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KHN First Edition: April 11, 2016


First Edition

Monday, April 11, 2016
Check Kaiser Health News online for the latest headlines

Today's early morning highlights from the major news organizations.

Kaiser Health News: Hospitals Eye Community Health Workers To Cultivate Patients’ Successes
Kaiser Health News staff writer Shefali Luthra reports: "For decades, community health workers have tried to fill the system’s gaps. Often hired by the local health department, they take on diverse public health initiatives -- running diabetes or nutrition education programs, counseling patients to stick to their medication regimens or teaching new mothers about vaccinations. But now, hospitals across the country are turning to them in a bid to revamp patient care. They are using these aides to strengthen their relationships with patients and surrounding neighborhoods -- improving the community’s health and, along the way, their own finances." (Luthra, 4/11)

Kaiser Health News: California Insurance Marketplace Imposes New Quality, Cost Conditions On Plans
Kaiser Health News staff writers Ana B. Ibarra and David Gorn report: "Moving into a realm usually reserved for health care regulators, the California health marketplace Thursday unveiled sweeping reforms to its contracts with insurers, seeking to improve the quality of care, curb its cost and increase transparency for consumers. The attempt to impose quality and cost standards on health plans and doctors and hospitals appears to be the first by any Obamacare exchange in the nation." (Ibarra and Gorn, 4/8)

The Washington Post: A New Divide In American Death
White women have been dying prematurely at higher rates since the turn of this century, passing away in their 30s, 40s and 50s in a slow-motion crisis driven by decaying health in small-town America, according to an analysis of national health and mortality statistics by The Washington Post. Among African Americans, Hispanics and even the oldest white Americans, death rates have continued to fall. But for white women in what should be the prime of their lives, death rates have spiked upward. In one of the hardest-hit groups — rural white women in their late 40s — the death rate has risen by 30 percent. (Achenbach and Keating, 4/10)

NPR: It's Not Just What You Make, It's Where You Live, Study On Life Expectancy Says
Poor people who reside in expensive, well-educated cities such as San Francisco tend to live longer than low-income people in less affluent places, according to a study of more than a billion Social Security and tax records. The study, published in The Journal of the American Medical Association, bolsters what was already well known — the poor tend to have shorter lifespans than those with more money. But it also says that among low-income people, big disparities exist in life expectancy from place to place, said Raj Chetty, professor of economics at Stanford University. (Zarroli, 4/11)

The New York Times: Alone On The Range, Seniors Often Lack Access To Health Care
What’s it like to grow old in rural America? Millie Goolsby is a retired nurse, so when she experienced chest pain five years ago, she recognized the signs of a potential heart attack. But her family didn’t call 911. The drive from her home to the hospital in Klamath Falls, Ore., requires at least half an hour. ... Through his 95th summer, Bill Kolacny was tending the tomato patch on the 400-acre Wyoming ranch where he and his wife, Beverly, had lived for 25 years. When he began to weaken from heart failure in December, all he wanted was to die in their log home on the Clark Fork River. But the nearest hospice organization, in Red Lodge, Mont., isn’t licensed to care for patients in Wyoming. (Span, 4/8)

The New York Times: Small, Piecemeal Mergers In Health Care Fly Under Regulators’ Radars
Federal officials are expected to argue in court starting Monday that a large hospital merger in the Chicago area could hurt consumers and should be stopped. It would be the latest in a series of efforts by regulators to push back against a wave of consolidation among major health care providers. But a frenzy of smaller transactions is also profoundly changing the landscape, many of which face little regulatory resistance. The deals are often for a couple of doctors here, or a hospital there, making them too small to attract much attention. (Abelson, 4/8)

The Washington Post: UnitedHealth Quitting Obamacare Markets In Georgia, Arkansas
UnitedHealth Group, the largest U.S. health insurer, has decided to call it quits in two state Obamacare markets in the latest challenge to President Obama’s health-care overhaul. The insurer won’t sell plans for next year in Georgia and Arkansas, according to state insurance regulators. Tyler Mason, a UnitedHealth spokesman, confirmed the exits and declined to say whether the company would drop out of additional states. (Tracer, 4/9)

The Associated Press: NY Health Exchange Expects 470,000 To Insure With New Option
The state's health exchange expects to enroll more than 470,000 New Yorkers in its new low-cost option for coverage this year. Testifying at an Assembly hearing this week, exchange Executive Director Donna Frescatore said New York chose to participate with the Essential Plan. The plan is an option under the federal Affordable Care Act starting in 2016. It's aimed at adults who don't qualify for Medicaid but have been unable to afford private coverage. (4/9)

The Associated Press: Medicare Plan On Payment For Cancer Drugs Stirs Battle
A Medicare proposal to test new ways of paying for chemotherapy and other drugs given in a doctor's office has sparked a furious battle, and cancer doctors are demanding that the Obama administration scrap the experiment. The vehement reaction is raising questions about the government's ability to tackle high drug costs, the top health care concern for the public. (4/11)

The Associated Press: Arkansas Medicaid Plan Approved As Funding Showdown Looms
Arkansas Gov. Asa Hutchinson signed into law Friday his plan to keep the state's first-in-the-nation hybrid Medicaid expansion and urged fellow Republicans to avoid a Washington-style shutdown fight over their efforts to defund the program. The bills outline Hutchinson's proposal to rework the program, which uses federal funds to purchase private insurance for more than 250,000 low-income people. (4/8)

Politico: Surgeon General Uses Bully Pulpit To Combat Opioid Crisis
If C. Everett Koop became the highest-profile surgeon general ever by giving the AIDS epidemic a national profile, Vivek Murthy wants to be the surgeon general who united America to combat opioid abuse. Over the last few months, Murthy went from stressing nutrition, exercise and the benefits of not smoking to a far more urgent message about the lethal painkillers. He has become a much more visible public figure as he speaks out in Washington and takes his message on the road to communities hard hit by the double whammies of opioid and heroin use. (Kenen, 4/8)

The Associated Press: Low-Level Drug Offenders Find New Source Of Addiction Help
When pondering how to keep low-level drug offenders out of jail, officials in Albany, New York, faced a challenge: How could they pay for a case manager to coax addicts onto the straight and narrow, sometimes by tracking them down on the streets? The money turned up in a previously untapped source: President Barack Obama's health care law, which by expanding Medicaid in some states has made repeat drug offenders eligible for coverage, including many who are homeless or mentally ill and have never been covered before. (4/11)

The New York Times: The Female Viagra, Undone By A Drug Maker’s Dysfunction
Last August, Sprout Pharmaceuticals had a new pill on its hands that quickly captured the nation’s imagination. The Food and Drug Administration had just approved its drug Addyi to treat low sex drive in women. Late-night comedians joked about “female Viagra.” Wall Street analysts conjectured about blockbuster sales. In clinical trials, women reported a small, but statistically significant, uptick in the number of satisfying sexual experiences per month. Things got even better for Sprout a day after the F.D.A. approval, when Valeant Pharmaceuticals International, a drug company whose deal-making acumen had made it a stock-market darling, bought Sprout for an astonishing $1 billion — twice its value just two months earlier. What could go wrong? Well, just about everything. (Thomas and Morgenson, 4/9)

The Washington Post: Tackling The Financial Toll Of Cancer, One Patient At A Time
Even before Scott Steiner started treatment for a rare gastrointestinal cancer that had spread throughout his abdomen, a dangerous side effect threatened his health. His doctor had prescribed the cancer drug Gleevec, but Steiner’s insurance refused to cover its $3,500 monthly cost. Steiner, a warehouse manager for a publisher of Bible-themed literature, and his wife, Brenda, a part-time nurse, made just $30,000 a year. No way could they afford the drug on their own. It was a scary brush with “financial toxicity,” as researchers call the mix of economic stress, anxiety and depression cancer patients often endure. (McGinley, 4/9)

The Washington Post: The Burden Of Cancer Isn’t Just Cancer
Money is low on the list of things most people want to think about after a doctor says the scary word "cancer." And it's not just patients — physicians also want to weigh the best treatment options to rout the cancer, unburdened by financial nitty gritty. But a growing body of evidence suggests that, far from crass, ignoring cost could be harmful to patients' health. (Johnson, 4/8)

The Washington Post: Private Ambulances Deployed To Ease The District’s 911 Burden
Late last month, the District began using the commercial service to transport patients with less-serious symptoms. The new system is intended to free up city medics and ambulances for more dire cases and ease the strain on a department that has struggled to handle a growing number of medical calls. City paramedics or firefighters still respond to each 911 call and assess each patient’s condition. In the more serious cases, they transport patients as usual. During the first week, 2,135 people were taken to hospitals; 678 were transported by the private service, or about 32 percent of the overall cases. They represent about half of the patients with less-serious conditions. (Williams, 4/10)

Los Angeles Times: Doubts Remain As California Allows Girls And Women To Get More Birth Control Without A Prescription
As of Friday, girls and women in California can pick up hormonal contraceptives, including pills and patches, at pharmacies without first visiting a doctor. Supporters of the change say that requiring an annual doctor’s visit creates unnecessary barriers to contraception and that easing access could reduce unintended pregnancies. ... Many people are raising questions about the new system, in which females of any age in California no longer need a doctor’s prescription to get certain types of birth control. California becomes just the third state to allow women to obtain hormonal birth control directly from a pharmacist, though many more are currently considering similar legislation. (Karlamangla, 4/8)

NPR: When The Cost Of Care Triggers A Medical Deportation
In an emergency, hospitals, by law, must treat any patient in the U.S. until he or she is stabilized, regardless of the patient's immigration status or ability to pay. Yet, when it comes time for the hospitals to discharge these patients, the same standard doesn't apply. Though hospitals are legally obligated to find suitable places to discharge patients (for example, to their homes, rehabilitation facilities or nursing homes), their insurance status makes all the difference. (Schumann, 4/9)

NPR: A Fitbit Saved His Life? Well, Maybe
Wearing a Fitbit? If so, you already know that electronic fitness trackers can let you keep records on your smartphone of how many steps you've walked, how much you've slept, maybe your heart rate, or even where you've been. But what can the gadget tell your doctor? A few things that are pretty useful, it turns out. Doctors at an emergency room in New Jersey recently used heart-rate data from a patient's Fitbit to quickly figure out what treatment he needed to get his suddenly irregular heartbeat under control. They published the case study online this month in the Annals of Emergency Medicine. (Kodjak, 4/11)

Kaiser Health News is an editorially independent operating program of the Kaiser Family Foundation. (c) 2016 Kaiser Health News. All rights reserved.

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