human Services announced Wednesday (Kennedy, 5/22).

CQ HealthBeat: HHS Report Shows Strong Growth In Use Of Electronic Health Records
More than half of all doctors now get Medicare or Medicaid incentive payments for using electronic health records, according to a report federal officials released on Wednesday. But Republicans say medical professionals should not just use the records in their own offices but also should exchange them with other providers (Adams, 5/22).

The Associated Press: Pentagon To Seek New Records System For Vets Health Care, Says It Won’t Solve Claims Backlog
The Pentagon has decided to buy a new computerized health records system to be able to better share and merge its data with the Department of Veterans Affairs, but officials cautioned that it was part of a “long-term modernization” effort and would not help ease the backlog in VA disability claims (5/22).

California Healthline: San Francisco Leading The Way In Health Data Applications
The city of San Francisco is leading the way in using health data in innovative ways and it's paying off in a big way, according to several city officials who spoke yesterday at the Healthy Communities Data Summit. The summit was held in San Francisco and that meant a number of success stories were local, but the conference cast a wide net in its approach to innovation prompted by public release of health data (Gorn, 5/22).

More Than Half Of U.S. Docs Now Using EHRs

Wed, 22 May 2013 13:12:30 GMT

The Wall Street Journal: Electronic Health Data Gaining Favor
More than half of U.S. doctors have switched to electronic health records and are using them to manage patients' basic medical information and prescriptions, according to federal data set to be released Wednesday. The Department of Health and Human Services says it has reached a tipping point as it seeks to steer medical providers away from paper records (Radnofsky, 5/22).

Health Care Innovations In Technology Spotlight

Tue, 21 May 2013 13:17:16 GMT

A Silicon Valley conference offers insights regarding what's working and what is coming next for health care innovation. Meanwhile, some startup companies are aiming technology advances at medication adherence.

The Washington Post: Health-Care Training And Data Storage Innovations Featured At Silicon Valley Conference
This year's HealthBeat conference continues through Tuesday in San Francisco, with health technology innovators gathering to offer their take on what's challenging, what's working and what's next in innovation for the health care industry (Kolawole, 5/20).

The Wall Street Journal: Forget To Take Medicine? These Pills Will Tell Your Doctor
Startup companies are coming up with new technologies aimed at getting people to take medicine only as directed. Taking medication haphazardly—skipping doses, lapsing between refills or taking pills beyond their expiration date—has been linked to health complications and hundreds of millions of wasted dollars for insurers and hospitals (Hay, 5/20).

First Edition: May 8, 2013

Wed, 08 May 2013 11:04:27 GMT

Today's headlines include reports about government data showing the wide variation in what hospitals charge Medicare patients for common inpatient procedures.

Kaiser Health News: Capsules: Harkin Withdraws Hold On Tavenner; Reid Says Timing For Vote Is Unclear; Study Models Three Big Changes To Medicare
Now on Kaiser Health News' blog, Mary Agnes Carey reports on movement on Capitol Hill regarding the nomination of Marilyn Tavenner to head Medicare: "Sen. Tom Harkin Tuesday removed the hold he had placed on the nomination of Marilyn Tavenner to head the Centers for Medicare and Medicaid Services and said he would no longer stand in the way of a Senate vote despite actions by the Obama administration that he said violate 'both the letter and the spirit' of the 2010 health care law. But after Harkin announced his decision on the Senate floor, Majority Leader Harry Reid said it was unclear when the Senate would vote on the nomination" (Carey, 5/7).

Also on the blog, Ankita Rao reports on how three Medicare models could play out: "A study from the Rand Corporation, a nonprofit research organization, compared the impact of three proposals that have been discussed by Congress or the White House to curb the costs of the government health care program for seniors and the disabled. The study is published in the May issue of Health Affairs" (Rao, 5/7). Check out what else is on the blog.

The New York Times: Hospital Billing Varies Wildly, Government Data Shows
Data being released for the first time by the government on Wednesday shows that hospitals charge Medicare wildly differing amounts — sometimes 10 to 20 times what Medicare typically reimburses — for the same procedure, raising questions about how hospitals determine prices and why they differ so widely. The data for 3,300 hospitals, released by the federal Center for Medicare and Medicaid Services, shows wide variations not only regionally but among hospitals in the same area or city (Meier, McGinty and Creswell, 5/8).

The Washington Post: One Hospital Charges $8,000 — Another, $38,000
Consumers on Wednesday will finally get some answers about one of modern life’s most persistent mysteries: how much medical care actually costs. For the first time, the federal government will release the prices that hospitals charge for the 100 most common inpatient procedures. Until now, these charges have been closely held by facilities that see a competitive advantage in shielding their fees from competitors. What the numbers reveal is a health-care system with tremendous, seemingly random variation in the costs of services (Kliff and Keating, 5/8).

The Washington Post: As Red Ink Recedes, Pressure Fades For Budget Deal
In the meantime, Republicans face a listless summer, with little appetite for compromise but no leverage to shape an agreement. Without that leverage, House Budget Committee Chairman Paul Ryan (R-Wis.) said Tuesday, there is no point in opening formal budget negotiations between the House and the Senate, because Democrats have no reason to consider the kind of far-reaching changes to Medicare and the U.S. tax code that Republicans see as fundamental building blocks of a deal (Montgomery and Goldfarb, 5/7).

The Associated Press/Washington Post: As Deficit Bargain Remains Elusive, Pessimism Abounds At Annual Fiscal ‘Summit’
But barely 100 days into President Barack Obama’s second term — supposedly a time of peak possibility in a divided capital city — a bipartisan squad of Washington’s budget big shots was decidedly downbeat on the chances of following up January’s big tax increase on the wealthy with a follow-up deal. “A ‘grand bargain’ implies you’re going to fix the problem, but when you have the majority party in Washington unwilling to embrace the kinds of reforms that make Medicare solvent or make Social Security solvent ... I don’t see a grand bargain happening,” said House Budget Committee Chairman Paul Ryan, R-Wis., a frequent attendee at Peterson’s event (5/7).

The Wall Street Journal: Ryan Sees No 'Grand Bargain' On Budget
A top House Republican lawmaker said he didn't think that a "grand bargain" on a broad deficit-reduction agreement would be reached in the near term, casting new doubts on the chances for such a deal. House Budget Committee Chairman Paul Ryan (R., Wis.) said that he thought the parties were too far apart on the question of overhauling major entitlement programs like Medicare and Medicaid, saying this would prevent a major deal from being concluded (Boles, 5/7).

The New York Times' The Caucus: Judge Criticizes Obama Administration As It Appeals Contraception Decision
A federal judge on Tuesday angrily accused the Obama administration of hurting poor and minority women by seeking to restrict their access to morning-after contraceptive pills. Lawyers for the Justice Department appeared before Judge Edward R. Korman in an effort to delay his previous order that the drug be made available to girls of all ages without a prescription. The department announced last week that it planned to appeal the ruling (Shear, 5/7).

Politico: Missouri Lawmakers Torpedo Medicaid Expansion
Republican supermajorities have all but scuttled Medicaid expansion in Missouri, defeating — at least for this year — efforts supported by the Democratic governor to extend basic health coverage to an estimated 250,000 low-income state residents. State lawmakers are set to finalize their annual budget this week, and neither chamber included expansion in their blueprints. They’ve opted to create committees to study the issue for the rest of the year and to report on the impact of expansion in early 2014, delaying any decision until after the Jan. 1 start date (Cheney, 5/8).

USA Today: Hospitals Lose $8.3 Billion Using Old Technology
U.S. physicians and hospitals are in the digital dark ages when it comes to using the latest mobile devices and Internet services to deliver patient care. As a result, U.S. hospitals are absorbing an estimated $8.3 billion annual hit in lost productivity and increased patient discharge times, according to a Ponemon Institute survey of 577 health care professionals, released Tuesday to Cyber (Acohido, 5/7).

The New York Times: Otis R. Bowen, Health Secretary Under Reagan, Dies At 95
Otis R. Bowen, who served two terms as governor of Indiana and later became the first physician appointed as secretary of health and human services, serving under President Ronald Reagan amid the rising debate about AIDS, died on Saturday in Donaldson, Ind. He was 95 (Yardley, 5/7).

Los Angeles Times: California Senate Leader Proposes Mental Health Program Expansions
State Senate leader Darrell Steinberg (D-Sacramento) on Tuesday proposed a plan to significantly increase mental health services in California with the goal of reducing the number of people ending up in prison, jail and emergency rooms. Steinberg said the plan is in response to the Newtown, Conn., school massacre, in which a gunman killed 20 students and six adults, as well as a scandal involving a Nevada hospital dumping patients in other states, and the recent order by a federal court to further cut the number of inmates in California prisons (McGreevy, 5/7).

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Concerns Surround Medical Records Privacy Issues

Thu, 02 May 2013 13:36:59 GMT

The Wall Street Journal: Poor Prognosis For Privacy
The sharing of Americans' health information is set to explode in coming years, with millions of patients' medical records converted to electronic form and analyzed by health-care providers, insurers, regulators and researchers. That has prompted concerns over privacy—and now, new federal rules that aim to give patients more control over their information are posing technical and administrative problems for the doctors and hospitals that have to implement them. … The new rules are part of a revision of the 1996 Health Insurance Portability and Accountability Act, known as HIPAA. They went into effect in March, but providers have until Sept. 23 to comply. One key new provision requires doctors and hospitals not to disclose medical information to a patient's insurer if the patient requests it and pays for the services out-of-pocket (Beck, 5/1).

First Edition: April 26, 2013

Fri, 26 Apr 2013 11:32:41 GMT

Today's headlines include reports that some Democratic senators have concerns about the health law's roll out as well as other news about the measure's implementation.

Kaiser Health News: With Time Running Out, Florida Medicaid Expansion Is In Doubt
Kaiser Health News staff writer Phil Galewitz, working in collaboration with USA Today, reports: "When the U.S. Supreme Court upheld the health law last year … the justices made the expansion of Medicaid voluntary. Of the 27 million people projected to gain coverage under the law, about 13 million are expected to do so through Medicaid. … Fourteen states, many in the Republican-controlled South, have already rejected the Medicaid expansion, while 20 have agreed to comply with the law, according to consulting firm Avalere Health. Florida, with nearly four million uninsured residents, is one of more than a dozen still weighing the issue. And just as it has an outsized impact on presidential elections, it is likely to play a significant role in the success of the 2010 health law" (Galewitz, 4/26). Read the story.

Kaiser Health News: Capsules: Survey Finds Rate For Young Adult Coverage Improves While Others Decline
Now on Kaiser Health News' blog, Alvin Tran reports: "While the number of medically uninsured young adults dropped over the past two years, coverage of the overall working age population failed to improve, according to the findings of the Commonwealth Fund's 2012 biennial health insurance survey released Friday" (4/25). Check out what else is on the blog.

The New York Times: Democratic Senators Tell White House of Concerns About Health Care Law Rollout
Democrats in both houses of Congress said some members of their party were getting nervous that they could pay a political price if the rollout of the law was messy or if premiums went up significantly (Pear, 4/26).

Politico: Obamacare Exemption Talk Lights Up Capitol Hill
The Obamacare war is on in Congress. A top aide to House Minority Leader Nancy Pelosi sent an email to Democratic offices Thursday afternoon, warning that "Republican trackers" are on Independence Avenue asking lawmakers about the effort to rework which health care insurance members of Congress must use (Sherman, 4/25).

The Washington Post: Aide: Congressional Leaders Consulting On Health Law's Effects On Legislators, Hill Staffers
Congressional leaders are discussing how to mitigate the potential effects of a section of the 2010 health-care law that could cost lawmakers and their employees subsidies for health insurance, an aide said. The Affordable Care Act included a provision requiring members of Congress and their staffs to obtain insurance from online marketplaces set to open in 2014. The exchanges will sell insurance to Americans who don’t have health-care coverage from their employers (Wayne and Hunter, 4/25).

The Wall Street Journal’s Washington Wire: Obamacare Gives Hill Big Headaches
President Barack Obama's health-care law could cause big headaches for members of Congress and their staff, but efforts to address the potential problem are drawing complaints that congressional leaders are trying to protect their own. At issue is a provision that requires lawmakers and their staff to participate in the health-insurance exchanges that are being set up to help individuals who do not have group coverage to get affordable policies (Hook, 4/25).

The Washington Post’s Wonk Blog: 'The Outlook For Medicaid Expansion Looks Bleak'
Twenty states and the District of Columbia have agreed to expand their Medicaid programs, to cover everyone under 133 percent of the federal poverty line. That leaves 30 states that haven’t, although Avalere categorizes four states as leaning in that direction (Tennessee, Kentucky, Florida and New York). Some of these states have especially large uninsured populations. Texas, for example, has an estimated 1.8 million people who would be expected to enroll in Medicaid under the expansion (Kliff, 4/25).

The Washington Post: Maryland Announces Connector Program To Help Enroll Residents Under Federal Health Overhaul
Maryland launched an initiative on Thursday to help residents get health insurance under the federal health care law. Lt. Gov. Anthony Brown and the Maryland Health Benefit Exchange announced the start of the Connector Program, which will be funded with about $24 million in anticipated state and federal grants. The money will be used to fund six organizations that will provide consumer assistance and enrollment resources throughout the state (4/25).

The Wall Street Journal's Risk & Compliance Journal: South Carolina Upgrades Medicaid System To Prepare for ACA
South Carolina is rolling out a new Medicaid platform to meet rules mandated under the Affordable Care Act that require states significantly upgrade their technology and accept more enrollees. The state is turning to an International Business Machines Corp. platform to meet the new requirements. But upgrades to social service platforms aren't without risk, as illustrated by another IBM deal to modernize a state welfare system (Schectman, 4/24).

The Washington Post: White House Chief Of Staff Meets With Senate Republicans On Budget Deal
Earlier this week, the White House considered trying to assemble a group of interested Republicans for further talks, according to Democratic congressional aides. But the administration rejected that approach, and is encouraging Republicans to choose their own negotiating party. Still, several Republicans involved in the process say there is little interest in setting up another "gang" or "supercommittee" to hold private talks with the White House outside the normal committee structure. Instead, senators are talking to the White House about setting a broad framework for moving forward, and then handing the job of drafting a deal off to the Senate Finance Committee, which has jurisdiction over Medicare as well as tax policy (Montgomery, 4/25).

USA Today: Startup Helps Health Insurance Cards Go Digital
In an era of e-tickets, bitcoins and app-based banking, it seems pretty antiquated that we still have to fumble through our wallets for an insurance card each time we go to the doctor's office. But a Philadelphia-based startup has a plan for making those flimsy pieces of cardboard digital — and the upside isn't just the potential for going paper-free. With the rise of high-deductible plans, patients are increasingly on the hook for more of their medical expenses than they've ever been before. For patients, that means a bigger need for tools that provide more transparency about health care costs. And for doctors, particularly independent physicians, said Medlio co-founder and CEO David Brooks, that means a growing problem with collecting payment (Heussner, 4/25).

The New York Times: Doctors Denounce Cancer Drug Prices Of $100,000 A Year
With the cost of some lifesaving cancer drugs exceeding $100,000 a year, more than 100 influential cancer specialists from around the world have taken the unusual step of banding together in hopes of persuading some leading pharmaceutical companies to bring prices down (Pollack, 4/25).

The Washington Post: Women's Health Groups Want Peace Corps Volunteers To Have Insurance Coverage For Abortions
If a Peace Corps volunteer is raped and becomes pregnant as a result, she has to pay for an abortion herself, because the federal government refuses to cover the cost. Yet women on the paid Peace Corps staff, along with other federal employees, federal prisoners, women on Medicaid and Native Americans, have long received insurance coverage for abortions in cases of rape or incest or if their health is in danger. In January, women in the military got the same access (Rein, 4/25).

Los Angeles Times: HIV Vaccine Trial Shut Down
In another major setback for efforts to develop an HIV vaccine, federal researchers have shut down a key clinical trial after an independent panel of safety experts determined that volunteers who got an experimental vaccine appeared to be slightly more likely to contract the human immunodeficiency virus than those who got a placebo. … The announcement came Thursday from the National Institute of Allergy and Infectious Diseases, known as NIAID, which developed the HVTN 505 vaccine and launched the advanced clinical trial in 2009. The vaccine was designed to prime the immune system to mount a robust defense against all three subtypes of the HIV virus (Healy, 4/25).

The Associated Press/Washington Post: Md. Hospital Association Asks State Panel To Spare Hospitals From A Medicare Cut
The Maryland Hospital Association urged a state commission on Thursday to spare hospitals from a 2 percent Medicare cut that is part of federal budget reductions. In response to the recommendation by staff members of the Health Service Cost Review Commission to have hospitals absorb the cuts for the rest of the fiscal year, the group issued a report warning the panel about deteriorating financial health of hospitals in the state (4/25).

The New York Times: State Suspends Enrollment In Adult Care Plan Amid Fraud Concerns
State officials have suspended enrollment in New York’s largest managed long-term care plan for frail elderly and disabled people, and investigators have begun examining the relationships between such plans, which are financed by Medicaid, and the social adult day care centers that send them new customers (Bernstein, 4/25).

Los Angeles Times: Medical Board Of California Could Lose Investigative Powers
The Medical Board of California would be stripped of its power to investigate physician misconduct under a sweeping reform plan by legislators who say the agency has struggled to hold problem doctors accountable. The medical board has come under fire for failing to discipline doctors accused of harming patients, particularly those suspected of recklessly prescribing drugs (Glover and Girion, 4/25).

Los Angeles Times: Labor Groups Renew Push For Paid Sick Leave
Following recent legislative victories in New York and Portland, Ore. — and one of the worst flu seasons in years — advocates for paid sick leave are hoping to ride that momentum to win victories locally. Previous failures to get the Legislature to mandate paid sick leave have taught labor groups a few lessons. Among them: Focusing on passing legislation on a city-by-city basis appears to be more fruitful (Lopez, 4/26).

The Washington Post: Plan Coming For Unpaid Chartered Health Claims, Gray Says
Not quite a week after it was announced that D.C. Chartered Health Plan could owe tens of millions more than previously anticipated to city health-care providers, Mayor Vincent C. Gray said Thursday his administration is "developing a plan to provide relief." Chartered Health Plan is currently the city's largest Medicaid contractor, handling the care of more than 104,000 District residents (DeBonis, 4/25).

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House-Senate 'Endgame Talks' Face Political Hurdles, Delays

Wed, 17 Apr 2013 13:24:00 GMT

The House GOP is moving slowly in naming negotiators to work through differences between the House- and Senate-passed budgets. The reason -- Republicans may want to avoid being on the record regarding politically-charged proposals related to Medicare and other issues. Also on Capitol Hill, new legislation was introduced regarding drugmaker rebates for "dual eligibles," and lawmakers scrutinize the Food and Drug Administration's oversight of drug compounders and raise concerns about electronic medical records.

The Associated Press/Washington Post: After Demanding Budget Debate, GOP Resists Naming Negotiators For Endgame Talks
What may be really motivating House Republicans to delay is a wish to avoid a series of politically difficult votes that Democrats could force upon them soon after a conference committee is named. Democrats could force such votes on a daily basis for months if negotiations drag on, and the tallies on highly charged topics like Medicare could produce fodder for campaign commercials. "We don't want to ... have an endless process that focuses on our differences," Ryan said (4/16).

Kaiser Health News: Capsules: Democratic Lawmakers Seek To Restore Drugmaker Rebates For 'Dual Eligibles'
The legislation would require drug companies to provide rebates to the federal government for drugs used by a group of beneficiaries often called 'dual eligibles.' These beneficiaries are predominantly low-income seniors and people with disabilities who qualify for both Medicare and Medicaid (Carey, 4/16).

Politico: Lawmakers Blast FDA On Outbreak
House Energy and Commerce Committee Republicans blasted Food and Drug Administration Commissioner Margaret Hamburg on Tuesday for failing to crack down on the compounding pharmacy responsible for a deadly fungal meningitis outbreak last fall despite a history of known problems. The committee released a report at an oversight hearing Tuesday showing the agency chose to suspend its inspections of the New England Compounding Center and a sister company in 2011 while it worked to clarify its policy toward compounders (Norman, 4/17).

Medpage Today: GOP Report: FDA Failed To Act On Compounder
The FDA had all the authority it needed to take action against the compounding pharmacy at the center of last fall's fungal meningitis outbreak, the results of a Congressional investigation showed. However, the agency failed to act; 53 people died, and more than 700 were infected, Republican lawmakers said in a report issued Tuesday. … "In the 6 years following [a] 2006 Warning Letter, FDA failed to take any enforcement action against NECC or Ameridose despite receiving complaint after complaint, often relating to the safety of the companies' drugs," the report stated. "Though several inspections and related enforcement actions were considered during this time period, they were repeatedly delayed and ultimately cancelled” (Pittman, 4/16).

The Hill: GOP Senators Raise Concerns With Push For Electronic Medical Records
A 2009 law designed to promote electronic health records and make the healthcare system more efficient isn't living up to its goals, Republican senators said Tuesday. Six GOP senators, led by Sen. John Thune (R-S.D.) released a lengthy report Tuesday criticizing the execution of a $35 billion initiative to promote the use of electronic health records (Baker, 4/16).

Also in the headlines, the increasingly dark outlook for the federal government's long-term care panel and how the blanks are being filled in regarding this month's Medicare Advantage stock surge.

Medpage Today: Long-Term Care Panel Seen As Likely To Flop
Without financial support, the federal government's new unpaid and volunteer long-term care commission is likely to do little more than produce yet another report about the challenge of providing care for an aging nation, experts said. The federal Commission on Long-Term Care has been asked to evaluate long-term care in the U.S. and suggest solutions in a report due next fall. Just last month, President Obama appointed the final three of 15 panel members; three each were selected by Senate Majority Leader Harry Reid (D-Nev.), Senate Minority Leader Mitch McConnell (R-Ky.), House Speaker John Boehner (R-Ohio), and House Minority Leader Nancy Pelosi (D-Calif.). Commission members include a state Medicaid director, a nursing home executive, an advocate for persons with disabilities, and advocates for and against government involvement in long-term care financing (Struck, 4/16).

The Wall Street Journal: Stock Surge Linked To Lobbyist
A key source for a private report that sent health-care stocks on a tear earlier this month is a former top congressional aide who is now a health-industry lobbyist, according to emails reviewed by The Wall Street Journal. Mark Hayes is currently an outside lobbyist for health-insurance giant Humana Inc. His email to Washington investment-research firm Height Securities, alerting it to a government decision that will save the industry billions of dollars, was a final piece of confirmation Height received before blasting a news alert to its clients, according to emails and people familiar with the matter (Mullins, Strasburg and McGinty, 4/17).

Does ICU Remote Monitoring Save Lives, Money?

Mon, 15 Apr 2013 13:34:22 GMT

The New York Times: Debating The Effectiveness Of Remotely Monitoring Intensive Care Patients
High in a Manhattan skyscraper near Grand Central Terminal on a recent Tuesday, 80 critically ill patients in intensive care units scattered from Georgia to New Jersey were being monitored, remotely, by a doctor scanning a dozen computer screens. ... More than a decade ago, this kind of tele-ICU command center was trumpeted by its creators as the new standard in critical care, a way to save lives and money ... Today, with the growth of such systems stalled at about 10 percent of ICU patients nationwide, and wildly contradictory studies about the results, no one can say with authority if, or under what circumstances, tele-ICUs deliver on their promises (Bernstein, 4/14).

Medical Society Suggests That Docs 'Pause Before Posting'

Fri, 12 Apr 2013 13:39:15 GMT

Modern Healthcare: Physicians Urged To 'Pause Before Posting'
Physicians should exercise caution—and "pause before posting"—when interacting in online settings in order to preserve professionalism and maintain appropriate patient-physician relationships, according to a policy paper released today by the American College of Physicians and the Federation of State Medical Boards. "This is a very important addition to the ethics literature," Dr. David Fleming, chair of the ACP's ethics, professionalism and human rights committee, said during a news briefing (Landen, 4/11).

Research Roundup: Lesson For Insurance Exchanges From Europe

Fri, 12 Apr 2013 13:26:00 GMT

Each week, KHN reporter Alvin Tran compiles a selection of recently released health policy studies and briefs.

Health Affairs: Health Insurance Exchanges In Switzerland And The Netherlands Offer Five Key Lessons For Operations Of US Exchanges – As states and the federal government begin creating insurance exchanges under the health law, researchers highlight several lessons from Switzerland and the Netherlands. Those countries have private insurance markets with five aspects of success: "risk-adjustment mechanisms—which provide premium adjustments intended to compensate health plans for enrolling people expected to have high medical costs" are "sophisticated and continually updated;" the importance of identifying barriers to enrollment among those eligible; a simple application process for subsidies; clear negotiating power for insurers on prices and quality of service; easy availability of reliable data regarding providers’ costs and quality of care for insurers and consumers. "American policy makers will need to conduct ongoing analyses of the different ... [exchanges] to learn what works best to create incentives for efficiency," the authors concluded (van Ginneken, Swartz, and Van der Wees, 4/8).

Health Affairs/Robert Wood Johnson Foundation: Health Policy Brief: The Multi-State Plan Program - The insurance markets for individuals and small businesses are highly concentrated in some states, meaning a single insurer could dominate the market. To spur competition and increase the number of options for individuals, the federal health law created the Multi-State Plan Program and put it under the direction of the Office of Personal Management (OPM). "OPM must certify at least two issuers to be able to sell coverage in the exchanges in time for open enrollment on October 1, 2013," the author writes. "Also, under the law, insurers participating in the multistate program must offer at least two plans through each exchange." This brief delves into the program's background and explores the OPM's role and potential challenges as its administrator (Goodell, 4/3).

JAMA Pediatrics: Association Between State Laws Governing School Meal Nutrition Content And Student Weight Status – By studying 4,800 eighth-graders from 40 states, researchers aimed to determine if school meal nutrition standards that exceeded the Department of Agriculture’s school meal standards improved the weight status of adolescents. "The results of this study suggest that in states with laws that encouraged or required a specific number of fruits/vegetables, reductions in trans fats, 1% skim milk, and/or a minimum proportion of whole grains, students who obtained school lunches had a more favorable weight status, particularly among participants eligible for a free/reduced-price lunch," the authors wrote. "The evidence supporting stringent school meal standards is far from conclusive, but this study provides promising signs of the potential for the USDA updated standards to improve student weight status" (Taber, Chriqui, Powell and Chaloupka, 4/8).

The Kaiser Commission on Medicaid and the Uninsured/Kaiser Family Foundation: Health Coverage For The Hispanic Population Today And Under The Affordable Care Act –The authors of this brief write: "The more than 50 million Hispanics living in the United States make up 17 percent of the total population and are the nation's fastest growing racial or ethnic group. Many Hispanics continue to face disparities in health coverage and care, and they have the highest uninsured rate among racial/ethnic groups, with nearly one in three lacking coverage. The Affordable Care Act (ACA) could help many uninsured Hispanics through the law's expansion of Medicaid and the creation of new health insurance exchange marketplaces with tax credits to help moderate-income people purchase coverage" (4/9).

Here is a selection of news coverage of other recent research:

NPR' SHOTS blog: Seniors In The South Are More Apt To Be Prescribed Risky Drugs
Health care types have spent years trying to make the point that seniors are being prescribed medications are unnecessary and dangerous. But the message hasn't really sunk in. More than 20 percent of people with Medicare Advantage coverage are taking at least one high-risk medication, a new study finds (Shute, 4/11).

Medscape: Adverse Drug Events Found By Mining Clinical Notes In EHR
Mining unstructured clinical notes written in electronic health records (EHRs) can be used as a strategy to identify early signs of adverse drug events, according to the findings of a new study by Paea LePendu, PhD, and colleagues from Stanford University in California. The authors published their findings online April 10 in Clinical Pharmacology and Therapeutics (Barber, 4/10).

Medscape: Drug Reps Provide Little Information On Harmful Effects
Pharmaceutical sales representatives (PSRs) rarely present serious adverse events during their sales calls. France has stricter standards than the United States and Canada, and therefore presentation of "minimally adequate safety information" is slightly higher in France than in these North American countries. Barbara Mintzes, PhD, from the School of Population and Public Health, University of British Columbia in Vancouver, Canada, and colleagues published the results of their prospective cohort study online April 10 in the Journal of General Internal Medicine (Pullen, 4/10).

State Roundup: Minn. Democrats Push Pay Hike For Nursing Home Workers

Wed, 10 Apr 2013 13:22:00 GMT

A selection of health policy stories from Minnesota, Colorado, New York, Delaware, Georgia, Oregon, Connecticut, Pennsylvania, Arizona, Massachusetts and California.

The Associated Press: Minnesota House Health Bill Has Care Worker Pay Hike
Minnesota House Democrats proposed a health programs spending bill Tuesday that includes new money for mental health treatment and small salary hikes for nursing home and long-term care workers, but helps pay for it with an increase in the state surcharge on hospitals that even the bill sponsor said was likely to be "very controversial." The health and human services (HHS) finance bill amounts to the DFL-controlled House's opening offer on how to divide public dollars in one of state government's largest spending areas (Condon, 4/9).

MPR News: DFL Spending Cuts Target Hospitals, HMOs
Minnesota House Democrats are proposing a health and human services budget that spares drastic cuts to poor people, the elderly and people with disabilities. But the plan would raise about $152 million from the state's hospitals and HMOs. It would also increase funding for the state's nursing homes and other long-term care facilities. Three weeks ago, DFL legislative leaders announced their intention to cut $150 million from the health and human services budget, but didn't explain how they would do it until now (Scheck, 4/9).

Health Policy Solutions (a Colo. news service): 'Risks' Loom For Health Exchange Technology
As Colorado’s health exchange managers sprint toward an October 1 launch, a top manager warned board members on Monday that a recent decision to build a new "eligibility" IT system poses the greatest risk of delay and could undermine the quality of the online health marketplace. … No. 1 on that list of risks is the new decision to divide one planned IT system into two. ... State Medicaid managers are building their own separate system to determine if exchange customers are eligible for Medicaid. Previously, Medicaid and the health exchange were planning to operate one "shared eligibility service," the report said (Kerwin McCrimmon, 4/9).

The Wall Street Journal: Health Care Ails In Rockaways
After superstorm Sandy disrupted many of the Rockaway Peninsula's health care facilities, volunteer doctors and nurses filtered into the devastated area, knocking on doors to see if residents needed help and serving hundreds of them from mobile medical units (Dawsey, 4/9).

The Associated Press/Washington Post: Del. Officials Reduce Hours At Public Health Clinic, Cite Low Patient Numbers, Consolidation
Delaware public health officials say services at a Middletown clinic are being reduced because of low patient number and a need to consolidate services. Officials say the Division of Public Health alerted patients last week of a reduction in service hours at the Middletown Health Unit, Sexual and Reproductive Health Clinic, effective last Friday (4/10).

Kaiser Health News: Capsules: Colorado's Pitch For New Business: Healthy, Lean Workers Cost Less
The cost of doing business may be lower in areas where there's a 'culture of health.' And that's put Colorado, which has the lowest rates of obesity in the nation, on the map for companies looking to relocate or expand. Kelly Brough is proud of this. She runs the Denver Metro Chamber of Commerce, and she's creative about luring businesses to relocate in Colorado. For instance, she runs a 'Colorado loves California' campaign (Whitney, 4/10).

Georgia Health News: Website Data For Some Ga. Hospitals Are Flat Wrong
One thousand, one hundred and fifteen minutes. That’s 18.5 hours. It’s not much time in the grand scheme of things. But it's a very long time for a person who arrives in an ER to have to wait before being sent home. The 1,115-minute figure is reported on a public federal website as the average time an emergency room patient waits at Archbold Medical Center in Thomasville before being sent home. The national average is just 140 minutes (Miller, 4/9).

The Lund Report: Bill Would Ban Pop And Junk Food In Public Vending Machines
If you want to buy a Coke or a Snickers bar from a state Capitol vending machine, you’d better get yours while you can. If House Bill 3403 becomes law, those and other products like fatty potato chips or whole milk would be off-limits at any vending machine in Oregon public buildings. … House Bill 3403 requires that all food and drinks sold in public vending machines meet strict specifications. Snacks may not be more than 200 calories and may contain no more than 35 percent of their calories from fat or sugar (Gray, 4/9).

CT Mirror: For Better Mental Health Coverage, Help With The Paperwork
Talk to people involved the mental health system and it won't be long before you hear complaints about the difficulty of getting private insurance to pay for mental health services. Some advocates say the answer is to better enforce state and federal laws requiring equal coverage for mental health and medical services. Some clinicians and lawmakers want the state to take over insurance coverage for mental health care, billing insurance carriers for the cost (Becker, 4/9).

Philadelphia Inquirer: IBC To Sell Percentage Of Insurance Subsidiary To Cooper
Independence Blue Cross has agreed to sell a 20 percent stake in its New Jersey health insurance subsidiary, AmeriHealth New Jersey, to Cooper University Health Care, of Camden, the organizations plan to announce Wednesday. The deal, which requires regulatory approval, is part of a trend toward increased integration of hospitals and insurers in preparation for a shift to a system that pays providers lump sums for all care needed by an individual rather than for each discrete visit and treatment (Brubaker, 4/10).

Arizona Republic: Human Side Of Arizona Debate Over Medicaid
John Froneberger has been without medication to treat his depression and high blood pressure since last fall, when a cost-of-living increase in his disability benefit, to $970 a month, put him just above the poverty level and cost him his health insurance. Froneberger’s monthly disability check helps pay for rent and food, but, as with hundreds of other Arizonans, it disqualifies him from the Arizona Health Care Cost Containment System, the state’s Medicaid program (Reinhart, 4/9).

Boston Globe: Quincy Medical Center, Nurses Far Apart As Strike Nears
Quincy Medical Center nurses sat in a sea of blue in the basement of a Quincy church Tuesday morning, as they aired their grievances in a dispute that centers on staffing levels. The public event came a day after unsuccessful negotiations between the Massachusetts Nurses Association and hospital officials to call off a one-day nurses strike that is scheduled for Thursday (Bartlett, 4/10).

California Healthline: Physician Assistant Bill Clears First Hurdle
The Senate Committee on Business and Professions approved SB 352 by Sen. Fran Pavley (D-Agoura Hills), a bill designed to allow physician assistants and other providers to oversee work by medical assistants. … Pavley made it a point to say the bill doesn't change what medical assistants are allowed to do, or even what physician assistants or nurse practitioners are allowed to do (Gorn, 4/9).

Moody's: Sequestration Increases Pressure On Non-Profit Hospitals

Tue, 09 Apr 2013 13:31:00 GMT

Also in the news, the Centers for Medicare & Medicaid Services has begun auditing some of the physicians who qualify for a Medicare EHR "meaningful use" bonus before they even receive a check -- a step that has triggered grumbling from organized medicine.

Reuters: New Medicare Cuts Threaten Non-Profit Hospitals – Moody's
Not-for-profit U.S. hospitals began confronting another threat to their shaky finances last week with the start of reductions to Medicare that are included in the universal federal spending cuts known as sequestration, Moody's Investors Service said on Monday (4/8).

Medscape: In Reversal, CMS Audits EHR Bonus Winners Before Payment
After panning the idea last fall, the Centers for Medicare & Medicaid Services (CMS) has begun auditing between 5% and 10% of physicians who qualify for a Medicare bonus for meaningful use of an electronic health record (EHR) system before they ever receive a check. The new audit, which comes on top of double-checking a similar percentage of physicians after they receive the bonus, has leaders of organized medicine grumbling about red tape and payment delays (Lowes, 4/8).

Proposal To Eliminate SGR Payment Formula Is Revised

Thu, 04 Apr 2013 04:00:00 GMT

The House panels' proposal to replace Medicare's sustainable growth rate formula is seen as a way to change how Medicare delivers care. Meanwhile, some House GOP lawmakers who have complained about the health law's costs said Wednesday that it should have allocated more money to a program to cover people with pre-existing health conditions.

Modern Healthcare: House GOP Releases Revised Proposal For Replacing SGR
House Republican leaders released a revised proposal to replace Medicare's sustainable growth-rate physician payment formula. The proposed system would include specialty-specific performance measures, payment rates partly based on patient experience, and development of an appeals process to contest or reconsider a provider's quality score. Chairmen of the House Energy and Commerce and Ways and Means committees along with their respective health subcommittees issued the revised proposal on April 3 with a letter to the "provider community" (PDF) requesting comments on the new draft by April 15 (Robeznieks, 4/3).

The Hill: House Panels Release New Outline For Permanent 'Doc Fix'
Leaders of two top House committees are circulating an expanded draft of their plan to repeal Medicare's sustainable growth rate (SGR), the flawed physician payment formula that necessitates an annual "doc fix." The plan from the Energy and Commerce and Ways and Means panels would use SGR repeal as an opportunity to make dramatic changes to healthcare delivery within Medicare (Viebeck, 4/3).

Kaiser Health News: Capsules: GOP Members Call For Increased Spending To Cover Pre-Existing Conditions
Republicans who have spent the past three years blasting the health care overhaul as an overreach by the federal government said Wednesday the law didn't allocate nearly enough money for a temporary program offering insurance coverage to those with pre-existing conditions (Galewitz, 4/3).

Medpage Today: $$$ For Pre-existing Conditions Pain ACA
The high cost of covering adults with preexisting conditions before 2014 could signal greater costs for all individuals within the broader health insurance market, a health economist warned lawmakers. The Pre-Existing Condition Insurance Plan (PCIP), which the Affordable Care Act (ACA) created as a way to provide health coverage to those with preexisting medical conditions before other aspects of the law take effect in 2014, does nothing to reduce the costs of care for those patients, Thomas Miller, JD, resident fellow at the conservative American Enterprise Institute here, said at a congressional hearing Wednesday. Despite garnering only 110,000 enrollees -- far less than the 375,000 expected -- the PCIP program has run out of the $5 billion Congress gave it (Pittman, 4/3).

In other Capitol Hill action, Rep. Diane Black, R-Tenn., introduced legislation to give some physicians nearing retirement a break regarding electronic health record adoption penalities -

Medscape: Bill Would Exempt Retirement-Age Physicians From EHR Penalty
Physicians near retirement wouldn't suffer a Medicare pay cut for failing to adopt an electronic health record (EHRs) system, and soloists would get a 3-year hiatus from this penalty under a bill introduced last month by Rep. Diane Black (R-TN). The measure, which Black had introduced in the previous session of Congress, also would give specialists some breaks in earning bonuses and avoiding penalties in the incentive program, designed to promote "meaningful use" of EHRs for the sake of improved patient care and lower costs (Lowes, 4/3).

Roundup: Feds Cut N.Y. Medicaid Payments $1.2B; 93,000 Fewer Kids Enroll In CHIP In Pa.

Tue, 02 Apr 2013 13:28:00 GMT

Reuters: Federal Government Slashes New York's Medicaid Payments
Federal authorities have dramatically lowered the amount that New York state can claim from the federal government for certain medical services, costing the state an estimated $1.2 billion. The Center for Medicaid Services (CMS), the federal agency that administers the nation's medical insurance system for people on low incomes, cut the per-patient reimbursement rate for patients in developmental centers to $1,200 from $5,100 from April 1, according to CMS documents seen by Reuters (Krudy, 4/1).

Philadelphia Inquirer: 93,000 Fewer Kids Enrolled In CHIP Under Corbett
For years, the Philadelphia region has been among the best places for a child to get sick. Pennsylvania's Children's Health Insurance Program, dating to 1992, was a model for what Congress expanded to all the states five years later. New Jersey set one of the easiest income thresholds for SCHIP and has aggressively enrolled children into Medicaid as well. New Jersey still has a top reputation, with more than 25,000 children added to the public insurance rolls since July 1, 2011. It has won more than $50 million in federal "bonus" grants for its performance.There have been no bonuses for Pennsylvania. Since Gov. Corbett's first budget took effect in mid-2011, enrollment has dropped by 93,000 (Sapatkin, 4/2).

The Wall Street Journal: Lawmakers Back Fight to Maintain Miners' Benefits
West Virginia's top lawmakers pledged at a rally Monday to ramp up pressure on Patriot Coal Corp. to continue providing health benefits to 23,000 retired coal miners and their dependents who could lose much of their coverage in bankruptcy court. U.S. Sens. Joe Manchin and Jay Rockefeller, and Rep. Nick Rahall, all Democrats, told several thousand gathered in the Charleston Civic Center that the retirees were entitled to keep receiving benefits, and that the company is breaking a contractual promise negotiated with the United Mine Workers of America to maintain benefits for life (Maher, 4/1).

Asbury Park (N.J.) Press/USA Today: Health Care Costs For Older Inmates Skyrocket
Older prisoners are also the fastest growing segment of the U.S. prison population. There were an estimated 246,000 people over 50 behind bars last year, according to a 2012 American Civil Liberties Union report. The growing number of older prisoners like (Stephen) Thomas represents a potential fiscal time bomb for the state and nation: Elderly prisoners cost more because almost all expenses related to their health care must be borne by state tax dollars (Mikle, 3/30).

Georgia Health News: Coverage Switch Affects Many Georgia Seniors
More than 7,000 Medicare beneficiaries in Georgia are switching health plans after a Florida-based insurer was ordered to liquidate. All policies of Universal Health Care have been canceled. Last week, federal agents raided the St. Petersburg headquarters of Universal Health Care, after a bankruptcy court trustee alleged a "pattern of dishonesty or gross mismanagement" at the company, including "side deals" that benefited insiders, according to a Tampa Bay Times article. A judge placed the insolvent Medicare insurer into receivership a week prior to the FBI raid. About 800 Universal employees lost their jobs last week after the company shut down (Miller, 4/1).

MPR News: Legislators Balk At $500M Request From Mayo To Aid Expansion
When Minnesota lawmakers return to the state Capitol on Tuesday to focus on a two-year budget, they will also weigh whether to approve the Mayo Clinic's request for $500 million to support its $3 billion expansion plan. Supporters of the project say state financing for roads, bridges, parking garages and other improvements would ensure that the hospital and clinic system cements its future in the Rochester area (Scheck, 4/2).

MPR News: 2012 Health Care Spending Per Person Up 5%
Health care spending per person rose 5 percent in Minnesota last year, reports the Minnesota Council of Health Plans, the trade group representing the state's health insurers. HMOs are required to annually report their financial reports to the state. The Minnesota health plans reported total revenue of nearly $21 billion; with an operating profit of $120 million. That's a margin of about six-tenths of a percent. Part of the rise in total spending per person is due to increased costs for chemical dependency and mental health services; chiropractors and social workers -- all were up 15 percent, said Julie Brunner, the council's executive director (Stawicki, 4/1).

Kansas City Star: Prime Healthcare Completes Hospital Purchases In Kansas City Area
A few hours after gaining Kansas regulatory clearance, Prime Healthcare Services on Monday said it completed its purchase of hospitals in Kansas City, Kan., and Leavenworth. The 400-bed Providence Medical Center and 80-bed St. John Hospital join 23 acute-care hospitals in the California-based Prime chain (4/1).

CT Mirror: Attorneys Press For Change In Medical Malpractice Procedure
Medical malpractice laws are getting an airing at the Capitol today as the Judiciary Committee hears testimony on a proposed change to how cases against physicians come to court. Since 2005, a patient wanting to claim damages from a doctor for alleged negligence must have his or her case reviewed by a similar health care provider, who will certify whether the claim has merit. If the patient can't get what's known as a good faith certificate, the courts will dismiss the case before it gets to trial. Attorneys say the statute has a chilling effect on cases (Jones, 4/1).

Baltimore Sun: Bill To Increase Oversight Of Cosmetic Surgery Centers Making Late Push In Assembly
A bill to give health regulators more oversight of facilities like the now-closed Monarch Medspa in Timonium is making a late surge in the General Assembly after weeks of discussions among state and industry officials. The House of Delegates unanimously passed the legislation Monday afternoon. It needs to clear the Senate, including an extra procedural step, within the next week (Dance, 4/1).

The Lund Report: Ore. House Bill 3000 Requires Children To Have Eyes Checked For School
Sen. Richard Devlin, D-Tualatin, as the co-chairman of the Joint Ways & Means Committee, presides over much of the budget and has to be well-versed on statistics and figures. But to show his support for House Bill 3000 -- which would require all Oregon children entering public schools to have a vision screening -- Devlin told the House Education Committee last week he didn't want to focus on statistics and reports, but wanted to tell a story (Gray, 4/1).

Modern Healthcare: Bill Would Offer Meaningful-Use Exemptions
A Republican congresswoman from Tennessee has introduced legislation that would exempt solo practitioners and physicians nearing retirement from the upcoming Medicare reimbursement cuts for physicians who do not meet meaningful-use requirements for electronic health-record systems under the American Recovery and Reinvestment Act. Rep. Diane Lynn Black, a former nurse and member of the House Budget and Ways and Means committees, re-introduced her Electronic Health Records Improvement Act last month (Conn, 4/1).

California Healthline: Mobile App Highlights Patient Advocate Site
Ratings of health plans' performance put together by the state Office of the Patient Advocate and newly displayed on its website are now accessible by mobile application. "This is the first app of this type nationally," said OPA director Amy Krause. "We hope this makes quality an important part of every doctor visit." At the heart of what makes the mobile app worthwhile, Krause said, is the rating system itself, which is based on information provided by the Department of Insurance. Patients can compare performance and quality factors among HMOs, PPOs and medical groups in California, both overall and within specific categories, such as how plans' providers handle diabetes prevention and treatment (Gorn, 4/1).

California Healthline: Changes Set Stage For 'Shakeout' Of Medical Suppliers, Services
Shifts in contracting practices -- part of the trickle-down effects of health care reform -- are going to change the landscape of medical equipment and service suppliers in California, stakeholders predict. ... Bob Achermann, executive director of the California Association of Medical Product Suppliers ... predicted the number of California businesses providing medical supplies and services may be cut in half over the next few years. Two changes are at the heart of the "thinning of the herd," as Achermann calls it. One is state-driven: California is shifting beneficiaries of Medi-Cal -- California's Medicaid program -- from fee-for-service to managed care. The second is a federally mandated change in the way Medicare contracts with suppliers (Lauer, 4/1).

Health Industry Faces Shortage Of IT Professionals

Fri, 29 Mar 2013 13:32:24 GMT

In addition, a regulation permitting hospitals to donate medical records software to doctors is scheduled to expire.

The Wall Street Journal: Talent Deficit, Poaching Weigh On Healthcare IT
Healthcare CIOs are finding it hard to attract and retain IT professionals to operate hospital computer systems. They blame the talent crunch on several factors, including limited supply of qualified workers, poaching by rivals, rising levels of compensation, and legacy computer systems that IT staff don't like to use. A shortage of workers is never a good thing, but in this case, it's particularly worrisome. Without a proper IT staff, hospitals may have a more difficult time qualifying for federal incentives that are paid to hospitals that can demonstrate that better management of healthcare information is leading to an improvement in patient outcomes. The incentives—which total billions of dollars—are being distributed by the U.S. Centers for Medicare and Medicaid (Boulton, 3/28).

Modern Healthcare: Lawmakers Urges Extension Of Safe Harbor For EHRs
Normally, it would be illegal for a hospital to donate electronic medical-record software to an independent doctor who refers patients for treatment at the hospital. But federal officials created special rules to allow such transfers as a way to encourage healthcare providers to adopt the costly systems. Those exceptions to the Stark law and the anti-kickback statute are due to expire at the end of the year, and observers say little is being done to renew them, even though federal subsidies for EHR systems are slated to continue via Medicare until 2016 (Carslon, 3/28).

Study: Experts Question Cost Benefits Of 'Telehealth'

Fri, 22 Mar 2013 13:51:20 GMT

Reuters: As 'Telehealth' Grows, Experts Question Cost Benefits
Monitoring patients at home using modern technology, so-called 'telehealth', is tipped as the next big thing in healthcare, but a new study by British researchers suggests it may not be worth the extra expense. The findings will fuel controversy over the economic case for telehealth, which many information technology and telecoms companies are betting on as a multibillion-dollar market opportunity (Hirschler, 3/21).

Weekend Reading: Spiritual Bedside Manner; Cancer And The Environment

Thu, 21 Mar 2013 13:31:00 GMT

Every week reporter Ankita Rao selects interesting reading from around the Web.

The Atlantic: Should Your Doctor Pray With You?
"I can fix this." The neurosurgeon was nothing if not confident. … Then, just when it looked like the surgeon would head back to the operating room, he instead lowered his head and held the professor's hands. And began to pray. Not pray as in silently meditate by the bedside. But pray out loud, in an almost Pentecostal, sermon-y kind of way. … As physicians, we interact with patients during some of the most important moments of their lives -- at their births and at their deathbeds, at events bursting with spiritual significance. And yet most of us are afraid to talk about spirituality with our patients, much less discuss religion, out of fear that such conversations would be inappropriate (Peter Ubel, 3/18).

Slate: Cancer Cluster Or Chance?
Lay a chessboard on a table. Then grab a handful of rice and let the grains fall and scatter where they may. They won't spread out uniformly with the same number occupying each square. Instead there will be clusters. Now suppose that the chessboard is a map of the United States and the grains are cases of cancer. Each year about 1.6 million cases of cancer are diagnosed in the United States, and epidemiologists regularly hear from people worried that their town has been plagued with an unusually large visitation. Time after time, the clusters have turned out to be statistical illusions—artifacts of chance. ... Of the handful of residential clusters that have not been dismissed as flukes, only two in the United States have been associated, with a great deal of uncertainty, with environmental contaminants. Both involved childhood cancer (George Johnson, 3/19).

The New York Times: The Face Of Future Health Care
When people talk about the future of health care, Kaiser Permanente is often the model they have in mind. The organization, which combines a nonprofit insurance plan with its own hospitals and clinics, is the kind of holistic health system that President Obama's health care law encourages. Kaiser has sophisticated electronic records and computer systems that — after 10 years and $30 billion in technology spending — have led to better-coordinated patient care, another goal of the president. And because the plan is paid a fixed amount for medical care per member, there is a strong financial incentive to keep people healthy and out of the hospital, the same goal of the hundreds of accountable care organizations now being created (Reed Abelson, 3/21). (Kaiser Health News is not affiliated with Kaiser Permanente.)

American Medical News: How To Talk About Hospice Care
About once a year, a patient or family member will "jump up and just walk out of the room when I mention hospice," says David Casarett, MD, chief medical officer of the University of Pennsylvania Health System's hospice program. … Even though such harsh reactions may be the exception, Dr. Casarett says, they are enough to make many doctors uneasy about bringing up hospice — a program that offers at-home nursing care, pain and symptom relief, spiritual counseling and other services but typically requires patients to forgo disease-directed treatments that aim to extend survival time (Kevin O’Reilly, 3/21).

New Apps, Social Networks Shaping Doctor Delivery Of Care

Wed, 20 Mar 2013 13:29:00 GMT

Adoption of health information technology is examined as new computer application development and adoption change how doctors deliver care. In Kansas, developers are trying to quicken the pace of doctors adopting new technologies.

The New York Times: The Doctor Is In (Well, Logged In)
Surfing the Web in his all-white Dumbo loft, Dr. Jay Parkinson, 37, looks like any other young tech visionary. He has a trim beard and thick-framed glasses. He wears slim-fitting black outfits and jaunty scarves. He speaks with a measured, "This American Life"-like cadence. And he's a firm believer in the utopian promise of the Internet. But Dr. Parkinson's start-up isn't a new app or social network. He is a founder of Sherpaa, a Web site that operates like a virtual doctor's office, examining patients by e-mail and text message (Stein, 3/19).

Kansas Health Institute: Health IT Innovations, Value Of EHR Systems Discussed
If there were as many software developers working on applications for storing and exchanging patient data as there are working on apps like Angry Birds, electronic health record systems wouldn't be so chronically outdated. That's the mantra of experts working on a software project based here that is aimed at transforming a "monolithic and slow-to-evolve" health information technology industry into one modeled after the iPhone app developer community (Cauthon, 3/19).

State Roundup: Inmates Sue Calif. Counties Over Prison Care

Tue, 19 Mar 2013 13:25:00 GMT

A selection of health policy stories from California, Oregon, Michigan, Kansas, Massachusetts and New Jersey.

Los Angeles Times: California Scores Poorly On Posting Health Care Prices, Report Says
California consumers don't have easy access to prices for medical care, according to a national report card that gave the state a letter grade of D for its dismal showing. Overall, 36 states received grades of D or F in the report issued Monday by two nonprofit healthcare groups that analyzed government efforts to make pricing information widely available to consumers (Terhune, 3/18).

The Associated Press: Counties Now Facing Inmate Lawsuits
California has spent billions of dollars and endured years of federal lawsuits to improve conditions in its state prisons, but the problems it has been trying to correct are now trickling down to local governments as county jails deal with thousands of additional inmates. Law firms advocating for inmates' rights have sued or threatened lawsuits against a handful of California counties because of Gov. Jerry Brown's plan to send lower-level offenders to local jails instead of state prisons as a way to comply with a federal court order (Thompson, 3/19).

The Lund Report: Shields And Holvey Want Unlawful Trade Act To Cover Insurers
Sen. Chip Shields, D-Portland and Rep. Paul Holvey, D-Eugene, rolled out legislation last week that would open up the insurance industry to torts under the state's Unlawful Trade Practices Act and allow the attorney general to sue insurers for fraud. ... Shields said the special exemption allows insurance companies to act with impunity and reduces their incentive to pay out claims as warranted. If they commit fraud, they cannot be sued by the attorney general under any tort or statute (Gray, 3/19).

The Associated Press: Michigan Reveals Goals For State Autism Services
State health officials laid out long-term goals Monday designed to improve access to services for the estimated 50,000 people living with autism spectrum disorders in Michigan, including more early screening and the creation of a state resource center to provide families with information about services. The Autism Spectrum Disorders State Plan revealed by the Michigan Department of Community Health and Autism Council identifies gaps in the availability of services and makes recommendations for how to improve the lives of adults and children with autism spectrum disorders (Durkin, 3/19).

Los Angeles Times: Two Former CalPERS Officials Indicted On Fraud Charges
Three years after a major influence-peddling scandal rocked California and the nation's largest public pension fund, a federal grand jury indicted two former top officials on fraud, conspiracy and obstruction charges (Lifsher, 3/19).

The Lund Report: Troubled Oregon Counties Turn To Cigarette Tax For Public Health
Portland City Commissioner Steve Novick told the House Revenue Committee Friday that the state of Oregon trusts local governments to do a lot of things -- arrest people, put them in jail, set zoning ordinances, raise property taxes, even generate income taxes (Gray, 3/19).

Kansas Health Institute: Senate Panel Advances HIE Bill
A Senate panel voted today to advance favorably a bill that would shift regulatory power from KHIE, Inc. to the Kansas Department of Health and Environment. KHIE is the entity created in 2010 to oversee the digital exchange of patient records. State officials have said they could regulate the exchange networks without requiring additional funding. The shift also has been endorsed by the KHIE, Inc. board of directors (Shields, 3/18).

Medpage Today: Mass. Health Plans Aim To Slow Rising Costs
The state -- policymakers, insurers, and providers -- is taking steps to rein in cost. Gov. Deval Patrick (D) signed into law this summer a bill aimed at doing just that. Among its many provisions, the law tries to move providers away from a fee-for-service model, creates an independent Health Policy Commission, and sets a target growth rate of 3.6 percent in 2013. Patrick told attendees at the Association of Health Care Journalists' annual meeting here that the state "will crack the code on cost containment." In 2008, Blue Cross Blue Shield created an "Alternative Quality Contract" which provides a global payment to providers to care for the insurers' members (Pittman, 3/18).

California Healthline: Concern Over Mental Health Provider Shortage
Legislation introduced last week would expand the scope of practice for nurse practitioners, optometrists and pharmacists. Separate legislation looks to expand scope of practice for physician assistants, as well. The bills hope to address the dearth of primary care providers in California by allowing some mid-level health care providers to do more. With the Affordable Care Act's expansion of Medi-Cal and introduction of the state exchange starting in 2014, there is expected to be a much greater need for primary care services. Some mental health providers are citing a similar access concern for mental health professionals (Gorn, 3/18).

California Healthline: Legislature Will 'Look Carefully' At UC Medical System After Report
California state Sen. Ed Hernandez (D-West Covina), chair of the Senate Committee on Health, said state legislators will look into allegations of mismanagement at University of California medical centers that have put patient safety in jeopardy. A new report from the American Federation of State, County and Municipal Employees Local 3299 contends that the UC system's five medical centers are understaffed and patient care is suffering. … The report says frontline providers in hospitals and medical centers are understaffed, sometimes leading to dangerous situations threatening patient safety (Lauer, 3/18).

Medpage Today: One More Compounding Pharmacy Recalls Drugs
In a move that is reminiscent of last fall's fungal meningitis outbreak, a New Jersey compounding pharmacy is recalling all its products after fungal particles were found in bags of magnesium sulfate intravenous solution. The FDA said Med Prep Consulting of Tinton Falls, N.J., recalled all lots of all products after a Connecticut hospital observed the particles in the solution. As well, the FDA said in a release, the firm has temporarily halted production, including processing and shipping drugs, under an order from the New Jersey State Board of Pharmacy. There have been no reports of patients being infected, according to Janet Woodcock, MD, director of the FDA's Center for Drug Evaluation and Research (Smith, 3/18).