First Edition: August 5, 2014

Today's headlines include coverage of a partnership between two of California's largest insurers in which they will join forces to create a database of patient medical records.

Kaiser Health News: Patients Seeking Cheaper Care Are Soliciting Bids From Doctors Online
Reporting for Kaiser Health News, Sandra G. Boodman writes: "To Medibid founder Ralph Weber, a benefits consultant who said he left his native Canada for the United States in 2005 to escape "socialized health care," using the Internet to arrange non-emergency medical care is long overdue. Americans, he says, are increasingly going online to book travel and even find a mate. Medibid enables them to strip away the opacity that surrounds health-care pricing, Weber maintains, where charges vary wildly even in the same market and can be nearly impossible for consumers to obtain" (Boodman, 8/5). Read the story, which also appeared in The Washington Post.

Kaiser Health News: Insuring Your Health: Health Law Calls For Some Workers To Be Automatically Enrolled In Coverage
Kaiser Health News consumer columnist Michelle Andrews writes: "Newly hired employees who don't sign up for health insurance on the job could have it done for them under a health law provision that may take effect as early as next year. But the controversial provision is raising questions: Does automatic enrollment help employees help themselves, or does it force them into coverage they don't want and may not need? A group of employers, many of them retail and hospitality businesses, want the provisions repealed, but some experts say the practice has advantages and is consistent with the aims of the health law" (Andrews, 8/5). Read the column.

Kaiser Health News: Cleveland's Early Medicaid Expansion Paying Off
WCPN's Sarah Jane Tribble, working in partnership with Kaiser Health News and NPR, reports: "So long before Ohio expanded Medicaid, the hospital redirected more than $30 million from Cuyahoga County taxpayers to create its very own Medicaid program for residents. Here's how it worked: MetroHealth used extensive electronic medical records to carefully select uninsured patients and sent 28,000 of them Medicaid cards before they even applied. Then, the hospital gave highly personalized attention to some patients and kept track of them" (Tribble, 8/5). Read the story.

Kaiser Health News: Capsules: Study: ER Closures Raise Death Rates At Nearby Hospital; Smokers Paying Less For Some Health Plans Than Expected
Now on Kaiser Health News' blog, Roni Caryn Rabin reports on a study regarding ER closures and death rates: "Emergency patients who are admitted to the hospital are at greater risk of dying if another emergency room at a hospital nearby has closed its doors, a new study of California hospitals has found. The analysis is believed to be the first to examine the impact that emergency department closures have on the quality of patient care at other hospitals within the same service area" (Rabin, 8/4). 

Also on the blog, Shefali Luthra reports on the surcharges some tobacco users now pay as part of their health insurance premiums: "The health law allows insurance plans to charge tobacco users as much as 50 percent more for their premiums, but plans on average increased costs for these consumers by significantly less, according to a new study published in Health Affairs. Researchers found the median surcharge amount to be about 10 percent. Close to 90 percent of plans stayed well below the maximum surcharge, according to the study's authors. But even still, because tobacco users were still charged more than others, they more frequently could not access affordable health insurance, a situation that the authors said could deter tobacco users from purchasing insurance at all" (Luthra, 8/4). Check out what else is on the blog.

The Wall Street Journal: Hospitals Cash In On The Newly Insured
A rush of newly insured patients using health services has boosted hospital operators' fortunes but has racked up costs that insurers didn't anticipate, corporate filings and interviews with executives show. People are getting more back surgeries, seeking maternity care and showing up at emergency rooms more frequently, executives say, boosting income for hospital operators (Weaver, 8/4).

Los Angeles Times: Insurance Giants Creating Massive Database Of Patient Records
Two of California's largest health insurers are partnering to create a massive database of patient medical records. With just a few strokes of a keyboard, doctors and nurses will be able to access the medical histories of about one in four California residents. Supporters say the effort by Anthem Blue Cross and Blue Shield of California could mean faster, cheaper and better healthcare. But the system faces significant technological challenges and privacy concerns (Logan and Pfeifer, 8/4).

The Wall Street Journal: Two Insurers To Pool Medical Records In California
Two major California insurers are teaming up to create what will be one of the nation's largest health-information exchanges, making the medical records of about nine million plan members available to participating doctors and hospitals. It is an ambitious effort, as dozens of similar information exchanges have closed or consolidated because of financial and administrative problems (Beck and Wilde Mathews, 8/5).

NPR: Minnesotans Question State's Ailing Insurance Marketplace
Minnesota spent $100 million dollars on creating its new health care website, and while the state has added some 180,000 people to insurance coverage, some are asking whether it was worth it for the state to embark on its own -; or even have an exchange at all (Stawicki, 8/4).

The Associated Press: Vermont: State Severs Link To Web Designer
The state is ending its relationship with CGI, the company that designed the troubled website used to sign people up for health insurance. Lawrence Miller, the state's chief of health care overhaul, said Monday that the Vermont Health Connect website was still failing many people who were trying to manage their health insurance via the online marketplace. The state has hired the company Optum to continue work on the website. CGI will continue to host the website (8/4).

The New York Times' Political Memo: Democrats Seize On Social Issues As Attitudes Shift
On some divisive issues like abortion, attitudes have not shifted much; sonograms and advances in medical treatment have increased the discomfiture of some Americans with the procedure. Part of Republicans' defensive crouch on social issues, pollster Whit Ayres noted, reflects the fact that "Democrats have done a better job" with campaign communications. Republicans tried to regain advantage by casting the Hobby Lobby decision as being about religious freedom rather than the availability of contraception. But Democrats' aggressive response underscored their higher confidence (Harwood, 8/4).

Politico: Obamacare Opponents Seek Message To Drive Midterms
Three months before the mid-term elections, political operatives and activists are groping for an anti-Obamacare message that sticks -; or 57 of them. Republican pollsters tested nearly five dozen criticisms of the health care law with likely voters and listed the most effective messages to combat the law, as well as the ones that resonated best with target groups like seniors, tea partiers or independents (Cheney and Wheaton, 8/4).

ProPublica/The New York Times' The Upshot: The Obscure Drug With A Growing Medicare Tab
An obscure injectable medication made from pigs' pituitary glands has surged up the list of drugs that cost Medicare the most money, taking a growing bite out of the program's resources. Medicare's tab for the medication, H.P. Acthar Gel, jumped twentyfold from 2008 to 2012, reaching $141.5 million, according to Medicare prescribing data requested by ProPublica. The bill for 2013 is likely to be even higher, exceeding $220 million (Ornstein, 8/4).

ProPublica/The New York Times' The Upshot: Top Medicare Prescribers For Acthar Have Links To Its Maker
Many of Medicare's top prescribers of the expensive specialty drug H.P. Acthar Gel have financial ties to the drug's maker. Only 18 practitioners wrote 15 or more prescriptions for the drug in 2012. At least nine -; and all of the top four -; were promotional speakers, researchers or consultants for Questcor Pharmaceuticals, a ProPublica analysis shows (Ornstein, 8/4).

The Wall Street Journal's Pharmalot: What Will The New Hepatitis C Medicines Do To Medicare Part D?
In the latest salvo fired over the cost of hepatitis C treatments, a new report projects that the cost of these drugs – including the Sovaldi medication sold by Gilead Sciences – will increase 2015 federal spending by Medicare Part D between $2.9 billion to $5.8 billion (Silverman, 8/4).

The Associated Press: Community Health Paying $98M To Settle US Claims
Community Health Systems Inc. has agreed to pay $98 million to settle federal claims of improper billing by the hospital company. The Justice Department and Community Health announced the settlement Monday. The government alleges that the company admitted patients to the hospital when it wasn't medically necessary and then billed Medicare, Medicaid and the military's Tricare program for those inpatient services. Community Health should have billed for less costly outpatient or observation cases, the government said (8/4).

The Wall Street Journal: Tenet Healthcare's Loss Narrows As Admissions Increase
Tenet Healthcare Corp. said its second-quarter loss narrowed amid improved admissions that received a boost from the U.S. health-care policy overhaul. For the year, the hospital operator raised its projection for adjusted earnings before interest, taxes, depreciation and amortization to a range of $1.85 billion to $1.95 billion, from its previous estimate of $1.8 billion to $1.9 billion. Tenet in October completed its acquisition of Vanguard Health Systems Inc., a move that aimed to broaden its geographic reach (Stynes, 8/4).

Los Angeles Times: Study: Emergency Room Closures Can Be Deadly For Area's Residents
It stands to reason that when a hospital emergency room closes, people in the surrounding neighborhood suffer. But how much? A new study quantifies the impact in California, finding that patients affected by ER closures were 5% more likely to die after being admitted to a hospital than were patients who didn't lose an ER in their neighborhood (Kaplan, 8/4).

The New York Times: Abortion Providers In Texas Press Judge To Block Portions Of New Law
Owners of Texas abortion clinics asked a federal judge on Monday to block enforcement of stringent new building and equipment standards, set to take effect on Sept. 1, that they say could force more than half the state's remaining abortion clinics to shut down, leaving fewer than 10 across a sprawling state (Fernandez and Eckholm, 8/4).

Los Angeles Times: Federal Judge Rules Alabama Abortion Law Unconstitutional
A law that would have closed three of five abortion clinics in Alabama is unconstitutional, a federal judge ruled Monday, concluding in an extensive 172-page opinion that a "climate of extreme hostility" toward abortion already makes it difficult for doctors to perform and for women to access the procedure in the state (Semuels, 8/4).

Politico: Judge: Alabama Abortion Clinic Law Unconstitutional
A federal judge has blocked an Alabama law requiring abortion providers to obtain admitting privileges at a nearby hospital, making it the second such law to be ruled unconstitutional within a week. U.S. District Judge Myron Thompson issued an order Monday that temporarily blocks enforcement of the Alabama statute, which he said would place an undue burden on women seeking an abortion by forcing the closure of three of the state's five clinics. A federal appeals court issued a similar ruling last week on a Mississippi law, which would have shuttered that state's only clinic (Winfield Cunningham, 8/4).

The Wall Street Journal: Moody's: Medicaid Issue Puts New York State Rating At Risk
One of the nation's biggest credit-rating firms warned New York officials and investors Monday that the state's much-improved rating is at risk as the federal government tries to claw back nearly $1.3 billion in Medicaid payments. In its report published Monday, Moody's Investors Service MCO +1.39% said the potential Medicaid repayment is a "credit negative" for the state. The "repayment would result in an unwelcome drain on the state's cash balances," the report said, and future repayments would "pinch the state's liquidity" (Kravitz, 8/4).

The Associated Press: NYC To Pay $1M To Settle Medicaid Probe
Federal authorities say New York City has agreed to pay $1.05 million to settle allegations that the city's Human Resources Administration failed to stop Medicaid payments for health care coverage for beneficiaries who became ineligible (8/5).

The Wall Street Journal: Hospital Mergers In The New York Area Bring Cost Fears
Hospital takeovers are surging in the New York region, raising concerns that health costs could climb and care could change. In New York state, at least a dozen hospitals, many of them financially ailing, have become part of larger networks since 2011, according to the state Department of Health. More than a dozen have new owners or new affiliations in New Jersey during the same period as well (Dawsey, 8/4).

Los Angeles Times: Court Says Paid Caregivers Can't Sue If Injured By Alzheimer Patients
Home health workers hired to care for unruly Alzheimer's patients may not sue them or their families for injuries inflicted by the patients, the California Supreme Court decided Monday. In a 5-2 decision, the state's highest court said employers have no liability as long as the caregiver was warned of the risks and the injury was caused by symptoms of the disease. Workers voluntarily assume the risk of violent injury in caring for patients with the brain disease, the court said (Dolan, 8/4).