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March 18, 2019

VIRGINIA

Long-term-care insurers ask Virginia to approve huge premium hikes
(Virginian-Pilot – March 16, 2019)

Insurers are seeking increases of as much as 339.6 percent in the premiums they charge for long-term-care policies — the coverage many Virginians expect will pay for any nursing home bills or home health care. The companies, including Richmond-based Genworth Financial, moved aggressively into the business in the 1990s, but have long faced challenges pricing the product so that it generates enough of a pool of money to cover the ever-rising cost of long-term care. Now, insurers are asking the State Corporation Commission to grant them double- and triple-digit percent increases in their premiums. All in all, some 26 companies are seeking increases for 60 different policies.

Community Health Worker initiative gets national attention
(Danville Register and Bee – March 17, 2019)

The Community Health Worker project of the Dan River Region received national attention during a March 11 panel discussion at the annual South by Southwest Conference, held in Austin, Texas. The panel, “The Community Health Worker of the Future,” discussed how data projects, public/private partnerships and digital health tools have shaped the way that communities provide essential outreach, community education, informal counseling, social support and advocacy. Julie Brown, director of advanced learning at the Institute for Advanced Learning and Research, spoke as a panelist at the conference and shared how the Dan River Region program has benefitted the health and well-being of citizens and how it can serve as a model to other areas seeking enhanced health care access.

As Medicaid Changes, Local Families Struggle: Cuts impact ‘the most fragile in our Medicaid system’
(Fredericksburg Free Lance-Star – March 17, 2019)

The sign on the door tells visitors they’re at the home of a medically fragile child and would they please wash their hands, remove their shoes and use sanitizer upon entering—or not enter at all if they’re sick or have been around someone who is. “We appreciate your help in keeping our sweet girl healthy and germ-free,” reads the Welcome sign at the Louisa County home. Parents Amy and Shannon Fields are trying to keep 7-year-old Cary Lynn stable. They adopted the girl when she was 9 months old—just a “little butter bean”—her mom recalled, and she was about to be put in an institution because no one wanted to undertake her lifetime of care. One glance changed everything. “She opened her eyes and looked at us,” the mother said, “and we felt like she fit in our family.” Since then, Amy Fields has become her daughter’s caregiver, with help from personal care attendants paid for by Medicaid. Cary Lynn and Marvin, 11, who asked for a “baby scissor,” both receive Medicaid as all children adopted through Virginia agencies do. Their father, Shannon Fields, works in information technology for a supermarket chain based in Mechanicsville. Cary Lynn has “about a bajillion things going on,” her mother said, including cerebral palsy that’s taken away all body movement, fluid on the brain, visual impairment and mitochondrial disease. Her needs are so severe, she qualifies for placement in a nursing home. Yet as a result of recent changes, the amount of time Medicaid will pay attendants to help with her care has dropped from 80 hours to 49 hours a week. Similar reductions are happening statewide as the Virginia Department of Medical Assistance Services, which administers Medicaid, tries to cut costs.

Morgan Griffith: Real health reform still needed
(Augusta Free Press – March 16, 2019)

More than 10 years have passed since Barack Obama, then a senator from Illinois and a presidential candidate, promised at high school in Bristol that his health care plan would lower insurance premiums by an average of $2,500 per family. He became president and enacted Obamacare. Certainly, enough time has passed to judge whether his plan succeeded or not. Clearly, it has not. This fact is reiterated to me all the time by constituents frustrated by their ever-increasing premiums and copays. A study just released by the Kaiser Family Foundation provides yet more data indicating the high costs of health insurance.

Research at UVA Aims to Improve Treatment of Sleep Apnea
(WVIR – March 15, 2019)

Frequent snoring can lead to more serious problems, but professors at the University of Virginia may have found the cure to those sleepless nights. Haibo Dong started researching snoring and sleep apnea two years ago. He and two graduate students are using CT scans and MRIs to take images of the way the mouth and nose move when a person snores. If Dong and his colleagues can understand the sound and vibration behind snoring they say they could predict and eventually control it.

Virginia mother takes to Facebook to find kidney for her 12-year-old son
(Fox 61 – March 15, 2019)

A Virginia Beach mother running out of time and options hopes social media will help her son find a new kidney. Cory Clabon is only 12 years old, but his kidneys are functioning at less than 50 percent. Clabon’s mother, Jessica Josephine, says Cory was born with sickle cell disease. When he was 3 years old, he was also diagnosed with a rare kidney disorder. To treat the disorder, Josephine says Clabon has been receiving blood transfusion therapy. She says her family has spent much of Clabon’s life at the hospital. “We are there so much, they are like our family at CHKD.”

Class to help families of people diagnosed with mental illness
(Winchester Star – March 15, 2019)

The National Alliance on Mental Illness, Northern Shenandoah Valley affiliate, will sponsor the NAMI Family-to-Family Education Program specifically for families of persons diagnosed with serious mental illness.

Women with cancer invited to ‘Surviving with Laughter’
(Winchester Star – March 15, 2019)

Professional comedian and breast cancer survivor Joy Julian will be the keynote speaker at an evening of learning and laughter for women diagnosed with cancer. Valley Health and the American Cancer Society are hosting “Surviving with Cancer” from 5:45 to 8 p.m. March 29 at the Winchester Medical Center Conference Center. The free event includes a presentation by Dr. Devin C. Flaherty with Valley Health Surgical Oncology in recognition of Colorectal Cancer Awareness Month.

Virginia spends hundreds of millions every year on wasteful medical services. A study is looking to put a dent in that figure
(Virginia Mercury – March 14, 2019)

In 2017, Virginia clinicians provided $747 million worth of wasteful services to patients, according to the Virginia Center for Health Innovation. Those services ranged from ordering tests and images before low-risk surgeries to unnecessarily screening for vitamin D deficiencies.

Woman recovering from drug addiction founds social recovery group, Sober Friends
(Bristol Herald Courier – March 18, 2019)

Connie Pierce is going to jail. The 55-year-old with a history of drug dependency is scheduled to plead guilty to a drug charge April 15. Before they shackle her arms and legs, though, she’s determined to help others learn to live successful sober lives through a group she launched in February called Sober Friends.

Medical students at the University of Virginia and across the country are celebrating the next chapters of their lives.
(WVIR – March 15, 2019)

Video: Medical students at the University of Virginia and across the country are celebrating the next chapters of their lives.


OTHER STATES

Trump officials approve Ohio Medicaid work requirements
(The Hill – March 15, 2019)

The Trump administration on Friday approved Ohio’s request to impose work requirements on Medicaid beneficiaries, a sign that recent legal challenges have not slowed efforts to implement the controversial rules. Starting in 2021, Medicaid beneficiaries ages 19 through 49 in Ohio will need to work, attend school, volunteer or attend job training for at least 80 hours a month to remain in the health care program. Beneficiaries who do not meet the requirements for 60 days will lose their coverage. Unlike other states, people who lose coverage in Ohio will be allowed to immediately reapply for enrollment.

Judge Vows To Rule On Medicaid Work Requirements By End Of March
(Kaiser Health News – March 14, 2019)

The federal judge who shot down a Medicaid work requirement plan last June remained deeply skeptical Thursday of the Trump administration’s renewed strategy to force enrollees to work. U.S. District Judge James Boasberg, who last year blocked Kentucky’s work requirement, heard testimony on a revised federal approval. He also had a hearing on Arkansas’ Medicaid work requirement — which took effect last July and has led to 18,000 Medicaid enrollees losing coverage.

Senate advances bill that could eliminate Medicaid work requirement in NH
(New Hampshire Union Leader – March 14, 2019)

The Senate on Thursday voted to move forward with a bill that would weaken, and potentially eliminate, the work requirement for Medicaid expansion recipients. The measure has angered many Republicans, who see it as a betrayal of a compromise reached during the last Legislative session. While most states with GOP majorities chose not to expand Medicaid under the Affordable Care Act, the Republican-controlled New Hampshire House and Senate voted last year to extend the Medicaid expansion, which provides coverage to 50,000 people, for another five years. A key factor for Republicans at the time was the addition of a requirement that certain able-bodied Medicaid recipients complete 100 hours of work, community service, or other eligible activities each month in order to maintain their health care.

Mental health program being tried in Missouri gets support from Roy Blunt
(St. Louis Post-Dispatch – March 16, 2019)

Sen. Roy Blunt of Missouri and a bipartisan group of co-sponsors are pushing to extend a federal pilot program that mental health professionals say has transformed the way they deal with people suffering from behavioral health and addiction crises. “What we have been able to accomplish,” said Laura Heebner, executive vice president of Missouri’s Compass Health Network, “has been nothing short of astonishing.” But federal support for the “Excellence in Mental Health and Addiction Treatment Expansion Act” begins running out in April for two states, and in July for Missouri and five other states that are part of a $1 billion pilot project.

Bill would use tax returns to identify and help Marylanders without health insurance
(Baltimore Sun – March 14, 2019)

Maryland would use state tax forms to identify uninsured residents and refer them to options for no-cost or low-cost health care under a bill moving forward in the General Assembly. The bill, if approved, would add a question on state tax returns asking taxpayers if they have health insurance. Those who answer that they don’t have health insurance would be referred to the state’s Medicaid program or the health exchange, where individuals can buy health insurance plans.

Effort to tamp down surprise ER bills faces trouble in Georgia House
(Atlanta Journal-Constitution – March 14, 2019)

The Georgia Legislature appears set to go another year without passing legislation addressing surprise billing, leaving Georgia hospital patients to face potentially thousands of dollars in unexpected doctor bills. Senate Bill 56, a proposal that aims to protect properly insured patients who go to emergency rooms from receiving additional surprise doctor bills after the fact, was debated Thursday before a Georgia House Insurance subcommittee. But the panel ended its meeting without taking a vote. Its chairwoman, state Rep. Darlene Taylor, R-Thomasville, said she didn’t know whether she’d be able to find the time or schedule a room by the end of the legislative session to take a vote.


MISCELLANEOUS

State Legislators May Write a Short-Term Health Model
(Think Advisor – March 14, 2019)

State lawmakers with an interest in insurance may write their own short-term health insurance model law. The National Council of Insurance Legislators (NCOIL) has put the short-term health insurance issue on its agenda for its spring meeting, in Nashville, Tennessee. NCOIL started the four-day meeting today. The group’s Health Insurance and Long Term Care Issues Committee has put a short-term health insurance item on the schedule for a session set to take place Friday afternoon.

Updated CMS drug dashboards shows prescription price hikes sustained by Medicaid, Medicare
(Fierce Healthcare – March 15, 2019)

One of the drugs paid for by Medicaid plans with the largest price growth in five years is a $5,000-per-unit medication for sore throats. Average spending per dose of Cepacol Sore Throat grew nearly 1,000% from $493 in 2016 to $5,000 in 2017, according to updated Centers for Medicare & Medicaid Services drug dashboards released on Thursday. At a total Medicaid spending of about $34,000, the drug manufactured by Reckitt Benckiser was but a tiny blip in the overall spending by the federal healthcare program last year.

The 3 Biggest Threats Healthcare Data Security is Facing Right Now
(Read Write – March 14, 2019)

The year 2017 suffered the greatest ransomware attack in the history of the internet. The WannaCry ransomware detected in hospitals of the UK. It then exploded across the globe and affected more than 200,000 computers across 150 countries. This attack targeted the computers running with the Microsoft Windows operating system by encrypting data and demanded a ransom payment in bitcoin currency. This cyber attack damaged the global economy by billions of dollars. Moreover, there were around 2181 healthcare breaches, between 2009 to 2017 and each one of them has compromised at least 500 records, according to HIPPAJournal.com. These breaches have entirely exposed 176 million healthcare records, which is roughly half of the population of entire America. The numbers illustrate that cybersecurity is a major issue in the healthcare sector and that it should be the top priority of the industry to implement security measures and take steps towards the protection of data.

Nursing Home Fines Drop As Trump Administration Heeds Industry Complaints
(Kaiser Health News – March 15, 2019)

The Trump administration’s decision to alter the way it punishes nursing homes has resulted in lower fines against many facilities found to have endangered or injured residents. The average fine dropped to $28,405 under the current administration, down from $41,260 in 2016, President Barack Obama’s final year in office, federal records show. The decrease in fines is one of the starkest examples of how the Trump administration is rolling back Obama’s aggressive regulation of health care services in response to industry prodding.

Azar calls out ‘absurdity’ in Medicare wage index
(Modern Healthcare – March 14, 2019)

HHS Secretary Alex Azar on Thursday acknowledged “absurdity” in the Medicare wage index after several senators complained about wide disparities in payments between states. During a Senate Finance Committee hearing, Azar said HHS is seeking comments on a revision to the entire wage index system but cautioned that HHS can only change the index so much on its own. Sen. Sheldon Whitehouse (D-R.I.) complained that hospitals in his state have a lower wage index compared to hospitals in nearby states, saying it “boggles his mind” why his local hospitals would get a 20% hit compared to those in Connecticut.

Rate of dementia deaths in US has more than doubled, CDC says
(Atlanta Journal-Constitution – March 14, 2019)

A new report from the National Center for Health Statistics has found the rate of deaths linked to dementia has more than doubled over the past two decades. Based on nationwide death certificate data — which scientists with the Atlanta-based Centers for Disease Control and Prevention note “underrepresent the true death rate from Alzheimer’s and other dementias” — the disease was found as the primary cause of 261,914 deaths in 2017, up from 84,000 deaths in 2000.

Mental health problems are on the rise among American teens and young adults
(Los Angeles Times – March 14, 2019)

You can call the generation of young Americans now working their way to adulthood Generation Z, because they follow Generations X and Y. You can call these 14-to-27-year-olds “iGen,” after the wireless devices that seem permanently affixed to their persons. And if they’re your kids and still living with you, you can even call (or text) them late for dinner. What you can’t call them, according to new research, is happy.

A Rise In Depression Among Teens And Young Adults Could Be Linked To Social Media Use
(NPR – March 14, 2019)

A study published Thursday in the Journal of Abnormal Psychology finds the percentage of U.S. teens and young adults reporting mental distress, depression and suicidal thoughts and actions has risen significantly over the past decade. While these problems also increased among adults 26 and older, the increase was not nearly as large as among younger people.

Rural nursing homes face closure as occupancy wanes
(Modern Healthcare – March 14, 2019)

Rural skilled-nursing facility occupancy levels continue to decline, making them susceptible to closure or consolidation, researchers at the National Investment Center for Seniors Housing & Care said. While average occupancy levels in urban and rural areas have relatively stabilized over the past year, there is still a significant gap between the two at 83.7% and 80.4% as of the fourth quarter of 2018, NIC data show. Skilled-nursing facilities in rural and urban areas were around 87% full in 2012.

How Accountable Care Organizations Can Prepare for Downside Risk
(Rev Cycle Intelligence – March 14, 2019)

Accountable care organizations (ACOs) are part of the foundation of the healthcare industry’s transition to value-based care and purchasing. Since the passage of the Affordable Care Act (ACA), ACOs have realized clinical and financial improvements. Organizations in the Medicare’s largest ACO program average a quality performance score north of 90 percent, and CMS estimates that the program saved about $954 million from 2013 through 2015. However, the federal government says ACOs could do more to reduce costs and improve care quality. And the organizations can achieve the goals through downside financial risk. ACO programs with higher financial risk levels compared to the MSSP are generating greater savings.

Amazon-Berkshire-JPM’s Haven hires clinical strategy leader
(Healthcare Dive – March 15, 2019)

Haven, the Amazon-Berkshire Hathaway-J.P. Morgan Chase joint healthcare venture, has hired Sandhya Rao as vice president of clinical strategy, CNBC first reported and Healthcare Dive confirmed. Rao, who previously served as senior medical director for Partners Population Health, will join Haven CEO Atul Gawande and a fledgling staff tasked with improving healthcare for the three companies’ 1.2 million employees.

Quality varies wildly among affiliates linked with US News top hospitals, JAMA study finds
(Healthcare Dive – March 14, 2019)

Choosing to have surgery at a facility affiliated with a highly rated U.S. hospital doesn’t guarantee the same quality experience, a new study in JAMA Surgery finds. In an analysis of hospitals affiliated with U.S. News & World Report Honor Roll hospitals, surgical outcomes varied widely both within and across networks.

MedPAC wants to boost Medicare acute-care hospital payments 2.8%
(Modern Healthcare – March 15, 2019)

Medicare payment advisors are expected to call on Congress to boost payments to hospitals by 2.8%, with some of the raise going to fund a revamped quality program. The Medicare Payment Advisory Commission made the recommendation in its March report to Congress expected to be released on Friday, the executive director of the commission said. It is rare for MedPAC to call for a payment above current law, but the panel was concerned that high-quality hospitals were losing money under Medicare.


REFORM

Editorial: Medicare for All isn’t the only way to go
(Modern Healthcare – March 16, 2019)

Healthcare providers and insurers are gearing up to oppose Medicare for All. No surprise there. Insurers can’t look kindly on legislation that would put them out of business. And providers are deathly afraid of losing the high rates from private insurers that cross-subsidize government-funded patients. But at the same time as they mobilize to defeat M4A, shouldn’t they be outlining what they support?

House Scrutiny of Obamacare Suit Lags Behind Health Legislation
(Bloomberg Law – March 14, 2019) SUBSCRIPTION REQUIRED

Scrutiny of the Trump administration’s decision not to defend Obamacare in a lawsuit has gotten little public attention from House Democrats even as key lawmakers say it is still a top priority. House Energy and Commerce Chairman Frank Pallone Jr. (D-N.J.) said at a March 12 hearing that the inquiry into the administration’s decision is the “No. 1 investigative priority” for his panel.

Azar says HHS talking with states interested in Medicaid block grants
(Fierce Healthcare – March 14, 2019)

The Trump administration has been in talks with states that are interested in rolling out Medicaid block grant programs, Health and Human Services Secretary Alex Azar said Thursday. The HHS head was testifying before the Senate Finance Committee to stump for the White House’s 2020 budget proposal—which includes a call for Medicaid to be restructured into a block grant program nationwide—and said some states have inquired about block grants or per capita caps during discussions about Medicaid waivers. Azar said he wasn’t sure how many states were involved in these talks.

MACPAC to Congress: Roll out DSH cuts first in states with unspent funds
(Fierce Healthcare – March 15, 2019)

Medicaid and CHIP Payment and Access Commission has submitted its latest report to Congress, calling for legislators to consider tweaking federal law to roll out payment cuts to safety-net hospitals first in states that already have unspent money. In the report, MACPAC recommends that Congress amend the Social Security Act to direct the Department of Health and Human Services to apply the cuts first in states with a pot of unspent disproportionate-share hospital funds, as that could make the transition easier for impacted providers. Congress should also consider changing existing law to allow DSH payments to more effectively confirm to the need of each state’s population, MACPAC said.