First Edition: June 9, 2014

Today's headlines include reports about efforts on the state level and within the health care system to address health care costs and advance other system reforms.

Kaiser Health News: Coast-to-Coast Health Care Woe: Cost
Kaiser Health News staff writer Jenny Gold, working in collaboration with NPR, reports: "Recently, I moved across the country, from Washington, D.C., to San Francisco. I drove the Southern route and decided to conduct an informal survey, asking folks I met along the way a question relevant to the health care reporting I've been doing for the past five years. The question: What bugs you most about your medical care?" (Gold, 6/9). Read the story.

Kaiser Health News: More Than 1.7 Million Consumers Still Wait For Medicaid Decisions
Kaiser Health News staff writer Phil Galewitz, working in collaboration with The Washington Post, reports: "While an unprecedented 6 million people have gained Medicaid coverage since September, mostly as a result of the Affordable Care Act, more than 1.7 million more are still waiting for their applications to be processed-;with some stuck in limbo for as long as eight months, according to officials in 15 large states. The scope of the problem varies widely. California, the most populous state to implement the health law's expansion of Medicaid, accounts for a lion's share of the backlog with 900,000 applications still pending as of early June. The next biggest pileup is in Illinois, with 283,000 cases, while New York has no backlog at all" (Galewitz, 6/9). Read the story.

The Wall Street Journal: Some States See In The Health Law A Chance To Pursue Unique Solutions
The federal health-care law was intended to create a uniform standard of health coverage across the U.S. But the law also is creating opportunities for states to pursue their own solutions. For states like Vermont, that means pursuing liberal experiments that go further than the Affordable Care Act; for others, it means expanding coverage for the poor in a way that's more palatable to conservative lawmakers (Radnofsky, 6/8).

The New York Times: In Texarkana, Uninsured And On The Wrong Side Of A State Line
Arkansas accepted the Medicaid expansion in the Affordable Care Act. Texas did not.That makes Texarkana perhaps the starkest example of how President Obama's health care law is altering the economic geography of the country. The poor living in the Arkansas half of town won access to a government benefit worth thousands of dollars annually, yet nothing changed for those on the Texas side of the state line (Lowrey, 6/8). 

The Washington Post: Opponents Of Health-Care Law Turn To Faith-Based Non-Profits to Cover Medical Expenses
Susan Tucker is one of millions of Americans who dislike the health law and want nothing to do with it. But the 54-year-old Venice, Fla., homemaker took her opposition a step further: She opted out. Tucker dropped the private health plan she had carried for more than a decade and joined Christian Healthcare Ministries, a faith-based nonprofit in which members pool their money to pay for one another's medical needs -; and promise to adhere to biblical values, such as attending church and abstaining from sex outside marriage (Somashekhar, 6/5).

The Wall Street Journal: Hospitals Push Bundled Care As The Billing Plan Of The Future
Hospital bills may soon get a lot simpler. Traditionally, hospitals have charged patients separately for every service and supply they use-;as anybody who has waded through pages of charges knows. Fees for surgeons, anesthesiologists and other providers come in complex bills of their own. Now, more hospitals see so-called bundled payments as the wave of the future (Beck, 6/8).

The Wall Street Journal: The Health-Care Industry Is Pushing Patients To Help Themselves
It's the last mile in the race to fix health care-;getting patients more involved. Hospitals, doctors and public-health officials are pushing patients to keep track of their medical data, seek preventive care and stay on top of chronic conditions. They're measuring how motivated patients are to manage their own health and adopting a wide range of strategies to help them do better, a concept known as patient engagement (Landro, 6/8).

The Wall Street Journal: Take Your Heart Medicine-;And Win A Prize!
In the Heartstrong study being conducted by the University of Pennsylvania's Center for Health Incentives and Behavioral Economics and the Penn Medicine Center for Health Care Innovation, 1,000 patients will be given pill bottles that transmit wireless alerts to researchers if the patients fail to take their medicine. The study is testing new ways to motivate people to take their medicine more consistently-;including greater involvement of friends and family and the possibility, every day, for those who take their pills to win a small cash prize (Ward, 6/8). 

The Wall Street Journal: HealthCare.gov Floats To Amazon's Cloud in Revamp
The Obama administration has turned to Amazon.com Inc. to host certain HealthCare.gov components in the latest sign that cloud is gaining traction in the government sector. The move will give the government more flexibility in the amount of computing power it uses to run its health exchange, experts say, allowing it lower costs outside of peak usage periods (Boulton, 6/6).

The Washington Post: CareFirst Seeks Price Hikes For Individual Health Plans
Maryland's dominant insurance company, CareFirst, is proposing hefty premium increases of 23 to 30 percent for consumers buying individual plans next year under the federal health-care law, according to filings released Friday. The rate proposals by CareFirst and several other carriers were posted on the Web site of the Maryland Insurance Administration and paint a mixed picture. Two other insurers, Kaiser Foundation Health Plan and Evergreen Health Cooperative, are proposing to lower rates for next year, by 12 percent and about 10 percent, respectively (Sun, 6/7).

Los Angeles Times: Anthem, HealthCare Partners Save $4.7 Million By Coordinating Care 
Insurance giant Anthem Blue Cross and the HealthCare Partners physician group say a new effort to coordinate care among 55,000 patients helped save $4.7 million. In results released Friday, the two companies said their collaboration, known as an accountable-care organization, or ACO, cut costs by reducing hospital admissions, emergency-room visits and lab tests, particularly among patients with chronic conditions (Terhune, 6/6).

Louisville Courier Journal/USA Today: More Patients Flocking To ERs Under Obamacare
It wasn't supposed to work this way, but since the Affordable Care Act took effect in January, Norton Hospital has seen its packed emergency room become even more crowded, with about 100 more patients a month. ... Nationally, nearly half of ER doctors responding to a recent poll by the American College of Emergency Physicians said they've seen more visits since Jan. 1, and nearly nine in 10 expect those visits to rise in the next three years. Mike Rust, president of the Kentucky Hospital Association, said members statewide describe the same trend. Experts cite many reasons (Ungar, 6/8).

The New York Times: Judge Voids Expansion Of Discount Drug Program
A federal judge has struck down a new rule requiring drug companies to offer certain drugs at discounted prices, saying the Obama administration had no authority to issue the rule. Federal officials said the decision could provide a windfall to drug makers. However, the pharmaceutical industry said that the administration was stretching the Affordable Care Act to provide discounts on more drugs for more people, and that the rule was "inconsistent with the plain language of the statute" (Pear, 6/8). 

NPR: Hospitals Put Pharmacists In the ER To Cut Medication Errors
In the emergency department at Children's Medical Center in Dallas, pharmacists who specialize in emergency medicine review each medication to make sure it's the right one in the right dose. It's part of the hospital's efforts to cut down on medication errors and dangerous drug interactions, which contribute to more than 7,000 deaths across the country each year (Silverman, 6/9).

Los Angeles Times: Scale Of Medical Decisions Shifts To Offer Varied Balances Of Power
Doctors still make decisions sometimes, but sometimes patients make them, and sometimes doctors and patients make them together. Doctors and bioethicists are engaged in a vigorous debate about the relative merits of these various approaches. Meanwhile, you may want to consider which suits you best as a patient (Ravn, 6/6).

Sioux City Argus Leader/USA Today: Johnson Joins Other Democratic Senators To Urge Medicaid Expansion
Sen. Tim Johnson and other colleagues in the Senate have asked Republican governors in states such as South Dakota to "put politics aside and do the right thing" by expanding Medicaid coverage under the Affordable Care Act. In a letter last week, Johnson told Republican governors, including South Dakota's Dennis Daugaard, that an estimated 6 million Americans, including almost 50,000 in South Dakota, are not getting coverage because those 18 states have failed to expand Medicaid. The letter also was sent to governors in nearby states such as Wyoming, Wisconsin and Nebraska (Doering, 6/8).

The Wall Street Journal: Tie To Obama's Health Law Proves Risky For Arkansas Republican
Arkansas legislator John Burris says he is a staunch opponent of President Barack Obama's health-care expansion. But after helping to engineer a compromise that allowed Arkansas to use dollars aimed at broadening Medicaid coverage to enroll poorer residents in private health insurance, the Republican finds himself in a tough runoff election Tuesday against an opponent who has played up his link to the Affordable Care Act (Campoy, 6/6).

The Associated Press: Arkansas State Senate Race Focuses On Medicaid Expansion 
State Rep. John Burris was among the most vocal opponents of the federal health care overhaul among the Republicans in the state House. Now running for a north Arkansas state Senate seat, however, he finds himself being portrayed as a cheerleader for the law he derides as "Obamacare" (DeMillo, 6/8).

The Associated Press: VA Head Says 18 Vets Left Off Wait List Have Died
In a new revelation in the growing Veterans Affairs' scandal, the organization's acting head says that an additional 18 veterans whose names were kept off an official electronic VA appointment list have died. Acting VA Secretary Sloan Gibson said he would ask the inspector general to see if there is any indication those deaths were related to long wait times. If so, they would reach out to those veterans' families (Tang and Daly, 6/6).

Los Angeles Times: More Details From Audit Of VA Healthcare Scandal Expected Monday 
As the acting secretary of Veterans Affairs tries to assure congressmen that he is moving to address the VA healthcare scandal, his department is preparing to release more results of a nationwide audit of scheduling practices that have been denounced as misleading and harmful to veterans. The results are expected to be released Monday, as a House committee puts VA officials through another round of grilling over findings that VA employees falsified records to conceal long waits for medical appointments (Simon, 6/7).

The New York Times: Cleveland Clinic Chief Out of Running For V.A.
Dr. Delos M. Cosgrove, the chief executive of the Cleveland Clinic, said Saturday he had been considered by President Obama for the job of secretary of the Department of Veterans Affairs, but had withdrawn his name and would stay at the clinic (Pear, 6/7).

The Wall Street Journal: Cosgrove Takes His Name Out Of Contention For Top VA Job
A person familiar with the situation said Dr. Cosgrove was moved by the White House's pursuit of him for the job and seriously considered it. But he decided not to take it in part because he didn't feel he could walk away from his commitments at the Cleveland Clinic, including the opening of a new facility in Abu Dhabi that he personally saw through (Armour, 6/7).

The Cincinatti Enquirer/USA Today: The Doctor Will See You Now – Virtually
Advances in telehealth are changing the way health care is delivered in the Cincinnati area. ... At St. Elizabeth Healthcare in Northern Kentucky, seeing your primary doctor may soon be as easy as logging onto your computer. And in Cincinnati's West End, formerly homeless veterans and recovering drug addicts at the Talbert House now have access to free, live online doctor's visits thanks to a first-of-its kind telehealth video console donated by Anthem Blue Cross and Blue Shield (Bernard-Kuhn, 6/7).

Los Angeles Times: Unequal Treatment: Las Vegas Tries New Tactic To Improve City's Notorious Healthcare
Now, Las Vegas is emerging as a test of how much a community can improve chronically poor health by expanding insurance coverage and using models of medical care pioneered in healthier places. "We are a prime example of what people see as problematic about the American healthcare system," said Larry Matheis, the former longtime head of the Nevada State Medical Assn. "That makes a lot of the ideas in health reform very attractive. … The challenge is going to be figuring out how to make it all work" (Levey, 6/7).

The Wall Street Journal's CIO Journal: Hospital Giant Uses Data To Vet Treatment Options
University of Pittsburgh Medical Center has found a way to improve health outcomes at lower cost thanks to a new data analytics program in which the hospital-and-insurance behemoth invested $105 million last year. UPMC says a pilot program that directed patients to a centralized care facility helped save $15 million in medical costs over the course of a year. These clinics, known as patient centered medical homes, centralize all of a patient's various care and medical services under the auspices of a single physician, and are assigned to patients once they've been released from the hospital (Hickins, 6/6).