Daily Health Policy Report

Monday, January 14, 2013

Last updated: Mon, Jan 14

KHN Original Reporting & Guest Opinion

Health Reform

Administration News

Capitol Hill Watch

Public Health & Education

Health Care Marketplace

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

As 'Bodega Clinicas' Fill Void, Officials Are Torn On Embracing Them

Kaiser Health News staff writer Sarah Varney, working in collaboration with The New York Times, reports: "The so-called bodega clinicas that line the streets of Los Angeles' immigrant neighborhoods blend into a dense forest of commerce. Wedged between money order kiosks and pawn shops, these storefront doctors' offices treat ailments for cash: a doctor's visit is $20 to $40, a podiatry exam is $120 and at one bustling clinica, a colonoscopy is advertised on an erasable white board for $700" (Varney, 1/12). Read the story.

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Who Knew? Patients' Share Of Health Spending Is Shrinking

Kaiser Health News staff writer Jay Hancock reports: "Consumer-driven medical spending may be the second-biggest story in health care, after the Affordable Care Act. As employers give workers more 'skin in the game' through higher costs from purse and paycheck, the thinking goes, they'll seek more efficient treatment and hold down overall spending" (Hancock, 1/13). Read the story.

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Voice For Medicare, Medicaid Retiring

Kaiser Health News staff writer Mary Agnes Carey reports: "Sen. John D. Rockefeller's announcement Friday that he would not seek a sixth term in 2014 will leave the poor, elderly and disabled without one of their strongest advocates on Capitol Hill. Rockefeller played a leading role in 1997 in creating the Children's Health Insurance Program (CHIP), which serves nearly 8 million children nationwide, including 40,000 in his home state of West Virginia. He has been a fierce protector not only of CHIP, but also of the federal entitlement programs Medicare and Medicaid, which provide health care coverage to tens of millions of people" (Carey, 1/11). Read the story.

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Political Cartoon: 'May I Peas Be Excused?'

Kaiser Health News provides a fresh take on health policy developments with "May I Peas Be Excused?" by Paul Fell.

Meanwhile, here is today's health policy haiku:

SHOPPING AROUND

High deductibles
Hit health care consumers hard
Or maybe they don't.
-Anonymous

If you have a health policy haiku to share, please send it to us at http://www.kaiserhealthnews.org/ContactUs.aspx and let us know if you want to include your name. Keep in mind that we give extra points if you link back to a KHN original story.

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Health Reform

Analyzing How Well The Individual Mandate May Work

Politico looks at the practical task ahead for the health law's individual mandate.

Politico: Obamacare Mandate May Be 'Mandate Plus'
Can't get enough of Obamacare's individual mandate? Get ready for "mandate plus." The Obama administration always said there was a practical reason it needed the mandate, which starts next year. It wasn't to be mean to people — it was supposed to pull in enough healthy customers to help pay for all the sick people who will get coverage. That's why the White House stuck with it all the way to the Supreme Court — however unpopular politically, it was the best tool to make the new health system work. Here's the catch: The individual mandate penalties will be pretty weak as they are phased in over two years — only $95 when they start in 2014, much less than it costs to buy insurance. And yet, everyone with pre-existing conditions will have to be accepted for coverage right away (Nather, 1/13).

News outlets also track state implementation developments -- including the latest regarding the health exchanges and the Medicaid expansion --

MPR News: Some Insurers Question Claim Of Same Or Smaller Premiums Under Insurance Exchange
The state Commerce Department says the majority of Minnesotans who buy individual health insurance plans will pay the same or smaller premiums on the state insurance exchange in 2016. But some insurers question the figures. The Commerce Department's April Todd-Malmlov told a state insurance exchange task force that on average, 70 percent of the premiums in the individual market would remain the same in 2016. "There's definitely some that will see higher premiums but most of them are projected to have lower ones with the tax credits that are there," Malmlov said. Insurers question how the department arrived at those numbers. Commerce officials based their conclusions on an analysis by a prominent health economist at M.I.T. The full report won't be released for about a month (Stawicki, 1/11).

Pioneer Press: Federal Health Law Wrinkle Could Penalize Minnesota Insurers
Without a change in proposed federal rules, the continuation of a Minnesota health insurance program for people with costly illnesses could cost health plans and their subscribers more than $60 million next year, state officials say. The issue involves a long-standing program called the Minnesota Comprehensive Health Association, which the Legislature created in 1976. It helps provide coverage for Minnesotans who can't find insurance on the open market, often because of a costly pre-existing health condition. One of the key changes coming in 2014 with the federal Affordable Care Act is that insurers no longer will be able to deny people coverage based on pre-existing conditions. To make sure that the expense of covering these patients is evenly spread among insurers, the federal law will give health plans a chance to receive "reinsurance" payments if they happen to attract many patients with costly conditions (Snowbeck, 1/12).

On the Medicaid expansion front -

The Associated Press: Medicaid Rejection Prompts Look For New Options
Gov. Mary Fallin's decision to reject a Medicaid expansion that would have made health coverage available to roughly 200,000 uninsured low-income, working class Oklahomans has left health officials scrambling to come up with alternative ways to make health care available to this population. Although no concrete proposals have been developed, the Oklahoma Health Care Authority on Thursday approved a $500,000 sole-source contract with Utah-based health consultant Leavitt Partners to develop ways to target the nearly 20 percent of Oklahoma's population that have no health insurance (Murphy, 1/14).

The Associated Press: Focus On Medicaid As Session Begins Monday
Leaders of the Arkansas House and Senate say most questions about the state budget, tax cut proposals or a possible special session depend on how legislators address a Medicaid program that already receives nearly one out of every five tax dollars the state receives in its general revenue budget. Medicaid is the biggest issue facing members of the 89th General Assembly, who gather Monday. For the first time in 138 years, Republicans will control the state House and Senate (1/14).

The Associated Press: Governor Jerry Brown Commits State To Health Reform
Gov. Jerry Brown says he's firmly committed to making national health care reform work in California, but he also is wary of potential costs that could affect state spending for years to come. In releasing his budget for the coming fiscal year last week, Brown pledged to be a reliable partner in implementing the federal Affordable Care Act by expanding Medicaid coverage for low-income Californians (1/14).

Also in the news --

The Wall Street Journal: Public-Private Fund Aims At Health Care, Housing Gap
Hoping to bridge the gap between low-income residents and health-care services, a $100 million fund will be unveiled this week to build community centers near affordable housing as demand for primary-care services is expected to rise. Supporters say it is a new kind of public-private partnership boosted by the philanthropic sector that was inspired by the 2010 Affordable Care Act, which could expand Medicaid coverage by up to 16 million additional people. The act includes about $10 billion for the creation of new, federally qualified health centers. The fund's backers say the financial need is greater still (Dolan, 1/13).

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Administration News

DeParle Reportedly Exiting The White House, Moving On To Brookings

Nancy-Ann DeParle, an Obama administration deputy chief of staff, played a prominent role in advancing the Affordable Care Act in 2010. 

CQ HealthBeat: DeParle Departing The White House For Brookings
White House deputy chief of staff Nancy-Ann DeParle is leaving her post to take a position as a guest scholar with the Brookings Institution, according to the head of the Washington, D.C.-based think tank. Strobe Talbott, president of Brookings, said in a tweet on Friday, "Welcome to Nancy-Ann DeParle, who joins Brookings as Guest Scholar after serving Pres. Obama & nation as White House Deputy Chief of Staff." DeParle led the White House effort to negotiate the 2010 health care overhaul law and ran the nation’s Medicare and Medicaid programs during the Clinton administration (1/11).

Fox News: Deputy Chief Of Staff DeParle Leaving White House To Join Brookings, Think Tank Says
White House Deputy Chief of Staff Nancy-Ann DeParle is leaving the Obama administration to join the Brookings Institute, the Washington-based think tank has confirmed. The White House has yet to confirm the departure, following several other high-ranking women leaving the administration at the start of the president's second term and amid criticism that all of Obama's Cabinet-level nominations thus far are men. DeParle helped Obama craft the Affordable Care Act in 2010 and led the Clinton administration's Health Care Financing Administration, now called the Centers for Medicare and Medicaid Services (1/12).

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Capitol Hill Watch

Sen. Rockefeller, Key Defender Of Health Programs, Announces He Will Retire

The West Virginia Democrat may have been born to wealth, but he made federal efforts to ensure health coverage for the poor his mission.

Kaiser Health News: Voice For Medicare, Medicaid Retiring
Sen. John D. Rockefeller's announcement Friday that he would not seek a sixth term in 2014 will leave the poor, elderly and disabled without one of their strongest advocates on Capitol Hill. Rockefeller played a leading role in 1997 in creating the Children's Health Insurance Program (CHIP), which serves nearly 8 million children nationwide, including 40,000 in his home state of West Virginia. He has been a fierce protector not only of CHIP, but also of the federal entitlement programs Medicare and Medicaid, which provide health care coverage to tens of millions of people (Carey, 1/11).

The Hill: Colleagues Say Sen. Rockefeller Will Be Missed On Health Care Issues
With the retirement of Sen. Jay Rockefeller (D-W. Va.), the left -- not to mention the Senate -- is losing one of its biggest voices on health care. Rockefeller announced Friday that he won't run for reelection in 2014, when his current term ends. Colleagues and allies praised his long record of pushing for universal health care coverage, as well as his aggressive defense of Medicaid (Baker, 1/11).

CQ HealthBeat: Rockefeller To Retire: Championed CHIP, Medicaid
For years, let anyone suggest that maybe one way to save on health care costs would be to scale back Medicaid or the Children's Health Insurance Program and Sen. Jay Rockefeller has stood in their way. ... In a news release Rockefeller put out announcing his retirement, when he listed his most proud accomplishments, health policy topped the list, specifying his championing of CHIP and the health care overhaul law (Bunis, 1/11).

Politico Pro: Health Care For The Poor Centerpiece Of Rockefeller's Career
Sen. Jay Rockefeller's family name may evoke images of wealth, but when he retires at the end of this term, he'll be remembered as one of the Senate's most ardent advocates for the poor and the sick in his adopted home state of West Virginia and beyond. Few have fought harder for government programs that provide low-income Americans with health coverage than Rockefeller, who announced Friday that he would not seek reelection. From his role on the Pepper Commission on uninsurance and long-term care, to his work on behalf of President Bill Clinton's failed health reform effort, to helping to pass the State Children's Health Insurance Program, to placing limits on insurers' overhead spending in President Barack Obama's health care law, expanding access to health insurance has long been his cause (Cunningham, 1/11).

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Waxman Urges Biden To Consider Mental Health In Gun Violence Talks; Mentally Ill Missing From Background Check System

As the nation grapples with mental health issues in the wake of recent violence, issues related to restricting gun ownership for the mentally ill take shape on Capitol Hill.

The Hill: Waxman Urges Attention To Mental Health In Gun Debate
A leading House Democrat urged Vice President Biden Friday not to ignore mental health issues as his panel grapples with U.S. gun violence. Rep. Henry Waxman (D-Calif.), the top Democrat on the Energy and Commerce Committee, wrote to Biden recommending better gun-safety standards, more research applying a public-health perspective to gun violence and greater mental health coverage for people in the United States. "Experts agree: the prevalence of guns and gun violence in our society is not just a criminal justice problem; it is also a public health and safety problem," Waxman wrote in a letter Friday (Viebeck, 1/11).

Los Angeles Times: Many Mentally Ill Missing From Gun Background Check System
Swept along by the tide of outrage and sorrow after the 2007 Virginia Tech massacre, Congress passed a law to try to prevent future tragedies by keeping guns out of the hands of the mentally ill. The measure, signed by President George W. Bush, promised to strengthen the 14-year-old National Instant Criminal Background Check System by establishing incentives and penalties to prod states to submit records of people legally barred under federal law from buying guns -- including those who had been committed to mental institutions. But today, that promise remains unfulfilled. More than half the states haven't provided mental health records to the federal database that gun dealers use to check on buyers. And the gap in dealing with the mentally ill is just one of myriad problems that have hampered background checks (Tanfani, 1/12).

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Public Health & Education

It's Still Too Early To Evaluate Whether Flu Season Is Worse Than Normal

New York officials declare a public health emergency as federal officials say the epidemic may have peaked.

Politico: 2013 Flu Epidemic? Too Soon To Tell, Experts Say
This flu season struck hard about a month earlier than usual. But despite all those news reports about overcrowded emergency rooms, it's too soon to say whether it will be worse than normal. In fact, federal health officials said last week it may already have peaked (Norman, 1/14).

The Associated Press/Wall Street Journal: Hospitals Crack Down On Workers Refusing Flu Shots
Patients can refuse a flu shot. Should doctors and nurses have that right, too? That is the thorny question surfacing as U.S. hospitals increasingly crack down on employees who won't get flu shots, with some workers losing their jobs over their refusal (1/12).

The New York Times: Cuomo Declares Public Health Emergency Over Flu Outbreak
With the nation in the grip of a severe influenza outbreak that has seen deaths reach epidemic levels, New York State declared a public health emergency on Saturday, making access to vaccines more easily available. There have been nearly 20,000 cases of flu reported across the state so far this season, officials said. Last season, 4,400 positive laboratory tests were reported (Santora, 1/12).

The New York Times: Pharmacies Pressed To Meet High Demand For Flu Vaccine
Pharmacies around the city struggled to meet the demand for flu vaccinations on Sunday, a day after Gov. Andrew M. Cuomo declared a public health state of emergency in response to a drastic increase in the number of flu cases this year (Secret, 1/13).

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Health Care Marketplace

Doctor/Nurse Shortages Come With A Twist

A new study said the projected shortage of primary care physicians may be overstated, and new nurses are having trouble finding work.

Medpage Today: Doc Shortage May Be Smaller Than Projected
The projected shortage in the nation's primary care physician work force may be overstated, and any that does develop can be eliminated with wider adoption of EHRs and practice restructuring, a study suggests. By working in practices of two or three doctors while shifting as little as 20 percent of patients to a nonphysician provider and using an EHR, "most if not all of the projected primary care physician shortage could be eliminated," according to an analysis of several scenarios published in the January issue of Health Affairs (Pittman, 1/11).

Modern Healthcare: Projected Doc Shortage Is Real, Experts Say
Although they found areas of partial agreement, two experts who believe the threat of an imminent physician shortage is real disagreed with the basic premise of a recent Health Affairs report that concluded that the projected shortage was "greatly overestimated." ... "Our position is that you do have to do that stuff, but you also have to train a couple more thousand doctors a year—it's not an either-or proposition,” said Dr. Atul Grover, chief public policy officer for the Association of American Medical Colleges (Robeznieks, 1/11).

CNN Money: For Nursing Jobs, New Grads Need Not Apply
Registered nurses fresh out of school are coming across thousands of job postings with an impossible requirement: "no new grads." It's a problem well documented by the nursing industry. About 43% of newly licensed RNs still do not have jobs within 18 months after graduation, according to a survey conducted by the American Society of Registered Nurses. ... The recession is to blame, says Peter Buerhaus, a registered nurse and economist who teaches at the Vanderbilt University School of Nursing (Kurtz, 1/14).

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Patients' Health Care Decisions, Spending Key To Future Of Medicine

As patients become more engaged in decisions related to treatment and health care, their role in holding down health care spending will likely become more prominent.

Kaiser Health News: Who Knew? Patients' Share Of Health Spending Is Shrinking
Consumer-driven medical spending may be the second-biggest story in health care, after the Affordable Care Act. As employers give workers more 'skin in the game' through higher costs from purse and paycheck, the thinking goes, they'll seek more efficient treatment and hold down overall spending (Hancock, 1/13). 

The Washington Post: Health Care Firms Attract Interest From Financial Backers
Two Washington area firms working to engage patients in their health care decisions and treatment have secured financial backing from investors looking to find companies that will play a leading role in the future of medicine (Overly, 1/13).

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State Watch

Retiree Health Care Costs Have Mass., Calif. Officials Seeking Change

Budget issues continue to force officials to seek ways to cut their health care bills, especially for retirees. Massachusetts and California are the latest to seek solutions to these inflating costs.

Reuters: Massachusetts Governor Seeks To Revamp Retiree Health Care
Massachusetts Governor Deval Patrick said on Friday that he will file legislation to overhaul benefits for public retirees, including a proposal to double the number of years an employee would have to serve to be eligible. The bill would require most current employees of the state and its cities, towns and school districts to work for 20 years instead of 10 years to become eligible for health benefits when they retire (Russ, 1/11).

Los Angeles Times: California's Debt Still A Heavy Cloud Over State's Future
Gov. Jerry Brown proclaimed last week that California, which now has enough cash to pay its day-to-day bills, can no longer be described by naysayers as a "failed state." But even though it appears to be free of the deficit that dogged the Capitol in recent years, the state is no model of financial health. … Sacramento is legally obligated to pay many billions of dollars withheld from schools, local governments and health care providers as lawmakers struggled repeatedly to balance the books. … And it has accumulated a crushing load of debt for retiree pensions and health care, now totaling more than taxpayers spend each year on all state programs combined (Halper and Megerian, 1/13).

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Hospital News: Nantucket's Paradox; Maryland Overbilling; Calif. Fee Complication

News media covered hospital issues in Massachusetts, Maryland and California.

The Boston Globe: 21 States Take Aim At Mass. Hospitals' Medicare Windfall
Nestled on an island 30 miles out to sea, Nantucket Cottage Hospital is the only rural hospital in Massachusetts, as defined by the federal government. Its weathered cedar shingles and widow's walk evoke the bygone era of its founding a century ago ... But the 19-bed hospital on the tony island, where the number of residents balloons from 10,000 to 50,000 each summer and the median home price hovers north of $1 million, has become a national symbol of inequity and political machinations in the way the federal government reimburses hospitals for treating Medicare patients (Jan, 1/13).

The Associated Press: Audit: Hospital Billing Not Properly Investigated
A Maryland commission did not adequately investigate the impact of hospital overbilling identified through annual reviews, a state audit released Friday found, noting overcharges of at least $13.2 million at four hospitals. ... The audit found four hospitals, which it did not name, charged for a procedure at rates ranging from 67 percent to 1,880 percent higher than allowed by the commission (Witte, 1/11).

California Healthline: Hospital Tax May Go To Reserve
The state budget proposed by Gov. Jerry Brown extends the Hospital Quality Assurance fee, which is due to expire at the end of 2013. The complicated fee structure was originally planned to gather about $2.8 billion from private hospitals over the 30-month life of the fee. Some of the money is used to tap federal matching money, which benefits both hospitals and the state. ... The issue for private hospitals, [Jan Emerson-Shea, of the California Hospital Association] said, is that the state wants to use the fee money to salt away a general fund reserve -- and the hospitals want it to go to health care services (Gorn, 1/14).

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Abortion, Contraception Coverage Fights Continue As Roe V. Wade Birthday Nears

Abortion and contraception coverage make news in Texas, Virginia and Pennsylvania while both sides prepare for the 40th anniversary of the Roe v. Wade decision.

Reuters: Judge Keeps Planned Parenthood Out Of Texas Program
A Texas judge on Friday denied a Planned Parenthood request to be allowed to offer health services to low-income women through a state program. Texas now excludes abortion providers and affiliates from the program and Planned Parenthood has been fighting to become a provider again (MacLaggan, 1/11).

The Associated Press: Va. GOP Walks Gingerly Around Congraception Proposals
Gov. Bob McDonnell didn't utter a syllable about abortion legislation in his 50-minute State of the Commonwealth speech Wednesday. House Speaker Bill Howell and other GOP House leaders didn't raise it in a press conference the next morning outlining a sober, mainstream policy agenda of jobs, schools and roads. But it's there, just as sure as Del. Bob Marshall is: more Republican-authored legislation that would restrict abortion and, for some, contraception coverage through employers' health insurance plans (Lewis, 1/13).

CQ HealthBeat: Mennonite-Owned Company Loses Request For Injunction From Birth Control Rule
A federal district court judge in Pennsylvania on Friday turned down a request for a temporary injunction filed by a company owned by Mennonites who object to an Obama administration requirement that they provide no-cost birth control coverage in employee health plans. ... The owners asked in December for an injunction and Judge Mitchell S. Goldberg on Dec. 28 granted a temporary stay while arguments were heard (Norman, 1/11).

The Washington Post: Roe At 40: 'It's Never Been This Frightening Before.'
On a cold morning before dawn, one of the nation’s oldest abortion clinics is getting ready for its newest patients. ... It's been almost 40 years since the Supreme Court legalized abortion on Jan. 22, 1973, galvanizing people on both sides. Abortion clinics sprang up across the country. The National Right to Life Committee was founded. Opponents and proponents girded for an epic conflict. But today, the battle is a slog of legislative fights and piecemeal regulations (Kliff, 1/13).

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State Roundup: Mental Health Care Changes In Conn.

A selection of health policy stories from Connecticut, the District of Columbia, California, Oregon, Arkansas, Florida and Kansas.

Kaiser Health News: As 'Bodega Clinicas' Fill Void, Officials Are Torn On Embracing Them
The so-called bodega clinicas that line the streets of Los Angeles' immigrant neighborhoods blend into a dense forest of commerce. Wedged between money order kiosks and pawn shops, these storefront doctors' offices treat ailments for cash: a doctor's visit is $20 to $40, a podiatry exam is $120 and at one bustling clinica, a colonoscopy is advertised on an erasable white board for $700 (Varney, 1/12). 

CT Mirror: State Reversing Mental Health Cuts -- For This Year, At Least
State officials have reversed plans to cut more than $7 million in funding from mental health and addiction programs this fiscal year. The cuts, made late last year in response to a budget shortfall, had led the nonprofit mental health and addiction service providers that contract with the state to make plans that included layoffs and reduced services. But Department of Mental Health and Addiction Services Commissioner Patricia Rehmer advised them this week to delay drastic budget-cutting measures. Last month's shooting of 20 children and six educators at Sandy Hook Elementary School has led state officials to reevaluate Connecticut's mental health system. In light of that, "We really can't afford to hit the service system" right now, Rehmer said. The department is expected to find offsetting cuts elsewhere in its budget, although the commissioner said she's not certain it will be possible to absorb it all (Becker, 1/11).

The Washington Post: Department Of Behavioral Health Will Combine Mental Health, Substance Abuse Functions
A new Department of Behavioral Health will become one of the District government's largest agencies after Mayor Vincent C. Gray (D) announced Friday that he was combining the city's mental health and substance abuse functions for the first time. The new department, to begin operations Oct. 1, will combine the Department of Mental Health, with its $190 million budget and 1,200 employees, with the Department of Health's Addiction Prevention and Recovery Administration, which has a $32 million budget and about 90 employees. Those agencies currently manage services for about 35,000 District residents (DeBonis, 1/11).

The Associated Press/Washington Post: Oregon, California Tell Insurance Companies To Stop Denying Transgender Health Care
Regulators in Oregon and California have quietly directed some health insurance companies to stop denying coverage for transgender patients because of their gender identity. The states aren't requiring coverage of specific medical treatments (1/11).

Modern Healthcare: Wal-Mart Boosts Ark. Medical Home Effort
The state of Arkansas's health system transformation was given a significant financial boost from the state's largest company, Wal-Mart Stores, which committed to providing $670,000 to help underwrite the work of the Arkansas Health Care Payment Improvement Initiative. But Arkansas Surgeon General Dr. Joe Thompson said the significance of the contribution stems from Wal-Mart's standing as the state's largest self-insured employer. The initiative, Thompson said, is a multipayer effort and the intent is to make it all-payer -- and this includes self-insured employers such as Wal-Mart. Thompson explained how Arkansas is part of the CMS' Comprehensive Primary Care Initiative, which has 500 practices across the nation serving as patient-centered medical homes. With those participating practices, the intent is to have 60 percent of their patients covered by a payer that is contributing a monthly per member care-management fee. That fee is used to cover expenses, such as staff salaries (Robeznieks, 1/11).

The Miami Herald: Health Care Accelerator Now Accepting Applications
Project Lift Miami, a new accelerator designed to help develop young health care-technology companies and prepare them for investment opportunities, is now accepting applications for its first class, which will begin in May. Its website is live beginning Monday at www.lift1428.com/projectlift. The accelerator is a partnership between Lift1428, an innovation design, strategy and communications firm, the University of Miami Life Science & Technology Park and its developer, Wexford Science + Technology, and the UM Miller School of Medicine, said Robert Chavez, executive director of Project Lift Miami. It will offer up to 15 selected entrepreneurial teams a structured 100-day program of training by a large network of local and national experts as well as mentoring and strategic support that will continue well beyond the program (Dahlberg, 1/13).

Kansas Health Institute: State Supreme Court Decides Three Health-Related Cases
The Kansas Supreme Court today released decisions in three health-related cases. One involved a dispute over the state's calculation of Medicaid reimbursements for a small group of northeast Kansas nursing facilities specializing in care for the mentally ill. The other two decisions upheld lower court findings in medical malpractice cases and hinged on the correctness of the instructions given to the district court juries, each of which rejected the malpractice claims. In the Medicaid reimbursement case, Village Villa v. Kansas Health Policy Authority, the court found for the agency, which since the case was brought has been dissolved and replaced by the Health Care Finance Division at the Kansas Department of Health and Environment (1/11).

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Editorials and Opinions

Viewpoints: Health Law's 'Sticker Shock;' Changing Medicare Eligibility Age Is Not A Simple Solution

The Wall Street Journal: Obama's Health Spending 'Problem'
President Obama said a fair bit during the fiscal-cliff negotiations—speaking for 45 minutes in one 50-minute meeting, for example—but today let's zero in on the claim he kept repeating: "We don't have a spending problem. We have a health-care problem." For our money—and yours—those are two of the most remarkable sentences our Orator in Chief has ever strung together (1/13).

The Wall Street Journal: ObamaCare's Health Insurance Sticker Shock
Health-insurance premiums have been rising—and consumers will experience another series of price shocks later this year when some see their premiums skyrocket thanks to the Affordable Care Act, aka ObamaCare (Merrill Matthews and Mark E. Litow, 1/13).

Bloomberg: Medicare Must Change, Even If Its Eligibility Age Doesn't
One tempting idea for saving money on Medicare, a program that vacuums up some 15 percent of federal spending, is to raise the age at which Americans become eligible for it. We ourselves have succumbed to this temptation, on more than one occasion. Raising the eligibility age a couple of years, to 67, remains an attractive idea; it would save the program a lot of money. It's just that there are a lot of other things Washington should try first. Before we get to those, allow us to explain our newfound hesitation: Raising the eligibility age is neither as simple nor as effective as many of its proponents claim (1/10).

The Fiscal Times: The Real Reason Medicare Costs Will Explode
Medicare costs continue to be under the microscope as Congress and President Obama gear up for a fight over spending cuts, but a couple of reports released in recent days offer seemingly encouraging news in the decades-long fight to keep health care costs in check. In both cases, though, the positive signals come with plenty of questions (Yuval Rosenberg, 1/13).

Forbes: Insurers To Obama: Make The Individual Mandate Stronger
If you're going to double the cost of health insurance for young people, and thereby increase premiums by thousands of dollars, many people will be better off going without insurance and paying the mandate's fine. Insurers have always understood this problem. … Now that President Obama has been reelected, and Obamacare’s imposition is assured, people are starting to pay attention to this problem (Avik Roy, 1/14).

Los Angeles Times: Wealthy, But Not So Healthy
For all of our sophisticated medical care, Americans can expect shorter lives and more health troubles than the people of other well-off nations, according to a new report. And that's not just true of infants and poor people, the groups usually pinpointed as particularly vulnerable to health issues; it is also the case for the affluent, teenagers and middle-aged people (1/12).

Los Angeles Times: Finding An Economic Model For High-Tech, Efficient Healthcare
A nagging issue for healthcare reformers is the disincentive for many providers to adopt innovative approaches to care that improve health and cut costs. If you're paid a fee for each service you provide in your office, why would you invest in technologies and procedures that led to fewer billable services? One reason is to achieve better results, and that's good enough for some providers. But the Medicare program is supplying another rationale. It started cracking down last year on hospitals that readmit too many patients soon after discharging them (Jon Healey, 1/12). 

The Wall Street Journal: The Tragedy Of Mental-Health Law
After Newtown, there is widespread concern that laws regarding mental-health services need reform. Two places to start are the laws governing involuntary hospitalization, and the restrictions placed on communication with a patient's family. Across the U.S. today, federal and state laws give people with mental illness the right to decide when, where, how, and if they will receive care. Yet some serious mental illnesses (such as schizophrenia or mania) can make it difficult for those affected to assess the reality of their own experiences or their need for treatment (Lloyd I. Sederer, 1/11).

The Boston Globe: Mass. Should Give Registry Data For Mental-Health Gun Checks
Massachusetts can be justly proud of its strong gun laws, but that attitude shouldn't lead to self-congratulation or, worse, complacency. As many states consider tighter gun-control regulations after the Newtown, Conn., massacre last month, Massachusetts has work to do, too (1/13).

The Washington Post: A Bad Flu Season
CDC data out Friday show that the flu struck early this season, shooting up in December when it usually peaks in January or February, and it struck hard. Doctor visits for influenza-like illness, a primary measure of infection, are classified as high for half the country. The last time flu activity was this severe so early was during the particularly deadly 2003-04 season. Add an influenza cliff, too, to the possible drags on the economy; normal flu seasons cost the country more than $10 billion. This year, more Americans cashing in sick days might push that toll up (1/13).

The Wall Street Journal: Making Opioid Drugs Less Alluring
The Centers for Disease Control and Prevention estimates that 15,000 Americans die annually from opioids, either in suicides or accidental overdoses by addicts and non-addicts. Given that opioids used in prescription drugs are a mainstay of treatment for millions of Americans with moderate-to-severe pain, how can the drugs be made safer (Lynn Webster, 1/13)? 

The Associated Press: Familiar Debate Revived In Obesity Crisis
Americans have always been conflicted on what role government should have in their private lives. The scale tilts wildly depending on the issue and the era. Each day, people, courts and lawmakers wrestle with this constant tension: Where does government's duty to protect its people end and an individual's right to choose begin? And when someone's choice impacts society, how far is too far? These questions are at the core of the national conversation over America's obesity epidemic, a private issue that's become more public as rates rise and stress our healthcare system (Liz Sidoti, 1/14).

San Jose Mercury News: Pancreatic Cancer Finally Gets Federal Attention
Pancreatic cancer is a devastating and unforgiving disease. My husband, Patrick Swayze, was diagnosed with this terrible cancer in January of 2008. ... Of the top five cancer killers, pancreatic cancer is the only one with a five-year survival rate in the single digits -- just 6 percent. Patrick fought valiantly before passing away almost 22 months later. While pancreatic cancer may have taken him in the end, it never beat him. And for me, just because he's gone doesn't mean this fight is over. Due in part to the lack of federal resources, scientific advances against this disease, whose statistics are shocking, have been minimal at best. No early-detection tools exist, and few effective treatment options are available. Further, despite its being one of the most deadly cancers, there has been no national plan to address pancreatic cancer (Lisa Niemi Swayze, 1/11).

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EDITOR:
Stephanie Stapleton

ASSOCIATE EDITOR:
Andrew Villegas

WRITERS:
Lisa Gillespie
Marissa Evans

The Kaiser Daily Health Policy Report is published by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation. (c) 2014 Kaiser Health News. All rights reserved.