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Industry News
Is the Anthem/Cigna deal in trouble? That's the talk in recent weeks. If it does dissolve, that could mean deals for smaller health plans, Bloomberg reports. Cigna could target smaller insurers including WellCare Health Plans Inc., Centene Corp. and Molina Healthcare, all of which specialize in government-funded health plans. Anthem, meanwhile, may try to acquire assets from Aetna and Humana as they move forward their merger. (Bloomberg)
Physicians and teaching hospitals in the U.S. took in fees, educational services, meals and other services worth $6.49 billion from the pharmaceutical industry and device makers in 2015, according to CMS Open Payments data. Nearly 2.3 percent of the transactions between doctors and drug makers were related to opioids. Kaiser Health News provides a roundup. (KHN; Open Payments)
With 91 percent of Americans now covered by some form of health insurance, attention is turning to the deductibles, Drew Altman, president and CEO of the Kaiser Family Foundation, writes in a Wall Street Journal blog post. He points out payments toward deductibles by individuals with insurance through large employers rose 256 percent from 2004 to 2014; over the same period, wages increased 32 percent. "The question of how much cost-sharing is too much, and what to do about it, could be the next big debate in health care," he concludes. (Wall Street Journal blog post)

In 2013 mental disorders topped the list of most costly conditions, with spending at $201 billion, according to research published in Health Affairs. The researchers note spending on mental disorders tends to be underestimated in other sources because institutionalized populations are excluded. They point to another interesting finding: the low rate of growth in spending on heart conditions and cerebrovascular disease. "Most of the fastest-growing medical conditions, in terms of spending, are associated with obesity, yet heart conditions and cerebrovascular disease--which are also associated with obesity--have exhibited very low spending growth." (Health Affairs)
Innovation & Transformation  
Micro-hospitals are 24/7, small-scale (15,000 to 50,000 sq. ft.) inpatient facilities with eight to 10 inpatient beds for observation. Health systems are using them as entry points into markets where demand would not be able to support a full-scale hospital. "Micro-hospitals like this are more suited for large urban and suburban metro areas," according to Michael Slubowski, president and CEO of Denver-based SCL Health. He sees it as a trend to more accessible, cost-effective access points. (FierceHealthcare; Advisory Board) 
Cedars-Sinai is launching Safe Transition Home, a program designed to transition patients from the hospital to home. The goals: reducing readmissions, increasing patient satisfaction and improving health outcomes. It's a partnership between Cedars-Sinai and HomeHero, a nonmedical home care provider. HomeHero focuses on patients' non-medical needs, such as transportation to and from medical appointments, medication management, safety assessments of patients' home environments and evaluations of patients' support systems, among other variables. (HealthLeaders Media)
Consumers & Providers
Alert fatigue can be deadly. That's because there are so many, and clinicians have stopped paying attention--they ignore safety notifications between 49 and 96 percent of the time, according to some estimates. "When providers are bombarded with warnings, they will predictably miss important things," said David Bates, senior vice president at Brigham and Women's Hospital in Boston. Research is starting to explore the degree of risk posed by excessive alerting versus the benefits of the alerts. Health IT departments and hospital systems are looking into solutions that capitalize upon the benefits of the alert capabilities. (Kaiser Health News)
Is it harder to become a nurse? In terms of supply and demand, the answer is a resounding, "Yes!" because of an inadequate number of slots for qualified applicants, according to Juliana Adams, BSN, MSN, MA. Percentage-wise, the numbers are the same, but when you consider there are only 48,000 qualified physician applicants compared to 265,000 qualified nursing applicants, the numbers are startling. The projected physician shortage for 2025 is 90,000, compared to a shortage of 700,000 to 900,000 nurses. (MedPage Today blog post)
A recent study in JAMA Internal Medicine suggests that opioids are not disposed of properly. In the survey of 1,032 people with 592 respondents, 60.6 percent said they had leftover pills; 61.3 percent of those said they kept them for future use; and 20 percent said they'd shared their medication with another person. "The fact that people are sharing their leftover prescription painkillers at such high rates is a big concern," the study's senior author, Colleen L. Barry, PhD, MPP, said in a statement. Participants also report they received no information about safely storing the meds or how to dispose of them safely. (HealthLeaders Media; report) 
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New & Noted   
CMS rules on data mining/selling: CMS finalized new rules Friday authorizing certain CMS-approved organizations--including for-profit companies--to buy Medicare claims and other federal data, Modern Healthcare reports. These entities can then combine it with patient data from insurance companies, providers and other sources, and then resell that data. (Modern Healthcare; announcement)

Calif. NP bill scrapped: Legislation that would have given California's nurse practitioners more independence in treating patients has died. The expanded scope-of-practice bill was pulled by the measure's author after he determined it did not have the votes needed to pass. (California Healthline)

Telemedicine can't replace FTF: While telemedicine does have practical and appropriate uses, it's often not the route to choose for things that require a face-to-face exam or lab tests, Dr. Chad Hayes writes in The Washington Post. "[W]hile the convenience of a 2 a.m. virtual visit for a child with a fever might be tempting, sometimes a face-to-face visit is clearly superior--and less risky." (The Washington Post)

A recent infographic from the Healthcare Intelligence Network examines which populations are targeted using data analytics, the type of data collected and the percent of the population for which data analytics is collected. (infographic)
MarketVoices...quotes worth reading
"If you see enough nonsense, you're going to start ignoring it."-- Eric Shelov, associate chief medical information officer, Children's Hospital of Philadelphia, on why physicians are ignoring EHR alerts, quoted in Kaiser Health News  
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Roxanna Guilford-Blake
Sandy Mau




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Wednesday, July 6, 2016