News Headlines for August 31, 2016

News Headlines Article

Vote yes on Prop. 52, hospital fees for Medi-Cal
Editorial, Bakersfield Californian

Facing a mind-numbing field of ballot propositions and the din of campaign bellicose, Proposition 52 struggles to get voters’ attention. Proposition 52 is arcane, complex and has a high “who cares?” factor. But we can make this simple. Voters should care. They should vote yes because it will improve and stabilize government funding for California hospitals that provide Medi-Cal services for the state’s poorest residents. If you are not poor and if you do not receive Medi-Cal services, you still might be asking: Why should I care?

News Headlines Article

Cardiac Rehab Improves Health, But Cost And Access Issues Complicate Success
Kaiser Health News

Mario Oikonomides credits a massive heart attack when he was 38 for sparking his love of exercise, which he says helped keep him out of the hospital for decades after.

While recovering, he did something that only a small percentage of patients do: He signed up for a medically supervised cardiac rehabilitation program where he learned about exercise, diet and prescription drugs.

“I had never exercised before,” said Oikonomides, 69, who says he enjoyed it so much he stayed active after finishing the program.

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More doctors are firing patients for refusing vaccines—with support from the medical establishment
San Francisco Chronicle

Doctors have long been tiring of continuing to educate parents who do not want to have their children vaccinated, with nearly 12 percent “always” dismissing their patients for refusal to vaccinate in 2013 versus 6.1 percent in 2006. Those numbers may go much higher now that doctors have more support to ditch their nonvaccinating patients from the American Academy of Pediatrics, which recently issued a new report altering their stance on the subject. The AAP had previously stated that doctors should continue to educate resistant parents about the high benefits and low risks of vaccines in the hopes of changing their minds, no matter how long that persuasion might take.

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CMS offers solutions as improper Medicaid payments skyrocket
Modern Healthcare

Improper Medicaid payments hit $30 billion last year, according to the CMS. Now, the agency is giving states tools to address the issue.Medicaid’s improper payment rate was 9.8% for 2015, nearly double what it was in 2013. The agency is anticipating the rate to hit 11.5% this year.“States are facing greater challenges keeping pace with stricter enrollment requirements, tracking providers who have been excluded from other states’ or federal health care programs, and generally adapting to changing regulations for qualifications of certain provider types,” CMS said in an alert.

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Changes to ACA exchanges may be enough to keep them afloat for now
Modern Healthcare

Proposed changes to help stabilize the Affordable Care Act health insurance exchange markets should be enough to stop the bleeding, but further changes will likely be needed next year. The rule (PDF), which was released a couple of months earlier than expected includes changes in 2018 to the ACA risk-adjustment program as well as changes to plan requirements. The rule changes are a response to tumult in the exchanges as Aetna, Humana and UnitedHealth Group have all said they will be significantly scaling back their plan offerings in 2017. That and overall low enrollment from consumers has led some to question whether the exchanges can remain viable.

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The call for universal health care is getting louder
Benefits Pro

The fragmentation within much of our country was on full display during the recent national conventions and their aftermath. The gatherings in Philadelphia and Cleveland presented two very disparate views of America, along with enough sound bites and discord to keep the Twitterverse buzzing indefinitely. Sure, every election cycle comes with its fair share of bluster, partisanship and hyperbole, but this year seems to be moving into fairly unprecedented territory — and we’re still months away from November.

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Gilead’s blockbuster hepatitis C drugs targeted in University of Minnesota suit
San Francisco Business Times

The University of Minnesota is suing Gilead Sciences Inc., alleging the Foster City-based drug company’s blockbuster hepatitis C drugs infringe on a university patent. In a lawsuit filed Monday in Minnesota’s U.S. District Court, the university claimed its intellectual property covers Gilead (NASDAQ: GILD) products that contain the drug sofosbuvir, including those sold under the brand names Sovaldi and Harvoni. Those hepatitis C treatments have generated more than $20 billion in revenue for Gilead.

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Employers pushing rising healthcare costs onto employees
Employee Benefit News

Healthcare costs are rising. And as employers face higher price tags, many are pushing costs onto workers to help maintain budgets.

The average cost per covered employee has increased by nearly $500 in the span of one year, according to the Society for Human Resource Management’s new Health Care Benchmarking Report, released Tuesday. Employers spent an average of $8,669 per covered employee in 2015, compared to $8,171 per employee in the previous fiscal year.

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20 Democratic senators blast steep price hike for EpiPens
Modern Healthcare

In a sign of growing concern in Congress, 20 Democratic senators are demanding answers about steep price hikes for the life-saving EpiPen injector device.The senators said in a letter Tuesday that price hikes of more than 500 percent have jeopardized access to emergency allergy shots for many Americans. The letter was addressed to Heather Bresch, CEO of the pharmaceutical company that makes the devices, Mylan N.V.Bresch is the daughter of Sen. Joe Manchin, (D-W.Va.). Manchin did not sign the letter.Mylan has responded to the public outcry over the price hikes by expanding programs to make EpiPens more affordable and promising a cheaper, generic version.

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Bakersfield Heart Hospital presented with American Heart Association award on Tuesday
ABC News

Bakersfield Heart Hospital will be presented with the American Heart Association’s Mission: Lifeline® STEMI Receiving Center Bronze Level Recognition Award, acknowledging the hospital’s commitment and success in implementing exceptional standards of care for heart attack patients. “Bakersfield Heart Hospital is committed to improving patient outcomes and providing prompt consistent care to our heart and vascular patients,” said Rasham Sandhu, Medical Director of BHH’s Chest Pain Program. “Our heart, vascular and emergency medicine teams all collaborate to get patients the critical care they need quickly, which this award recognizes.”

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ACO Winners and Losers: A Quick Take
The Health Care Blog

Last week, CMS sent out press releases touting over $1 billion in savings from Accountable Care Organizations. Here’s the tweet from Andy Slavitt, the acting Administrator of CMS: The link in the tweet is to a press release. The link in the press release citing more details is to another press release. There’s little in the way of analysis or data about how ACOs did in 2015. So I decided to do a quick examination of how ACOs are doing and share the results below.