First Edition: August 19, 2014

Today's early morning highlights from the major news organizations, including stories about a how a hospital system's data was hacked, involving as many as 4.5 million patients' records.

Kaiser Health News: San Antonio Police Have Radical Approach To Mental Illness: Treat It
Kaiser Health News staff writer Jenny Gold reports: "To deal with the problem, San Antonio and Bexar County have completely overhauled their mental health system into a program considered a model for the rest of the nation. Today, the jails are under capacity, and the city has saved $50 million over the past five years. The effort has focused on an idea called "smart justice" – basically, diverting people with serious mental illness out of jail and into treatment instead. It is possible because all the players in the system that deal with mental illness -- the police, the county jail, mental health department, criminal courts, hospitals and homeless programs – pooled their resources to take better care of people with mental illness" (Gold, 8/19). Read the story, which also ran on NPR.

Kaiser Health News: Insuring Your Health: HMO, PPO, EPO: How's A Consumer To Know What Health Plan Is Best?
Kaiser Health News consumer columnist Michelle Andrews writes: "What's in a name? When it comes to health plans sold on the individual market, these days it's often less than people think. The lines that distinguish HMOs, PPOs, EPOs and POS plans from one another have blurred, making it hard to know what you're buying by name alone--assuming you're one of the few people who know what an EPO is in the first place" (Andrews, 8/19). Read the column.

The Washington Post: The Trouble With Trying To Sign People Up For Health Insurance When Care Is Already Free
It's hard work trying to get people to sign up for health insurance when their care is mostly free to them. Andrea Thomas is working to get Alaska Natives in Sitka, Alaska, to do just that. She's the outreach and enrollment manager at SouthEast Alaska Regional Health Consortium (SEARHC), and it's her job to sign people up for health insurance coverage through exchanges created as a result of the Affordable Care Act. To get a sense of just how uphill Thomas's battle is, consider this: Of the more than 100,000 people who live in Alaska and self-identify as Alaska Native or American Indian, only 115 had signed up for health insurance through an Affordable Care Act exchange as of March 31. Alaska Natives and American Indians are exempt from tax penalties for not signing up for health insurance (Sheftie, 8/18).

The New York Times: Behind Closed Doors, Obama Crafts Executive Actions
When President Obama announced in June that he planned to bypass congressional gridlock and overhaul the nation's immigration system on his own, he did so in a most public way: a speech in the White House Rose Garden. As recommendations pour in, the most frequent question Mr. Obama's aides are asking, the people involved said, is whether the moves could withstand a legal challenge, which comes as House Republicans voted to sue Mr. Obama for unilateral action in changing elements of his signature health care law (Hirschfeld Davis, 8/18).

The New York Times: Hack Of Community Health Systems Affects 4.5 Million Patients
Community Health Systems, a publicly traded hospital operator based in Franklin, Tenn., said that personal data, including names, Social Security numbers and addresses, for 4.5 million patients had been compromised in a Chinese cyberattack on its systems from April to June (Perlroth, 8/18).

Los Angeles Times: Hackers Stole 4.5 Million Patients' Data In Hospital Breach
Cyberattack suspected to have originated in China stole Social Security numbers and other personal data for 4.5 million patients whose records were in Community Health Services Inc.'s system, the company said Monday. The data breach included the names, addresses, birth dates, telephone numbers and Social Security numbers of patients who were referred for or received services from doctors affiliated with the hospital group in the last five years. It did not include patient credit card, medical or clinical information, the company said in regulatory filings (Garland, 8/18).

The Wall Street Journal: Community Health Systems Says It Suffered Criminal Cyberattack
The rural hospital operator and cybersecurity firm Mandiant believe the attacker was an "Advanced Persistent Threat" group originating from China, it said. The attacker, which used highly sophisticated malware and technology to attack the company's systems, was able to bypass Community Health Systems' security measures and to successfully copy and transfer certain data outside the company, it said. The company said it is notifying affected patients and regulatory agencies as required by law. The data transferred, which was nonmedical patient-identification data related to the company's physician-practice operations, affected about 4.5 million individuals who were referred for or received services from company-affiliated physicians during the past five years. The data includes patient names, addresses, birth dates, telephone numbers and Social Security numbers, but not patient credit-card, medical or clinical information. Community Health Systems said it would offer identity-theft protection services to those affected by the attack (McCarthy, 8/18).

The Wall Street Journal: Investigators: We Don't Know Why China Hacked Hospitals
Community Health Systems Inc. made headlines Monday when it announced Chinese hackers took records on 4.5 million patient records, according to a securities filing. But it remains unclear why the hacker group, which normally targets trade secrets like plane blueprints and health device designs, wanted personal data. "We have tracked this group for the past four years and we have never seen them steal this type of information before," said Charles Carmakal, a managing director at FireEye Inc.'s Mandiant unit, which is investigating the breach, according to company filings (Yadron, 8/18).

The Washington Post: Chinese Hackers May Have Stolen Your Medical Records
Chinese hackers have stolen medical records for 4.5 million patients, according to a regulatory filing from Community Health Systems, a publicly-traded company that runs 206 hospitals in 29 states. The stolen data includes records for patients of who have seen doctors affiliated with the company in the past five years (Sullivan, 8/18).

The Associated Press: Community Health Details Attack On Patient Records
The Franklin, Tennessee, company said Monday that no medical or credit card records were taken in the attack, which may have happened in April and June. But Community said the attack did bypass its security systems to take patient names, addresses, birthdates, and phone and Social Security numbers (8/18).

USA Today: Health Network Reports 4.5 Million Patients Had Information Hacked
Community Health Systems, based in Franklin, Tenn., said the attack occurred in April and June. In a filing with the U.S. Securities and Exchange Commission on Monday, the company said the attacker was an "Advanced Persistent Threat" group, possibly based in China. It used "highly sophisticated malware and technology to attack the company's systems," the filing said. The company's forensic computer experts at Mandiant said the Chinese hacking group "was able to bypass the company's security measures and successfully copy and transfer certain data outside the Company" (Weise, 8/18).

The Washington Post: James M. Jeffords, Vermont Republican Who Became Independent, Dies At 80
A former Vermont state senator and attorney general, Mr. Jeffords served seven terms in the U.S. House of Representatives before winning election to the Senate in 1988. He established himself as a moderate-to-liberal Republican, a reflection of his state's political tendencies, and frequently voted with Democrats on matters such as health care, taxes, abortion, gay rights, gun control and the environment. He had long considered a party change, he said, without making the move. But his alienation worsened in the later years of his career -; a shift attributed, depending on the source, to factors such as genuine philosophical disagreements or a desire for greater influence on behalf of his state (Langer, 8/18).

The Wall Street Journal: Risks Create Tumult for Tech, Health-Care Firms
Seismic shifts in the technology and health-care sectors highlight why executives are divided or undecided about taking financial and strategic risks. … At the opposite end of the spectrum is the health-care industry. The still-evolving Affordable Care Act, has made many companies hire thousands and plow millions into their businesses. The health-care sector is expected to post revenue growth of 12.2%, the highest of any sector, and earnings growth of 15.9%, second only to the telecommunications industry. Health-care companies increased spending on buildings and equipment by 15%, the greatest surge of any sector and compared with a 24% decline in the second quarter last year, according to FactSet (Knox and Murphy, 8/18).

USA Today: Hospitalizations, Deaths For Heart Disease Fall
Hospitalizations for heart disease and stroke fell by about one-third over the past decade, according to a new study of nearly 34 million Medicare recipients. The number of Medicare patients hospitalized with heart attacks fell 38% from 1999 to 2011, while the number hospitalized with blood-clot-related strokes fell 34%, according to a study in Circulation. Hospitalizations fell 31% for heart failure, which occurs when the heart is too weak to pump efficiently, and 84% for unstable angina, a sudden chest pain that often leads to heart attacks, partly because some of these cases were reclassified as heart attacks (Szabo, 8/18).

NPR: Pittsburgh Health Care Giants Take Fight To Each Other's Turf
Pittsburgh's dominant health insurance company and its largest healthcare provider are, essentially, getting a divorce. For decades, Highmark Blue Cross/Blue Shield and University of Pittsburgh Medical Center worked together. But as the line between insurance companies and health care providers across the country blurs, these longtime allies are venturing into each other's business and becoming competitors (Brady, 8/19).