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USHL NEWS & Updates

On March 5, 2014, CMS announced that it would allow insurers to extend some health plans until October 2016 even if the plans do not meet new healthcare reform standards.

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The USHL Metal Plan lineup is now available for Indiana groups.

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Standard Analytical Service, Inc. (SAS), publishers of independent insurance reports, recently released its 2014 annual comparative report of the 25 leading domestic health insurance providers. USHL received a favorable ranking.

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USHL recently introduced its Wellness Resources Center, a convenient one-stop health and wellness information library on the USHL website which visitors can reference for a variety of objectives.

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  • Appeals Court Weighs Texas Abortion Law

    NEW ORLEANS -- A federal appeals court in New Orleans is reviewing whether 11 clinics that provide abortion in Texas must immediately close their doors because they don’t comply with a state law requiring that they meet all the standards of an outpatient surgical center.

    Sandy Jones, left, an activist with Stop Patriarchy and Amelie Hahn and Michelle Colon, from Pink House Defenders, traveled to New Orleans to protest the abortion law (Photo by Carrie Feibel, KUHF).

    A three-judge panel heard arguments this morning for more than 90 minutes, first from the Texas solicitor general and then from a lawyer with the Center for Reproductive Rights, representing many of the Texas clinics. The questions from the judges centered mainly on what constitutes an “undue burden” when a woman is trying to get an abortion, and what fraction of Texas women would be affected.

    Advocates say that about 20 abortion clinics in Texas have already closed in advance of the law; if the court rules in Texas’s favor, fewer than 10 clinics that provide abortion would remain in a state with a population of 26 million.

    Both sides agreed that if the 11 clinics close, women in the Rio Grande Valley would have to travel more than 200 miles to San Antonio to get an abortion under the new law. But Jonathan Mitchell, the Texas solicitor general, said there was no good evidence that women weren’t figuring out how to deal with that and no evidence that if the abortion rate in Texas had fallen, that it was related to the law.

    “An abortion law cannot be enjoined based on conjecture,” Mitchell said. Judge Jennifer Elrod questioned him about a clinic’s survey of 20 patients presented at the trial in August. An expert testifying for the clinics said one patient surveyed said she did not get an abortion after the law, known as HB2, went into effect.

    “He did not report she was unable to get it, he did not report she encountered an undue burden,” Mitchell answered. “She could simply have changed her mind.”

    Furthermore, patients in El Paso, where another clinic might close because it is not an ambulatory surgical center, could just travel to New Mexico for an abortion, Mitchell added.

    Stephanie Toti with the Center for Reproductive Rights argued on behalf of affected clinics such as Whole Woman’s Health. She says lots of evidence was presented at the trial last month that women were facing numerous burdens exercising their constitutional right to an abortion. For example, a San Antonio clinic had offered women in the Rio Grande Valley who were seeking abortions free bus passes to help them travel north. But the patients told the clinic it wasn’t just the distance and money, but the problems with child care, time off work, and explaining to family why they were going so far.

    Toti said a promontora, a health outreach worker, testified at the trial that women were experiencing obstacles due to the clinics closing in Rio Grande Valley. “She says she personally observed women turning to illegal means to get an abortion,” Toti told the judges.  

    In a rebuttal, Mitchell called that testimony “vague” and says the promontora couldn’t give specific numbers of women doing that and couldn’t provide evidence that those choices were related to the effects of HB2.

    The three judges did not indicate when they would decide, but if the decision goes for state of Texas, the clinics would probably close immediately. The judges could also decide that some of the most isolated clinics could remain open, while others must close.

    Federal district Judge Lee Yeakel ruled in August that the surgery center regulation had no health benefit and would place numerous burdens on women seeking care, especially if they lived in the Rio Grande Valley and west Texas. Yeakel allowed the non-complying clinics to remain open, but the state asked for an emergency motion to overrule that and close them. The three judges did not indicate when they would decide.

    Mitchell told the panel the state of Texas has a compelling interest in closing clinics that it deems unsafe, and that’s why the state sought an emergency motion to stay Yeakel’s decision.

    “If there is a Kermit Gosnell-type clinic in a state, and that’s the last clinic in the state, I think everyone could agree that clinic could be shut down,” Mitchell said, referring to a notorious abortion doctor convicted of murder in Philadelphia.

    Outside the hearing, reproductive rights protesters carried signs.

    Bethany van Kampen, a lawyer and board member of the New Orleans Abortion Fund, attended the hearing. She said it seemed that the judges were asking very hard questions of Toti.

    “It’s a bit discouraging,” she said. “It felt very targeted. I felt our line of questioning was harder and more difficult, and I think we tried to do our best."

    Sandy Jones, an activist with Stop Patriarchy, traveled from Houston to attend. She said it seemed the judges had too narrow of a focus.

    “These are forces that are determined to criminalize every abortion, every woman and make it inaccessible to every woman,” Jones said. “And birth control as we know is not far behind. This is a war on women; this is a state of emergency.”

    Abortion opponents had also traveled from Austin and Fort Worth to listen.

    “It’s hard to say how this will go,” said Emily Horne, a legislative associate for Texas Right to Life.

    She said there was a need for Texas to seek this emergency hearing to shut down the non-complying clinics right away. “It is a direct safety measure for the health and safety of Texas women, so we think that sooner is better to implement that,” Horne said.

    Horne said it was exciting to be there, and important for all states, not just Texas.

    “Texas is definitely setting some precedents as far as what states are being allowed to pass, so there is a lot that does hinge on this,” she added.

  • State Decisions Impact How Residents Fare Under Obamacare

    The report by a Yale University economist found it difficult to generalize about the health law's impact because it varies greatly state by state.

    The Washington Post’s Wonkblog: Measuring The Impact Of States’ Obamacare Decisions
    The early story of the Affordable Care Act can be challenging to generalize sometimes because so much of it depends on decisions made at the state level — both before and during implementation of the ACA. Did states defer to a federal-run exchange, or did they set up their own? In the states that built their own insurance marketplaces, did the Web site actually work? Did they expand Medicaid programs to low-income adults? Did they temporarily let people keep their old health plans? (Millman, 9/11).

    The Wall Street Journal’s Real Time Economics: Obamacare Participants Worse Off, But Don’t Blame Washington — Blame States, Paper Says
    The president’s health-care law has made participants in most states worse off, but the result may reflect decisions made in state capitals, not the broader policy, a new study from a Yale University economist found. The average enrollee in a health plan made available under the Affordable Care Act saw individual welfare decline in 35 states, according to the study Amanda Kowalski presented Thursday at the Brookings Institution in Washington. The report found the majority of those states either handed over at least part of the rollout to the federal government or were crippled by technology glitches (Morath, 9/11).

  • Groups Get $3.2 Million To Enroll Minorities In Obamacare

    Federal health officials award grants to 13 community organizations to sign up racial and ethnic minorities in health plans through online insurance marketplaces. Meanwhile, a group of South Florida hospitals raises money to help low-income patients pay their insurance premiums, and Massachusetts details plans to re-enroll 450,000 residents.

    The Hill: HHS Pledges More Funds To Enroll Minorities In Obamacare
    Federal health officials announced $3.2 million in new funding to help racial and ethnic minorities enroll in health coverage under ObamaCare.  The Department of Health and Human Services (HHS) and the Office of Minority Health awarded grants to 13 organizations that will help educate and encourage minority communities to sign up for health plans through the marketplaces. The grantees — which include universities, community health centers, nonprofits and charities — fall under the Partnership to Increase Coverage in Communities (PICC), an initiative devoted to increasing minority enrollment in health insurance (Hill, 9/11).

    WBUR: How Mass. Plans To Re-Enroll 450,000 Residents In Health Insurance
    All of the estimated 450,000 Massachusetts residents who get health insurance through the Health Connector or MassHealth — some of whom have been in a confusing phase of temporary coverage this year — will soon begin the process of applying for coverage for 2015. If the state's new health insurance website is up and running — which the Patrick administration promises it will be — then residents will be able to beginning applying online Nov. 15. If the website still isn't working, or using a computer isn't convenient, then you’ll have to fill out a paper application (Bebinger, 9/11).

    The Associated Press: Hospitals Mull Paying Patient Insurance Premiums
    A group of South Florida hospitals is trying to raise $5 million to donate to a foundation that would pay one year's worth of health insurance premiums for thousands of low-income consumers who bought insurance under the Affordable Care Act. But insurance companies bristle at the idea, saying it poses a conflict of interest. It's an effort to keep consumers covered and ensure hospitals get paid for treating them, said Linda Quick, president of the South Florida Hospital and Healthcare Association. It's unclear whether the program will be ready when open enrollment begins in November, but it should be ready before the enrollment period concludes in February (Kennedy, 9/11).

    Related KHN coverage: Hospitals Seek To Help Consumers With Obamacare Premiums (Appleby, 8/14).

  • Flaw In Federal Software Lets Employers Offer Plans Without Hospital Benefits, Consultants Say

    A flaw in the federal calculator for certifying that insurance meets the health law’s toughest standard is leading dozens of large employers to offer plans that lack basic benefits such as hospitalization coverage, according to brokers and consultants.

    The calculator appears to allow companies enrolling workers for 2015 to offer inexpensive, substandard medical insurance while avoiding the Affordable Care Act’s penalties, consumer advocates say.

    Insurance pros are also surprised such plans are permitted.

    Employer insurance without hospital coverage “flies in the face of Obamacare,” said Liz Smith, president of employee benefits for Assurance, an Illinois-based insurance brokerage.

    At the same time, a kind of catch-22 bars workers at these companies from subsidies to buy more comprehensive coverage on their own through online marketplaces. No federal tax credits for health coverage are available to people with workplace plans approved by the calculator.

    The calculator is used by self-insured employers, which include most large firms.

    Like insurance companies, self-insured employers must certify that their plans pass health-law standards for consumer value.

    One official way to do that is to get a passing score on the Department of Health and Human Services’ “minimum-value” calculator, an online tool.

    An employer checks boxes on the screen indicating what benefits are offered —such as hospitalization, mental health care and pharmacy coverage — as well as workers’ share of the cost. The calculator then determines if the plan covers enough potential medical costs to be considered adequate insurance.

    “There are a lot of errors in the calculator,” said Shannon Demaree, director of actuarial services at Lockton Companies, a large broker. “It allows more plans to pass as qualifying coverage than we believe really do.”

    It’s unclear which companies, or how many, are offering calculator-approved coverage without hospital benefits.  Retailers, temp agencies and other lower-wage employers that haven’t traditionally offered comprehensive insurance are the most likely to sign up, brokers say.

    “There is very high interest” among Lockton’s clients, Demaree said.

    Some 35 employers working with Assurance plan to offer such coverage, said Smith. The American Worker Plans, another Illinois firm, is advising about 30 companies considering one, said Jon Duczak, the company’s senior vice president.

    While they offer such plans because employers ask for them, Assurance and The American Worker Plans said they are cautioning them about their use. They did not identify the employers.

    HHS is aware of potential problems with the calculator but has not changed it, said industry authorities.

    “I think they were somewhat naïve in not realizing that people were going to game the heck out of it,” said Hobson Carroll, an independent actuary who works closely with self-insured employers. “I’ve got to believe they’ve been getting input from all over” on revising it, he added.

    Concerns Raised

    Cori Uccello, a senior fellow at the American Academy of Actuaries, a trade group for insurance risk experts, said “several members” have raised “potential issues” about HHS’s software.

    “Any inaccuracies in the MV calculator would be of concern,” she said, without elaborating. “We made informal inquiries to appropriate agencies.”

    HHS, which developed the calculator, referred queries about it to the Treasury Department, which it says is responsible for ensuring plans meet value standards. Treasury referred a reporter back to HHS.

    Intended to discourage coverage that leaves workers vulnerable to large medical costs, the calculator is an official yardstick for determining whether plans meet a “minimum value” of benefits, the most stringent health-law standard for employers.

    Passing the calculator test shields an employer from getting fined as much as $3,000 per worker next year, lawyers say.

    Instead of buying a commercial medical plan, employers that self-insure assume most of the risk of covering worker health costs. They generally outsource the design of the insurance and the administration of claims, however.

    Problems For Workers

    The average inpatient hospital bill is more than $10,000. But for workers, the plans’ disadvantages go beyond the lack of hospital benefits.

    The availability of company-sponsored, calculator-approved coverage at a certain price disqualifies them from getting tax credits that could help pay for better coverage through an online marketplace, said Sabrina Corlette, project director at Georgetown University’s Center on Health Insurance Reforms.

    “Employers who offer these types of plans as the only option for their employees really need to search their consciences,” she said.

    Next year, large employers face penalties for the first time for not providing qualified insurance. Benefits experts stressed that most will offer traditional coverage including hospitalization.

    But temporary staffing firms are especially interested in lower-value plans that may not include hospitalization, said Brian Robertson, executive vice president at Fringe Benefit Group, which recently bought the The American Worker Plans.

    “They are being forced into this game kicking and screaming and they’re trying to figure out, ‘What is my lowest cost to comply?’” with the health law, he said.

    Key Benefit Administrators, which designs coverage and handles claims for what it says are more than half a million members, offers a minimum-value plan to self-insured employers that lacks inpatient hospital benefits, according to documents on Assurance’s website.

    Key’s design “meets the… actuarial value requirement” measured by the calculator and immunizes employers from paying all health-law penalties for insufficient coverage, the promotional materials say.

    The plan’s total cost of about $200 per month per worker is about half the price of similar coverage with hospital benefits, experts said. Offering such coverage might cost an employer little or nothing to satisfy the health law.

    That’s because, under ACA affordability rules, workers must be asked to pay no more than 9.5 percent of family income for coverage. So companies could fulfill ACA obligations even if they required employees making more than about $25,000 a year to pay the full, $200-a-month cost.

    Confidentiality agreements with customers prohibit Key from commenting on the plan, said Wallace Gray, the company’s general counsel.

    Edward Lenz, senior counsel at the American Staffing Association, a trade group for temp and recruiting firms, argued that the calculator works as HHS intended.

    “I think they knew what they were doing and were trying to avoid placing unreasonable constraints on large employers,” he said.

    Neil Trautwein, the top benefits lawyer at the National Retail Federation, said he was unaware of employers offering supposedly minimum-value plans without hospital benefits. He doubted such plans would pass the minimum-value test. 

    “I would say that any policy that proposes to satisfy that without hospitalization coverage is pure fantasy,” he said.

    Flunking The Test

    But such policies can, say insurance pros who have tested Key’s plan and similar coverage on the government software.

    “We’ve had a million different attorneys check this out,” Assurance’s Smith said of Key’s design. According to HHS’ standards, “it does meet all the criteria to be a compliant plan,” she said.

    But when Lockton tested such plans on a calculator used by the private sector, they flunked.

    To meet the health law’s minimum value threshold, self-insured coverage must pay for at least 60 percent of expected medical costs in a typical plan. (Members pay the rest in deductibles, copays and other out-of-pocket expense.)

    In Lockton’s analysis, one plan with no hospital benefits being promoted as health-law compliant scored 63 percent on HHS’ calculator — slightly above the minimum. But the industry calculator gave the same plan a value of only 47 percent — far below the 60 percent level needed to qualify as adequate, Demaree said.

    “All of their [Lockton’s] concerns are definitely concerns that we’ve had,” said Assurance’s Smith.

    Minimum-value plans lacking hospital coverage are different from “skinny plans,” another kind of limited-benefit plan offered by lower-wage firms such as retailers and staffing companies. 

    Employer-sponsored skinny plans come with preventive-care benefits and little else. Consumer advocates were surprised to learn last year that skinny plans fulfill one ACA requirement for employers, which is to provide “minimum essential coverage.”

    Failure to offer minimum essential coverage can cost employers $2,000 per worker.

    Advocates hoped that the tougher requirement — for calculator-approved minimum value — would still induce many of these same employers to offer more-comprehensive insurance.

    But concerns about the calculator mean that the minimum-value standard may also be weaker than believed.

    People offered employer-sponsored, minimum essential coverage are still eligible for subsidies to buy insurance through an online marketplace. But workers offered calculator-certified, minimum-value coverage are not.

    Several consultants said they wouldn’t be surprised to see revisions in the minimum-value calculator — if not this year, then next.

    “We tell people: ‘Do not rely on the minimum value calculator,’” said Lockton’s Demaree. Brokers are selling a plan “based on the fact that it passes through the MV calculator,” she added. “And that’s when we come in and say, ‘Well, it does, but for how long?’

  • Health Value Of Apple's Watch Questioned

    Health care professionals say there is little evidence the new watch surpasses gadgets already on the market, although more health features may be in store, Reuters reports. Meanwhile, The Associated Press examines tensions between Silicon Valley tech giants and government regulators.

    Reuters: Health Developers, Doctors Want To See More From Apple's Watch
    Technology pundits were quick to predict the demise of most fitness wristbands and smartwatches when Apple Inc launched its Apple Watch. But healthcare professionals and fitness junkies were left wanting to see more. Observers say there is little evidence for now that the device's fitness capabilities surpass the competition. Others, hoping for groundbreaking health features from a company whose Chief Executive Officer Tim Cook spoke of how sensors are "set to explode," were left wondering what's in store for the product. Two people familiar with Apple's plans told Reuters the company is planning to unveil richer health features and additional sensors in later versions, the first iteration not hitting the market until early 2015(Farr, 9/11).

    The Associated Press: Silicon Valley Struggles To Speak FDA’s Language
    Silicon Valley is pouring billions into gadgets and apps designed to transform health care. But the tech giants that have famously disrupted so many industries are now facing their own unexpected disruption: regulation. Before tech companies can turn America's smartphones into portable medical suites, they must meet the rigorous standards of the Food and Drug Administration ... "This is a culture war," says Steve Grossman, a longtime FDA consultant to companies. "Silicon Valley is used to just bringing their products straight to the market and any regulatory scheme that involves scrutiny and delay is alien to them”  (Perrone, 9/12).

    The Associated Press: 23AndMe CEO Navigates Health Regulation
    No Silicon Valley company better embodies the promise and the pitfalls of working in health care than DNA testing firm 23andMe. ... CEO Anne Wojcicki laid out a bold plan to make genetic testing affordable to the general public, while simultaneously building a massive archive of DNA results for use in medical research. More than 700,000 people have used the company's test kit ... But last November, the Food and Drug Administration ordered the company to stop marketing its personalized health reports, which purported to tell customers if they were genetically predisposed to more than 250 diseases and medical conditions. Now, 23andMe is working to win FDA clearance for its health tests one at a time, a process that will take years. Wojcicki spoke to The Associated Press about operating under FDA oversight and the future of her company (Perrone, 9/11).

    Also, companies mining health data spur privacy concerns -

    Bloomberg: Did You Know You Had Diabetes? It's All Over The Internet
    Dan Abate doesn't have diabetes nor is he aware of any obvious link to the disease. Try telling that to data miners. The 42-year-old information technology worker's name recently showed up in a database of millions of people with "diabetes interest" sold by Acxiom Corp., one of the world's biggest data brokers. One buyer, data reseller Exact Data, posted Abate's name and address online, along with 100 others, under the header Sample Diabetes Mailing List. ... Tapping social media, health-related phone apps and medical websites, data aggregators are scooping up bits and pieces of tens of millions of Americans’ medical histories. Even a purchase at the pharmacy can land a shopper on a health list (Pettypiece and Robertson, 9/11).

  • OTC Birth Control Issue Triggers Debate, Campaign Ads

    Planned Parenthood Votes is stepping into the fray with new ads arguing that a policy now being embraced by some GOP candidates -- over-the-counter availability of birth control pills -- is more expensive for women.

    NPR: Changing Tack, GOP Candidates Support Better Access To Birth Control
    A string of Republican candidates for Senate are supporting an issue usually associated with Democrats: increased access to contraception (Liasson, 9/12).

    Politico Pro: Planned Parenthood Fires Back With $900K Ad Buy In Colorado, North Carolina
    Planned Parenthood Votes will launch its first TV ads of the year today, a nearly million-dollar buy aimed at countering Republican Senate candidates who recently embraced making oral contraception available over the counter and boosting Democratic incumbents Kay Hagan and Mark Udall. The group casts this proposal, newly popular with some GOP candidates, as more expensive for women with a $500,000 buy in the Raleigh, N.C., market and a $400,000 buy in the Denver market (Hammon, 9/12).

    Also in the news -

    Kaiser Health News: Capsules: Apparent Retail Glitch Triggers Copays For Birth Control
    CVS Health is investigating a potential glitch in its drug pricing system that appears to have charged women copayments for prescription birth control – though the scope of the error remains currently unclear. The problem came to the attention of Rep. Jackie Speier, D-Calif., after one of her staffers attempted to buy generic prescription birth control in Washington D.C. and was charged a $20 copay (Luthra, 9/11).

  • House Approves Bill To Extend Some Plans That Don't Meet Health Law Standards

    The legislation would allow people to use the once-canceled policies through 2018. However, the measure is not expected to get a vote in the Senate.

    Politico: House Returns To Anti-Obamacare Votes
    House Republicans on Thursday returned to the Obamacare well for another vote against the law, this time to allow consumers to stay on once-canceled plans until 2019. The House approved the bill, 247-167, with the support of all Republicans and 25 Democrats. It was the first vote on the health care law since April (Haberkorn, 9/11).

    Modern Healthcare: House Backs Bill Extending Small-Group Plans That Violate ACA
    Legislation that would allow insurers to continue selling small-group plans that don't comply with the coverage requirements of the federal health care law through 2018 cleared the House with bipartisan support on Wednesday. But there is practically no chance the proposal will be taken up this year by the Democratic-controlled Senate (Demko, 9/11).

    CBS News: Rob Portman: Obamacare Repeal Still Atop Senate Republicans’ To-Do List
    Sen. Rob Portman, R-Ohio, vice chairman of the National Republican Senatorial Committee, said Thursday that if Republicans take the Senate in November, he suspects that repealing President Obama's signature Affordable Care Act will be a policy priority. "I suspect we will vote to repeal early -- to put on record the fact that we Republicans think it's a bad policy and we think it's hurting our constituents," he said at a Christian Science Monitor breakfast. "We think health care costs should be going down, not up. We think people should be able to keep insurance that they had. We're worried about the fact that the next shoe to drop is going to be employer coverage” (Alemany, 9/11).

    The Wall Street Journal’s Washington Wire: Portman: Four Things A GOP Senate Could Do Quickly
    Another early item on a GOP Senate’s agenda is oft-debated legislation to repeal the 2010 health care law, Mr. Portman said, but he hoped that it would be followed by other measures to replace the law with other health measures. President Obama, in fundraising events for Democrats this year, has made a big plea for keeping the Senate in Democratic hands to keep a check on Republican obstructionism (Hook, 9/11).

  • State Highlights: Ga. Delays Nursing Home Rate Hike

    A selection of health policy stories from Georgia, California, Texas, Minnesota, Colorado, Ohio, New York, Illinois and Florida.

    CQ Healthbeat: States Push For Delay In Wage Protections For Home Care Workers
    State officials that argued against providing overtime and minimum wage protections to the nation’s 2 million home care workers are asking the Department of Labor to push back a Jan. 1 start date for the policy to take effect. State Medicaid officials concerned that their costs will rise are asking for a delay and tweaks to the policy, even though the Centers for Medicare and Medicaid Services finalized the rule a year ago. A final rule is often the best opportunity for major revisions to a proposed policy before it takes effect. The Department of Labor regulation guarantees federal labor protections to workers who help seniors and people with disabilities live in their homes. Home care workers had been exempt from those protections because their jobs were classified in the same category as babysitters. The rule affects workers who help elderly or frail people with activities such as dressing, eating meals, bathing, and taking medication, among others (Adams, 9/11).

    Atlanta Journal-Constitution: State Stalls Obscure Nursing Home Rate Hike
    The head of the state’s community health agency on Thursday pulled from consideration a special reimbursement increase for select nursing homes that would have rewarded some of Georgia’s biggest campaign donors (Salzer, 9/11).

    Georgia Health News: Nursing Home Rate Change Put On Hold
    A health agency commissioner Thursday pulled off the table a controversial rate change that would benefit the state’s nursing home industry. It was designed to pay extra money to companies that bought Georgia nursing homes between Jan. 1, 2012, and June 30 of this year, because of the costs that new owners bear in upgrading the facilities. Clyde Reese, commissioner of the Department of Community Health, told the agency’s board that he wants to spend more time reviewing the rate hike. The payment idea, Reese said, has “definite merit.’’ But he said he would like to change the methodology so that it would reward a broader range of nursing homes, with faster reimbursement, for upgrades they make (Miller, 9/11).

    California Healthline: L.A. County Aims To Transform Health Care With New EHR System
    Los Angeles County's Department of Health Services is installing a new countywide electronic health record system that officials say could end up being a model for other health care organizations across the country. An L.A. County Civil Grand Jury report examined the initiative this summer, assessing how EHR implementation and integration of EHR systems and data among county departments could set the pace for development of a countywide health information exchange for both private and public providers (Stuckey, 9/11).

    NPR: A Doctor Who Performed Abortions In South Texas Makes His Case
    In a Brownsville family clinic, a powerfully built, bald doctor treats a never-ending line of sick and injured patients. He has been practicing for nearly four decades, but family medicine is not his calling. He seems an unlikely doctor to perform abortions. The son of an Army officer, he grew up in a deeply religious family in rural Texas. His career path was shaped by an experience in medical school in the early '70s. A young woman whose uterus had been accidentally pierced by a backroom abortionist bled to death in front of him. After Roe v. Wade was decided, the young doctor devoted his career to helping poor and working-class women terminate their unwanted pregnancies in South Texas (Goodwyn, 9/11).

    Los Angeles Times: Skid Row Sweep Finds Many Homeless With Medical, Psychiatric Needs
    A joint city-county sweep of skid row last month to provide sanitation and social services identified more than 100 homeless people in need of immediate medical and mental health care, officials said Wednesday. Eighty homeless people received medical attention for scabies, wounds and other conditions during the August operation and 27 were referred to mental health services, City Councilman Jose Huizar said in a statement (Holland, 9/11).

    Sacramento Bee: Support Plummets For California Health Initiatives
    Support for a pair of health-related ballot initiatives is eroding, though a large portion of voters remain undecided eight weeks before the Nov. 4 election, according to the latest Field Poll. Forty-one percent of likely voters say they would support Proposition 45, while 26 percent would vote against the initiative requiring health insurance rate changes to be approved by the state’s elected insurance commissioner. A growing proportion, 33 percent, are undecided. When asked about Proposition 46, which would mandate random drug testing of doctors and quadruple the state’s $250,000 limit on medical malpractice awards, just 34 percent of voters say they are inclined to vote yes and 37 percent are preparing to vote no. Twenty-nine percent are undecided (Cadelago, 9/11).

    Minneapolis Star-Tribune: Cargill Foundation Grant Takes Aim At Rural Nursing Shortage
    In an effort to draw more nurses to rural Minnesota to care for the elderly, the Margaret A. Cargill Foundation has made a $1.9 million grant to pay for classes, internships and work bonuses to nursing students. The grant, announced Thursday by Minnesota State Colleges and Universities and senior housing and services nonprofit Ecumen, runs for two years, with some of the work bonuses running longer (McKinney, 9/11).

    Health News Colorado: Anthem Partners With Mountain Hospitals To Drive Rates Down 8 Percent
    Rates for health insurance in Colorado’s mountain resort communities -- which notoriously have been the highest in the country this year -- are heading down for 2015 with Anthem Blue Cross and Blue Shield of Colorado’s announcement today that it will sell a new product for residents in four pricey resort counties. The preemptive move aims squarely at Kaiser Permanente, which has announced plans to expand into mountain resort regions in 2016 (McCrimmon, 9/11).

    The Associated Press: Ohio: Law Against Lies Is Nullified
    The case began in the 2010 congressional race after Steve Driehaus, a congressman at the time, filed a complaint when the Susan B. Anthony List planned to post billboards claiming the Democrat’s support for President Obama’s health care overhaul equated with support for abortion, even though he opposed abortion. Judge Black had said earlier that the anti-abortion group did not have standing to sue, and an appeals court agreed. But the Supreme Court said the challenge should be considered (9/11).

    CNN: 9/11 Responders With Rare Cancer Denied Insurance Coverage
    According to the most recent data from the World Trade Center Health Program, there are nearly 3,000 cases of cancer among firefighters, police officers, contractors and civilians who worked or lived near the site of the attacks. A growing number are being diagnosed with oropharyngeal cancer, but some -- including [John] Meyers -- are being denied insurance coverage because their cancers were diagnosed too soon after 9/11 (Smith, 9/11).

    Stateline: States Seek To Protect Student Athletes From Concussions, Heat Stroke
    When Georgia public high schools were asked several years ago to devise a policy to govern sports activities during periods of high heat and humidity, one school’s proposal stood out: It pledged to scale back workouts when the heat index reached 140. Those who understood the heat index, the combined effects of air temperature and humidity, weren’t sure whether to be appalled or amused. “If you hit a heat index of 140,” said Bud Cooper, a sports medicine researcher at the University of Georgia who examined all the proposed policies, “you’d basically be sitting in the Sahara Desert.” The policy reflected an old-school, “no pain, no gain” philosophy, a view that athletes need to be pushed to their physical limits -- or beyond them -- if they and their teams are to realize their full potential (Ollove, 9/12).

    Chicago Sun Times: Illinois’ Largest Health System Getting Bigger
    Illinois’ largest health system is about to get even bigger. Downers Grove-based Advocate Health Care, one of the largest systems in the country, on Friday announced plans to merge with NorthShore University HealthSystem to create a health system with 16 hospitals, 4,438 beds and 45,000 employees. The combined system would also have a new name: Advocate NorthShore Health Partners. Both hospital systems said consolidation is necessary to stay competitive amid health care reform and other market trends (Thomas, 9/12).

    Health News Florida: Home Care Firm Rules Medicaid Market
    It’s much too soon to say whether this summer’s flood of Florida Medicaid patients into private managed-care plans will accomplish the state’s goals of improving access to care and saving money. But one result is already clear: The overhaul is concentrating power in the hands of specialty companies over which the state has no direct control.  Some say one such company has essentially taken over home care services and equipment. Univita Health, based in Miramar, has tied up so much of the market for Florida Medicaid health plans that many in the industry call it a monopoly. Managed care plans contract with Univita to manage their home-care business, even though the company itself is a provider of home-care and equipment to the same health plans (Gentry, 9/11).

  • Health Costs Inch Up As Coverage Expands

    According to the Census Bureau's Quarterly Services Survey, total revenue at health care and social-assistance firms rose 3 percent in the second quarter of the year. But analysts described the increase as modest.

    The Wall Street Journal: Health-Care Spending Picks Up
    The sprawling U.S. health-care industry saw revenue rebound last quarter, a sign that stronger spending at hospitals and medical offices could help boost U.S. economic growth to its highest level in eight years. Total revenue at health-care and social-assistance firms rose 3% in the second quarter from the first three months of the year, the Commerce Department said Thursday in its Quarterly Services Survey. Hospital revenue rose 2.8% from the first quarter and revenue at physician offices jumped 4.1% (Leubsdorf, 9/11).

    Kaiser Health News: Census Bureau: Health Costs Inch Up As Obamacare Kicks In
    Doctors and hospitals treated more patients and collected more payments in the spring as millions gained insurance coverage under the health law, new figures from the government show. But analysts called the second-quarter increases modest and said there is little evidence to suggest that wider coverage and a recovering economy are pushing health spending growth to the painful levels of a decade ago (Hancock, 9/11).

  • Viewpoints: Ebola Takes Us To 'Uncharted Waters'; The Failure Of Workplace 'Wellness' Programs

    The New York Times: What We're Afraid To Say About Ebola
    There have been more than 4,300 cases and 2,300 deaths over the past six months. Last week, the World Health Organization warned that, by early October, there may be thousands of new cases per week in Liberia, Sierra Leone, Guinea and Nigeria. What is not getting said publicly, despite briefings and discussions in the inner circles of the world’s public health agencies, is that we are in totally uncharted waters and that Mother Nature is the only force in charge of the crisis at this time (Michael T. Osterholm, 9/11). 

    The Washington Post: The World Yawns As Ebola Takes Hold In West Africa
    The United States has the expertise and the personnel to get this outbreak under control. This week there were encouraging signs that the U.S. government was starting to take it more seriously and scale up the response (Richard E. Besser, 9/11). 

    The Wall Street Journal: Doctoring In The Age Of Obamacare
    It has been four years since the passage of the Affordable Care Act, so I thought it may be useful to provide the perspective of a physician providing daily medical care. I am an endocrinologist in Washington, D.C., and have been in solo private practice for 17 years after seven years at an academic institution. Since 1990, the practice of medicine has changed significantly, seldom for the better (Dr. Mark Sklar, 9/11).

    The New York Times’ The Upshot: Do Workplace Wellness Programs Work? Usually Not
    Most news coverage of the new Kaiser Family Foundation annual survey on employer-sponsored health plans has focused on the fact that growth in premiums in 2013 was as low as it has ever been in the 16 years of the survey. But buried in the details of the report are some interesting insights into how employers think about controlling health care costs. One example is that they're very fond of workplace wellness programs. This is surprising, because while such programs sound great, research shows they rarely work as advertised (Austin Frakt and Aaron E. Carroll, 9/11). 

    The New York Times' Taking Note: Want An Abortion In Missouri? Wait 72 Hours.
    Missouri’s Republican-controlled state Legislature on Wednesday imposed a 72-hour waiting period for women seeking an abortion, overriding a veto of the measure in July by the state’s Democratic governor, Jay Nixon. Governor Nixon criticized the legislation’s tripling of the state's 24-hour waiting period as "extreme and disrespectful" to women’s rights and well-being. He was especially troubled by the absence of any exception for victims of rape and incest (Dorothy J. Samuels, 9/11). 

    The Washington Post: Whatever Its Motive, CVS Does The Right Thing By Ending Cigarette Sales
    CVS stopped selling cigarettes last week. The move may be little more than a business calculation for the pharmacy chain. But it is one worth cheering: It makes the sale of cigarettes less ubiquitous, and it shows that, after decades of effort, smoking is getting the stigma it deserves (9/11).