Daily Health Policy Report

Friday, May 18, 2012

Last updated: Fri, May 18

KHN Original Reporting & Guest Opinion

Health Reform

Administration News

Campaign 2012

Health Care Marketplace

Health Information Technology

State Watch

Health Policy Research

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Innovation Grants: Adding Resources To Ideas To Improve Health Care Delivery

Kaiser Health News staff writer Christian Torres reports: "To save on health care, you have to invest in it. At least that's the thinking of the Centers for Medicare & Medicaid Services. Last week, the CMS innovation center awarded 26 grants – worth a total of $122.6 million – to a variety of health care organizations. If these plans for better patient care pan out, the programs estimate they could reap about $254 million in savings over three years" (Torres, 5/17). Read the story.

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Political Cartoon: 'Good News, Bad News'

Kaiser Health News provides a fresh take on health policy developments with "Good News, Bad News" by Dan Reynolds.

Meanwhile, here's today's health policy haiku:

(Because the Supreme Court's health law decision is all we really think about anyway...)

They are drafting opinions...
Keeping us waiting...

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

GOP Stakeholders Have Different Views For Health Law Strategies

News outlets report Republican lawmakers' conflicting views as they wait for the Supreme Court's decision on its constitutionality. Meanwhile, The Associated Press reports that the fate of the nation's "uninsurables" is tied to what the justices decide.

Politico: Right Infighting Over Health Care
Thirty minutes. That's the roughly time it took for conservatives to jump all over Speaker John Boehner (R-Ohio) and his leadership team after the GOP's game plan for dealing with President Barack Obama's health care law leaked to the media. … The behind-the-scenes fight among Republicans richly illustrates why House GOP leadership is so cautious, sensitive and calculating when it comes to dealing with the conservative right. POLITICO obtained the email chain, the contents of which show that health care reform remains just as emotional an issue as ever (Sherman, 5/17).

The Washington Times: Senate Republicans Wary Of Health Care Law
Republican governors and GOP-dominated state legislatures were united in opposing President Obama's health care law, but now that it's in place, they are far more divided over how far to go in complying with it, especially with the U.S. Supreme Court poised to rule on the law's constitutionality (Winfield Cunningham, 5/18).

The Associated Press: Fate Of 'Uninsurables' Hinges On Supreme Court
Cancer patient Kathy Watson voted Republican in 2008 and believes the government has no right telling Americans to get health insurance. Nonetheless, she says she'd be dead if it weren't for President Barack Obama's health care law. Now the Florida small businesswoman is worried the Supreme Court will strike down her lifeline. Under the law, Watson and nearly 62,000 other "uninsurable" patients are getting coverage through a little-known program for people who have been turned away by insurance companies because of pre-existing medical conditions (Alonso-Zaldivar, 5/18).

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Administration News

Geithner Pushes Back Against GOP Calls For Long-Term Cuts To Medicare, Social Security

The Wall Street Journal: Geithner Says Austerity Alone Won't Work
Treasury Secretary Timothy Geithner sharpened the Obama administration's criticism of Republican fiscal policy in a speech Thursday, pushing back against the GOP on calls for immediate spending cuts and long-term plans for Social Security and Medicare. Geithner offered a broad-based critique of what he called an "economic agenda of severe, immediate austerity, combined with deep, permanent cuts in education and the safety net for retirees" (Crittenden, 5/17).

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Despite Contraception Controversy, Sebeilus To Speak Today At Georgetown

Criticism about Health and Human Services Sec. Kathleen Sebelius' appearance at the Jesuit institution has mounted this week because of her role in the Obama administration's rule on contraception requirements in the health care law.

The Hill's Healthwatch Blog: Fury Over Birth-Control Mandate Trails HHS Sec. Sebelius To Georgetown
Health and Human Services (HHS) Secretary Kathleen Sebelius will visit Georgetown University on Friday for a speech that has raised Catholic ire in light of the Obama administration's birth-control coverage mandate. … Leaders in the U.S. Catholic Church have loudly called on the administration to repeal the mandate, and as recently as this week threatened to sue the government barring "prompt" action on the issue by Congress (Viebeck, 5/17).

CQ HealthBeat: Sebelius Expected At Georgetown On Friday Despite Controversy
Health and Human Services Secretary Kathleen Sebelius is expected to speak at a Georgetown University awards ceremony on Friday, despite intense criticism from the Archdiocese of Washington connected to an agency rule on contraceptive requirements in the health care law. Archdiocese officials said in a statement on Tuesday that Sebelius' actions as a public official "present the most direct challenge to religious liberty in recent history" (Norman, 5/17).

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Campaign 2012

As Presidential Campaign Ads Hit The Airwaves, Health Policies Have Big Role

The general election TV ad released by GOP presidential hopeful Mitt Romney's campaign touts the candidates first-day plan to "move to replace" the health law with "common sense health reform." Also in the news, President Barack Obama's campaign rebuts an attack ad by Crossroads GPS.     

The Associated Press: Romney Releases First General Election TV Ad
Mitt Romney's presidential campaign has released a new television ad outlining steps Romney would take on the first day of his presidency... It says Romney would approve the Keystone oil pipeline, introduce tax cuts and tax reform, and move to replace President Barack Obama's health care plan with what the ad calls "common sense health care reform" (5/18).

CNN: Romney Campaign Touts Day One Initiatives In First General Election Ad
The Romney commercial emphasizes some of the same policy ideas the candidate highlights on the stump, promising tax cuts that "reward job creators, not punish them." The spot says on Romney's first day as president he would issue an order to begin replacing the Obama health care initiative "with common sense health care reform" (Bohn, 5/18).

The Boston Globe: Barack Obama Campaign Rebuts $25 Million Attack Ad But Avoids Facts
The Obama campaign called "BS" Thursday on an independent group's $25 million attack ad that accuses the president of breaking his promises. ...  Crossroads GPS claim centers on a Heritage Foundation analysis of Obama's health care law, which showed that if the law's provisions are classified as taxes, they do amount to increases -- albeit future hikes aimed mostly at high earners. The Obama administration said the health care mandate is not a tax then argued before the Supreme Court in March that it is (Borchers, 5/17).

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Health Care Marketplace

Responding To Flap, Hospital Debt Collector Draws On Political Defenders

Chicago-based Accretive Health calls for national standards on bill collection practices, as the American Hospital Association reports recent updates to its 2003 guidelines on the topic.

NPR Shots Blog: Embattled Hospital Debt Collector Taps Politicians For Defense
So what do you do when you're accused of hitting up sick patients in the hospital to pay their bills — sometimes even before they get treatment? Well, if you're Chicago-based Accretive Health, under fire by not only the Minnesota Attorney General but key members of Congress and possibly the Obama Administration, you fight fire with fire. You line up your own set of political defenders (Rovner, 5/17).

CQ HealthBeat: AHA: Standards For Hospital Billing, Collection Practices Already Exist
The company accused of out-of-bounds tactics in getting patients to pay for their hospital care says national standards are needed to deal with billing and collection practices. But the American Hospital Association issued such guidelines in 2003 for the thousands of facilities it represents. The hospital trade group recently updated it's "Principles and Guidelines on Hospital Billing and Collection Practices." The AHA board said it updated the guidelines because of press reports concerning Chicago-based Accretive Health, and to conform with provisions of the health care law that deal with the issue (Bunis, 5/17).

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FDA Gives Patients Less-Expensive Option, Approves First Generic Versions Of Plavix

The Food and Drug Administration's go-ahead will give patients who have to take blood thinners more options.  

The Associated Press: FDA OKs Multiple Companies To Sell Generic Plavix
Patients taking the popular blood thinner Plavix now have the option of getting a less-expensive pill, following the approval Thursday of the first generic versions in the U.S. That's because the patent for Plavix, the world's second-best-selling medicine, just expired. Plavix is taken by millions of people every day to prevent heart attacks and strokes, by preventing platelets in the blood from clumping together (Johnson, 5/17).

The Boston Globe: Momenta: The Perfect Massachusetts Success Story
Momenta Pharmaceuticals Inc. has discovered that reining in the cost of health care can be hugely profitable. The company's generic version of the anti-blood-clotting drug Lovenox -- priced about 30 percent cheaper than the brand-name drug made by French pharmaceutical giant Sanofi SA -- helped boost Momenta's revenues by 142 percent to $283 million last year, while profits zoomed 383 percent to $180 million (Weisman, 5/17).

Meanwhile, on Capitol Hill --

Politico: User Fee Bill May Hinge On Drug Tracking System
Perhaps the biggest piece of unsettled business in the massive Food and Drug Administration user fee bill is whether it will include a national system for tracking drugs -- an effort to combat the menace of counterfeit medications (Norman, 5/17).

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Health Information Technology

Survey: Health IT Spending A High Priority At Not-For-Profit Hospitals

In other news, Partners HealthCare hopes to replace its patchwork approach to electronic health records with a single commercial system.

Modern Healthcare: IT Top Financial Priority At Not-For-Profit Hospitals: Survey
Capital spending, particularly on information technology, is expected to remain stable or even increase over the next five years at not-for-profit hospitals, according to a Fitch Ratings survey. The survey found that not-for-profit hospitals ranked spending on IT as their top priority—as a way to manage costs, increase quality of care and adapt to new reimbursement methods like bundling and pay-for-performance (Kutscher, 5/17).

The Boston Globe: Partners HealthCare In Talks To Unify Electronic Medical Records
Partners HealthCare is in negotiations to replace its patchwork of electronic health records systems, built in-house by pioneers in the industry, with a single commercial system created by Wisconsin developer Epic Systems Corp. Expected to cost at least $600 million over 10 years, the Epic system would give each patient a single up-to-date record accessible by all Partners providers, at a time when doctors and hospitals are under pressure to keep closer tabs on the sickest people they care for and to better track their own performance over time (Conaboy, 5/18).

And, in California, the Institute for Population Health Improvement takes on the Cal eConnect effort -

California Healthline: Cal eConnect 'Not Able To Move Fast Enough'
Cal eConnect, an important part of the state's ambitious health information exchange effort, is no longer the same independent entity it was when it was born two years ago. The organization's efforts to make electronic health records ubiquitous in California will continue, officials said, but under a different organizational umbrella. At a meeting last week, the 22-member board rescinded its cooperative grant agreement with the state. On Wednesday, state officials announced that Cal eConnect will now be part of the Institute for Population Health Improvement at UC-Davis. Officials said the same work will continue in a new administrative structure (Gorn, 5/18).

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State Watch

Mass. Senate Passes Health Care Cost Measure With Eye On Saving $150B

The Massachusetts Senate passed a health care cost containment bill Thursday that aims to cut costs by $150 billion over 15 years. The bill, which now goes to the Massachusetts House, would eventually align cost growth with gross state product, would move toward paying for health care with global payments and would change the state's medical malpractice lawsuit system.

The Associated Press/Boston Globe: State Senate OK's Version Of Health Care Bill
The Massachusetts Senate passed its version of a health care cost reduction bill Thursday night, aimed at trimming projected health care costs in the state by $150 billion over the next 15 years. The Senate voted 35 to 2 for the measure after two days of debate on 265 amendments. It now goes to the House, which has proposed its own version of cost control. ... The Senate bill would limit future growth in health care costs to no higher than the annual growth of the overall state economy and create a new state agency to monitor spending (Young, 5/18).

WBUR: Senate Passes Health Care Cost Control Bill With Few Major Changes
In a near unanimous vote -- 35-2 -- the Massachusetts Senate passed a major health care bill Thursday night that legislators estimate will save $150 billion over the next 15 years. … In two days of debate, the Senate made dozens of large and small adjustments to this complex health care bill. Members set a health care cost control goal that's more aggressive than in their original bill. The bill would allow costs to grow 0.5 percent more than the gross state product (GSP) through 2015 and then drop to level with GSP indefinitely. The Senate bill would also create standards as more public and private insurance plans switch to global payments. Senate Democrats rejected a Republican amendment that would have gotten rid of a new surcharge to fund electronic health records and prevention programs (Bebinger, 5/18).

The Associated Press/WBUR: Mass. Senate OKs Health Care Cost-Cutting Bill
It would require health care providers to disclose costs of services upon a patient's request and encourage local health care providers to promote prevention of common illnesses. It would develop a process to track service price variations in which a commission would determine if the cost differences are valid. The legislation also seeks changes in the current medical malpractice system by reducing unnecessary litigation and its associated costs through establishing a 180-day waiting period before both sides begin negotiations. Among the amendments senators passed were the creation of a fund to improve and expand the ability of certain community hospitals to better serve those in need. Other changes to the legislation call for establishing both a residency grant program to finance primary care provider training at teaching community health centers and a commission to study the values of graduate medical education in the state and recommend a sustainable model for funding of such education (5/17).

WBUR: Patrick: Use Anti-Trust Laws To Fix High Hospital Prices
The Governor framed the problem as one of "market clout" and said dealing with the market clout of top Boston hospitals is in the hands of AG [Martha] Coakley. The AG, said Patrick, "has tools today to address these imbalances and we have to look to her office to use those tools." I called Patrick's office to clarify. What "tools?" An aide says the Governor was referring, loosely, to the AG's ability to file anti-trust charges against hospitals (Bebinger, 5/17).

In the meantime, community organizations are trying to lower health care costs in Massachusetts by better identifying and eliminating fraud --

The Boston Globe: Latest Efforts To Eliminate Fraud In Health Care System To Be Highlighted In Friday Conference
As Massachusetts leaders seek to slow soaring health care costs, a growing network of community-based organizations is trying to squelch Medicaid and Medicare fraud and abuse -- which also drive up costs. On Friday, a coalition of groups known as the Massachusetts SMP (Senior Medicare Patrol) Program, will outline its efforts to eliminate fraud at a day-long conference in Marlborough. The event, which is free and open to the public, will feature presentations by an agent with the Boston office of the FBI, an agent from the state's office of Inspector General and the state's Undersecretary of Consumer Affairs and Business Regulation (Lazar, 5/17).

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Legislatures Confront Coverage Issues, Cuts To Health Programs

State lawmakers in North Carolina and California consider cuts to health and welfare programs, including children's health care. In Kansas, legislation to require insurers to cover autism disorders fails to advance.

Kansas Health Institute News: Autism Initiative Fails To Get Senate Vote
An effort to get the Kansas Senate to vote on a House-passed bill that would require health insurance companies to cover autism disorders appears to have run out of gas. … The bill would cap the benefits payable by the companies at $36,000 a year for children under age seven. For children ages seven and older, the benefit would be capped at $27,000 per year. Insurance lobbyists have opposed the bill, calling it a mandate that would increase health care costs and cause insurers to raise premiums (Ranney, 5/17).

North Carolina Health News: Governor's Budget Has Rough Cuts For Health & Human Services
State health officials presented the governor's proposed budget before the House Health and Human Services Appropriations Committee today, and while there were a few bright spots in the budget, there's a lot of pain, especially in children's services. Secretary of Health and Human Services Al Delia delivered the good news first: money to increase the number of community mental health beds around the state, funding for the NC Pre-K program, and the introduction of 'smart cards' to identify recipients of Medicaid and social service payments and reduce fraud. ... Nothing in Wednesday's meeting got as much attention as cuts to children's services around the state. Those cuts come, in part, as the result of automatic spending cuts mandated by Congress' debt ceiling deal struck last summer (Hoban, 5/17).

Bloomberg: Brown Boosts Bullet Train While Cutting Welfare For Moms
California Governor Jerry Brown is seeking a 38,000 percent spending increase for a proposed high-speed rail system, even as he plans to raise taxes, cut state worker pay and reduce social programs to narrow a $15.7 billion deficit. … Brown proposed a 38-hour government workweek to reduce payroll, and cuts of $1.2 billion from health care for the poor, $1.1 billion from welfare and in-home help for the elderly and disabled, and $500 million from courts (Nash, 5/18).

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AMA: FTC Decision On Who Can Whiten Teeth Could Change Medical Practice Regulation

The doctors' group says the federal rule could have a "devastating impact on public health" by impeding state regulation. Other legal cases in today's news include a dentist in trouble in Florida and a deal on mental health care in Arizona.

Modern Healthcare: AMA Seeks Reversal Of FTC Ruling
The AMA filed a brief with the U.S. Court of Appeals in Richmond, Va., seeking to reverse an FTC order forbidding the state dental board to restrict nondentists from whitening teeth in North Carolina. ... "That effect would reach far beyond providers of teeth whitening services, far beyond dental boards, and far beyond North Carolina. In fact, as this brief will demonstrate, affirming the FTC order would greatly impede state regulation of the practice of medicine, with a devastating impact on public health, at least within the Fourth Circuit and perhaps nationally" (Robeznieks, 5/17). 

Meanwhile in Florida, recent administrative law decisions could undermine professional board decisions.

Health News Florida: Legal Opinion Forces Dental Board To Drop Fraud Charges
Professional boards have always held doctors and dentists responsible for filing accurate claims and honest bills. Deliberate overcharges or fraud could end a career. Now a legal opinion in a South Florida dental case has placed that assumption in question. It has forced dismissal of fraud charges against two dentists, including one who is to come before the Board of Dentistry today in Panama City (Gentry and Sexton, 5/18).

In an Arizona lawsuit, officials announced an agreement on care for the mentally ill.

Arizona Republic: Interim Deal OK'd In Arizona Mental-Health Case
Gov. Jan Brewer, state health officials and attorneys for the seriously mentally ill today announced a two-year agreement in a landmark class-action lawsuit that governs treatment of some of the state's most vulnerable residents. Key to the agreement was new funding for people with serious mental illnesses who don't qualify for Medicaid. Roughly 12,000 people lost about $50 million worth of services in 2010. The budget for the fiscal year that begins July 1 includes $38.7 million for this population (Reinhart and Sanchez, 5/17).

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Mo. Legislators Reportedly Reach Compromise On Abortion Coverage Bill

The St. Louis Beacon reports that the legislature might take up a bill Friday that strips controversial provisions passed by the House earlier in the week.

St. Louis Beacon: House-Senate Compromise Reached On Contraception, Sterilization And Abortion Coverage
[Missouri] House and Senate leaders in the debate over insurance coverage for contraception, abortion and sterilization have agreed to a compromise that is expected to be presented to both chambers on Friday, the session's last day. Gone are many of the provisions passed by the House on Wednesday – including the amendment that would have allowed pharmacies to carry products of their own choosing and decline to stock any drug or medical device (Mannies, 5/17).

Meanwhile, in Iowa -

Des Moines Register: Priest Joins Medical Board After Senate Declines To Vote On Him
A prominent Catholic priest has begun serving on the Iowa Board of Medicine, after state senators opted not to vote on his nomination. Msgr. Frank Bognanno's appointment had overtones of the debate over abortion. Gov. Terry Branstad chose him after Senate Democrats rejected the governor's nomination of an anti-abortion activist who had appeared before the medical licensing board in 2010 (Leys, 5/17).

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State Highlights: U.S. Says Medicaid Overpaid $700M To N.Y

A selection of health policy stories from New York, Kentucky, Texas, Connecticut and California.

The New York Times: Report Details Medicaid Overpayments To New York State
The federal government paid New York State $700 million more in 2009 than the state needed to care for residents with developmental disabilities who lived in its institutions, according to the inspector general of the Department of Health and Human Services in Washington (Hakim, 5/18).

Connecticut Mirror: Report Says State's Unfunded Health Care Liabilities Down, But By How Much?
The Malloy administration Thursday announced a "dramatic" reduction in Connecticut's future unfunded employee and retiree health care liabilities, but Republicans said the state should count on only a fraction of that. The figures at issue are part of an actuarial report by The Segal Co., which said the state has a $17.9 billion unfunded liability for health care costs, referred to as "other post-employment benefits." That's down $8.7 billion from the previously reported value, and $13.3 billion less than had been expected, according to the report (Becker, 5/17).

The Associated Press: Ky. Weighed Politics, Medicine In Inmate's Surgery
A condemned killer's fight to receive surgery for agonizing hip pain pushed Kentucky officials into an uncomfortable debate over security, politics and even the possibility of inviting scorn from Fox News pundits. E-mails and memos obtained by The Associated Press show corrections officials struggling for a year to reconcile their duty to provide medical care with the political ramifications of spending tens of thousands of dollars for surgery on a man they plan to execute (Barrouquere, 5/17).

The Dallas Morning News: Construction On Parkland's New Emergency Room Put On Hold While Officials Consider Redesign
Construction on the emergency room of the new Parkland Memorial Hospital remains in limbo as officials struggle to redesign the space to satisfy government regulators. Lou Saksen, Parkland's senior vice president for new development, said Wednesday it would probably take several months to complete the redesign after federal regulators found extensive patient-safety problems in the current ER. The main problem involved inadequate medical screening of ER patients, who were being sent to other areas of the hospital for treatment, a violation of federal law (Jacobson, 5/16). 

San Francisco Chronicle: S.F. To Replace Lost Federal AIDS/HIV Funds
Mayor Ed Lee announced Thursday morning that he will use city money to backfill $6.6 million in federal cuts to AIDS and HIV care in the city for the new fiscal year that starts July 1. "Despite continuing local budget issues, we remain committed to funding critical care services for people living with HIV/AIDS in San Francisco," Lee said. … Still not resolved is the reduction of $8.1 million in federal funding for HIV and AIDS services that will hit the city in the fiscal year that starts July 1, 2013 (Gordon, 5/18).

KQED: SF Supervisors Urge Mayor To Increase HIV/AIDS Funding
San Francisco supervisors are pressuring Mayor Ed Lee to fill in a federal funding gap for HIV/AIDS care in the city. The city is losing about $8 million in federal funds for preventing HIV and treating low-income HIV patients. Supervisor Scott Wiener says the cuts will limit access to care, and that's a serious long-term problem (Hawkings, 5/16).

KQED's State Of Health: Bridge to Health Reform "Undoable" In San Luis Obsipo
California's "Bridge to Reform" program is intended to do exactly that: provide a bridge to the 2014 roll-out of the Affordable Care Act. Right now, 47 of California's 58 counties have already provided health care to more than 335,000 people. San Luis Obispo is a case study in one county that is not participating. … In San Luis Obispo, Health Agency Director Jeff Hamm said he made the decision to withdraw from participation reluctantly. For years, the county has slashed its health budget and outsourced its medical safety net. It reached the point, Hamm said, of not having the start-up funds, or medical infrastructure, needed to implement the Bridge to Reform (Gonzales, 5/17).

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Health Policy Research

Research Roundup: EHRs Don't Seem To Improve Diabetes Care

Each week KHN reporter Christian Torres compiles a selection of recently released health policy studies and briefs.

Annals of Family Medicine: Typical Electronic Health Record Use in Primary Care Practices And The Quality Of Diabetes Care -- Federal officials and health policy experts believe that electronic health records (EHRs) will improve patient care. Researchers measured adherence to diabetes care guidelines as well as patient outcomes over three years at 16 practices using EHRs and 26 practices using paper records. Practices with EHRs did not show signs of better care and providers using them "have not made the necessary changes to both work processes and ways of thinking about care that would lead to improvements in chronic illness management." They conclude: "Ongoing efforts to encourage adoption and meaningful use of EHRs in primary care should focus on ensuring that use succeeds in improving care" (Crosson et al., 5/14).

Urban Institute: The ACA Basic Health Program in Washington State -- This study looks at how a basic health program (BHP) -- a state-run, federally financed program -- in Washington state would function under the health law. These programs allow states the option of using federal funds for some of the people who would otherwise receive subsidies to buy insurance through the state exchanges. The researchers write: "We find that more than 160,000 Washington residents would be eligible for BHP. ... Even with BHP, the exchange in Washington would still cover about 250,000 lives, and BHP would not notably affect premiums in the individual market," and they estimate that Medicaid reimbursements could rise 4-5 percent above current levels (Buettgens and Carroll, 5/10).

Robert Wood Johnson Foundation: Workplace Wellness Programs -- Many employers offer wellness benefits in coordination with their health insurance, and some use incentives -- such as premium discounts, rebates or extra benefits -- to encourage better health. The author of this policy brief notes that "[w]hether rewards for participating in a wellness program are viewed by employees as incentives or penalties may depend on how the program is structured." Because of the health law, employers will be able to raise these wellness incentives beginning in 2014 from 20 to 30 percent of the cost of health benefits. As their programs expand, employers will likely have to address some privacy and discrimination concerns (James, 5/10).

RAND: A Shot In The Arm For Adult Vaccination -- Adults have relatively low rates of vaccination for diseases such as shingles, influenza, HPV and hepatitis A and B, but that could change with the health law along with vaccinations becoming increasingly available outside the doctor's office. This research brief provides several recommendations including the development of better counseling tools for patients. The authors conclude that to make "adult vaccination in office-based settings more routine, stakeholders need to collaborate to integrate advice about vaccination and other efforts to incorporate vaccination into routine office-based care," including incorporating vaccinations into pay-for-performance models of health care, to help create an incentive for doctors (Adamson, 5/16).

Here is a selection of news coverage of other recent research:

MedPage Today: Malpractice Trends: Good News and Bad News 
Results of a new study of medical malpractice claims offer a mix of reassurance and sobering reality.  According to the results, 55.2% of medical malpractice claims that required some defense cost led to litigation. However, of the claims that do go to court, most are ultimately decided in the physician's favor. ... The sobering news is that litigated claims often take months or years to be resolved, according to the study, which was published online May 14 in the Archives of Internal Medicine (Fox, 5/14).

Modern Healthcare: Insurance Exchanges Could Mean Savings For Some, Researcher Says
People who purchase health insurance policies on the individual market may save an average of $280 annually under the healthcare overhaul's coming insurance exchanges, according to projections by a federal researcher. Steven Hill, a senior economist in the Center for Financing, Access and Cost Trends at the Agency for Healthcare Research and Quality, analyzed costs for the 11 million beneficiaries in the individual insurance market in recent years and projected their future costs under the Patient Protection and Affordable Care Act (Daly, 5/16).

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Editorials and Opinions

Viewpoints: VA Failing To Provide Timely Care; Roll Up Your Sleeves To Help Fight AIDS; Primary Care Doctors' Uncertain Future

San Francisco Chronicle: Veterans Wait Too Long On Disability Claims
Those who have served know the military rules: Be on time, do it now. Once they file disability claims with the Department of Veteran Affairs, however, veterans wait, and wait longer…. Delay is not without consequences for the individual or the community…. We sent these young men and women off to battle. We owe them timely care (5/18).

The Washington Post's Plum Line: The Latest 'Repeal And Replace' Bait-And-Switch
The ongoing saga of the "replace" portion of repeal-and-replace has moved forward again. You'll recall that Republicans campaigned on the idea that after they got rid of the dreaded "Obamacare" they would immediately move to replace it with Republican health care reform. But then they ignored that pledge for the next fifteen months. Then, last week, one key GOP Member of the House said that replace was dead. This week, Republicans have yet another strategy in place (Jonathan Bernstein, 5/17).

Georgia Health News: Enlist In The War Against HIV
On Friday, HIV Vaccine Awareness Day, consider becoming a local participant in these trials at the Hope Clinic. If you are not infected with HIV, this is a powerful way to — literally — roll up your sleeves, take a shot, and help fight HIV (Dr. Mark Mulligan, 5/17). 

The New England Journal of Medicine: The Evolving Primary Care Physician
The primary care doctor is a rapidly evolving species — and in the future could become an endangered one. As the United States grapples with the dual challenges of making health care more widely available and reducing the national price tag, it's hard to say how primary care physicians will fit into the delivery models that emerge (Dr. Susan Okie, 5/17).

The New England Journal of Medicine: Emergency Departments, Medicaid Costs, And Access To Primary Care — Understanding The Link
In December, 2011, Washington State's Health Care Authority announced its intention to stop paying for emergency department (ED) visits by Medicaid beneficiaries "when those visits are not necessary for that place of service." ... Washington Governor Chris Gregoire suspended implementation in order to try a less drastic alternative. ... Instead of blocking the doors to the ED, policymakers in Washington State and elsewhere should ... unlock the doors to primary care (Dr. Arthur L. Kellermann and Robin M. Weinick, 5/17).

The New England Journal of Medicine: Lost in Translation — ¿Cómo se dice, "Patient Protection and Affordable Care Act"?
Putting aside the issue of illegal immigration, it is clear that undocumented immigrants' access to care is in jeopardy under the ACA. Deliberately excluded from insurance access, they are forced to fend for themselves in an artificial market system where inflated charges are set by insurance and governmental third parties, with fees for basic services beyond the reach of most working people. Economics notwithstanding, physician workforce shortages loom ahead and threaten to crowd out the uninsured with a deluge of newly arrived paying patients (Dr. James O. Breen, 5/17).

MinnPost: Women Will Always Need Access To Safe, Legal Abortions
The lives that we lead are complicated: often wonderful, often terrible, with many twists and turns along the way. There will always circumstances that result in unintended pregnancies. Sadly, there will always be ectopic pregnancies and fetal anomalies, no matter how wanted or planned the pregnancy is. And, I fear, our society will always have to deal with the risk of rape, and I am loath to imagine a woman forced through a pregnancy under such circumstances (Linnea House, 5/18).

Medscape: Which Complementary And Alternative Therapies Merit Study?
Since the founding in 1992, the National Center for Complementary and Alternative Medicine (NCCAM) has received about $1.6 billion of federal money to study a variety of things. What they have studied has been disappointing. They spent hundreds of thousands of dollars to see whether prayer treated AIDS; to see whether prayer could promote wound healing after breast reconstruction surgery; to see whether coffee enemas could treat pancreatic cancer; to see whether magnets (in mattresses or otherwise) could improve carpal tunnel syndrome, migraines, or arthritis. ... I think the disappointing part of these studies is that they are not based on any biological principle (Dr. Paul A. Offit, 5/17).

Medscape: Facebook: Pressuring Users To Become Organ Donors?
But listing yourself [as an organ donor] on Facebook has an even more important consequence. A lot of people sign [the organ donor line] on their driver's license or carry a card from the Kidney Foundation, but they do not tell anyone that they have done this. That means that other people do not know their wishes, and if their driver's license somehow is separated from them after an accident ... then people may not know that this person wanted to be an organ donor. Having this information on your account lets people know your wishes. It not only increases the number of donors, it increases the chance of donation (Art Caplan, 5/17).

Sacramento Bee: Feud Colors Clash Over California's Health Care Rates
The stage is set for an immense political clash over regulation of health insurance with multibillion-dollar stakes and an impact on virtually every Californian. Consumer Watchdog battled insurers over regulation of auto and other personal insurance 24 years ago and won, claiming that it has saved consumers tens of billions of dollars since. Now it wants regulation of health insurance, promising to cut costs by cracking down on bloated insurer overhead and profits. It launched the initiative after rate-regulation legislation, sponsored by Consumer Watchdog and Insurance Commissioner Dave Jones, stalled last year (Dan Walters, 5/18).

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Stephanie Stapleton

Andrew Villegas

Lisa Gillespie
Shefali Luthra

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.