First Edition: June 30, 2014

Jun 30 2014

Today's early morning highlights from the major news organizations, including an announcement coming today for a new VA secretary and expectations for a Supreme Court decision on the challenge to the health law's contraceptive mandate by two for-profit companies.

Kaiser Health News: Retooling Hospitals, One Data Point At A Time
Kaiser Health News staff writer Julie Appleby, working in collaboration with USA Today, reports: "When a car rolls off an assembly line, the automaker knows exactly what parts, labor and facilities cost. Not so in health care, and now some health executives are trying to change that. Although U.S. hospitals account for the single largest chunk of the nation's $2.7 trillion in health spending, few of them can say how much it actually costs them to care for every patient they admit. ... Today, the [University of] Utah health system is one of a handful in the nation with a data system that can track cost and quality for every one of its 26,000 patients. That data is shared with doctors and nurses for further input about ways to streamline cost and improve care (Appleby, 6/30).

Kaiser Health News: Capsules: Washington And Other States See New Insurers On Exchanges
Capital Public Radio's Pauline Bartolone, working in collaboration with Kaiser Health News andNPR, reports on the expansion of Washington's online insurance marketplace: "Washington State's health insurance exchange is looking to be an attractive marketplace for new health insurance carriers, according to an early analysis of insurer premium rate filings by McKinsey & Company. Four new insurers have applied to sell individual policies in the state's exchange next year, making Washington among the states with the highest number of new exchange entrants of the 12 states where preliminary 2015 rates have been filed, according to McKinsey. If insurance regulators approve the new carriers, Washington will have 12 insurers on the exchange in 2015, up from eight participating this year" (Bartolone, 6/30). Check out what else is on the blog.

The Washington Post: Bob McDonald, Former P&G Chief, To Be Obama's Nominee To Lead Veterans Affairs
President Obama on Monday will nominate Bob McDonald, a West Point graduate who served as the chief executive of Procter & Gamble, to take over as head of the troubled Department of Veterans Affairs, according to White House officials. The unorthodox pick of a retired corporate executive whose former company produces iconic household products such as Tide detergent and Charmin toilet paper -; rather than a former military general -; underscores the serious management problems facing the agency charged with serving more than 8 million veterans a year (Eilperin, 6/29).

The New York Times: Pick For V.A. Is Former Corporate Chief
President Obama on Monday intends to nominate Robert A. McDonald, a former chief executive of Procter & Gamble, to be the next secretary of Veterans Affairs, a White House official said Sunday, betting that a global corporate officer can turn around a government health system that has been rocked by allegations of mismanagement. ... "This is definitely a surprising pick," said Paul Rieckhoff, the chief executive and founder of Iraq and Afghanistan Veterans of America. "McDonald is not a name that was on anyone's radar over the last few weeks. His branding background may prove helpful because there are few organizations in America with a worse reputation toward customers than the V.A. right now" (Shear and Oppel, 6/29).

The Wall Street Journal: Ex-Procter & Gamble CEO To Be Nominated As VA Secretary
The White House said Mr. McDonald would bring gravitas and well-honed management skills to the troubled department, which is struggling to address an array of systemic problems. Mr. McDonald, 61 years old, is a veteran and a West Point graduate, but his limited military experience is unusual for the VA post (McCain Nelson and Kesling, 6/29).

Politico: Barack Obama Taps Ex-Procter And Gamble Exec Robert McDonald To Lead VA
A graduate of the U.S. Military Academy at West Point, McDonald rose from an entry-level job to CEO of Procter and Gamble over more than three decades at the company. He spent four years as CEO before leaving in mid-2013 amid cost-cutting at the Fortune 500 company (Epstein, 6/29).

USA Today: Obama To Name New VA Chief
McDonald, 61, was with Procter & Gamble for 33 years. As CEO, he oversaw more than 120,000 employees, with operations around the world, selling products in more than 180 countries and more than 2.5 million stores, reaching more than 5 billion customers (Jackson and Zoroya, 6/29).

Los Angeles Times: Obama Selects Former Procter & Gamble Chief To Lead Veterans Affairs 
In nominating Bob McDonald as the next secretary of Veterans Affairs, President Obama is recruiting a West Point graduate with experience in running a big corporation -; Procter & Gamble -; to turn around a department whose failure to provide timely care to veterans has caused a political furor. If confirmed by the Senate, McDonald would succeed Eric K. Shinseki, a retired four-star Army general who stepped down last month amid a scandal in which VA employees falsified records to cover up long waits for medical appointments (Simon, 6/29).

Reuters: Obama To Nominate Former P&G CEO Bob McDonald As Veterans Secretary
U.S. House of Representatives Speaker John Boehner called McDonald "a good man, a veteran, and a strong leader with decades of experience in the private sector. With those traits, he's the kind of person who is capable of implementing the kind of dramatic systemic change that is badly needed and long overdue at the VA" (Holland, 6/29).

The Associated Press: Ex P&G Head Obama Choice To Lead Veterans Affairs
Senate Veterans Affairs Committee Chairman Bernie Sanders, I-Vt., said in a statement that he looked forward to meeting with McDonald next week to get his views on issues he views as important. Among them, Sanders said in a statement, "The VA needs significantly improved transparency and accountability and it needs an increased number of doctors, nurses and other medical staff so that all eligible veterans get high-quality health care in a timely manner" (Pace, 6/29).

The New York Times: Report Finds Health Unit Of V.A. Needs Overhaul
The Veterans Health Administration has a corrosive culture that has led to poor management, a history of retaliation toward employees, cumbersome and outdated technology, and a shortage of doctors, nurses and physical space to treat its patients, according to a review presented to President Obama on Friday by one of his top advisers on veterans' issues. Mr. Obama called last month for the review of the Veterans Health Administration, a part of the Department of Veterans Affairs, just days before he accepted the resignation of the Veterans Affairs secretary, Eric Shinseki (Shear and Oppel, 6/27).

The Wall Street Journal: White House Review Of VA Finds 'Corrosive Culture,' Poor Management
A White House review of the VA health system points to a culture that has degraded the timely delivery of care and requires a restructuring to improve transparency and accountability. Acting Secretary of Veterans Affairs Sloan Gibson and Rob Nabors, White House deputy chief of staff, told President Barack Obama on Friday that significant further action was needed to address systemic problems (McCain Nelson and Kesling, 6/27).

Politico: White House Report: Overhaul VA's 'Corrosive Culture'
The Department of Veterans Affairs' "corrosive culture" can only be fixed by a near overhaul of the system, charged a report delivered to President Barack Obama on Friday. The report, authored by a top White House official, said the department needs to be "restructured and reformed" and shared a scathing view of a corrupt and poorly-managed agency keen to protect itself over the care of veterans (French, 6/27).

Los Angeles Times: White House Report Says VA Has 'Significant' And 'Systemic Failures'
The VA suffers from "significant and chronic systemic failures" that must be addressed by department leadership, according to a White House report delivered to President Obama on Friday, giving urgency to congressional legislation aimed at reducing veterans' wait times for healthcare and holding officials more accountable. Among the problems cited are a "corrosive culture" that has led to personnel problems within the Department of Veterans Affairs, exacerbated by poor management and a history of retaliation toward employees raising issues (Simon, 6/27).

The Hill: WH Report Finds 'Corrosive Culture' At VA
The report written by Rob Nabors, the president's deputy chief of staff, paints a bleak picture of operations within the department. It says the agency needs to take "significant further action" to address "systematic problems" with providing health service for former service members. "It is clear that there are significant and chronic systemic failures that must be addressed by the leadership at the VA," Nabors says in his report, presented to President Obama on Friday (Sink, 6/27).

The New York Times: In Military Care, A Pattern Of Errors But Not Scrutiny
The Zeppa case is emblematic of persistent lapses in protecting patients that emerged from an examination by The New York Times of the nation's military hospitals, the hub of a sprawling medical network -; entirely separate from the scandal-plagued veterans system -; that cares for the 1.6 million active-duty service members and their families. ... From 2011 to 2013, medical workers reported 239 unexpected deaths, but only 100 inquiries were forwarded to the Pentagon's patient-safety center, where analysts recommend how to improve care. Cases involving permanent harm often remained unexamined as well. At the same time, by several measures considered crucial barometers of patient safety, the military system has consistently had higher than expected rates of harm and complications in two central parts of its business -; maternity care and surgery (LaFraniere and Lehren, 6/28).

Politico: Kathleen Sebelius: I 'Made Some Mistakes'
Former Health and Human Services Secretary Kathleen Sebelius acknowledged Friday that she made mistakes leading up to the rollout of the Affordable Care Act, worrying too much about whether there'd be a market for Obamacare and spending "too little time clearly on the technology side." "I sure made some mistakes along the way in terms of focusing on some things and not on others," she said at the Aspen Ideas Festival. Instead of confirming what she was being told about HealthCare.gov's readiness "was actually accurate and getting enough eyes and ears on that," she said she concentrated on the insurers, consumers and regulators who needed to come together in the health exchanges (Villacorta, 6/27).

The Hill: Lawmaker Presses HHS For Small-Business Health Insurance Data
A top GOP lawmaker pushed the administration Friday to release enrollment data measuring the success of the Small Business Health Options Program (SHOP) under ObamaCare. Rep. Sam Graves (R-Mo.), chairman of the House Small Business Committee, issued a statement expressing frustration that the Department of Health and Human Services has repeatedly failed to provide the requested data. "It's astonishing how little information has been disclosed about a law in which the taxpayers are investing billions. What is the Administration hiding?" Graves asked (Al-Faruque, 6/27).

The New York Times: Medical Boards Draft Plan To Ease Path To Out-of-State And Online Treatment
Officials representing state medical boards across the country have drafted a model law that would make it much easier for doctors licensed in one state to treat patients in other states, whether in person, by videoconference or online. The plan, representing the biggest change in medical licensing in decades, opens the door to greater use of telemedicine and could alleviate the doctor shortage, a growing problem as millions of people gain insurance coverage under the Affordable Care Act (Pear, 6/29).

Los Angeles Times: Confusion Over Doctor Lists Is Costly For Obamacare Enrollees In State
Frustration and legal challenges over the network of doctors and hospitals for Obamacare patients have marred an otherwise successful rollout of the federal healthcare law in California. Limiting the number of medical providers was part of an effort by insurers to hold down premiums. But confusion over the new plans has led to unforeseen medical bills for some patients and prompted a state investigation. More complaints are surfacing as patients start to use their new coverage bought through Covered California, the state's health insurance exchange (Terhune, 6/28).

The Hill: Sebelius: Hobby Lobby Case About More Than ObamaCare
Former Health and Human Services Secretary Kathleen Sebelius said Friday that if the Supreme Court rules against ObamaCare's contraception mandate next week, it will have "huge" implications that go far beyond the healthcare law. Sebelius said a ruling against the law could allow employers maximum discretion to avoid following laws they say go against their religious beliefs. "I do think this issue is far beyond contraception coverage in the Affordable Care Act," she said. "This really is about whether or not employers based on religious views can pick and choose which federal laws to follow and not follow" (Al-Faruque, 6/27).

The Wall Street Journal: Religious Business Owners Brace For High Court's Contraception Ruling
Religious business owners and women's groups braced for Monday's expected Supreme Court ruling on an Affordable Care Act contraception-coverage requirement that could outline the flexibility owners of for-profit enterprises have in exercising religious beliefs. ... The contraception decision could have immediate consequences for a high-profile provision of the Affordable Care Act, two years after the court upheld the law's requirement that most Americans obtain health insurance (Radnofsky, 6/29).

Reuters: On Eve Of Court Ruling, Americans Oppose Contraceptive Ban: Reuters/Ipsos Poll
A majority of Americans oppose letting employers, based on their religious views, exclude certain contraceptives from workers' insurance coverage, says a Reuters/Ipsos opinion poll ahead of a U.S. Supreme Court decision expected on Monday. In one of the most closely watched cases of the year, the nine-member court will weigh whether for-profit corporations may raise religious objections to a mandate in President Barack Obama's signature 2010 healthcare law that their insurance cover contraceptives. ... The Reuters/Ipsos poll of 10,693 people was conducted April 28-June 20, 2014 (Biskupic, 6/29).

Politico: Hobby Lobby Decision: Nine Justices To Watch
Shortly after 10 a.m. Monday, the Supreme Court will issue its much-anticipated decision on the religious freedom challenge businesses have brought against the Obamacare contraception mandate. ... A win for the White House would help officials ensure that employer coverage is consistent, but employers would still be able to opt out of coverage altogether by paying a fine. A win for Hobby Lobby would mean other businesses with a small number of owners could opt out of aspects of Obamacare coverage, possibly leaving employees on their own to pay for particular drugs or procedures (Gerstein, 6/30).

The Hill: McConnell: I'd Fight To Limit Abortions
Senate Minority Leader Mitch McConnell (R-Ky.) promised Saturday to focus more attention on limiting abortions if Republicans take control of the Senate in November. Speaking to the National Right to Life Convention in his home state of Kentucky, the Senate's top Republican suggested Majority Leader Harry Reid (D-Nev.) has blocked the upper-chamber from voting on bills that would limit women's rights to abortion, according to conservative website Townhall.com. But McConnell said he would push abortion-limiting legislation to pressure President Obama to take a stand on the issue (Devaney, 6/28).

The New York Times: Cuomo Plan Seeks To End New York's AIDS Epidemic
Borrowing an idea from leading AIDS researchers, the Cuomo administration said on Friday that it had developed a plan to aggressively identify, track and treat people with H.I.V. infection with the aim of reducing new infection to the point that by 2020, AIDS would no longer reach epidemic levels in New York State. ... The state's acting health commissioner, Dr. Howard Zucker, said on Friday that he believed that by 2020, New York could reduce its annual incidence of new H.I.V. infections to about 750 from the current 3,000, bringing the number of new cases below the number of annual deaths, or as he put it, "bending the curve" in the direction of ending the epidemic in the state (Hartocollis, 6/28).

The Wall Street Journal: Cuomo Unveils New Effort To Reduce HIV/AIDS Cases
New York Gov. Andrew Cuomo on Sunday announced an initiative to bring new HIV/AIDS cases below epidemic levels in the state by 2020. The plan calls for more aggressive testing, treatment and tracking of the disease. "The state of New York was ground zero of HIV/AIDs when the crisis hit 30 years ago," Mr. Cuomo said in remarks before walking in New York City's gay-pride parade. "It's fitting that New York could be the state that is the most aggressive in eradicating the disease" (Vilensky, 6/30).

The Associated Press: Cuomo: Boost HIV Tests, Treatment To End Epidemic
New York state can end its three-decade HIV crisis by the year 2020, Gov. Andrew Cuomo said Sunday as he announced an ambitious plan to deliver a knockout blow to the epidemic by boosting testing, reducing new infections and expanding treatment. The governor said the state is aiming to reduce new HIV diagnoses to 750 by the end of the decade -; about the same number of tuberculosis cases seen in New York City each year -; down from 3,000 expected this year and 14,000 new cases of the disease in 1993 (Klepper, 6/29).

The Associated Press: Many Challenges Face Ex-Inmates Living With HIV
Several times each month, a white bus picks up newly released ex-inmates at New York's Rikers Island jail complex and drives into Harlem, where helping hands await at a transition program run by a nonprofit called the Fortune Society. These new arrivals face the myriad challenges confronting anyone leaving jail or prison -; and a daunting additional one. They have HIV (Crary, 6/28).