News Headlines

News Headlines
Health care news from around the state and nation

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CMS invites states to test new dual-eligible care models
Modern Healthcare

The CMS is inviting state Medicaid agencies to pursue new ways of integrating care for patients eligible for both Medicare and Medicaid—a population that has complex health needs and accounts for a big portion of spending in both public health programs.

In a letter dated Wednesday to state Medicaid directors, CMS Administrator Seema Verma described three new ways states can test approaches to integrating care for dual-eligible patients with the goal of improving the quality of their care and reducing costs for federal and state governments.

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CMS backtracks on mandating EHR-PDMP integration in 2020
Modern Healthcare

The CMS on Tuesday revised its IT efforts that target the opioid epidemic as part of its annual proposed update for the hospital inpatient prospective payment system.

The IPPS proposal would update inpatient hospital reimbursements for federal fiscal 2020, which starts in October.

Last year’s proposal included broad changes for hospital IT, overhauling the Medicare and Medicaid Electronic Health Record Incentive Programs, better known as “meaningful use,” to make the programs less burdensome and more patient-centered, according to the agency. Notably, the CMS renamed the programs “Promoting Interoperability” as part of the 2018 announcement.

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HHS postpones changes to liver allocation policy after lawsuit
Modern Healthcare

HHS on Wednesday said it would delay implementing a planned overhaul of the national liver distribution system after major medical centers and transplant patients sued to block the plan.

The agency will delay implementing the policy for two weeks, until May 14, to allow time for the court to weigh in. The judge ordered a hearing for May 7.

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Americans are more focused on health costs than Medicare-for-all, poll shows
Washington Post

Most Americans want Congress to take action to lower their family’s health care expenses, rather than make sweeping changes such as adopting Medicare-for-all, or repealing and replacing the Affordable Care Act, according to a new survey.

At a time when Democratic presidential candidates are emphasizing universal health coverage — with those on the left advocating Medicare-for- all — not quite half of the respondents who identify as Democrats regard that as a priority for Congress in the latest poll by the Kaiser Family Foundation. That compares with 14 percent of Republicans.

Majorities of both parties, on the other hand, believe Congress should find ways to lower the expense of prescription drugs, according to the poll results released on Wednesday. Drug costs are the top priority for respondents of both parties in Kaiser’s poll, as they have been for some time.

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Trauma-Informed Primary Care
The Health Care Blog

Jenny, a woman in her twenties with morbid obesity (not her real name), had already been through multiple visits with specialists, primary care physicians (PCPs), and the emergency department (ED) for unexplained abdominal pain. A plethora of tests could not explain her suffering. Monthly visits with a consistent primary care physician also had little impact on her ED visits or her pain.

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Healthcare CEOs debate impact of consumer-focused approach
Modern Healthcare

Two provider CEOs sparred on Wednesday over whether the “Amazonification” of healthcare is in the industry’s best interest, as they debated fixing a fractured consumer experience versus preserving its core mission.

Most healthcare spending is directed toward the sickest and most vulnerable who aren’t equipped to articulate their needs or shop around for care, according to Dr. Sachin Jain, CEO of CareMore Health System, at the MedCity Invest conference in Chicago. Providers need to proactively identify a patient’s needs and direct them appropriately, he said.

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Long-Term Use of Antibiotics Tied to Heart Risks
New York Times

Using antibiotics for two months or longer may be linked to an increase in a woman’s risk for cardiovascular disease.

The finding, published in the European Heart Journal, applied to women who used the drugs when they were 40 and older.

Researchers used data on 36,429 women free of cardiovascular disease at the start of the study who were participating in a continuing long-term health study. Beginning in 2004, the women reported their use of antibiotics.

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Association Insurance Pushes On Despite Court Ruling
Kaiser Health News

When the Trump administration in June issued rules making it easier for small employers to band together to buy health insurance, “we started looking immediately,” recalled Scott Lyon, a top executive at the Small Business Association of Michigan.

Although he offered traditional small-group health insurance to his association’s employees and members, Lyon liked adding a new option for both: potentially less expensive coverage through an association health plan, which doesn’t have to meet all the rules of the Affordable Care Act.

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In quest to control migraines, Peninsula company raises $62 million to send drug up your nose
San Francisco Business Times

Marrying the old and the new, this South San Francisco company is taking its experimental treatment for acute migraines into a huge late-stage clinical trial.

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Telemedicine startup Doctor on Demand taps giant health partner to debut virtual primary care plan
San Francisco Business Times

Doctor On Demand is paving the way for virtual-first health care, kicking off its primary care offering with nationwide health insurer Humana.

The San Francisco-based telemedicine company, which began as an urgent-care platform, has broadened its reach to include primary, preventative and chronic care — centralized on its digital app active 24/7 via video visits, phone calls and messaging. Humana’s Florida and Texas markets will be Doctor On Demand’s first test of this bridging between patients’ virtual primary care doctor visits and a network of referrals for in-person needs, such as specialists, scans and tests.

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Concussions and broken bones on the rise in S.F. as mobility startups bring more than convenience
San Francisco Business Times

“We’re under appreciating what these scooters can be in terms of danger,” said Dr. Chris Colwell, Zuckerberg San Francisco General Hospital’s chief of emergency medicine. “The hope is that we don’t discourage the use, just to understand the safety issues.”

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Humana announces virtual primary-care plan
Modern Healthcare

Humana and telehealth company Doctor on Demand will launch a new health plan design allowing employers and employees to receive primary care predominantly through virtual visits.

The plan, called On Hand, allows Humana members to avoid the doctor’s office and access primary-care services virtually from one Doctor on Demand physician, with access to urgent care, preventive care and behavioral health services.

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Anthem revenue buoyed by membership growth
Modern Healthcare

Anthem reported higher revenue and profit in the first quarter of 2019 as it grew membership across its business lines.

The Indianapolis-based health insurer experienced the fastest growth in its government-funded programs.

Its Medicare Advantage membership, including Medicare supplement plans, rose 15.6% to a little more than 2 million in the three months ended March 31 compared with the same period a year ago, driven by supplemental benefits.

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Top health systems focus on alignment of quality across facilities post-merger
Modern Healthcare

As health systems get larger, quality leaders are faced with the tough task of making sure outcomes are similar no matter where a patient receives care.

“Once you start adding more hospitals, it becomes very challenging to figure out how to align across the system,” said Ekta Punwani, leader of the 100 Top Hospitals Program at IBM Watson Health. “It’s not just about technology, it’s about strategies. How do you lead the organization? That is a newer challenge in healthcare.”

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Kaiser Permanente applies predictive analytics to suicide prevention
San Francisco Business Times

The Kaiser Center for Health Research analyzed certain data points in the medical records of 25 million Kaiser members across the country.

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