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Surgeon general urges ER docs to advocate for evidence-based opioid treatment
Modern Healthcare

U.S. Surgeon General Dr. Jerome Adams on Wednesday called for emergency physicians to take a bigger role advocating for evidence-based opioid abuse treatments including harm reduction. Speaking at an American College of Emergency Physicians forum in Washington, D.C., the nation’s top doctor supported harm reduction tactics such as needle exchange programs and safe injection sites to help mitigate health concerns associated with drug use. Over the past year, cities including Seattle, Denver, Philadelphia, San Francisco and New York have all proposed opening safe injection sites but none have opened yet as critics argue they promote illegal drug use.

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Dodging Dementia: More Of Us Get At Least A Dozen Good, Happy Years After 65
Kaiser Health News

You’ve turned 65 and exited middle age. What are the chances you’ll develop cognitive impairment or dementia in the years ahead?

New research about “cognitive life expectancy” — how long older adults live with good versus declining brain health — shows that after age 65 men and women spend more than a dozen years in good cognitive health, on average. And, over the past decade, that time span has been expanding.

By contrast, cognitive challenges arise in a more compressed time frame in later life, with mild cognitive impairment (problems with memory, decision-making or thinking skills) lasting about four years, on average, and dementia (Alzheimer’s disease or other related conditions) occurring over 1½ to two years.

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Health Insurance Coverage For Healthy Groceries? More Food-Based Interventions May Be Coming
Forbes

Health insurance plans cover a variety of medical procedures, prescriptions, and provider visits. A recent change in how some plans interpret health-related insurance benefits may see more plans offering food-based benefits, including meals and healthy groceries.

Hippocrates, of the eponymous Oath, famously wrote “Let food be thy medicine.” A little over a decade ago, the editor of the British Medical Journal lamented, “Although many patients are convinced of the importance of food in both causing and relieving their problems, many doctors’ knowledge of nutrition is rudimentary.  Fortunately, food as prevention-based medicine is gaining traction across the country, with some seeing the paradigm already shifting.

The federal government recently gave the go-ahead for Medicare Advantage plans to broaden the scope of supplemental, “health-related benefits” for individuals.  The Centers for Medicare & Medicaid Services (CMS) has signaled that they will consider approving insurance plans with additional benefits that “compensate for physical impairments, diminish the impact of injuries or health conditions, and/or reduce avoidable emergency room utilization.”

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CMS Medicaid access rule poses financial hit to hospitals
Modern Healthcare

A CMS proposal allowing states to cut Medicaid rates without oversight could put hospitals and medical practices at risk for soaring uncompensated-care costs and facility closures, providers told the agency.The CMS in March suggested that states cutting Medicaid rates by up to 4% in one year or up to 6% in two consecutive years would not need to conduct an analysis to determine if the cuts harm access to care. Comments on the proposal were due Tuesday.The change could especially hurt rural hospitals that serve a high percentage of Medicaid patients, according to Casey Dungan, senior vice president at the Tennessee Hospital Association.

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States face big costs, coverage losses from Medicaid work requirements
Modern Healthcare

Implementing Medicaid work requirements will be administratively cumbersome and costly, cause many people to lose coverage and drive up uncompensated care, according to a think tank report issued Wednesday. The liberal Center on Budget and Policy Priorities said implementing so-called community engagement requirements, premiums and other new conditions will cost states and the federal government tens of millions of dollars for eligibility system changes and increased staff to track compliance and handle appeals.

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Here’s why employer health care costs are rising at the lowest rate in two decades
San Francisco Business Times

One major factor is employers pushing more of the costs of care onto employees through higher premiums and the movement toward higher deductible plans, which impacts health care purchasing decisions due to higher out-of-pocket costs for employees.

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No stay of ruling that tossed California assisted-death law
Associated Press

An appeals court on Wednesday refused to block a court decision that said a California law allowing the terminally ill to end their lives was passed illegally. California’s 4th District Court of Appeal refused to grant an immediate stay requested by state Attorney General Xavier Becerra. However, the court gave Becerra and other parties time to “show cause” — that is, provide more arguments as to why the court should grant the stay and suspend the lower court ruling. There was no immediate comment from Becerra’s office. However, a national group that supports the law, Compassion & Choices, issued a statement saying it remains in effect as the case winds through the courts “and patients can still access it.”

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How ER docs could play a key role in fighting the opioid epidemic
Southern California Public Radio

 Dr. Mary Cheffers monitors patients’ vital signs on several computers in the emergency department at L.A. County-USC Medical Center. She explains to a visitor that she’s making sure everyone’s hearts are operating normally and that no one is experiencing a lack of oxygen.

County USC has one of the largest and busiest ER’s in the nation, treating some 500 patients daily. The facility is also the main safety net hospital for L.A. County. It often treats people living on the streets and those without private insurance, as well as inmates from the county’s jail system. 

Over her last four years at County USC — at the height of the opioid epidemic — Cheffers has seen many patients experiencing withdrawal from heroin or other opioids.

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Joint replacement surgery costs vary greatly between hospitals
Modern Healthcare

A joint replacement surgery can cost as little as $5,000 or as much as $30,000 depending on the hospital, according to a new report. The analysis, published Wednesday by Premier, found the cost of joint procedures vary significantly between hospitals because of differences in practice patterns and devices used. According to the analysis, the overall median cost of total joint replacement surgery is $14,520, but 50% of cases cost between $12,000 and $17,900. The cost data came from Premier’s database of 1,100 hospitals.

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Why Big Pharma is finally discovering the Bay Area
San Francisco Business Times

Some 40 years after the biotech industry’s birth, old-school Big Pharma is planting flags in the Bay Area.

AstraZeneca plc (NYSE: AZN) formally opened its 163,000-square-foot lab and office facility Tuesday in HCP Inc.’s (NYSE: HCP) Britannia Cove in South San Francisco. It joins Merck & Co. Inc. (NYSE: MRK) and Bristol-Myers Squibb (NYSE: BMY) as some of the traditional drug maker names expanding operations in the Bay Area while trying to snare some of the region’s drug-development mojo.

The movement from Big Pharma’s traditional East Coast home to new Bay Area outposts has taken decades, but the need to partner with up-and-coming teams at small biotech companies and research institutions, such as Stanford University, the University of California, San Francisco, and UC Berkeley, has become critical. Pharmaceutical companies for the past decade have faced a “patent cliff,” where generic companies can develop lower-cost alternatives to the drugs that made Big Pharma rich; at the same time, they have pared their own drug discovery and research costs to buoy earnings.

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Palo Alto ballot measure targeting Stanford hospital’s health care costs moves forward
Silicon Valley Business Journal

The national issue of sky-high medical medical costs will be on the November ballot in Palo Alto if one of the nation’s largest health care labor groups has its way.

SEIU-UHW — a major union for health care workers — has submitted signatures for a ballot proposal called the Palo Alto Accountable and Affordable Health Care Initiative that is meant to curb hospitals from overcharging patients for treatment.

The proposal would limit certain medical facilities in the city from charging patients more than 15 percent above what it costs to provide care. If that amount is exceeded, the provider would be required to issue an annual rebate and a reduction in billed amount back to the health care payer.

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Consumer access at the heart of CVS-Aetna deal
Modern Healthcare

The proposed merger between Aetna and CVS Health would give the combined organization unprecedented access to the consumer, according to Dr. Harold Paz, executive vice president and chief medical officer of Aetna. The driving force behind the marriage between the No. 3 health insurer and the pharmacy giant is steering patients to accessible, lower-cost care via 1,100 CVS walk-in clinics. Nearly 70% of the U.S. population lives within 3 miles of a CVS pharmacy.Tracking consumers more closely could produce dividends.

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Anthem Policy Discouraging ‘Avoidable’ Emergency Room Visits Faces Criticism
National Public Radio

One of the main principles behind purchasing health insurance is protection in the event of an emergency.

But in the case of Anthem, the nation’s second-largest insurer, policy holders may be denied coverage if the company considers their visit to the emergency room unnecessary.

Under the health insurance company’s “avoidable ER program,” Anthem can retroactively restrict or deny coverage if the company decides that the patient didn’t actually have an emergency condition.  For instance, if you went to the ER for chest pain that turned out to be attributed to anxiety or indigestion, rather than a serious heart condition.

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PHOTOS: Kaiser’s new downtown medical office complex to open June 4
Sacramento Business Journal

After four years of development, Kaiser Permanente plans to open its new downtown medical office complex on June 4.

The offices are in a six-story building formerly known as the Sacramento Corporate Center, which Kaiser purchased for $40 million in 2014. The space, which was built in 1982, sat vacant for years before Kaiser bought it. The 178,000-square-foot building, at 501 J St., is just across from the street from Golden 1 Center. It also comes with a 500-space parking garage, which will be used by Kaiser employees and patients.

Kaiser’s new J Street location will host services including primary care, optometry, pediatrics, women’s health and oncology, according to Kaiser spokesman Edwin Garcia. The facility also has a comprehensive Latino clinic to serve Spanish-speaking patients.

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California hospital’s workers will see wage hikes of 42% by 2020
Becker's Hospital Review

Fountain Valley (Calif.) Regional Hospital & Medical Center’s housekeepers and cafeteria workers will see a 42 percent increase in their hourly wage by January 2020, according to the Los Angeles Times.

Hospital workers will see their hourly wage immediately increase from $11 to $13. By January 2019, the workers will have a $14.84 hourly wage, and in January 2020, the base pay will be $15.61 per hour. In addition, workers will pay 20 percent less for their health insurance.

 

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