News Headlines

News Headlines
Health care news from around the state and nation

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The Health 202: Obamacare remains unaffordable for some. But Congress doesn’t plan on fixing it.
The Washington Post

Obamacare plans remain too expensive for some Americans — particularly those who are older and earn moderate income. But don’t expect Congress to do much about it.

For all the lip service lawmakers still pay to improving the Affordable Care Act, there’s little path forward this year for any bipartisan legislation to improve the affordability of plans offered through a law that remains sharply divisive nearly a decade after Congress passed it.

Moderate House Democrats trying to counter the Medicare-for-all push from liberals say they’re focusing on ACA fixes as a pragmatic, bipartisan way forward. But so far they’ve not advanced any such measures that have GOP buy-in, even as they prepare for another ACA-themed hearing tomorrow morning in the House Energy and Commerce Committee’s Health subcommittee.

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ACA premiums rising beyond reach of older, middle-class consumers
Washington Post

The sweeping health-care law created nearly a decade ago to put insurance within reach of more Americans has left significant holes in the ability of older, middle-class people to afford coverage, particularly in rural areas, according to a new analysis.

Sixty-year-olds with a $50,000 income must pay at least one-fifth of what they earn for the least expensive premiums for health plans in Affordable Care Act marketplaces across a broad swath of the Midwest, the analysis shows. In much of the country, those premiums require at least one-sixth of such people’s income.

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Stark law changes to open up value-based model participation, Verma says
Modern Healthcare

CMS Administrator Seema Verma gave her first update on a major overhaul to the Stark law, saying that a key part of the regulation will remove a barrier to doctors participating in value-based arrangements.

A major part of the agency’s updates to the anti-kickback law is clarifying areas of noncompliance for doctors and updating the decades-old rules to reflect the shift from a fee-for-service model to value-based care, Verma said during the Federation of American Hospitals’ policy conference in Washington Monday.

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Employers save money by paying workers to shop for healthcare
Modern Healthcare

Employers are experimenting with ways to get a handle on the rising cost of providing healthcare benefits to their workers. One study has found that mailing a check to workers who visit lower-price providers for certain elective healthcare services is an effective, though modest, way to reduce costs.

Paying workers between $25 and $500 for using a price transparency tool and then opting for a lower-cost provider for certain designated services resulted in a 2.1% reduction in the average prices employers paid for those services over one year, according to a RAND Corp. study of one such rewards program.

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Why prescription drug list prices matter
Modern Healthcare

Questioning drug company CEOs last week, Sens. Charles Grassley and Ron Wyden hammered away at the importance of high list prices for prescription drugs, while the CEOs testifying before the Senate Finance Committee mostly tried to change the subject.

But Grassley (R-Iowa) and Wyden (D-Ore.) were right that list prices matter a lot. Medicare Part D drug plan enrollees and a growing number of commercially insured patients pay a percentage of the list price for drugs under their health plans’ coinsurance designs.

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Patients Question How FDA Approves Medical Devices
Kaiser Health News

There’s no doubt that surgically implanted medical devices can improve lives.

Hip and knee replacements can help people regain their mobility. Drug pumps can deliver doses of pain-relieving medicine on demand. And metal rods can stabilize spines and broken bones.

But implanted devices can also do serious damage, as happened to Mechel Keel, who lives in Owosso, Mich.

To fix her leaky bladder, an OB-GYN stitched a flexible mesh strap inside her pelvis in 2004.

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Rising vaccine exemptions call physicians’ role in outbreaks into question
Modern Healthcare

California has one of the strictest requirements for childhood vaccinations in the U.S. after the state eliminated exemptions based on philosophical and religious grounds in 2015.

Yet the state has seen a rise of unvaccinated children over the past couple years due to physicians granting medical exemptions from immunization.

At least two children with medical exemptions contracted measles during an outbreak in the state last year, potentially exposing others to the highly contagious virus.

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A Large Study Provides More Evidence That MMR Vaccines Don’t Cause Autism
National Public Radio

There’s strong new evidence that a common childhood vaccine is safe.

A large study released Monday finds no evidence that the vaccine that protects against measles, mumps and rubella increases the risk of autism. The study of children born in Denmark is one of the largest ever of the MMR vaccine.

“The study strongly supports that MMR vaccination does not increase the risk for autism,” the authors write in the Annals of Internal Medicine. “We believe our results offer reassurance and provide reliable data.”

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Hospitals hopeful big changes are coming to the CMS’ star ratings
Modern Healthcare

Hospitals have for years been advocating for overhauling the CMS’ star-rating program. They may finally get their wish. The agency is seeking public input on a comprehensive list of potential changes to the program, including tossing out the long-standing model used to assign ratings.

In the 48-page document, the CMS acknowledged virtually all of the most common complaints pitted against the star ratings since they were first released to the public in July 2016.

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Azar: kidney dialysis needs to move to patient homes
Modern Healthcare

HHS Secretary Alex Azar on Monday told a crowd of kidney disease patients and advocates the Trump administration is overhauling Medicare’s payment system to move the bulk of dialysis treatments from clinics to the home.

He touted an existing payment demonstration launched by the CMS Innovation Center under the Obama administration in 2015, which has the backing of the dialysis industry: the End Stage Renal Disease (ESRD) Seamless Care Organizations.

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Paid Family Leave Gains Momentum In States As Bipartisan Support Grows
National Public Radio

In New Hampshire, there’s no requirement that employers offer paid leave to workers who are caring for newborns or taking care of elderly parents.

Wendy Chase campaigned last fall for a seat in the state House promising to change that — and won.

“This is my first term, and I’m not a politician. I’m just a mom on a mission,” she says. That mission started when her daughter, Erin Pappas, was diagnosed with a rare bone cancer at age 2. For over three decades, Chase accompanied Pappas to an endless series of surgeries, chemotherapy sessions, and doctor and emergency room visits.

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Eli Lilly offers half-price insulin as politicians pressure it over drug costs
San Diego Union-Tribune

Eli Lilly is offering a half-price version of a top-selling insulin to ease the financial strain for some patients, but an advocacy group says much bigger changes are needed.

The drugmaker said Monday it will introduce a version of the diabetes treatment Humalog that will be called Insulin Lispro and come with an initial price 50 percent lower than Humalog’s current rate of about $275 per vial.

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Lilly to sell cheaper version of top-selling insulin Humalog
Modern Healthcare

Eli Lilly is offering a half-price version of its top-selling insulin Humalog as drugmakers face growing pressure to control prices.

The company says it will introduce a version of the diabetes treatment called Insulin Lispro with a list price 50% lower than its current rate of about $275 per vial.

The discounted insulin will sell for $137.35 per vial or $265.20 for a five pack of Kwik Pens.

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CVS Health appoints CIO to lead Aetna integration
Modern Healthcare

CVS Health promoted its senior vice president of client services, Roshan Navagamuwa, to executive vice president and CIO.

Navagamuwa will lead technology operations and innovation, including client services for CVS Caremark. One of his primary responsibilities will involve overseeing integration of the company’s IT systems with Aetna’s, according to a CVS Health statement.

CVS Health and Aetna closed their merger in late 2018, nearly one year after they first announced the deal. Under the $70 billion merger, Aetna became a stand-alone unit within CVS.

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Kaiser Permanente plans to open a clinic two blocks from CPMC’s massive new hospital
San Francisco Business Times

Kaiser Permanente plans to open a health care clinic in San Francisco’s Cathedral Hill neighborhood, a booming area that’s becoming one of the city’s medical hotspots.

The Mental Health and Wellness Clinic — to occupy 42,000 square feet of the seven-floor building at 939 Ellis St. — will provide a variety of inpatient, outpatient, emergency, mental health and educational services, according to planning documents filed with the city.

The move comes just as California Pacific Medical Center is opening its $2 billion hospital on Van Ness Avenue and Geary Boulevard. In addition to the 700,000-square-foot hospital, a 250,000-square-foot medical office building being developed by San Diego-based PMB is opening across the street. Residential developers are also circling the area, with plans for a senior and other housing projects in the works.

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