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From Kaiser Health News: Latest Stories
Providers and insurers are balking at a Covered California proposal to eject hospitals with inordinately high costs and low quality from its networks. (Chad Terhune, 3/21)
Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Hand To Mouth'" by Dave Coverly, Speed Bump.
Here's today's health policy haiku:
EXCHANGE: HOSPITAL OUTLIERS COULD BE CUT
Poor performers out?
Maybe in California …
The market reacts.
If you have a health policy haiku to share, please Contact Us and let us know if you want us to include your name. Keep in mind that we give extra points if you link back to a KHN original story.
Summaries of the News
If at least five Supreme Court justices fail to agree on a decision on the contraception mandate, it would leave lower court's decision intact, creating different rules for different parts of the country.
The Associcated Press: Scalia's Death Could Affect Politically Tinged Cases
Challengers in two politically tinged cases before the Supreme Court this week face the seemingly insurmountable problem of being unable to count to five — as in five votes. The death of Justice Antonin Scalia has deprived conservatives of a reliable vote on a range of issues, including the design of congressional districts in Virginia and the Obama administration's effort to accommodate faith-based groups that object to paying for contraceptives as part of their health insurance plans. (Sherman, 3/18)
The Wall Street Journal: Timeline: Catholics And White House Battle On Health Law Contraception Rules
The Supreme Court on March 23 will weigh how far the government has to go to accommodate religiously affiliated employers that object to including contraception in workers’ insurance plans. The issues has been brewing since shortly after the Affordable Care Act was signed into law in 2010. Here is a timeline. (Radnofsky, 3/18)
Congress would need to act to make a dent in the astronomical cost of drugs, but pressure from the pharmaceutical industry and political gridlock have stymied action. Meanwhile, a new study finds that nearly half of all Americans 75 and older took five or more prescription drugs in 2011, a trend which has significant financial ramifications.
The Associated Press: No Clear Path To Government-Lowered Drug Prices
Most Americans support it. Virtually all other developed countries already do it. And the two leading presidential candidates on both sides of the aisle agree: the federal government should lower drug prices. But experts say the chances for government action in the near-term are close to nil. The reasons are familiar: political gridlock in Washington, pharmaceutical industry influence and the structure of the U.S. health system itself, which limits government intervention. (Perrone, 3/18)
CBS News: The High Cost Of Seniors' Soaring Rx Drug Use
A recent study found that almost half (47 percent) of Americans age 75 and older took five or more prescription drugs in 2011, nearly double the 24 percent that did so in 1999, just 12 years earlier. The comparable percentage for Americans 65 to 74 also increased significantly -- from 23 percent in 1999 to 33 percent in 2011. (Vernon, 3/21)
As consumers find their general health plans have higher deductibles, they are increasingly turning to policies that cover specific -- and expensive -- illnesses, such as cancer. But consumer advocates question the cost. Also, a look at cancer treatment expenses and surprise bills that some people receive after getting out-of-network care.
The New York Times: Insurance For Critical Illness May Add Security, But At A Cost
It’s often pitched as an insurance policy for your health insurance policy.The product, known as critical illness insurance, promises to pay a lump sum, anywhere from $5,000 to $100,000, after someone receives some sort of dreaded diagnosis, like cancer, a heart attack or a stroke. And the coverage is not terribly expensive; if you are in your 40s, it might cost $25 to $50 a month. These policies have become increasingly popular, partly because they are being marketed as a way to provide another layer of financial support now that consumers are shouldering an ever-rising share of medical expenses out of pocket. ... But some consumer advocates and health policy analysts have questioned whether these policies are worth the expense, partly because they are so narrowly focused. (Bernard, 3/19)
Earlier KHN coverage: More Employers Offer Plans That Provide Lump Sums For Critical Illnesses (Andrews, 1/5)
The Richmond Times Dispatch: For Many, Cancer Sets Off Financial Crisis
Cancer is a health crisis that for many sets off a financial crisis. In a study done by Virginia Commonwealth University School of Pharmacy researchers, nearly one-third of cancer survivors reported that their illness had caused financial problems. The patients who reported the most financial problems also reported more physical and mental health problems. Having health insurance was not a guarantee that a person would not face money problems. (Smith, 3/18)
USA Today/The Tennessean: 'Surprise Bills' Shock Those Who Choose In-Network Care
Because patients get billed by individual providers, a patient can go in-network but still get hit with an out-of-network charge. ... The inadvertent out-of-network bills are called “balance billing” because patients pay the difference between the insurance plan's out-of-network benefits and the provider's rack-rate charge, which is often considerably higher than the negotiated amount with an insurer. Some insurance plans offer little to no out-of-network coverage. Hospitals encourage the doctors to accept the same insurance plans and networks as the hospital — but it’s not required. (Fletcher, 3/18)
More Americans are turning to urgent care clinics, and patients are finding the dual benefit of the ones that are attached to a hospital: convenience but with a safety net if their problem proves more serious than they thought.
The Wall Street Journal: Traditional Providers Get Into The Urgent-Care Game
When it comes to health issues that need immediate attention but aren’t life-threatening, more Americans are turning to urgent-care centers—and traditional health-care providers are getting into the game. Over the past two years, hospital chains and insurance companies have snapped up urgent-care centers in a spate of mergers and acquisitions. Health systems, too, are moving into this space, striking joint ventures with independent urgent-care operators, says Tom Charland, chief executive of consulting firm Merchant Medicine. (Landro, 3/20)
As new apps allow patients to bring a health care provider to their house with a click of a button, there are those who think the model won't scale with the current shortfall of doctors. But in other news, home visits pay off for new mothers and kids with asthma.
Los Angeles Times: The Return Of Doctor House Calls: Convenient, But At What Cost?
Dr. Sam Kim works for Heal, a Los Angeles-based start-up that allows patients in several California counties to order doctor house calls through a smartphone app. Similar companies exist in other parts of the country, including Pager in New York City and Mend in Dallas. Health advocates generally support using technology to make medical care more convenient. As these companies grow, however, some question the return of the house call. A century ago, most medical visits were in the patient's home. But cities got bigger and doctors began using more equipment, therefore it made sense for them to not travel more than 10 steps from patient room to patient room. (Karlamangla, 3/19)
PBS NewsHour: How Home Visits For Vulnerable Moms Boost Kids’ Brainpower
A rapidly expanding medical program for low-income first-time mothers combines social services with the latest in brain science. The Nurse-Family Partnership provides in-home advice on health and parenting, which can lead to improved cognitive development and language skills for their children, who are showing up to school better prepared for learning. Special correspondent Cat Wise reports. (3/18)
The Des Moines Register: Home Inspections Seek Root Of Kids' Asthma Attacks
Kevin Ochoa’s family is getting unusual help in answering a vexing riddle: Why is he having so much trouble breathing? The Des Moines sixth-grader suffers severe asthma attacks, which routinely send him to the hospital. The situation is frightening, painful and expensive. Last week, a team of experts came to his south-side home to help figure out if something there was triggering Kevin’s lung spasms. (Leys, 3/18)
The cases involve a laparoscopic power morcellator made by J&J that doctors now fear helped spread undetected cancers. Also, the Food and Drug Administration is looking at the possible malfunctioning of devices that measure blood clotting and are commonly used in homes and doctors' offices.
The Wall Street Journal: Johnson & Johnson Settling Cases Tied To Device That Can Spread Uterine Cancer
Johnson & Johnson is settling a series of legal claims and lawsuits alleging that its now-discontinued hysterectomy device harmed women by spreading an undetected hidden cancer, according to court documents and plaintiff lawyers with knowledge of the settlements. An estimated 100 cases have either been filed—or readied for lawsuits—against J&J’s Ethicon unit related to a device known as the laparoscopic power morcellator, said Paul Pennock, a plaintiff lawyer and co-lead counsel on the steering committee for consolidated litigation under way in a Kansas City, Kan., federal court. (Levitz, 3/18)
The Wall Street Journal: FDA Weighs Danger Tied To Blood-Monitoring Devices
The Food and Drug Administration is striving to assess the scope of the danger from medical devices that sometimes produce erroneous readings of how quickly patients’ blood tends to clot when they are taking anticoagulant medicines such as warfarin. The small mobile devices, used in patients’ homes and in doctors’ offices, have malfunctioned in thousands of cases over
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