By Christine Vestal
If your infant has a high fever or you’re experiencing an unusual pain in your abdomen and you live in New Mexico, you may want to call the NurseAdvice line before you do anything else.
New Mexico is the only state with a 24/7 registered nurse call center that is free to all residents, whether insured or not. In operation since 2006, it has kept tens of thousands of New Mexicans out of emergency rooms and saved the state more than $68 million in health care expenses.
It has provided a basic form of health care to thousands of uninsured people who have no other access to care. It also has relieved demand on doctors and hospitals in a sparsely populated state where all but a few counties have a severe shortage of health care providers.
On top of that, the statewide call center has generated real-time public health data that has served as an early warning system during epidemics and natural disasters.
In April, the U.S. Centers for Disease Control and Prevention (CDC) will recommend New Mexico’s advice line as a national model that other states adopt during an emergency preparedness summit in Atlanta. Continue reading
By Michelle Andrews
May I Move My Son From My Insurance Plan To A Better Option On The Marketplace?
Some readers want to figure out how to become eligible for coverage on the health insurance marketplaces, while others want to figure out how to avoid it.
This week I answered questions from both.
I am covered by my employer’s health plan, but I’m not happy with it. My son is 21 and currently covered under my plan. While I realize that I am not eligible for Obamacare, I am curious if I can terminate my son’s policy so that he might be eligible. Continue reading
A new website, www.guroo.com, allows you to find out how much care for common conditions will cost. The site provides local, state and national average charges for these conditions. The site was created by the Health Care Cost Institute (HCCI), an independent, non-partisan, non-profit organization that promotes research and analysis on the causes of rising US health spending.
Guroo.com Demo from Health Care Cost Institute on Vimeo.
(Photo courtesy of Johns Hopkins Medicine)
By Jordan Rau
The sleek hospital tower that Johns Hopkins Medicine built in 2012 has the frills of a luxury hotel, including a meditation garden, 500 works of art, free wi-fi and a library of books, games and audio.
As Dr. Zishan Siddiqui watched patients and some fellow physicians in Baltimore move from their decades-old building into the Sheikh Zayed Tower, the internist saw a rare opportunity to test a widespread assumption in the hospital industry: that patients rate their care more highly when it is given in a nicer place.
For decades, hospital executives across the country have justified expensive renovation and expansion projects by saying they will lead to better patient reviews and recommendations. One study estimated $200 billion might have been spent over a decade on new building.
Hopkins’ construction of the tower and a new children’s hospital cost $1.1 billion. Patient judgments have become even more important to hospitals since Medicare started publishing ratings and basing some of its pay on surveys patients fill out after they have left the hospital.
Siddiqui’s study, published this month by the Journal of Hospital Medicine, contradicts the presumption that better facilities translate into better patient reviews. Siddiqui examined how patient satisfaction scores changed when doctors started practicing in the new tower, which has 355 beds and units for neurology, cardiology, radiology, labor and delivery and other specialties.
Siddiqui discovered that for the most part, patients’ assessments of the quality of the clinical care they received did not improve any more than they did for patients treated in the older Hopkins building, which had remained open. Units there were constructed as early as 1913 and as late as 1980, Hopkins officials said. They functioned as the control group in the study, since a hospital’s satisfaction scores often change over time even when a hospital’s physical environment remains constant. Continue reading
By Michael Ollove
Nearly half the states use higher copayments to dissuade Medicaid recipients from unnecessary visits to emergency rooms, where care is more costly.
These states require patients to make the payments, which are as high as $30 per visit in Oklahoma, when it is later determined that they did not experience a true medical emergency.
But at least one multistate study has found that charging higher copayments does not reduce emergency department (ED) use by Medicaid recipients.
One reason might be that copays are hard to enforce, since EDs are legally obligated to examine anyone who walks through the doors, whether or not they can pay.
ED doctors and others in health policy also criticize copays as potentially dangerous, since they may lead people to think twice about seeking emergency care when they really need it.
Washington state and some Medicaid managed care plans around the country are trying a different approach. Instead of using financial disincentives, they are trying to keep frequent users out of the emergency department (practitioners prefer the name “emergency department” to “emergency room”) by enrolling them in primary care practices, scheduling appointments for them and, in some cases, making sure they get to the doctor’s office on time. The hope is that giving people comprehensive health care will make many ED trips unnecessary.
Reliable data are still sparse, but the early signs are encouraging: Washington state reported that a year after implementing its program, emergency room visits by Medicaid beneficiaries had declined by nearly 10 percent. Among frequent ED users, the drop was slightly greater. Continue reading
Big U.S. majority favors mandatory vaccinations: Reuters/Ipsos poll | Reuters – “A large majority of Americans favor mandatory vaccinations of children, a Reuters/Ipsos poll showed on Tuesday, apparently unswayed by some senior Republicans who have raised fears the medical shots could lead to autism. Seventy-eight percent of respondents in the online survey said all children should be vaccinated unless there is a direct health risk to them from vaccination. Only 13 percent opposed vaccinations.”
Cannabis More Than 100 Times Safer Than Alcohol, Study Finds – “It found that the mortality risk to individuals posed by cannabis was approximately 114 times less than that of alcohol. In fact, cannabis was the only substance to be classified as ‘low risk’. In contrast, alcohol posed the highest risk to individuals and was ranked alongside nicotine, cocaine and heroin as ‘high risk’. “
Survey: Uninsured rate fell to new low in 2014 – AP – “Even as it faces another Supreme Court challenge, President Barack Obamas health care law has steadily reduced the number of uninsured Americans, according to an extensive survey released Tuesday.The Gallup-Healthways Well-Being Index found that the share of adults without health insurance dropped to its lowest level in seven years in 2014 as Obamas overhaul took full effec”
California lawmaker seeks to ban chewing tobacco in baseball | Reuters – “Major League Baseball players would be banned from using chewing tobacco at games in California under a bill expected to be introduced in the state legislature on Tuesday, the first in a nationwide campaign planned by anti-tobacco activists. The bill targets baseball’s ubiquitous habit less than a year after retired San Diego Padres outfielder Tony Gwynn died of cancer of the salivary glands, believed related to chewing tobacco or “dipping” it by lodging it between the lip and the gum.”
World’s diet worsening with globalization, major study finds: TRFN | Reuters – “The “globalization” of western diets – where a small group of food and agriculture companies have disproportionate power to decide what is produced – is partially causing the shift to unhealthy eating, Mozaffarian said. “
Africa’s expanding farms attract more plague-infested rats | Reuters – “In northern Tanzania, crop lands have expanded by 70 percent over the last few decades and the number of plague-carrying rodents in these corn growing lands has nearly doubled compared with neighboring wilderness areas, said the study published in the American Journal of Tropical Medicine and Hygiene on Monday. “
Seattle Children’s hospital and Mayo Medical Laboratories are creating a partnership to develop ways for children’s hospitals around the country to decrease costs and errors that come from unnecessary lab testing.
via Seattle Children’s and Mayo Clinic team to slash genetic testing costs – Puget Sound Business Journal.
By Sarah Varney
VISALIA, Calif. — In the farming town of Exeter, deep in California’s Central Valley, Anne Roberson walks a quarter mile down the road each day to her mailbox. Her walk and housekeeping chores are the 68-year-old’s only exercise, and her weight has remained stubbornly over 200 pounds for some time now.
“You get to a certain point in your life and you say, ‘What’s the use?’”
For older adults, being mildly overweight causes little harm, physicians say. But too much weight is especially hazardous for an aging body: Obesity increases inflammation, exacerbates bone and muscle loss and significantly raises the risk of heart disease, stroke, and diabetes.
Dr. Mylene Middleton Rucker, a primary care physician in Visalia, Calif., is using the new obesity counseling benefit with her patients, but many doctors aren’t aware of it yet. (Sarah Varney/KHN)
To help the 13 million obese seniors in the U.S., the Affordable Care Act included a new Medicare benefit offering face-to-face weight-loss counseling in primary care doctors’ offices.
Doctors are paid to provide the service, which is free to obese patients , with no co-pay. But only 50,000 seniors participated in 2013, the latest year for which data is available.
“We think it’s the perfect storm of several factors,” says Dr. Scott Kahan, an obesity medicine specialist at George Washington University.
Kahan says obese patients and doctors aren’t aware of the benefit, and doctors who want to intervene are often reluctant to do so. It’s a touchy subject to bring up, and some hold outmoded beliefs about weight problems and the elderly. Continue reading
Health Care Opens Stable Career Path, Taken Mainly by Women – NYTimes.com – A surge in spending on health care is translating into well-paying jobs, but opportunities are only available to those willing to put in the time and money to retrain.
More Frequent Meals Linked to Healthier Eating – “Adults who ate multiple small meals every day tended to eat better, and weight less, than those who had fewer but larger meals, in a recent study. People eating fewer meals tended to eat the most at night, and to drink alcohol with meals, both of which might contribute to their higher body mass index (BMI), the researchers said.”
Hand Dishwashing Tied to Fewer Allergies for Kids | Medpage Today – “Children whose families washed dishes by hand were associated with a lower risk of developing allergies compared to those who used a machine dishwasher, according to an observational study of Swedish families. “
We could cut the HIV transmission rate by more than 90 percent, CDC says – The Washington Post – “More than 700,000 of the 1.1 million people living with HIV in the United States are undiagnosed or not receiving care, a population responsible for 91.5 percent of the transmissions of the infection in 2009, researchers reported Monday. Diagnosing even some of those people, starting them on antiretroviral drugs and keeping them in treatment could have a large and immediate impact on transmission of the virus, according to the paper, published in JAMA Internal Medicine.”
Dr. Google may not be the best way to get information for picking a hospital – The Washington Post – “Searching for health information online has become almost a reflex for anyone with access to a computer. Worried about that pain in your left side? Concerned about drug interactions? Need a dentist or a dermatologist? You probably consult Dr. Google. But JAMA Internal Medicine has a new commentary article that questions the accuracy of online information about one of the biggest decisions you might have to make: picking a hospital.”
Meningitis bacteria to blame for Oregon student’s death | Reuters – “Freshman Lauren Jones, 18, was found unconscious on Tuesday and declared dead at a nearby hospital. An initial autopsy did not offer conclusive results, but tests completed on Friday confirmed that meningococcemia caused her death, Lane County Public Health spokesman Jason Davis said in a statement. “
Youth fighting ‘superbug’ infection from Los Angeles outbreak | Reuters – “An 18-year-old man who was one of seven patients infected with a drug-resistant bacterial “superbug” during a medical procedure in Los Angeles was under 24-hour monitoring at a hospital as he fought a severe infection, his attorney said on Friday.”
11 Wesleyan students treated for MDMA drug overdoses | Reuters – “The sophomore at the elite school in Middletown was transported to a hospital early on Sunday with two students in less serious conditions but showing similar symptoms, Michael Whaley, vice president for student affairs, said in an emailed statement to the school. “
Polluted Air Cuts Years Off Lives of Millions in India, Study Finds – NYTimes.com – “More than half of India’s population lives in places with such polluted air that each person loses an average of 3.2 years in life expectancy, according to a recent study by researchers from the University of Chicago, Yale and Harvard.”
Child dies of measles in Berlin, Germany vows to boost vaccinations | Reuters – “The German capital has seen about 600 cases of measles since an outbreak began last October, and the boy’s death reignited a debate about whether to make vaccination compulsory. It is not in Germany and some parents choose not to vaccinate their children due to fears about potential side effects. “
U.N. experts warn of ‘critical knowledge gaps’ on Saudi MERS virus | Reuters – “Cases of Middle East Respiratory Syndrome (MERS) are surging again, but Saudi health officials and scientists appear unable to explain where the infections start and how they spread, the UN experts said.”
Carbapenem-resistan Enterobacteriaceae – CDC
By Jordan Rau
The bacterial outbreak at a Los Angeles hospital highlights shortcomings in the federal government’s efforts to avert the most lethal hospital infections, which are becoming increasingly impervious to treatment.
Government efforts are hobbled, infection control experts say, by gaps in monitoring the prevalence of these germs both within hospitals and beyond. The continued overuse of antibiotics — due to over-prescription by doctors, patients’ insistence and the widespread use in animals and crops — has helped these bacteria evolve into more dangerous forms and flourish.
In the outbreak at UCLA’s Ronald Reagan Medical Center, two patients have died and more than 100 may have been exposed to CRE, an antibiotic-resistant bacteria commonly found in the digestive tract. When this germ reaches the bloodstream, fatality rates are 40 percent. The government estimates about 9,000 infections, leading to 600 deaths, are caused each year by CRE, which stands for carbapenem-resistant Enterobacteriaceae.
Close up of ERCP endoscope tip
UCLA Health says the infections probably were passed around by inadequately sterilized scopes used to peer inside a body.
Previous CRE outbreaks have occurred elsewhere in the country, including hospitals in Illinois and Seattle.
The immediate public health response has focused on the safety of the scopes and tracking down people who may have been exposed.
The U.S. Food and Drug Administration Thursday issued a warning about the devices. But the California outbreak comes amid the government’s broader struggle to spot and battle the swelling ranks of bacteria that are resistant to most, if not all, antibiotics. Continue reading
Credit: Dan Shirly
Tax time reprieve for Obamacare procrastinators | Seattle/LocalHealthGuide – “The Obama administration said Friday it will allow a special health law enrollment period from March 15 to April 30 for consumers who realize while filling out their taxes that they owe a fee for not signing up for coverage last year.”
Even with insurance you can get hit with big medical bills | Seattle/LocalHealthGuide – ““It’s not fair and probably not legal that consumers be left holding the bag when an out-of-network doctor treats them.””
Figuring out if a doctor is in your plan can be hard | Seattle/LocalHealthGuide – “Consumers who use out-of-network providers can rack up huge bills, depending on the care required.”
Many uninsured don’t realize they may face a tax penalty | Seattle/LocalHealthGuide – “Forty-four percent of uninsured people who may be subject to the penalty say they know nothing or only a little about the penalty.”
Fourth case of measles in Clallam County | Seattle/LocalHealthGuide – “Clallam County Health and Human Service, Public Health Section will continue with no cost clinics on February 23, 24, 26, and 27.”
Love to Eat Eggs? U.S. Panel Now Says They’re Not a Health Risk – ” Egg and red meat lovers may find reason to rejoice in a decision by a U.S. advisory health panel to remove warnings about dietary cholesterol, saying that there is no link to dangerous levels of blood cholesterol that cause disease.“
Challenges for doctors using fitness trackers & apps – AP – “More hospitals and doctors are starting to use data from fitness trackers and health apps to help treat patients. But they are moving cautiously. The technology has a lot of potential, but there are key challenges to work out:”
Doctors say fitness trackers, health apps can boost care – AP – “Why give your doctors permission to incorporate data from fitness trackers and health apps into electronic patient records? Well, they might spot signs of an ailment sooner and suggest behavioral changes or medication before you land in the emergency room. They also might be able to monitor how you’re healing from surgery or whether you’re following a treatment regimen.”
Dietary guidelines panel suggests tax on sugary foods – AP – “A tax on sugary drinks and snacks is one way a government panel of nutrition experts thinks Americans can be coaxed into eating better. Some members of Congress are already pushing back on the idea, saying the panel has overstepped its bounds.”