First Edition: April 30, 2012

In today's headlines, a variety of health policy headlines ranging from reports about state-level health law implementation progress to marketplace news.   

Kaiser Health News: Conflicts Arise As Health Insurers Diversify
Kaiser Health News staff writer Jay Hancock, working in collaboration with The Washington Post, reports: "As insurers eager to add revenue streams convert themselves into diversified health-services companies, they often buy traditional business adversaries, including physician groups and hospital consultants such as EHR. They're also buying technology companies and research firms that serve medical-care providers, raising questions not only about independence but about the privacy of patient information" (Hancock, 4/29). Read the story.

Kaiser Health News: Sued Over An $1,800 Hospital Bill
Kaiser Health News staff writer Jenny Gold, working in collaboration with NPR, reports: "Nonprofit hospitals, including Mount Carmel, pay no federal, state or local taxes, giving them a competitive edge over their for-profit counterparts. In return, they are expected to offer a community benefit, including free and discounted care for low-income patients. But even as more and more Americans need extra help after losing their jobs and health insurance in the recession, studies suggest that on average, nonprofits provide only slightly more free and reduced-cost care than for-profit hospitals. Patient advocates argue the line dividing nonprofit hospitals and for-profit hospitals, which do not receive the tax exemption, has blurred" (Gold, 4/27). Read the story.

Kaiser Health News: Quick Facts About High-Deductible Health Plans
Kaiser Health News staff writer Shefali S. Kulkarni, working in collaboration with PBS Newhour, reports: "High-deductible health care plans are no longer a novelty—they are becoming mainstream. According to the industry trade group America's Health Insurance Plans, the number of people with this kind of coverage reached more than 11.4 million in January 2011, up from 10 million in January 2010" (Kulkarni, 4/27). Read the story.

Kaiser Health News: Capsules: Breaux: Bipartisanship Necessary To Fix Medicare Finances
Now on Kaiser Health News' blog, Marilyn Werber Serafini and Mary Agnes Carey report: "Louisiana Democrat John B. Breaux left the Senate seven years ago, but old habits die hard. Today he fell back easily into his former role of compromise builder as he stressed the need for political common ground to overhaul Medicare next year" (Werber Serafini and Carey, 4/27). Check out what else is on the blog.

Kaiser Health News also tracked weekend health policy headlines, including reports about women's issues on the presidential campaign trail (4/28); Rep. Paul Ryan, R-Wis., on how his budget protects seniors; and the House vote on using the public health prevention fund to help pay for the student loan program (4/28).

The New York Times: The Ticket: Ryan's Rise From Follower To GOP Trialblazer
His prescriptions in the Republican budget plan he devised have become his party’s marching orders: cut income tax rates and simplify the code, privatize Medicare, shrink the food-stamp and Medicaid programs and turn almost all control over to the states, and reduce domestic federal spending to its smallest share of the economy since World War II (Weisman, 4/29).

Politico: States Could Be In A Bind On Mandate
If the Supreme Court strikes down the health reform law's individual mandate, the states at the forefront of implementing the law could find themselves like Wile E. Coyote in the Road Runner cartoons: racing ahead only to discover there’s no ground underneath their feet. These states were all counting on the individual mandate to make health insurance exchanges viable — because without a requirement for most people to buy coverage, there’s a chance that healthy people could avoid paying into the system, making premiums skyrocket (Feder and Millman, 4/29).

Politico: 5 Prevention Programs GOP Hopes To Target
The fight in Congress over the Prevention and Public Health Fund may rage on for a while longer. Republicans voted last week to eliminate what they termed as a "slush fund" as a way to prevent a large increase in student loan rates. Democrats disagree and will keep pushing for other student loan pay-fors. The prevention fund already has been hit with a $5 billion cut this year (Smith, 4/29).

The New York Times: In Hopeful Sign, Health Spending Is Flattening Out
The growth of health spending has slowed substantially in the last few years, surprising experts and offering some fuel for optimism about the federal government's long-term fiscal performance. Much of the slowdown is because of the recession, and thus not unexpected, health experts say. But some of it seems to be attributable to changing behavior by consumers and providers of health care — meaning that the lower rates of growth might persist even as the economy picks up (Lowrey, 4/28).

The Wall Street Journal: Ahead Of The Tape: Humana Is Poised To Weather Any Ills
Careful what you wish for—you just might get it. Investors in health insurers squirmed through the first year-and-a-half of Barack Obama's presidency as his industry overhaul took shape. Now, the sector that seemingly stood to lose the most from the Patient Protection and Affordable Care Act is in no mood to cheer the constitutional challenge the law faces in the Supreme Court (Jakab, 4/29).

Bloomberg News/The New York Times: Accretive Denies Accusations Of Pressuring Patients To Pay
Accretive Health, one of the nation’s largest collectors of medical bills, took issue on Sunday with a report by the Minnesota attorney general’s office that it puts bedside pressure on patients to pay their bills (4/29).

Chicago Tribune: Accretive Gets Clean Bill Of Health From Other Customers
Health systems that work with Chicago-based Accretive Health backed the company Friday, saying they hadn't seen evidence of the allegations raised in Minnesota that the debt collector violated patients' rights. Their endorsements came as the Minnesota-based hospital system embroiled in the payment controversy severed its remaining contracts with the Chicago-based company (Frost, 4/28).

The New York Times: Chicken Scratches vs. Electronic Prescriptions
E-prescribing comes as part of the switch to electronic health records, which can cost a medical practice tens of thousands of dollars. The stimulus package passed in 2009 included provisions that theoretically ease the financial burden for doctors, but the payments are tied to Medicare and Medicaid reimbursements that are spread out over five years. So the upfront costs remain substantial. In addition to those costs, the other large obstacle to adopting electronic records is their impact on office work flow, Dr. Kaushal says (Stross, 4/28).

USA Today: Report: Anti-Psychotics Wrongly Prescribed In Nursing Homes
Many nursing homes are typically using anti-psychotic drugs in residents who display agitation and combative behavior, but who should not be administered the powerful sedatives, a Boston Globe report based on government data has found (Eversley, 4/29).

The New York Times: How One Hospital Bent The Cost Curve
Many economists and health policy specialists think that changes made by insurers, hospitals and doctors to emphasize the quality of care rather than the quantity of care is a major factor, and Children’s Hospital Boston offers a good test case. But about four years ago, the hospital recognized the growth in costs as unsustainable — as many institutions in Massachusetts did after the state passed an individual mandate law. ... All in all, the hospital made more than 100 changes and cut tens of millions of dollars in costs (Lowrey, 4/28).

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This is part of Kaiser Health News' Daily Report - a summary of health policy coverage from major news organizations. The full summary of the day's news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.