News Headlines

News Headlines
Health care news from around the state and nation

 

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New hepatitis C drugs are costing Medicare billions
Washington Post

Medicare spent $4.5 billion last year on new, pricey medications that cure the liver disease hepatitis C — more than 15 times what it spent the year before on older treatments for the disease, previously undisclosed federal data shows.

The extraordinary outlays for these breakthrough drugs, which can cost $1,000 a day or more, will be borne largely by federal taxpayers, who pay for most of Medicare’s prescription drug program.

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97% of ED Physicians Order Unnecessary Imaging Tests
HealthLeaders Media

Nearly all of the 435 emergency physicians in a recent survey admitted to ordering too many diagnostic tests, but said they did so out of fear of error, uncertainty, and non-medical reasons.

The survey, published this month in Academic Emergency Medicine, focused specifically on the use, and over-use, of imaging tests. More than 85% of the respondents said they believe that too many tests are ordered in their own departments, and 97% admitted they ordered “medically unnecessary” radiology tests, which were defined as imaging the physician ordered in response to external pressures and not for optimal medical care.

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Exercising critically ill patients may help speed recovery
San Francisco Chronicle

The intensive care unit is a last frontier for physical therapy: It’s hard to exercise patients hooked to ventilators.

Some hospitals do manage to help critically ill patients stand or walk even if they’re tethered to life support. Now research that put sick mice on tiny treadmills shows why even a little activity may help speed recovery.

“I think we can do a better job of implementing early mobility therapies,” said Dr. D. Clark Files of Wake Forest Baptist Medical Center in Winston-Salem, North Carolina, who led the research and whose hospital is trying to get more critically ill patients up, ventilator and all.

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Colleges getting out of health insurance business
Modern Healthcare

The federal health care overhaul is leading some colleges and universities to get out of the health insurance business.

Experts are divided on whether this change will be good or bad for students. Some call it an inevitable result of health care reform and a money-saver for students since insurance in the marketplace is usually cheaper than the college plans.

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Providers Feel Pressure to Launch Payer Initiatives
HealthLeaders Media

Healthcare providers are clearly interested in offering their own insurance coverage products for patients, but adoption is more like a steady flow than a flood.

In January, St. Louis-based Ascension Health became the latest large health system to embrace the health plan business, with a $50 million bid to acquire a Michigan-based insurance carrier. Officials at Ascension and US Health and Life Insurance Company declined to comment, but Herb Kuhn, president and CEO of the Missouri Hospital Association, says the proposed acquisition deal is a sign of the times.

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Rising healthcare costs are pressuring patients
Los Angeles Times

Coping with ever-increasing medical bills is frustrating — and getting more so.

A recent survey by private health insurance exchange EHealth highlights the pressure Americans are feeling. It found that more than 6 in 10 people say they’re more worried about the financial effect of expensive medical emergencies and paying for healthcare than about funding retirement or covering their kids’ education.

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End of CHIP will spell fewer benefits, higher costs
Modern Healthcare

If the Children’s Health Insurance Program ended, children affected would still be able to get most, but not all, of the coverage options they have with CHIP if they buy a plan from an insurance exchange, according to a report Friday from the U.S. Government Accountability Office.

While there is substantial benefit overlap, qualified plans lack pediatric dental and other services, such as translation and transportation services, that are covered more frequently by CHIP plans.

Federal funding for the CHIP program is set to expire Sept. 30. The SGR fix that passed the U.S. House on Thursday and awaits Senate approval includes a two-year extension for the program.

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Doctors with major illnesses back state’s right-to-die movement
San Francisco Chronicle

Dan Swangard knows what death looks like. As a physician, he has seen patients die in hospitals, hooked to morphine drips and overcome with anxiety. He has watched death drag on for weeks or months as terrified relatives stand by helplessly. Then in 2013, Swangard was diagnosed with a rare form of metastatic cancer, and his thoughts about how seriously ill people die became personal.

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The High Cost of Reducing Waste in US Healthcare
The Health Care Blog

Recently, a jury awarded a young California resident $28.2 million for a delayed diagnosis of a pelvic tumor. The jury found Kaiser Permanente (KP) negligent. Doctors in the system, touted to be one of the finest systems by the President, allegedly refused an immediate MRI for back pain in a 17 year old. The patient eventually received an MRI three months after presentation, which found a tumor so extensive that the patient needed an amputation.

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UnitedHealth sets sail for drug manager Catamaran
USA Today

UnitedHealth Group (UNH), the nation’s largest medical insurer, plans to buy drug benefits manager Catamaran (CTRX) in an effort to contain pharmaceutical drug prices.

The deal, valued at nearly $13 billion ($61.50 a share), is designed to help the insurer seek better prices with pharmaceutical companies and drug stores.

Catamaran jumped 25% to $60.20 in early trading Monday. UnitedHealth is up 4% to $122.92.

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Sutter Health’s profit makes a healthy jump
San Francisco Business Times

Sutter Health, a Sacramento-based nonprofit battling a reputation for high costs, said its net income jumped 34 percent last year to $402 million, while revenue topped $10.1 billion. The prior year, Sutter posted a $300 million profit on $9.65 billion in revenue. Operational results improved significantly, producing $419 million in operating profit last year, compared to a $22 million loss in 2013 — its only such loss since 1999.

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Sutter Health improves its operating margin, reports less demand for charity care
Sacramento Business Journal

Sutter Health swung to a healthy operating surplus in 2014, according to a new financial report released Friday. The nonprofit Sacramento-based health system reported operating income of $419 million, up from a loss of $22 million in 2013. Sutter’s total revenue rose 5.3 percent to $10.16 billion. The company reported net income of $402 million, up 34 percent from $300 million in 2013. These figures translate to a profit margin of 4 percent in 2014 versus 3.1 percent in 2013.

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Blue Shield of California is under new pressure to lower rates
Los Angeles Times

With billions of dollars in reserve, nonprofit insurer Blue Shield of California is facing new pressure to offer better prices for its policies.

Despite its nonprofit status, the health insurance giant is usually on par or priced slightly above its for-profit rivals, according to a review of rates and interviews with insurance agents and industry officials.

That pricing trend can be seen at the state’s two biggest buyers of healthcare: the California Public Employees’ Retirement System and the state’s Obamacare exchange.

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