KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

First Edition: May 3, 2012

Today's headlines include a report exploring how the Medicare payment system could suffer unintended consequences if the Supreme Court overturns the health law.

Kaiser Health News: Analysis: ACOs Could Have The Medicare Muscle To Transform Health System
In this Kaiser Health News analysis, Michael L. Millenson writes: "A radical change just getting underway in the U.S. health system could transform how medical treatment has been paid for since Hippocrates made his first house call. But the new payment method faces conflicting dangers: either it won't be strong enough to upend entrenched incentives or it will be so successful it will prove too politically disruptive to survive" (Millenson, 5/2). Read the story.

Kaiser Health News: Capsules: 200 Years Of Surgery In Eight Pages (With Drawings!); Report: U.S. Has High Rate Of Babies Born Early; Costly Heart Procedures Thrive In Some Places
Now on Kaiser Health News' blog, Jordan Rau reports on how Atul Gawande notes a landmark for the New England Journal of Medicine: "For the 200th anniversary of the New England Journal of Medicine, Atul Gawande — surgeon, journalist, author, researcher, public speaker, father of three — takes a fun spin through two centuries of surgery by going back to the first volume of the publication, then known by the slightly less succinct name of the New England Journal of Medicine and Surgery, and the Collateral Branches of Science" (Rau, 5/2).

Also on the blog, Julie Appleby reports on new findings about the U.S.'s high rate of pre-term births: "About 12 percent of U.S. babies are born at 37 weeks or less, according to the report, which found a worldwide range of as few as 4.1 percent of babies in Belarus to as many as 18 percent in Malawi. Full term is considered 39 weeks" (Appleby, 5/2).

In addition, Jordan Rau also explores why doctors continue to choose to do a costly heart procedure: "Why do some doctors keep doing expensive medical procedures after it becomes apparent there are cheaper and equally safe ways to treat patients? A new study of cardiac procedures in Michigan takes a crack at this question, and while it comes up short on definitive answers, it has some interesting findings" (Rau, 5/2). Check out what else is on the blog.

The Associated Press/Washington Post: Problems Seen For Medicare Provider Payments If Supreme Court Strikes Down Health Care Law
Tossing out President Barack Obama's health care law would have major unintended consequences for Medicare's payment systems, unseen but vital plumbing that handles 100 million monthly claims from hospitals and other service providers, the administration has quietly informed the courts (5/3).

Politico: Issue Of Health-Care Reform Emerges In Races
Barack Obama and Mitt Romney are the marquee names in this year’s partisan fight over health care, but the undercard is pretty compelling, too. In House and Senate races across the country, from New York to Wisconsin to Montana, the president's health care law is re-emerging as a central issue in the fight for control in Congress (Allen and Haberkorn, 5/2).

Los Angeles Times: 107 Charged In Medicare Fraud Crackdown
Doctors, nurses and social workers from across the country, 107 in all, were charged in what federal officials in Washington called a "nationwide takedown" of medical professionals accused of fraudulently billing Medicare out of nearly half a billion dollars (Serrano, 5/2).

Reuters/The New York Times: More Than 100 Are Charged In Medicare Fraud Sweep
United States authorities have charged 107 people, including doctors and nurses, for trying to defraud the federal Medicare health care program for the elderly and disabled of about $452 million, the biggest Medicare fraud sweep to date, the Obama administration said Wednesday (5/2).

The Associated Press/Washington Post: More Than 100 Charged In Massive Medicare Fraud Busts In 7 Cities In Scams Totaling $452 Mil
It was the latest in a string of major arrests in the past two years as authorities have targeted fraud that’s believed to cost the government between $60 billion and $90 billion each year. Stopping Medicare’s budget from hemorrhaging that money will be key to paying for President Barack Obama’s health care overhaul (5/2).

The Wall Street Journal: U.S. Charges 107 With Defrauding Medicare
Attorney General Eric Holder and Health and Human Services Secretary Kathleen Sebelius said that charges were being brought against defendants in seven cities, including doctors and nurses, for seeking to defraud the federal health program for the elderly and disabled. At least 83 of the defendants were arrested Wednesday morning, officials said (Radnofsky, 5/2).

Politico: U.S. Health Care Spending 'Dwarfs' Other Countries
The United States spends more on health care than 12 other industrialized countries, a new Commonwealth Fund study finds – but that doesn't mean this country's care is any better. The U.S. spent nearly $8,000 per person for health care services in 2009, the study found, confirming that "health care spending in the U.S. dwarfs that found in any other industrialized country" (Smith, 5/3).

Chicago Tribune: Accretive Health Blasts Minnesota Attorney General Office, Says Agency’s Report Has Harmed The Chicago-Based Hospital Billing And Collections Company
Embattled hospital billing and collections company Accretive Health Inc. said Wednesday that it was blindsided by the critical report released last week by Minnesota's attorney general, and it vowed to explore "legal remedies for the damages" resulting from the fallout (Frost, 5/3).

The Wall Street Journal: Highmark, Hospitals Reach Pact
Under pressure from Pennsylvania officials, insurer Highmark Inc. and the University of Pittsburgh Medical Center reached an agreement to extend their contracts until the end of 2014, and negotiate new terms for certain services after that date (Mathews, 5/2).

The New York Times: U.S. Lags In Global Measure Of Premature Births
Fifteen million babies are born prematurely each year, and the United States fared badly in the first country-by-country global comparison of premature births, which was released Wednesday by the World Health Organization and other agencies (McNeil, 5/2).

Los Angeles Times: L.A. Program Offers Healthcare For Illegal Restaurant Workers
A restaurant workers' group and a Los Angeles community clinic have launched a unique cooperative to provide health coverage to a group of people excluded from federal healthcare reform — illegal immigrants. The pilot program, believed to be the first of its kind in the nation, offers preventive and primary care to low-wage, uninsured workers in the restaurant industry. Legal immigrants and other restaurant workers who don't meet the criteria or cannot afford coverage under the healthcare law are also eligible (Gorman, 5/2).

Reuters/Chicago Tribune: Wisconsin Governor, Likely Rival Tied IN Recall Vote – Poll
Walker enraged Democrats and unions representing government workers last year when he pushed through the legislature a measure reducing the powers of public sector unions. The law forced workers to pay a portion of the cost of health insurance and pensions, capped wage increases and required most unions to be recertified every year (O'Brien, 5/2).

The Associated Press/Washington Post: Illinois Democrats Consider Painful Cuts For Friends And Allies As Budget Crisis Continues
Facing one of the nation's worst budget crises, the Democrats who run Illinois insist they're serious about overhauling the state's expensive health programs and employee pensions. Gov. Pat Quinn underscored his determination by declaring he was "put on earth" to solve the multi-billion-dollar pension problem. But can the Democrats actually do it? (5/2).

The Wall Street Journal: Espada's Clinic Is Scaling Back
As Pedro Espada Jr. awaits a verdict in his corruption trial, the Medicaid-funded Bronx health clinic controlled by the former state senator says it plans to stay open despite efforts by the state to shut it down. Officials at Soundview Health Center in the South Bronx, say the nonprofit is running out money, claiming it is owed hundreds of thousands of dollars from Medicaid managed-care plans and the state (Gershman, 5/2).

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