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KHN First Edition: August 29, 2016


First Edition

Monday, August 29, 2016
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: Hospital Surprise: Medicare’s Observation Care
Kaiser Health News' Francis Ying, Thu Nguyen and Lynne Shallcross report: "Hospitals provide observation care for patients who are not well enough to go home but not sick enough to be admitted. The care may seem just like what an admitted patient receives — they are in a hospital room, nurses check on them and doctors  order treatments. But surprises can arise over billing because Medicare considers this outpatient care. So instead of Medicare picking up most of the bill, patients usually also have copayments for doctors’ fees and each hospital service, and they have to pay whatever the hospital charges for any routine drugs the hospital provides that they take at home for chronic conditions." (Ying, Nguyen and Shallcross, 8/29)

Kaiser Health News: Teaching Medical Teamwork Right From The Start
Kaiser Health News staff writer Julie Rovner reports: "There’s a new building going up on the campus of the Cleveland Clinic. A very big building. The structure will house the new Case Western Reserve University Health Education campus, eventually including Case Western’s medical, dental and nursing schools, as well as Cleveland Clinic’s in-house medical school. “The idea is to create a ‘mini campus’ that gives each school its own identity but fosters collaboration,” said Chris Connell, one of the architects. (Rovner, 8/29)

Kaiser Health News: As Aerial Spraying Winds Down In Miami’s Zika Fight, Effectiveness Up In Air
Kaiser Health News' Emily Kopp reports: "Miami-Dade County’s aerial spraying campaign against Zika-carrying mosquitoes is scheduled to end this month, and the blitz could be one for the record books if the Centers for Disease Control and Prevention records it as a success. Scant published research exists to prove aerial spraying works against the adult Aedes aegypti mosquitoes that carry Zika. Many experts in tropical diseases dismiss insecticide spraying from low-flying planes because they say the urban dwelling species may escape the killer spray by living indoors." (Kopp, 8/29)

The Wall Street Journal: Health Insurers’ Pullback Threatens To Create Monopolies
Nearly a third of the nation’s counties look likely to have just a single insurer offering health plans on the Affordable Care Act’s exchanges next year, according to a new analysis, an industry pullback that adds to the challenges facing the law. The new study, by the nonpartisan Kaiser Family Foundation, suggests there could be just one option for coverage in 31% of counties in 2017, and there might be only two in another 31%. That would give exchange customers in large swaths of the U.S. far less choice than they had this year, when 7% of counties had one insurer and 29% had two. (Wilde Mathews and Armour, 8/28)

Reuters: More U.S. Counties To See Obamacare Marketplace Monopoly: Analysis
Nearly a third of U.S. counties will likely be served by only one insurer that participates in an Affordable Care Act (ACA) marketplace in 2017, according to an analysis published Sunday by the Kaiser Family Foundation.The 31 percent of U.S. counties that will have just a single option of insurers within the ACA's exchanges would represent an increase from 7 percent this year, the nonpartisan group found. (Hunnicutt, 8/27)

The Washington Post: Health-Care Exchange Sign-Ups Fall Far Short Of Forecasts
Enrollment in the insurance exchanges for President Obama’s signature health-care law is at less than half the initial forecast, pushing several major insurance companies to stop offering health plans in certain markets because of significant financial losses. As a result, the administration’s promise of a menu of health-plan choices has been replaced by a grim, though preliminary, forecast: Next year, more than 1 in 4 counties are at risk of having a single insurer on its exchange, said Cynthia Cox, who studies health reform for the Kaiser Family Foundation. (Johnson, 8/27)

The Associated Press: Clinton Could Face Mounting Problem With Health Overhaul
With the hourglass running out for his administration, President Barack Obama's health care law is struggling in many parts of the country. Double-digit premium increases and exits by big-name insurers have caused some to wonder whether "Obamacare" will go down as a failed experiment. If Democrat Hillary Clinton wins the White House, expect her to mount a rescue effort. But how much Clinton could do depends on finding willing partners in Congress and among Republican governors, a real political challenge. "There are turbulent waters," said Kathleen Sebelius, Obama's first secretary of Health and Human Services. "But do I see this as a death knell? No." (8/29)

The Associated Press: Clinton Proposes Plan To Address Mental Health Treatment
Hillary Clinton is rolling out a comprehensive plan to address millions of Americans coping with mental illness, pointing to the need to fully integrate mental health services into the nation's health care system. Clinton's campaign released a multi-pronged approach to mental health care on Monday, aimed at ensuring that Americans would no longer separate mental health from physical health in terms of access, care and quality of treatment. (8/29)

The New York Times: All Donated Blood In U.S. Should Be Tested For Zika, F.D.A. Says
The Food and Drug Administration on Friday took steps to safeguard the nation’s blood supply from the Zika virus, calling for all blood banks to screen donations for the infection even in states where the virus is not circulating. The recommendations are an acknowledgment that sexual transmission may facilitate the spread of Zika even in areas where mosquitoes carrying the virus are not present. Officials also want to prepare for the possibility that clusters of local infection will continue to pop up in parts of the United States for years to come. (Saint Louis, 8/26)

The Washington Post: FDA Takes Radical Measure Of Recommending Zika Screening For Entire U.S. Blood Supply
Marks, director of the FDA’s Center for Biologics Evaluation and Research, said the advisory was put out because "there is still much uncertainty regarding the nature and extent of Zika virus transmission." In a media conference call, he noted the “rapid expansion” of the virus, which is actively spreading in more than 50 countries, mostly in the Americas and Caribbean. The United States has documented 8,000 cases of Americans who acquired the virus abroad and 2,000 infected through local transmission. Nearly all of those in the latter group are in Puerto Rico. (Cha, 8/26)

The Wall Street Journal: FDA Calls For Zika Testing Of All Blood Donations
Dr. Marks said testing of blood donations already is under way in Puerto Rico and Florida, where most of the U.S. Zika cases have occurred. The plan, he said, is to expand that testing in 11 more states over the next four weeks. They are Alabama, Arizona, California, Georgia, Hawaii, Louisiana, Mississippi, New Mexico, New York, South Carolina and Texas. Testing should begin in all states within 12 weeks, Dr. Marks said. “Given the very serious outcome of small-headed babies,” said Dr. Marks, “in order to prevent that from happening, we feel this step makes sense.” (Burton, 8/26)

NPR: FDA Says All Blood Donations Should Be Tested For Zika
Currently, Zika is being spread by mosquitoes in South Florida, Puerto Rico and the U.S. Virgin Islands, as well as most countries in the Caribbean and Central and South America. There are a total of 2,517 cases of Zika in the U.S. states and D.C., according to the Centers for Disease Control and Prevention, with 9,011 more in U.S. territories. (Neel, 8/26)

The New York Times: A Guide To Help Pregnant Women Reduce Their Zika Risk
Zika has a foothold in the continental United States now that mosquitoes in parts of Miami-Dade County, Fla., have infected people with the virus. Zika can cause harrowing brain damage in the developing fetus of a woman who is infected during pregnancy, so it is vital that pregnant women minimize that risk. Here’s some advice on how to do that. (Belluck, 8/26)

NPR: Audits Of Some Medicare Advantage Plans Reveal Pervasive Overcharging
More than three dozen just-released audits reveal how some private Medicare plans overcharged the government for the majority of elderly patients they treated, often by overstating the severity of certain medical conditions, such as diabetes and depression. The Center for Public Integrity recently obtained, through a Freedom of Information Act lawsuit, the federal audits of 37 Medicare Advantage programs. These audits have never before been made public, and though they reveal overpayments from 2007 — money that has since been paid back — many plans are still appealing the findings. (Schulte, 8/29)

The Wall Street Journal: Burden Of Health-Care Costs Moves To The Middle Class
Growth in overall health-care spending is slowing, but middle-class families’ share of the tab is getting larger, squeezing households already feeling stretched financially. Overall, health-care spending across the economy reached 18.2% of gross domestic product as of June, up from 13.3% in 2000, according to Altarum Institute, a health research group. However, the mix of who pays has evolved. (Sussman, 8/26)

The Washington Post: Healthcare Costs Are Still Going Up. Here’s How D.C.-Area Employers Are Compensating.
Seven years after the passage of the federal Affordable Care Act, health care costs are still going up at a robust rate for many in the region, according to a new survey of Washington area companies. Health insurance costs at a broad sample of local companies are projected to increase by 7.3 percent in 2016, the Human Resource Association of the National Capital Area reported. The association, which represents area human resource executives, said the survey found more local employers are offering higher-deductible plans and putting new restrictions on expensive prescription drugs. (Gregg, 8/26)

The Wall Street Journal: Theranos To Appeal Regulatory Sanctions
Silicon Valley startup Theranos Inc. said late Thursday it plans to appeal a decision made last month by regulators to revoke its license to operate a lab in California, among other penalties, because of unsafe practices. The Centers for Medicare and Medicaid Services, the agency that oversees U.S. labs, also banned Theranos founder Elizabeth Holmes from the blood-testing business for at least two years. (Ng, 8/26)

The Washington Post: At NIH, One Woman Says Gender Bias Has Blocked Promotions
During her time at the National Institutes of Health, Bibiana Bielekova has helped identify a treatment for multiple sclerosis. She has published 52 papers in peer-reviewed journals, some of them the most prestigious in her field. She has built an international reputation as a neuro-immunologist. What Bielekova doesn’t have, at age 47, is tenure, the coveted guarantee of recognition, job security and freedom to pursue controversial ideas that is critical to long-term success in an academic career. She was not put forward as a candidate for the second time last year, despite a positive recommendation from a panel of outside experts who reviewed her qualifications. (Bernstein, 8/28)

Los Angeles Times: Purdue Pharma Rejects Request From New Hampshire Attorney General For Information On Suspected Diversion Of OxyContin
The top law enforcement official in New Hampshire, a state ravaged by the opioid epidemic, accused the manufacturer of OxyContin on Friday of stonewalling demands for information the company collects about suspected criminal trafficking of its painkiller. “They are just refusing to turn over documents,” state Atty. Gen. Joseph Foster said of drugmaker Purdue Pharma in an interview. “On one hand, they tell us they have nothing to hide and they are doing everything appropriately, but then why are they fighting so hard not to turn over this information?” (Ryan, 8/26)

The Associated Press: Dozens Treated As Heroin Overdose Spikes Hit Several States
Officials in several states are scrambling to deal with a series of heroin overdose outbreaks affecting dozens of people and involving at least six deaths. The spikes in Indiana, Kentucky, Ohio and West Virginia over the past few days have seen rescue workers rushing from scene to scene to provide overdose antidote drugs. While it's unclear if one dealer or batch is responsible for the multistate outbreak, the spikes reflect the potency of heroin flooding the Midwest. (8/26)

The Washington Post: Cancer Researchers: It’s Time To Pay More Attention To ‘Miracle’ Patients
Call it luck — or a medical miracle. During clinical trials for experimental cancer drugs, some patients simply respond better than others. And a tiny fraction of patients see dramatic results, responding so well to treatment that they survive forms of cancers that quickly kill their counterparts. Stories about people like Emily Whitehead, the then-6-year-old who was enrolled in a clinical trial that saved her life, make headlines. But statistically speaking, they’re insignificant, mere outliers. Because they deviate so far from the norm, these “exceptional responders” are often overlooked by researchers. Not so fast, says Eric Perakslis. (Blakemore, 8/26)

Los Angeles Times: Pediatricians Urge States To Get Tough On Parents Who Don’t Want To Vaccinate Their Kids
The nation’s pediatricians are pushing back against parents who resist having their children vaccinated against a broad range of dangerous diseases by calling on states to stop offering waivers to those with non-medical objections to the practice. In a policy statement issued Monday, the American Academy of Pediatrics also said that if parents continue to refuse vaccinations despite exhaustive efforts to change their minds, it would be “acceptable” for doctors to exclude these families from their practices. (Healy, 8/29)

The Associated Press: Judge Won't Block California's Strict Child Vaccination Law
A federal judge will not immediately block a California law that requires all schoolchildren to be vaccinated and is one of the strictest in the nation for eliminating exemptions based on religious and personal beliefs. The ruling Friday by U.S. District Judge Dana Sabraw in San Diego comes as the law faces its first test with the end of summer break. A lawsuit filed by 17 families and two foundations sought an injunction while the lawsuit works its way through the courts. The law went into effect July 1 and eliminated religious and personal beliefs as reasons for opting out of the state's mandatory immunizations. (8/26)

NPR: Amoeba Parasites Cause Rare But Deadly Brain Infections
Doctors describe 16-year-old Sebastian DeLeon as a walking miracle — he is only the fourth person in the U.S. to survive an infection from the so-called brain-eating amoeba. Infection from Naegleria fowleri is extremely rare but almost always fatal. Between 1962 and 2015, there were only 138 known infections due to the organism, according to the Centers for Disease Control and Prevention. Just three people survived. This summer, two young people, one in Florida and one in North Carolina, became infected after water recreation. Only one had a happy ending. (Aboraya and Tomsic, 8/28)

The Washington Post: CPAP Machines Don’t Prevent Heart Attacks, Strokes In Some Sleep Apnea Sufferers
More than 25 million Americans have obstructive sleep apnea, a dangerous disorder that causes sufferers to briefly stop breathing while they sleep, sometimes many times each night. ... The standard treatment, the continuous positive airway pressure, or CPAP, machine, keeps the airway open by pumping a stream of air through a patient's nostrils as he or she sleeps. The biggest problem with the therapy is non-compliance; many people find the air mask and hose uncomfortable and give up on the machine. But a large new sleep study published Sunday raises a serious new issue: For people with existing cardiovascular disease and moderate to severe sleep apnea, CPAP doesn't prevent heart attacks, strokes, hospitalizations or deaths any better than sleeping without the machine. (Bernstein, 8/28)

NPR: Arkansas Schools College Students In Avoiding Pregnancy
Orientation at Arkansas Tech University this year included a surprising topic for a Bible Belt state that pushes abstinence-only in high school. Every freshman was shown a newly produced video in which real students talk about the struggle of an unplanned pregnancy, and the challenge of staying in school as a parent. "I lost a lot of friends," says one young woman in the video who had dreamed of becoming a surgeon. A young man says he "went from not having any responsibility to having a full-time responsibility," while another laments that Friday nights are no longer spent with friends but at home "watching Dora. A lot of Dora." (Ludden, 8/26)

Los Angeles Times: After Court Rules Against Parents, Toddler Is Taken Off Life Support
Two-year-old Israel Stinson, the curly-haired, angelic-looking toddler whose fight for life gained international attention, died Thursday after he was removed from a breathing ventilator against his parents wishes. Now, supporters of the family are questioning why a Los Angeles hospital moved so quickly to remove him from life support immediately after a judge upheld the decision. Israel’s parents, Jonee Fonseca and Nathaniel Stinson, sought an injunction Aug. 18 to prevent Children’s Hospital of Los Angeles from taking action while they rushed to make arrangements to put him in home care. (Evans, 8/26)

The Associated Press: California Judge Rejects Request To Suspend Assisted Suicide Law
A California judge has rejected a request by physicians to immediately suspend a new state law allowing terminally ill people to end their lives. Judge Daniel A. Ottolia of Riverside County Superior Court ruled on Friday that the law would remain in effect for now. But he agreed to allow the physicians to pursue their lawsuit claiming that the law lacks safeguards against abuse. (8/27)

The Associated Press: After Irene Forces Reckoning, Mental Health Care Rebuilt
For most Vermonters, Tropical Storm Irene was a disaster that tore roads, communities and lives apart. But for many of the state's neediest mental health patients, it was a blessing in disguise. The small state had struggled for years with its mental health system. The Vermont State Hospital in Waterbury lost its federal Medicaid funding after two patients committed suicide there in 2003. In 2010, the Justice Department and the state settled a lawsuit that claimed the hospital was deficient in care, treatment and programming. Some improvements were made, but a permanent, long-term solution remained elusive. (8/27)

The Washington Post: McAuliffe Sees Medicaid Expansion, Rainy-Day Fund As Fix For $1.5 Billion Budget Hole
Gov. Terry McAuliffe suggested tapping the state’s rainy day fund and accepting more federal Medicaid money on Friday as a way to patch the state’s $1.5 billion budget hole. McAuliffe (D) formally informed legislators of the budget shortfall, the result of lower-than-expected revenue from payroll and sales taxes, at a meeting of House and Senate money committees on Capitol Square. (Vozzella, 8/26)

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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