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Industry News
Last week, California  Insurance Commissioner David Jones urged federal antitrust regulators to block Aetna's proposed acquisition of Humana. He argued that the acquisition would be anti-competitive in California (and nationwide) and contribute to higher insurance prices. The previous week, he made a similar recommendation about the Anthem/Cigna deal. Reuters notes that, although he lacks the authority to block either merger, his opinion could influence the Department of Justice's decision. (Reuters)
After six years, House Republicans last week offered their proposal to replace the Affordable Care Act. They issued a 20,000-word plan that provides the most extensive description of their health care alternative to date. Many of the ideas in the plan--health savings accounts, sale of insurance across state lines and high-risk pools--are nothing new, according to the The New York Times. More contentious is a proposal to raise the eligibility age of Medicare. The plan did not provide cost estimates. (The New York Times)
Google is enhancing the functions of searches for health information by listing related conditions for the search term. For example, if someone searches "headache on one side," the search engine will give conditions like "migraine," "tension headache," "sinusitis" and more. "We worked with a team of medical doctors to carefully review the individual symptom information, and experts at Harvard Medical School and Mayo Clinic evaluated related conditions for a representative sample of searches to help improve the lists we show," according to Google in its official blog. (Google blog)
Innovation & Transformation  
A simple virtual intervention could help primary care physicians talk to patients about drinking habits, according to research published in the Journal of General Internal Medicine. In a study of more than 1,500 patients, researchers used an interactive voice response (IVR) system to screen patients within three days before their scheduled routine physician visit. With permission, it can ask additional questions to help determine a potential alcohol problem and deliver a brief intervention message encouraging the patients to talk to their doctors about their drinking. (Eureka Alert; Journal of General Internal Medicine--subscription required)
Comprehensive medication management (CMM) has emerged as a practice to improve outcomes, control costs and enhance satisfaction of clinicians and patients, and--according to Terry McInnis, MD, MPH, CPE, FACOEM, president of Blue Thorn Inc., and Katherine Capps, president of Health2 Resources--it's here to stay. In a new forecast brief, they discuss CMM and their latest research report, Get the medications right: a nationwide snapshot of expert practices, sponsored through a grant from the Community Pharmacy Foundation. Drawing on the report's examples, they offer a glimpse into CMM's present and future, and issue a powerful call to action. (brief)

To reduce repeated emergency department visits, Kaiser Permanente Northwest has now stationed navigators in the ED. In 2014, it began identifying some of the highest ED users and assigning them a navigator to create a care plan and connect them to the right resources in the community. High users are defined as those who come to the ED more than six times in a six-month period. The plan has paid off. Among 254 patients being closely managed, re-admissions dropped by 55 percent, hospital admissions by 38 percent and the number of days in the hospital by 30 percent. (Portland Business Journal)
Cleveland Clinic researchers have developed a working definition of spirituality to help establish a framework of spiritual care training and resources for clinicians providing bedside care; it was published in American Journal of Critical Care. "Without a clear definition, each nurse must reconcile his or her own beliefs within a framework mutually suitable for both nurse and patient," says lead author Christina Canfield of Cleveland Clinic. The definition: Spirituality is "that part of a person that gives meaning and purpose to the person's life. Belief in a higher power that may inspire hope, seek resolution, and transcend physical, and conscious constraints." (HealthLeaders Media; American Journal of Critical Care) 
Consumers & Providers
A national survey of almost 5,000 physicians reveals job satisfaction is essentially tied amongst employed versus self-employed physicians. Approximately 53 percent of employed doctors surveyed for Medscape's Employed Doctors Report 2016 said they are contemplating some type of change, while 47 percent say they plan to stay mostly because of the difficulties associated with leaving--such as agreeing to non-compete agreements. Almost two-thirds of employed physicians do report a good relationship with leadership, possibly because they are getting a seat at that table themselves. (HealthLeaders Media; report)
With health care consolidation accelerating nationwide, there are concerns that hospital chains use their market power to win higher rates. In fact, research published in the Journal of Health Care Organization, Provision and Financing indicates hospital chains that buy up other facilities, clinics and physician offices often tout savings and improved services from coordinating patient care and eliminating inefficiencies. (Kaiser Health News; study)
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New & Noted   
States and telemedicine: Recent efforts by lawmakers in Louisiana and New York are part of a larger push to remove the barriers that keep providers from using telemedicine to treat patients. (FierceHealthcare)

Medicare depletion: A new forecast shows Medicare's hospital-insurance trust fund will be depleted in 2028, two years earlier than estimated last year, according to a government review released Wednesday. (Wall Street Journal)

Psychotropic drugs and children: Children between the ages of six and 17 from families under the poverty line were significantly more likely to be prescribed psychiatric medication than any other economic group, and children on Medicaid were 50 percent more likely to get a prescription than those with private insurance. The findings come from The National Health Interview Survey from 2011-12. (Pacific Standard)

Opiate addiction and how best to treat it continues to be a focus in Vermont, and one response is to treat it in the medical home. (Vermont Public Radio)
MarketVoices...quotes worth reading
"Overall, the goal is to engage with that patient and find out what do they need? What does happiness and healthiness look like for them? Navigators permeate all these teams in terms of making connections and doing problem solving."--Dr. Briar Ertz-Berger, the ED doctor who led the embedded navigator pilot at Kaiser Permanente Northwest, quoted in the Portland Business Journal
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Roxanna Guilford-Blake
Sandy Mau




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Wednesday, June 29, 2016