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Industry News
The U.S. Justice Department is suing Carolinas HealthCare System, North Carolina's largest health care system, saying it illegally imposes contract requirements on insurers that reduce competition. Carolinas places restrictions in its contracts that bar insurers from offering tiered networks that include competing hospitals in their top tiers, Modern Healthcare reports. Carolinas also forbids insurers from offering narrow networks that include only its competitors, in violation of antitrust law according to the Justice Department. Carolinas said in a statement Thursday its arrangements are similar to others between insurers and health care systems. (Modern Healthcare) 
Large employers are less than enthusiastic about the proposed Aetna/Humana and Anthem/Cigna mergers. Several surveys of Fortune 500 companies and other large employers reveal concern that the reduced competition will mean higher health care costs, Modern Healthcare reports. "Any time you have a limited market and limited number of key players and they come together, that's not a great thing for a purchaser," says Larry Boress, CEO, Midwest Business Group on Health. (Modern Healthcare) 
About 136,000 Americans died accidentally in 2014, up 4.2 percent from 2013 and 15.5 percent over a decade, despite a 22 percent drop in car crash deaths since 2005, according to a new National Safety Council report. Overdose and accidental poisonings are up 78 percent over a decade--passing car crashes as the top accidental killer. Falls are up 63 percent over a decade, which analysts attribute to an aging society. (AP) 
Innovation & Transformation  

Free webinar to explore CMM in the community pharmacy setting

Wednesday, June 29, at 1 p.m. EDT, join Steve Simenson, BPharm, FAPhA, DPNA, CEO and managing partner of Goodrich Pharmacy, Inc., and Terry McInnis, MD, MPH, CPE, FACOEM, president of Blue Thorn Inc., for a webinar on comprehensive medication management in the community pharmacy setting. Simenson will discuss how Goodrich integrated CMM into an independent community pharmacy and how it has expanded these services beyond the pharmacy doors. McInnis, principal investigator of Get the medications right: a nationwide snapshot of expert practices--Comprehensive medication management in ambulatory/community pharmacy, will discuss key findings from the report and their relevance to community pharmacy. (Registration)
The Department of Veterans Affairs announced a plan to expand the scope of practice of its advanced practice registered nurses; the goal is to provide veterans with better access to care. More than 20 states have made similar moves to provide patients direct access to nurse practitioners by allowing them to practice independently; more are considering it. The proposal is now in a two-month public comment period. (Fierce Healthcareproposed rule)  
Consumers & Providers
The FDA, after hearing stories from frustrated patients who could not obtain data from their implanted devices, released draft guidance on the topic. Manufacturers had argued that their customers were doctors and hospitals and that providing data to patients would require FDA approval. The guidance indicates otherwise, explaining that manufactures can share "with patients at the patient's request, without obtaining additional premarket review before doing so." It also clarifies that HIPAA should not keep manufacturers form sharing that data with the patient. (FierceHealthCare; guidance
CMS has filed a final rule for the Medicare Shared Savings Program payments and performance measurements that is intended to create a more balanced way of determining ACO incentives. In short, ACOs will be measured against their peers on a regional basis instead of on a national scale. With national metrics, ACOs in low-cost areas had a built-in advantage over those in high-cost areas. The change will create a more level playing field, according to AAFP News. (AAFP News; final rule)
Although an overwhelming majority of physicians surveyed said doctors had a responsibility to control costs, fewer than half said they had a firm understanding of the costs of tests and procedures. About a third said it was unfair to ask doctors to be both cost-conscious and concerned with patient welfare; about a third said they try not to think about costs during treatment decisions. Primary care physicians reported feeling significantly more pressure from patients to order tests and procedures than specialists, and more pressure to refer patients to consultants. (Science Daily; American Journal of Managed Care)
Many patients with advanced cancers lack basic information about their prognosis or treatment; as a result, they cannot make informed decisions about their care, according to a study of 17 patients published in Journal of Clinical Oncology. "Many did not know that they were at the end-stage of their illness or that their cancer was incurable. They were basically making treatment decisions in the dark," explains Dr. Holly Prigerson of Weill Cornell Medicine. The study found reviewing test results with their oncologist improves patient understanding, helping them make informed decisions about care. (Consumer Health Day; study)
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New & Noted   
Dirty hands: Hand hygiene compliance varies significantly depending on whether health care professionals know they are being observed, according to a small study presented at the Association for Professionals in Infection Control and Epidemiology. When they know they are being watched, the rate is 57 percent; when they don't, it's about 22 percent. (ABC) 

Self-insurance for small companies: Bon Secours Richmond Health System has entered the health insurance game. The system recently launched its Bon Secours Value Network, a self-insured program for small- and medium-sized businesses in central Virginia. (Richmond Times Dispatch)

Louisiana shortages: With 81 percent of Louisiana designated as a health professional shortage area, the state is at risk for losing not only its current doctors but also the funding for residency training for new ones. Health and Hospitals Secretary Rebekah Gee, MD, says if the state loses some of its 1,900-plus residency positions, "we permanently lose capacity to train doctors in the state." (Associated Press) 

Future physicians learn a lot about the workings of the human body in school, but many learn almost nothing about the workings of the health care system. A three-week fellowship in health policy for medical residents, run jointly by the George Washington University schools of medicine and public health, hopes to change that. (Kaiser Health News)
MarketVoices...quotes worth reading
"If we can get the patients more involved in that--and get them to be able to speak up, that is really the main thing. A lot of patients are nervous about that kind of thing--that's another culture we're trying to change." -- Dr. Clifford McDonald, associate director for science at the CDC, encouraging patients to call out clinicians who don't wash their hands, quoted by ABC. 
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Roxanna Guilford-Blake
Sandy Mau




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Wednesday, June 15, 2016