Viewpoints: Kentucky What Are The GOP Replacement Plans?

Viewpoints: Kentucky What Are The GOP Replacement Plans?Viewpoints: Kentucky’s Obamacare Escape Route; What Are The GOP Replacement Plans?

A selection of opinions on health care from around the country.

Bloomberg: GOP Can Escape Health Care Trap What will happen if Republicans gain the votes – including the big one in the Oval Office – to do what they want to do to Obamacare? For a clue, look at what’s happening in Kentucky. Recall that the state’s new governor, Matt Bevin, is a tea partyer who fulminated against the Affordable Care Act in his campaign last fall and promised to get rid of it. (Jonathan Bernstein, 1/14)

Des Moines Register: Repeal And Replace … With What? Every remaining Republican presidential candidate supports repealing the Affordable Care Act. Yet their ideas for replacing the law are “still works in progress,” according to a headline last week in the Wall Street Journal. That’s a generous way of saying candidates have no comprehensive proposals. The newspaper said only Ben Carson and Jeb Bush have posted health plans, and both use “broad brush strokes.” (1/13)

Modern Healthcare: Liberal And Conservative Reformers Press Candidates On ACA Changes Some liberal healthcare policy experts are urging an ambitious, costly program to expand and improve the Affordable Care Act’s coverage. Meanwhile, conservative policy mavens are promoting an even more ambitious ACA replacement package they say would reduce the uninsured rate and lower healthcare spending with less government intervention. Falling in between, the centrist Bipartisan Policy Center recommended last month that the Obama administration meet with governors to advance new health insurance approaches, including flexible use of the ACA’s Section 1332 state innovation waivers allowing implementation of alternative coverage models. These proposals represent efforts from the left, right and center to frame the health policy options for the next president and Congress. (Harris Meyer, 1/13)

U.S. News & World Report: Clinton’s Health Care Attack Makes No Sense With the polls tightening in Iowa and voting both there and in New Hampshire just a few weeks away, the Kumbaya feeling in the Democratic primary is gone. In particular, the Hillary Clinton camp has evidently decided it’s time to go on offense against independent Sen. Bernie Sanders, lest 2016 start feeling like 2008 all over again. Predictably, one line of attack is on Sanders’ record on gun control, which certainly has its blemishes. Another, though, makes far less sense, particularly in a Democratic primary: Clinton is lambasting Sanders’ proposal for a universal, single-payer health care system. And she’s doing it in a pretty dishonest way. (Pat Garofalo, 1/13)

Forbes: Administrative Fixes Won’t Rescue Obamacare’s Broken Exchanges The healthcare sector is digesting an important speech by the man tasked with rescuing Obamacare’s exchanges. Andy Slavitt, formerly of UnitedHealth Group UNH -2.77%, joined the Administration in June 2014. Last February, he took over the Centers for Medicare & Medicaid Services. (John Graham, 1/13)

The Wall Street Journal: In N.Y. Policy On Out-Of-Network Medical Bills, A Model For Other States? Medical bills for out-of-network providers can surprise consumers with thousands of dollars in costs they didn’t plan for and sometimes cannot afford. I’m among those who have experienced this surprise despite efforts to determine that all my health-care providers are in-network. … a significant share of people who had problems paying medical bills say that the issue was charges for providers they did not know were out of network. New York state has a solution to this problem that bears watching. Under the New York policy, patients who are surprised by out-of-network bills pay only the amount of their regular in-network cost-sharing provided they fill out a form authorizing the provider to bill the insurer for the remaining amount. (Drew Altman, 1/11)

The New England Journal Of Medicine: Medical Taylorism Frederick Taylor, a son of Philadelphia aristocrats who lived at the turn of the last century, became known as the “father of scientific management” — the original “efficiency expert.” … Meanwhile, the electronic health record (EHR) — introduced with the laudable goals of making patient information readily available and improving safety by identifying dangerous drug–drug interactions — has become a key instrument for measuring the duration and standardizing the content of patient–doctor interactions in pursuit of “the one best way.” … The EHR was supposed to save time, but surveys of nurses and doctors show that it has increased the clinical workload and, more important, taken time and attention away from patients. (Pamela Hartzband,, MD and Jerome Groopman, MD, 1/14)

The New England Journal Of Medicine: Mr. Gilbreth’s Motion Pictures — The Evolution Of Medical Efficiency But when efficiency met medicine in the early 20th century, their relationship was no mere dalliance, and its form often diverged sharply from the Taylorist vision. One of its key figures was the industrial efficiency expert Frank Gilbreth, though his techniques were considered by many to be simply publicity-seeking smoke and mirrors. In place of a stopwatch, Gilbreth employed still and motion-picture cameras in his measurements, and he expanded his visual efficiency services — dubbed “motion study” — from industrial settings to the medical profession in the early 1910s. When he gained access to hospitals, Gilbreth transformed their operating rooms into efficiency laboratories, covering all available surfaces with gridded lines, and requiring the masked surgeons and nurses to don numbered or lettered caps to aid in his analysis of their movements across the axes of the surgical space. (Caitjan Gainty, PhD, 1/14)

The New England Journal Of Medicine: Shared Decision Making — Finding The Sweet Spot The importance of shared decision making in health care has been increasingly recognized over the past several decades. Consensus has emerged that of the various types of decisions we make, those that involve choosing among more than one reasonable treatment option should be made through a process in which patients participate: clinicians provide patients with information about all the options and help them to identify their preferences in the context of their values. (Terri R. Fried, MD, 1/14)

JAMA: If You Can’t Measure Performance, Can You Improve It? “If you can’t measure it, you can’t manage it” is an often-quoted admonition commonly attributed to the late W. Edwards Deming, a leader in the field of quality improvement. Some well-respected health policy experts have adopted as a truism a popular variation of the Deming quote—“if something cannot be measured, it cannot be improved”—and point to the recent enactment of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) as a confirmation of “the broadening societal embrace” of this concept. (Robert A. Berenson, MD, 1/13)

The Wall Street Journal: Chronic Indifference At Veterans Affairs During his Senate confirmation hearing in July 2014 to head the Department of Veterans Affairs, Robert McDonald pledged to “transform” the vast agency. After horrific reports of wait-time manipulation, coverups and even deaths at VA medical facilities across the country, veterans and the American people were calling for honest leadership to restore their trust in the department created to serve them. Sixteen months have passed but the VA’s culture of indifference persists, and the climate of accountability Mr. McDonald promised is nowhere in sight. (Jerry Moran and Jeff Miller, 1/13)

Bloomberg: How To Fix Drug Courts Again and again on the campaign trail, the presidential candidates have been faced by America’s rising concern about addiction, particularly to opioid painkillers and heroin. And from Hillary Clinton to Chris Christie, the politicians have responded by pledging their support for drug courts. This bipartisan reaction is correct, in principle: Drug courts, which now exist in every state, can motivate people to overcome their substance-abuse problems more effectively than punishment can. But to make the courts work in practice, states need to see that they’re adequately funded and properly run. (1/13)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations.

VA Secretary: Agency Providing Better Care Than Ever

VA Secretary: Agency Providing Better Care Than EverVA Secretary: Agency Providing Better Care Than Ever

During a congressional hearing on Thursday, Veterans Affairs Secretary Robert McDonald rebuffed charges that he had not fired enough employees for the scandal over veterans’ health care and outlined his plan for the VA “to become the No. 1 customer-service agency in the government.” In other Capitol Hill news, a Senate report finds that hospitals did not properly report outbreaks associated to dirty scopes.

The Associated Press: VA Chief To Congress: You Can’t Fire Your Way To Excellence Veterans Affairs Secretary Robert McDonald on Thursday disputed claims by members of Congress that his scandal-plagued agency hasn’t dismissed enough employees, saying, “You can’t fire your way to excellence.” McDonald told the Senate Veterans Affairs Committee that he and other top leaders are turning the VA around, “providing more and better care than ever before” and holding employees accountable, including firing about 2,600 workers since he took office 18 months ago. (Daly, 1/21)

Los Angeles Times: Hospitals Failed To Report Outbreaks Linked To Tainted Scopes, Senate Report Says A Senate investigation of deadly infections spread by contaminated scopes found that not one of the 16 or more American hospitals where patients were sickened appeared to have properly filed the required federal report. A Senate report titled “Preventable Tragedies” said the hospitals’ failure to properly report the outbreaks left the Food and Drug Administration “with an inaccurate picture of the frequency and severity” of the outbreaks. (Petersen, 1/22)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations.ъ

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State Highlights: Appeals Court Upholds Va. Hawaii Weighs Long-Term Care Benefit For Seniors

State Highlights: Appeals Court Upholds Va. Hawaii Weighs Long-Term Care Benefit For SeniorsState Highlights: Appeals Court Upholds Va. ‘Certificate Of Public Need’ Law; Hawaii Weighs Long-Term Care Benefit For Seniors

News outlets report on health care developments in Virginia, Hawaii, California, Florida, Delaware, Texas, Colorado and Missouri.

The Associated Press: Appeals Court Upholds Virginia Health Care Facility Law A Virginia law that requires government approval for new or expanded health care facilities is constitutional, a federal appeals court ruled Thursday. A three-judge panel of the 4th U.S. Circuit Court of Appeals unanimously rejected a claim that Virginia’s “certificate of public need” program impermissibly interferes with interstate commerce. (O’Dell, 1/21)

The Associated Press: Hawaii Could Be 1st To Start Long-Term Care Elderly Benefit Hawaii lawmakers are introducing a bill that could make the state the first in the nation to offer long-term care benefits to seniors. Democratic Sen. Rosalyn Baker said during a legislative hearing Thursday that the bill would provide eligible seniors with a benefit of $70 per day for a year. The seniors could use the benefit to pay family caregivers, hire in-home aides and help offset the cost of safety equipment, like walkers and ramps. (Riker, 1/21)

The Sacramento Bee: Many Sacramento Children On Medi-Cal Going Without Dental Care Low-income Sacramento children aren’t going to the dentist as much as they should, according to a report released Thursday. That’s despite a five-year effort to bring more dentists into Medi-Cal managed care plans, expand community clinics and educate families about the importance of dental care. In Sacramento County, only 40 percent of children on Medi-Cal managed care plans use the dental services they’re eligible for, compared to 52.5 percent statewide. (Caiola, 1/21)

The Miami Herald: Report: Miami-Dade To Face Tough Choices As Federal Funding For Uninsured Dwindles Florida legislators, meeting this month in Tallahassee, are looking down the barrel of a healthcare financial crisis for the second consecutive year — and once again, Miami-Dade, home to the state’s largest number of uninsured residents and its busiest public hospital, Jackson Health System, stands to lose more than any other county, according to a report released Wednesday. In the report, Florida Legal Services, a nonprofit advocate of expanding coverage through the Affordable Care Act, sounds an alarm about a confluence of state and federal health policy decisions that are likely to strain the healthcare safety net, forcing local hospitals to compete for a dwindling pot of money and to make difficult choices about how to best meet the needs of the uninsured. (Chang, 1/21)

The Associated Press: In State Of State, Markell Seeks To Trim Health Care Costs The rising cost of health care is Delaware’s biggest financial challenge, Gov. Jack Markell said Thursday in his final State of the State address, and he said he will propose reforms to help rein in state spending. The two-term Democrat said the current cost trend is not sustainable for taxpayers, and that he will seek reforms to improve the long-term outlook for the state’s health care plans while ensuring that state workers have access to high-quality care. (Chase, 1/21), a leading health, fitness and bodybuilding supplement company offers legal HGH products. To learn more about the many benefits of increasing your HGH levels naturally visit

The Denver Post: Colorado Report Finds Mixed Results On Infections From Surgeries If you need a hip replacement or colon surgery in Colorado, you have a relatively slim chance of picking up an infection in the hospital. Infection rates with breast surgeries, however, have been worse in Colorado hospitals than the national average for the past three years. Bloodstream infections in neonatal critical care units also have grown worse than the national average after being comparable to national rates the previous two years. Those are among the findings of the Colorado Department of Public Health and Environment’s ninth annual report of health care associated infections. (Olinger, 1/21)

Stateline: State Prisons Turn To Telemedicine To Improve Health And Save Money Most states have turned to telemedicine to some extent for treating prisoners — often in remote areas, where many prisons are located — because it allows doctors to examine them from a safe distance. It enables corrections officers keep potentially dangerous inmates behind bars for treatment rather than bearing the cost and security risk of transporting them to hospitals. And because more doctors are willing to participate, it makes health care more available for inmates. (Ollove, 1/21)

The Kansas City Star: HCA Appeals Order That It Pay $434M To KC Foundation Health care giant HCA is contesting a Missouri court judgment that it must pay the Health Care Foundation of Greater Kansas City $434 million. In papers filed this week with the Missouri Court of Appeals in Kansas City, HCA said the foundation lacks legal standing in its long-running dispute. (Bavley, 1/21)

The Kansas City Star: Northeast Joco Cities Consider Adding Mental Health Pro A group of northeast Johnson County cities wants to give their police officers better resources when answering calls involving suicide attempts, substance abuse or other mental health issues. The cities of Leawood, Prairie Village, Mission, Merriam, Fairway, Westwood and Roeland Park are considering a proposal to contract with Johnson County Mental Health to provide a mental health professional for the group. This professional, called a “co-responder,” would be available to accompany officers on calls at any time of day. (Twiddy, 1/21)

NPR/KQED: Childhood Vaccination Rates Climb In California Maybe it was last January’s big measles outbreak at Disneyland that scared more California parents into getting their kids vaccinated. Or maybe health campaigns have become more persuasive. Or maybe schools getting stricter about requiring shots for entry made a difference. Whatever the reasons, childhood vaccination rates last fall went up in 49 of 58 counties in California, according to data released Tuesday by state health officials. (Aliferis, 1/21)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations.

State Highlights: KanCare Rx Plan Would Change Under Budget Proposal; Fla. House Panel OKs Bill To End Process

State Highlights: KanCare Rx Plan Would Change Under Budget Proposal; Fla. House Panel OKs Bill To End ProcessState Highlights: KanCare Rx Plan Would Change Under Budget Proposal; Fla. House Panel OKs Bill To End ‘Certificate-Of-Need’ Process

News outlets report on health care developments in Kansas, Florida, New Hampshire, Minnesota, Michigan, Illinois, and California.

The Kansas Health Institute News Service: Budget Plan Includes Changes To KanCare Prescriptions, End Of ‘Health Homes’ Program Gov. Sam Brownback’s administration on Wednesday unveiled a budget proposal that would require new KanCare patients to try less-expensive drugs first and end a pilot program to improve the health of Kansans with severe mental illnesses. In a presentation to members of the House and Senate committees that control spending, Budget Director Shawn Sullivan outlined how Brownback planned to cover a projected $190 million shortfall in the fiscal year 2017 budget. The proposal relies on a series of revenue transfers and $105.7 million in spending reductions to balance the budget and generate an ending balance of nearly $88 million. (Hart, 1/13)

News Service Of Florida: Health Industry Regulatory Changes Sail In House A House panel Tuesday quickly approved two high-profile bills that would revamp health-care regulations — and are drawing opposition from at least parts of the hospital industry. The House Health Care Appropriations Subcommittee approved a measure (HB 437), filed by Rep. Chris Sprowls, R-Palm Harbor, that would eliminate the “certificate of need” regulatory process for hospitals. That process requires hospitals to get state approval for building or expanding facilities and for adding certain programs. (1/13)

The News Service Of Florida: House Speaker Backs KidCare For Legal Immigrants To the surprise and delight of lawmakers who have long backed the proposal, House Speaker Steve Crisafulli on Tuesday called for eliminating a five-year waiting period for children of legal immigrants to be eligible for the state’s KidCare health-insurance program. KidCare is a subsidized program that serves children from low- and moderate-income families. Children of lawfully residing immigrants currently have to wait five years before they can become eligible. The proposed bills lifting the waiting period would not apply to undocumented immigrants. (Menzel, 1/13)

The Kansas Health Institute News Service: Brownback Working Group To Tackle Rural Health Problems A key member of Gov. Sam Brownback’s new rural health working group says he hopes the initiative is a serious effort to address problems facing rural providers, not an attempt to divert attention from a renewed push to expand the state’s Medicaid program. Republican Rep. Jim Kelly represents Independence, the southeast Kansas community that recently lost its only hospital due to budget problems exacerbated by federal reductions in Medicare reimbursement rates and the state’s rejection of Medicaid expansion. (McLean, 1/13)

New Hampshire Public Radio: Low Pay Behind Nursing Crisis for N.H. Kids Who Need In-Home Care There is this monthly meeting that is typically as bureaucratic as it sounds: the Governor’s Commission on Medicaid Care Management. But last month, things were different. A group of mothers were there to testify with their children in tow. Heather Donnell, the first to speak, ditched her written testimony at the last minute. (Rodolico, 1/14)

Forum News Service: Lawmakers Told Not All Minnesota Doctors On Board With Medical Marijuana Many Minnesota doctors question the use of medical marijuana. An informal survey presented to a committee of Minnesota legislators and other involved with the subject Tuesday showed many doctors do not think they know enough about the subject to recommend their patients take it, worry that marijuana use is similar to narcotic use, do not support its use for severe pain and that the state medical marijuana law may cause conflict with patients. (Davis, 1/13)

The Associated Press: Michigan National Guard, FEMA Help Flint Amid Water Crisis Members of the Michigan National Guard began arriving in Flint on Wednesday for briefings on the drinking water crisis just as state health officials reported a spike in Legionnaires’ disease cases in the county where the city is located. Gov. Rick Snyder activated the National Guard late Tuesday, and Lt. Col. William Humes confirmed about a half-dozen representatives arrived Wednesday morning. They are part of a larger contingent of Guardsmen who will help distribute bottled water, filters and other supplies to residents. (Schneider and Eggert, 1/14)

The Kansas Health Institute News Service: Kansas Infant Mortality Problem Pushes Experts To Rethink Approach Thanks to advances in prenatal and neonatal care, the overwhelming majority of infants are born healthy and thrive. But sometimes things don’t go as planned. In Johnson County, for every 1,000 infants born in recent years, fewer than five don’t make it to their first birthday. In Wyandotte County, the number is closer to eight. For African Americans in both counties, the numbers are even higher. In fact, for the last few years the black infant mortality rate in Kansas has been the highest in the country. (Smith, 1/13)

The Daily Southtown: Collateral Damage In State’s Budget War Vera Cassata, 84, of Tinley Park [Ill.] depends on a home health care assistant to get her out of bed in the morning, wash her, dress her, buy food and help her go to the bathroom. Five days a week the home health care assistant visits, but due to the state budget crisis that help may disappear by the end of the month. Shay Health Care Services of Oak Forest provides home health care assistants for about 300 elderly residents of the Southland, which allows them to remain in their homes instead of going into nursing homes if their families can’t provide the care they need. Shay has a contract with the state’s Department on Aging to provide home care assistants and is supposed to be paid $170,000 a month. But since July 1, 2015, when the state failed to adopt a new budget, it has not been paid. (Kadner, 1/13)

The Associated Press: California Tubal Ligation Fight Heads To Court Thursday A San Francisco judge is set to hear arguments Thursday over whether to require a Catholic hospital to perform a contraceptive procedure known as tubal ligation. Attorneys for Rebecca Chamorro, the woman seeking the procedure, say Mercy Medical Center in Redding denied her the procedure. Chamorro wants to get the procedure immediately following her scheduled cesarean section Jan. 28 because she and her husband do not want more children. (1/14)

The Associated Press: Mental Health CEO Who Hired Fortuneteller Gets Prison The head of a southwestern Michigan mental health agency has learned his future: at least 32 months in prison for using public money to hire a fortuneteller. Ervin Brinker was sentenced by a Lansing-area judge Wednesday, two months after pleading guilty to embezzlement and Medicaid fraud conspiracy. (1/13)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations.

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Lilly Offers Underwhelming 2016 Forecast; Merck On Deals

Lilly Offers Underwhelming 2016 Forecast; Merck On DealsLilly Offers Underwhelming 2016 Forecast; Merck’s CEO Says The Company Is ‘Raring To Go’ On Deals

Also, Valeant names a new CEO while 21st Century Oncology withdrew its long-delayed public offering.

The Associated Press: Drugmaker Lilly’s 2016 Forecast Misses Street Expectations Eli Lilly has dropped a lower-than-expected 2016 forecast on Wall Street after wrapping up a year in which its stock soared above the broader market. … Lilly, also known for the erectile dysfunction drug Cialis and its portfolio of cancer treatments, has been recovering from the loss of patents protecting key products like the antidepressant Cymbalta from cheaper generic drugs. (1/5)

The Associated Press: Merck CEO: Eager For Deals, Strong Prospects For New Drugs Merck’s chief executive says the drugmaker is “raring to go” on deals this year, particularly for small and midsize acquisitions of companies or their experimental drugs. CEO Kenneth Frazier, speaking Tuesday at a Goldman Sachs conference of CEOs of health care companies in Boston, also said he expects more approvals and growing sales from new cancer drug Keytruda. (1/5)

The Wall Street Journal: 21st Century Oncology Withdraws IPO 21st Century Oncology Holdings Inc., the cancer-care giant that was recently embroiled in a Medicare billing investigation, on Tuesday withdrew its long-delayed initial public offering. In a regulatory filing, 21st Century Oncology said it had decided not to pursue the offering at this time. The company didn’t provide further detail. (Dulaney and Carreyrou, 1/5)

Bloomberg: Valeant To Name New CEO As Pearson Hospitalized, WSJ Says Valeant shares dropped 4.8 percent to $96 in late trading after the Journal report. Through Tuesday’s close, they had fallen 12 percent since Pearson’s hospitalization was disclosed on Christmas Day. … The drugmaker announced that Pearson was taking a medical leave of absence starting on Dec. 28, and that the company would be run by a team of three executives, including General Counsel Robert Chai-Onn, Executive Vice President Ari Kellen and CFO Rosiello. Valeant board members Schiller, Robert Ingram and Mason Morfit were tapped to oversee the executives. (Armstrong, 1/5)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations.

Blurred Ethical Lines Worry Advocates As Companies Use Patients To Sell Treatments

Blurred Ethical Lines Worry Advocates As Companies Use Patients To Sell TreatmentsBlurred Ethical Lines Worry Advocates As Companies Use Patients To Sell Treatments

The manufacturers of hemophilia and other drugs and the specialty pharmacies that dispense the medicines have been hiring patients or family members to sell their products. Some are concerned this practice is causing consumers to be misled by people they are more inclined to trust. In other pharmaceutical news, the Federal Trade Commission reports “pay-for-delay” deals have dropped following the Supreme Court ruling on the issue.

The New York Times: Hemophilia Patient Or Drug Seller? Dual Role Creates Ethical Quandary LaQuenta Caldwell-Moody considered it improper when a pharmacy sales representative tried to take her teenage son, when he was still a minor, to dinner without her. The salesman was the father of someone with hemophilia, the same disease her son has. But this invitation seemed mercenary, taking advantage of their friendship and shared illness to try to woo the business of her son, Austin Caldwell, whose drug treatments cost more than $1 million a year. … The companies, and some patients, say the practice can improve service. But some patient advocates say that having people with dual, and sometimes dueling roles, can result in patients being misled by someone they think of as their friend but who puts profits over their health. (Pollack, 1/13)

Reuters: Controversial ‘Pay-For-Delay’ Deals Drop After FTC’s Win In Top Court Branded drug companies hammered out far fewer deals with generic drug makers to delay sales of cheaper medicines in the year after the Supreme Court ruled the Federal Trade Commission could legally pursue such agreements as potentially illegal. The FTC, which has fought the practice for years, said that pharmaceutical companies reached 21 of the “pay-for-delay” deals in fiscal 2014, compared with 29 in 2013 and a record 40 in 2012. (Bartz, 1/13)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations.

Fueled By Health Law, Concierge Medicine Reaches New Markets

Fueled By Health Law, ‘Concierge Medicine’ Reaches New Markets

A growing number of primary care doctors, spurred by the federal health law and frustrations with insurance requirements, are bringing a service that generally has been considered “health care for billionaires” to middle-income, Medicaid and Medicare populations.

It’s called direct primary care, modeled after “concierge” practices that have gained prominence in the past two decades. Those feature doctors generally bypassing insurance companies to provide personalized health care while charging a flat fee on a monthly or yearly basis. Patients can shell out anywhere from thousands to tens of thousands of dollars annually, getting care with an air of exclusivity.

In direct primary care, patients pay about $100 a month or less directly to the physician for comprehensive primary care, including basic medication, lab tests and follow-up visits in person, over email and by phone. The idea is that doctors, who no longer have to wade through heaps of insurance paperwork, can focus on treating patients. They spend less on overhead, driving costs down. In turn, physicians say they can give care that’s more personal and convenient than in traditional practices.

This KHN story also ran on NPR. It can be republished for free (details).

The 2010 health law, which requires that most people have insurance, identifies direct primary care as an acceptable option. Because it doesn’t cover specialists or emergencies, consumers need a high-deductible health plan as well. Still, the combined cost of the monthly fee and that plan is often still cheaper than traditional insurance.

The health law’s language was “sort of [an] ‘open-for-business’ sign,” said Jay Keese, a lobbyist who heads the Direct Primary Care Coalition. Before 2010, between six and 20 direct primary care practices existed across the country. Now, there are more than 400 group practices.

The total number of physicians participating doctors may exceed 1,300. The American Academy of Family Physicians estimates 2 percent of its 68,000 members offer direct care.

“This is a movement – I would say it’s in its early phase,” said AAFP President Wanda Filer, a doctor in Pennsylvania. “But when I go out to chapter meetings, I hear a lot more interest.”

But questions persist about feasibility. The lower fees could still be a non-starter for people earning minimum wage or on a limited budget, said Robert Berenson, a senior fellow at the Urban Institute. “Can people afford this? Or is it [still] just for well-off people?”

The American College of Physicians advises doctors to consider whether direct primary care can work within their practices, but also urges physicians to recognize how it could affect poorer patients and look for ways to keep care affordable.

Direct primary care doctors say they see patients across incomes. Dr. Stanford Owen, of Gulfport, Mississippi, treats “waitresses and shrimpers, as well as doctors and lawyers.” He charges $225 for initial visits, $125 for a follow-up, if needed, and then about $50 per month after.

Owen and other physicians report positive experiences, triggering other efforts to apply direct care more broadly. Although most of these doctors eschew dealing with insurance, some have been trying the model with Medicaid and Medicare patients.

If those experiments work – and save money and improve health – they could mitigate concerns about who can afford direct primary care. Berenson pointed out that partnering with insurance or public programs is key to making direct care affordable for lower-income people.

“The idea of setting up stronger primary care services for patients is very exciting and very much needed,” said Ann Hwang, director of the Center for Consumer Engagement in Health Innovation, an outpost of the consumer advocacy group Community Catalyst. But, she added, “This is so new that I think the jury is still really out on whether this will be successful.”

In Seattle, a company called Qliance, which operates a network of primary care doctors, has been testing how to blend direct primary care with the state’s Medicaid program. They started taking Medicaid patients in 2014. So far, about 15,000 have signed up. They get a Qliance doctor and the unlimited visits and virtual access that are hallmarks of the model.

“Medicaid patients are made to feel like they’re a burden on the system,” said Dr. Erika Bliss, Qliance’s CEO. “For them, it was a breath of fresh air to be able to get such personalized care – to be able to talk to doctors over phone and email.”

Qliance has a contract with Centene, an insurance company in the state’s Medicaid program. That Medicaid coverage pays for the monthly fee, which covers primary and preventive care, and for other specialty and emergency services. If patients need a specialist, they’ll get referred to one who accepts Medicaid. Advocates in other states – such as North Carolina, Idaho and Texas – are watching the outcomes and costs while considering rolling out similar programs.

There’s little data so far. Bliss estimated participants will cost Washington state between 15 and 20 percent less than traditional Medicaid. Before launching the Medicaid pilot, Qliance contracted with some companies that provide insurance to their employees – in those cases, employees who opted for Qliance cost about 20 percent less than employees in traditional health insurance. Because patients get better care upfront, the theory goes, they’re less likely to develop expensive chronic illnesses.

Still, expanding this approach is tricky. The number of participating physicians is low. There’s already a nationwide shortage of primary care doctors. In this model, physicians see fewer patients, potentially exacerbating that shortage’s impact. Also, Medicaid negotiates the monthly payment rate, which could be less than what doctors might set independently.

In New Jersey, a pilot program using direct primary care is launching in 2016 for state employees, like firefighters and teachers. It’s a hybrid: When consumers pick a primary doctor, they can choose a direct primary care-style practice, which gives around-the-clock access to preventive and primary care services. The monthly fee is undetermined.

Participants will get benefits such as same-day appointments for non-emergency visits. But when they pick this plan – which will be administered by Aetna and Horizon – they will have access to specialists that participate in the insurers’ plan networks.

In New Jersey, about 800,000 people will be eligible to enroll in the direct primary care program. The state’s hoping to attract and accommodate at least 10,000 in the first year.

That’s appealing, said Mark Blum, executive director of America’s Agenda, an advocacy group that helped develop the project. He cited interest in California, Texas, Pennsylvania and Nebraska. “There are a lot of eyes on New Jersey right now.”

Meanwhile, direct primary care is finding traction with Medicare Advantage, the private health plan alternatives to traditional Medicare. Iora Health, a direct primary care system that contracts with unions and employers, a year ago launched clinics in Washington and Arizona catering to Medicare Advantage patients.

Iora’s setting up similar clinics in Colorado and Massachusetts.

Despite its potential, the direct care model faces the challenges of integration into existing payment systems and attracting more participating doctors. And navigating Medicare and Medicaid rules can deter physicians.

“It’s not for the faint of heart,” said Dr. Rushika Fernandopulle, Iora’s CEO.

How it evolves from here will vary across the country, said Filer, the AAFP president.

“There are some parts of the country where it is working very well,” she said. “But there are other reasons a physician might decide, ‘This is not for my patient base.’”

Categories Concierge Medicine, Doctors, Medicare | @Shefalil

If He Shows, Shkreli Plans To Invoke Fifth Amendment

If He Shows, Shkreli Plans To Invoke Fifth AmendmentIf He Shows, Shkreli Plans To Invoke Fifth Amendment

The Oversight and Government Reform Committee subpoenaed former Turing CEO Martin Shkreli, who became the face of the high drug costs controversy, to testify on the spiked prices.

Reuters: Drug Exec Shkreli, Lawmakers Clash Ahead Of Congressional Hearing Former pharmaceutical executive Martin Shkreli was on a collision course with Congress on Thursday as lawmakers warned he could be prosecuted for contempt if he does not appear next week for a hearing about drug prices. Shkreli, 32, has said he would invoke his Fifth Amendment right against self-incrimination. On Twitter, he told followers it was “disgusting and insulting” for lawmakers to try to subvert that right. … The dispute appeared likely to end in one of two ways: with Shkreli appearing in Washington on Tuesday to invoke that right, or with Shkreli staying home in New York, prompting the committee to vote to hold him in contempt and setting off a potential criminal prosecution. (Raymond and Ingram, 1/21)

The Associated Press: Reviled Pharma Exec Would Decline Congressional Questioning The House Committee on Oversight and Government Reform has subpoenaed [Martin] Shkreli to appear at a hearing on exorbitant drug pricing next Tuesday. Shkreli became the public face of pharmaceutical-industry greed last fall, after hiking the price of a 60-year-old drug for a rare infection by 5,000 percent. Questions emerged Thursday about whether Shkreli would even attend the hearing, in spite of the congressional subpoena. Rep. Elijah Cummings, D-Maryland, said Shkreli has apparently not made any legal arrangements to travel to Washington, based on conversations with his attorney. (1/21)

The Wall Street Journal: Shkreli Seeks To Shield Congressional Testimony Martin Shkreli, the former drug-company executive criticized for dramatically raising a pill’s price, has asked a congressional committee seeking his testimony to guarantee it can’t be used in a federal prosecution, according to materials reviewed by The Wall Street Journal. … Lawyers for Mr. Shkreli have told the committee he won’t answer questions, citing his Fifth Amendment privilege against self-incrimination, according to emails between Mr. Shkreli’s lawyers and the committee. The lawyers indicated that position would change if the committee would grant Mr. Shkreli the immunity so prosecutors couldn’t use his testimony against him, according to the emails. (Rockoff, 1/21)

The Fiscal Times: If Congress Has Its Way, You Could Pay Canadian Prices For Your Drugs With many lawmakers and presidential candidates declaring open season on drug companies that have substantially jacked up the price of critically needed drugs, the pharmaceutical industry is bracing for a bruising battle this year over calls for price restraints and other reforms. (Pianin, 1/21)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations.

Viewpoints: Joe Biden Takes Aim At Cancer; Obamacare As A Pay Cut

Viewpoints: Joe Biden Takes Aim At Cancer; Obamacare As A Pay CutViewpoints: Joe Biden Takes Aim At Cancer; Obamacare As A Pay Cut

A selection of opinions on health care from around the country.

Medium: Inspiring A New Generation To Defy The Bounds Of Innovation: A Moonshot To Cure Cancer. Tonight, the President tasked me with leading a new, national mission to get this done. It’s personal for me. But it’s also personal for nearly every American, and millions of people around the world. We all know someone who has had cancer, or is fighting to beat it. They’re our family, friends, and co-workers. (Vice President Joe Biden, 1/12)

The Wall Street Journal: Obamacare’s $1,200 Pay Cut Liberals insist the stagnation of real incomes in the Obama era can be solved with more redistribution, while the Donald Trump right focuses on immigrants and trade. Maybe the better explanation is this era’s onslaught of lousy economic policies, starting with ObamaCare. Among the law’s few popular features, even among Republicans, is the mandate to cover adult children through age 26 on the insurance plans of their parents. This benediction is sold as a gratuity, but somebody must ultimately pay, and new research suggests the hidden costs—in the form of lower take-home pay—are far higher than advertised. (1/12)

Forbes: Consumerism In Health Care Can’t Work. (Except For All The Places It Already Does.) Consumerism in health care just can’t work. It can’t work because seriously ill patients are under incredible stress and can’t shop around for the best care. It can’t work because information on quality and cost isn’t easily accessible. It can’t work because health care spending is heavily concentrated – just 5 percent of the patients account for 50 percent of the cost. What’s the point in having a $6,000 deductible when you need a $500,000 surgery? (Paul Howard, 1/13)

Modern Healthcare: Skin In The Game Gets Personal For Doctors Many healthcare providers and consumer advocates—and even some health insurance executives—say the skin-in-the-game model has been taken too far in the U.S. and is getting in the way of patients receiving appropriate care. Now physicians are finding themselves being held financially accountable for their medical choices, and they don’t much like the skin-in-the-game model or metaphor. Employed hospitalists at PeaceHealth Sacred Heart Medical Center in Springfield, Ore., have joined the American Federation of Teachers union partly in response to the hospital’s use of financial incentives to get them to achieve performance targets such as reducing length of stay and improving patient satisfaction scores, the New York Times reports. (Harris Meyer, 1/12)

Vox: Kentucky’s New Republican Governor Is Entrenching Obamacare While Pretending To Dismantle It Kentucky’s new Republican governor, Matt Bevin, plans to dismantle his state’s Obamacare marketplace, Kynect. On the surface, this looks like a Tea Party conservative governor taking a stand against the law he campaigned against in 2015. Except Bevin’s actions don’t really show that at all. (Sarah Kliff, 1/12)

New Orleans Times-Picayune: John Bel Edwards Begins By Acknowledging The Poor Edwards linked that poverty to the struggle women in this state have getting a decent pay check. And he linked that poverty to the struggle that young people have paying the cost of skyrocketing tuition at our public universities. And, indirectly, he linked poverty in the state to his predecessor’s refusal to accept the Medicaid expansion made possible by the passage of the Affordable Care Act. He vowed to accept the expansion immediately so our residents won’t be going without while our taxes help pay for Medicaid expansion in 30 other states. (Jarvis DeBerry, 1/12)

The Washington Post: Here’s The Real Deal On The Latest Big Clinton-Sanders Dust-Up While Hillary Clinton and Bernie Sanders started their presidential campaigns with an unspoken mutual non-aggression pact, it was inevitable that as the voting approached and the sense of urgency grew, they would start criticizing each other more and more. But an attack Clinton has now launched on Sanders’ support of single-payer health care is both odd and important, so I’m going to try to sort it out — both the substance and the politics. (Paul Waldman, 1/12)

The New York Times: Where Police Violence Encounters Mental Illness Nearly 20 years ago, I was a social worker in a county jail where I first began to understand just how frequently the police deal with people with mental illnesses. Run-ins with the police were a regular occurrence for many of my clients, with officers often knowing them by name. They were overwhelmingly poor, and poor people with mental illnesses are also likely to experience homelessness and substance abuse — issues that place them at increased risk of police contact and incarceration. (Matthew Epperson, 1/13)

The Baltimore Sun: Curbing Sugary Drinks In Baltimore Last summer, San Francisco became the first city in the nation to require businesses that sell sugary drinks to post this disclaimer: “WARNING: Drinking beverages with added sugar(s) contributes to obesity, diabetes, and tooth decay.” City leaders also banned ads for sugary drinks on public property and prohibited the use of city funds to buy such beverages. (1/12)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations.

MannKind Loses Key Partner For Inhaled Insulin Product

MannKind Loses Key Partner For Inhaled Insulin ProductMannKind Loses Key Partner For Inhaled Insulin Product

Sanofi-Aventis, a French pharmaceutical giant that had agreed to market and distribute Mannkind’s Afrezza, pulled out due to slow sales. The move is another stumble in an already troubled history to bring the diabetes treatment to market.

The Wall Street Journal: MannKind, Sanofi End Licensing Pact For Diabetes Medicine Afrezza MannKind Corp. on Tuesday announced the termination of its licensing pact with Sanofi-Aventis in the U.S. for the development and sale of its inhaled insulin product Afrezza and signaled that it might look to sell the drug. Shares of the company tumbled 27% in midday trading. Over the past three months, shares have dropped 67%, including Tuesday’s decline. (Beilfuss, 1/5)

Los Angeles Times: MannKind Plans To Seek New Marketing Partner For Insulin Drug Hours after MannKind Corp. announced on Tuesday that Sanofi had pulled out of an agreement to license its Afrezza inhaled insulin, a MannKind executive said the Valencia company does not plan to sell the drug and will seek a new marketing partner. (Darmiento, 1/5)

Los Angeles Times: A Rare Stumble For Biotech Pioneer Alfred Mann Over seven decades, billionaire Alfred Mann has founded 17 companies, including ones that help the blind see and the deaf hear. Along the way, he’s built a fortune that at one point topped $2 billion, but in what could be his final act, the 90-year-old biotech entrepreneur has stumbled. His latest big venture, a treatment that lets diabetics inhale their insulin instead of injecting it, has been a huge disappointment. (Rufus Koren, 1/6)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations.

Viewpoints: Sanders On Ky. Reform

Viewpoints: Sanders On Ky. ReformViewpoints: Sanders’ Health Plan Draws Concerns; Gov.’s ‘Bizarre Attack’ On Ky. Reform

A selection of opinions on health care from around the country.

Bloomberg: Medicare Paperwork For All In making his case for universal health care, Senator Bernie Sanders has reignited a debate over whether the U.S. should have a single-payer system. It would simplify the administration of health insurance, but his proposal is nevertheless ill-advised — not least because it’s possible to simplify billing and claims processing in health care without making such an extreme change. (Peter R. Orszag and Timothy G. Ferris, 1/21)

Bloomberg: Sanders’s Health-Care Plan Is Missing Its Price Tag So Bernie Sanders has a health-care plan. It sounds wonderful. It covers everything, from dental to long-term care. There will be no co-pays or deductibles. You will not have to hassle with an insurer over what’s covered. There’s just one small problem, which is how Sanders is planning to pay for this. Yes, his health care plan lays out revenue estimates in great detail. But the revenue estimates and the cost estimates are perhaps just a trifle too rosy for me to take seriously. (Megan McArdle, 1/20)

The Houston Chronicle: Sanders’ Health Care Plan Is A Distraction If you’ve successfully landed on the beaches, but your forces are still taking heavy fire, what do you do? Do you concentrate on trying to hold the line and make further advances or do you sit in a circle and design a better landing craft? The problem with Bernie Sanders’ health care vision isn’t the vision. His raw outline for a greatly simplified and less expensive health-care system is excellent in theory. The problem is the politics — the reality of which battle-scarred Hillary Clinton clearly has the better grasp. (Froma Harrop, 1/20)

The Chicago Sun-Times: Bernie Sanders’ Health Care Plan Loaded With Fiction Bernie Sanders is a democratic socialist who thinks the United States needs a “political revolution.” His plan to replace our health insurance system with “Medicare for All” is in some ways a dramatic break with the status quo. But it rests on an old and thoroughly conventional formula: Promise voters that they will get more and better health care without paying for it. Simply expanding Medicare to include everyone would be a big enough step. But Sanders’ plan is to Medicare what a Tesla is to a Toyota. (Steve Chapman, 1/20)

The New York Times: Kentucky’s Bizarre Attack on Health Reform Gov. Matt Bevin of Kentucky is dismantling the state’s highly successful exchange on which people buy private health insurance policies or enroll in Medicaid under the Affordable Care Act. His shortsighted and pointless show of defiance against the Obama administration’s health care reforms could harm thousands of people in Kentucky, who may fall between the cracks as the state shifts their coverage from its own exchange, known as Kynect, to the federally run exchange at (1/21)

Des Moines Register: Governor Perpetuates Myths About Medicaid Privatization As Iowa’s 118 community hospitals and 71,000 hospital employees work daily to bring healing and wellness to all Iowans, the state’s reckless rush toward privatization of the Medicaid program has been a source of extreme concern. Most concerning are the myths about privatization perpetuated by our own governor, including during his interview with the Des Moines Register editorial board, as he tries to promote what is simply a bad idea for Iowa and, especially, for 560,000 vulnerable Iowans who depend on Medicaid. (Kirk Norris, 1/20)

The New York Times’ Room for Debate: The Best Missions For A Cancer Moonshot In his final State of the Union address, President Obama said he would put Vice President Biden in charge of a “moonshot” program to conquer cancer with the same level of effort that went into the Apollo lunar missions. Some cancer researchers say the idea of curing cancer with a massive government program relies on an outmoded, simplistic model of the disease. But even if a “victory” against cancer is unrealistic, how can government best be used to reduce its threat and lethalness? (1/19)

The New England Journal of Medicine: Regulating Homeopathic Products — A Century Of Dilute Interest Unlike dietary supplements, which were explicitly excluded from rigorous FDA regulation in 1994, homeopathic products can actually be substantially regulated by the FDA, since the Food, Drug, and Cosmetic Act allows them to be sold as “therapeutic.” We believe that, at minimum, regulators should reconsider the way homeopathic drugs are marketed, so that consumers who are seeking conventional medicines at pharmacies don’t become confused. In August, the FTC submitted comments to the FDA recommending that the agencies better harmonize their approaches to regulating homeopathic products and their advertising. … The recent actions by the FDA and FTC may finally signal the end of homeopathic drugs’ century-long evasion of regulatory scrutiny. (Scott H. Podolsky and Aaron S. Kesselheim, 1/21)

The New England Journal of Medicine: Data Sharing The aerial view of the concept of data sharing is beautiful. What could be better than having high-quality information carefully reexamined for the possibility that new nuggets of useful data are lying there, previously unseen? The potential for leveraging existing results for even more benefit pays appropriate increased tribute to the patients who put themselves at risk to generate the data. The moral imperative to honor their collective sacrifice is the trump card that takes this trick. However, many of us who have actually conducted clinical research, managed clinical studies and data collection and analysis, and curated data sets have concerns about the details. (Dan L. Longo and Jeffrey M. Drazen, 1/21)

The New England Journal of Medicine: Time For A Patient-Driven Health Information Economy? As patients strive to manage their own health and illnesses, many wonder how to get a copy of their health data to share with their physicians, load into apps, donate to researchers, link to their genomic data, or have on hand just in case. To seek diagnosis or better care, many patients are taking steps outside traditional doctor–patient relationships. Some join 23andMe to obtain genetic information. Others bring data to the Undiagnosed Diseases Network at the National Institutes of Health (NIH). Patients are coalescing with others with the same disease in what the Patient Centered Outcomes Research Institute calls patient-powered research networks. But such patients have found no easy way to get copies of their electronic health records (EHRs). (Kenneth D. Mandl and Isaac S. Kohane, 1/21)

The New England Journal of Medicine: ACOs And High-Cost Patients Managing the care of high-cost patients is a key concern of physicians and health systems that are forming accountable care organizations (ACOs) and entering into alternative payment contracts tying reimbursement to performance on cost trends and quality measures. The logic is simple: given that a small percentage of patients (often those with complex or multiple medical conditions) account for the majority of health care spending, directing additional resources and services toward patients who are likely to incur high costs and experience poor outcomes … Can tactics honed among the elderly be successfully applied to other high-cost populations? (Brian W. Powers and Sreekanth K. Chaguturu, 1/21)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations.

State Highlights: Bill Would Let Californians Know About Unreasonable Rate Hikes; Va. Mental Health Advocates Push For Reforms

State Highlights: Bill Would Let Californians Know About Unreasonable Rate Hikes; Va. Mental Health Advocates Push For ReformsState Highlights: Bill Would Let Californians Know About Unreasonable Rate Hikes; Va. Mental Health Advocates Push For Reforms

News outlets report on health care developments in California, Virginia, Minnesota, North Carolina, Connecticut and Florida.

California Healthline: Unreasonable Rate Hike? Proposed Legislation Would Tell You About It California consumers should know when their health insurance premium rates have been deemed unreasonable by the state. That’s the primary purpose of a bill (SB 908) proposed yesterday in the state Senate. (Gorn, 1/27)

The Richmond Times-Dispatch: Advocates Push For Mental Health Reforms With a steady smile and commanding voice, Beth Hilscher led a group of mental health advocates from office to office in the General Assembly building on Wednesday. She introduced them to senators and staff members and gently encouraged them to tell their stories — Pat, whose 34-year-old son needs intensive treatment for schizoaffective disorder; Rebekah, whose sister is often without insurance because bipolar disorder makes it hard for her to hold a job. (Kleiner, 1/27)

CALmatters: California Doles Out Millions To Insurers For Hepatitis C Drugs In an unusual funding arrangement, California is paying private health plans hundreds of millions of dollars in supplemental payments to cover the high price of hepatitis C drugs for patients in Medi-Cal managed care plans. (Bartolone, 1/27)

Minnesota Public Radio: St. Paul Will Explore Making Earned Sick And Safe Time Mandatory St. Paul leaders want to explore mandatory earned sick and safe time for all employees in the city. Under a City Council resolution to be released Thursday, a task force will explore how businesses of all sizes in St. Paul could offer earned sick and safe time benefits to their employees. (Nelson, 1/28)

The Charlotte Observer: Attention, Please: Plain Language Replaces Color-Coded Alerts At Some Hospitals I was sitting at Carolinas Medical Center Last month when an ominous-sounding voice came over the loud speaker: “Security alert. Threat of violence. Levine Children’s Hospital. 10th floor. Avoid the area.” (Garloch, 1/27)

The Connecticut Mirror: In Shoreline Cancer Treatment Dispute, Questions About Hospital Competition What began with a plan to replace an aging piece of medical equipment has turned into a dispute over the delivery of cancer care along Connecticut’s affluent shoreline. (Levin Becker, 1/28)

The News Service Of Florida: Florida Prisons Sued Over Treatment Of Disabled Inmates A group representing disabled inmates has filed a federal lawsuit accusing Florida prison officials of discriminating against prisoners who are deaf, blind or confined to wheelchairs, in violation of the federal Americans with Disabilities Act. The lawsuit, filed Tuesday in Tallahassee by Disability Rights Florida, alleges that the Department of Corrections failed to provide interpreters and auxiliary aids, prosthetic devices and wheelchairs, and assistants and tapping canes to inmates with disabilities. (Kam, 1/27)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations.

In Latest Blow To Theranos, Walgreens Halts Use Of California Lab

In Latest Blow To Theranos, Walgreens Halts Use Of California LabIn Latest Blow To Theranos, Walgreens Halts Use Of California Lab

Walgreens said the blood testing startup “must immediately cease sending any clinical laboratory tests” to the company’s Palo Alto lab, which is facing federal scrutiny for deficient practices that the Centers for Medicare & Medicaid Services say pose immediate jeopardy to patient health and safety.

The New York Times: Walgreens Says No Customers’ Tests Will Be Done At Theranos Lab In California Walgreens, the giant drugstore chain, offered the latest vote of no confidence for Theranos, the Silicon Valley laboratory testing company it had collaborated with to offer blood tests for some of its customers. In a statement issued on Thursday, Walgreens said that none of the tests for its customers could be performed at Theranos’s Newark, Calif., laboratory, which federal regulators just cited for violations of clinical standards. Walgreens said it was also suspending Theranos laboratory testing at its Palo Alto, Calif., store. (Abelson, 1/29) Chronicle: Walgreens Pumps The Brakes On Theranos Partnership Amid Problematic Lab Audit In a statement, Walgreens — Theranos’s first retail partner, which operates blood-testing centers in 40 locations throughout Arizona and one in Palo Alto, Calif. — said that Theranos “must immediately cease sending any clinical laboratory tests…to the Theranos lab in Newark, Calif., for analysis. In addition, Walgreens is suspending Theranos laboratory services at its Palo Alto, Calif., store, effective immediately.” (Weiss, 1/28)

The Associated Press: Walgreens Tells Theranos To Stop Using Lab Under Scrutiny The company said Thursday that it told Theranos to either send tests to a certified lab in the Phoenix area that Theranos runs or to an accredited third-party lab. (1/28)

KQED: Walgreens Suspends Theranos Blood-Testing At Palo Alto Store Theranos responded to news of the CMS findings by stating that the agency’s inspection took place last year, and that the report doesn’t reflect current practices. The Silicon Valley company also said it is taking corrective steps. Theranos Vice President of Communications Brooke Buchanan said in an email statement today that, “We look forward to continuing to work with Walgreens to provide access to reliable, high quality, and low-cost lab testing services.” (Brooks, 1/28)

CNN Money: Walgreens Cracks Down On Theranos Walgreens is Theranos’ big retail partner: It has more than 40 Theranos Wellness Centers in its stores. But it’s not clear how much of an impact dropping the Newark lab will have, since Theranos said that it processes 90% of its tests in its Arizona lab. (O’Brien, 1/28)

The Arizona Republic: Walgreens Halts Use Of Theranos’ California Lab Amid Safety Concerns The decision appears to have little immediate affect on anyone who uses Theranos’ testing centers inside 40 metro Phoenix Walgreens stores. Those centers remain open, and blood samples collected there will be processed at Theranos’ lab in Scottsdale or at an accredited third-party lab. (Alltucker, 1/28)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations.

McCaskill Calls For Treatment Centers, Monitoring Program To Fight Opioid Abuse

McCaskill Calls For Treatment Centers, Monitoring Program To Fight Opioid AbuseMcCaskill Calls For Treatment Centers, Monitoring Program To Fight Opioid Abuse

Sen. Claire McCaskill, at a field hearing in Jefferson City on Tuesday, called on lawmakers to rectify the lack of a drug monitoring program in Missouri. Elsewhere, Ohio announces new guidelines for prescribing painkillers, and New York extends its rebate for naloxone, an antidote for heroin and other opioid overdoses.

The Associated Press: McCaskill Says Missouri Needs Tighter Drug Monitoring U.S. Sen. Claire McCaskill said Tuesday that Missouri needs more tools to fight opiate abuse, including a prescription drug monitoring program, more specialized treatment centers and better research about average drug use. The Senate’s committee on aging, on which McCaskill sits as the ranking Democrat, heard testimony on opioid abuse Tuesday during a field hearing in Jefferson City. Opioids include prescription painkillers as well as illegal drugs such as heroin and opium. McCaskill was the only U.S. senator in attendance, though at least nine state lawmakers sat in on the hearing. (Aton, 1/19)

The Associated Press: Ohio Sets New Guidelines For Short-Term Pain Prescribing People with short-term pain from injuries or surgery should be given alternatives to prescription painkillers whenever possible and be provided only the minimum amounts if absolutely needed, according to guidelines announced Tuesday by Gov. John Kasich’s office. Alternatives to the class of painkillers known as opioids could include ice, heat, wraps, stretching, massage therapy, acupuncture, seeing a chiropractor or physical therapy, along with medicines that don’t have addictive qualities, such as ibuprofen, said Dr. Mary DiOrio, medical director for the state Department of Health. (Welsh-Huggins, 1/19)

The Associated Press: NY Rebate Extended For Heroin Overdose Antidote New York’s attorney general has announced an agreement with Amphastar Pharmaceuticals to extend a nearly 20 percent price cut for naloxone, an antidote for heroin and other opioid overdoses. The attorney general’s office says Tuesday that Amphastar for another year will cover a $6 rebate per dose, which will also automatically increase, dollar-for-dollar, to match future growth in the wholesale price. (1/19)

Meanwhile, NPR takes a look at opioid addiction and the workplace —

NPR: Opioid Abuse Takes A Toll On Workers And Their Employers According to one study, prescription opioid abuse alone cost employers more than $25 billion in 2007. Other studies show people with addictions are far more likely to be sick, absent or to use workers’ compensation benefits. When it comes to workers’ comp, opioids are frequently prescribed when pain relievers are called for. How often doctors choose opioids varies by state, with an analysis finding the highest rates in Arkansas and Louisiana. (Noguchi, 1/20)

And The New York Times examines the spread of the opioid epidemic across the country —

New York Times: How The Epidemic Of Drug Overdose Deaths Ripples Across America Deaths from drug overdoses have jumped in nearly every county across the United States, driven largely by an explosion in addiction to prescription painkillers and heroin. Some of the largest concentrations of overdose deaths were in Appalachia and the Southwest, according to new county-level estimates released by the Centers for Disease Control and Prevention. (Park and Bloch, 1/19)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations.

Aetna Pulls Out Of Insurance Industrys Lobbying Group

Aetna Pulls Out Of Insurance Industrys Lobbying GroupAetna Pulls Out Of Insurance Industry’s Lobbying Group

Aetna is the second major insurer to leave America’s Health Insurance Plans, or AHIP. The company’s decision is viewed as a big blow to the organization.

The Wall Street Journal: Aetna Leaves Health Insurance Industry’s Largest Trade Group Aetna Inc. on Tuesday became the second major insurer to leave the health insurance industry’s largest trade group, a setback to the membership organization that was a major force during the crafting of the Affordable Care Act. Aetna, the third-largest U.S. health insurer, said it wouldn’t renew its membership for 2016 with America’s Health Insurance Plans, a national association with almost 1,300 companies. (Armour, 1/5)

Modern Healthcare: Aetna Departure Delivers Second Big Blow To AHIP Another top-five health insurance company is ditching the industry lobbying group as a new CEO attempts to right the ship. Aetna, which is in the process of buying competitor Humana, is not renewing its membership in America’s Health Insurance Plans for 2016, a spokeswoman for the Hartford, Conn.-based health insurer confirmed Tuesday. This comes several months after UnitedHealth Group, the nation’s largest insurer, made the same announcement and said its interests “are no longer best represented by AHIP.” (Muchmore and Herman, 1/5)

Politico Pro: Two More Insurers Leaving AHIP Aetna is leaving America’s Health Insurance Plans, the second major health insurer to leave the powerful K Street lobby group. Unum, a leading disability insurer with $10.5 billion in revenues last year, has also dropped out, POLITICO has learned. That’s a less significant blow since the company does not sell health insurance. (Palmer and Demko, 1/5)

In other news -

Bloomberg: Health Care’s $605 Billion Buying Binge May Slow In 2016 When it comes to dealmaking, the health-care industry defied belief in 2015 with $605 billion of takeovers. While 2016 may be a good year, it’s unlikely to beat that record. “We entered 2015 with what I would characterize as almost a perfect M&A environment: a generally stable economy, lack of volatility in the equity markets, low interest rates, tons of cash on companies’ balance sheets,” said Jeff Stute, head of health-care investment banking at JPMorgan Chase & Co. His firm is hosting its annual conference next week in San Francisco, where health-care executives flock to hold court with top investors. (Koons and Chen, 1/6)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations.

Bernie Sanders Kicks Distant Candidature With A Center Indication Fettle Issues

Bernie Sanders Kicks Out Crusade With A Center Explanation Robustness Issues At his premier authentic statesmanly struggle convention, the Vermont senator hammered his ongoing view, including a “Medicare-for-all”
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Built Thrift, Obamacare Encouragement Bid Representing Tourism Nurses

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