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Hanley on Health Care: Antipsychotic drugs; virtual colonoscopies; and oil drilling = higher Medicaid costs

Mar 20

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3/20/2012 1:34 PM  RssIcon

A very disturbing, I thought, article on the dramatic rise in use of powerful, expensive antipsychotic drugs for patients WITHOUT mental illness.  Antipsychotic drugs grow more popular for patients without mental illness, Sandra G. Boodman, Published: March 12, Washington Post — Adriane Fugh-Berman was stunned by the question: Two graduate students who had no symptoms of mental illness wondered if she thought they should take a powerful schizophrenia drug each had been prescribed to treat insomnia. “It’s a total outrage,” said Fugh-Berman, a physician who is an associate professor of pharmacology at Georgetown University. “These kids needed some basic sleep [advice], like reducing their intake of caffeine and alcohol, not a highly sedating…

 

I thought this a clever, without being offensive, rebuttal of the Obama mandate for insurers to cover contraceptives free to the patients.  Coffee Is an Essential Benefit Too, Allysia Finley, WSJ, 03/12/2012 — Here are some other health-care mandates that government should impose on employers…. Dear President Obama, Can you believe the nerve of employers? … Really, it's amazing that we aren't all dead. Now, thanks to you, we'll enjoy free and universal access to preventative care just like workers do in Cuba. Even so, there are still many essential benefits that the government must mandate to make the U.S. the freest country in the world…

 

Expanding Medicaid reduces access? Then I noticed that part of the study is attributed to John Goodman, whom I’ve met a couple of times and who seems unduly cynical about the role of government in health care. He points out one reason is Medicaid underpays providers? Has he looked at Medicare on this score? Medicaid is going to vary from state to state; some have worked hard to keep up rates, others have been hammered by the recession. I would reject the notion that Medicaid has not improved access in a well-run Medicaid program, and there are a number of them around the country, not the least here in Arkansas ... New Study: Expanding Medicaid Reduces Access to Health Care, Forbes — Chapin White of the Center for Studying Health System Change has published an important new paper in Health Services Research, a journal of health economics, which suggests that a critical part of the Affordable Care Act—its expansion of Medicaid ...

 

Bipartisan sponsors in Congress would mandate Medicare coverage of virtual colonoscopies … those done via MRI. Effectiveness and cost debated … but if Medicare is forced to cover, Medicaid will be pressured to do so as well ... Manufacturers laud bill to make Medicare cover virtual colonoscopies, DOTmed.com, by Brendon Nafziger, DOTmed News Associate Editor — A bill introduced into the House of Representatives yesterday that would require Medicare to cover virtual colonoscopies for colon cancer screenings was lauded by medical imaging manufacturers

 

Alzheimers patients cost Medicaid 19 times more than those without … but more evidence how thin Medicare LTC coverage is and how most defaults to Medicaid for a population largely covered by both programs ... Those with Alzheimer's and other dementias cost Medicaid 19 times more than other Seniors, Cedartown Standard — Medicare payments for an older person with Alzheimer's or other dementias are nearly three times higher while Medicaid payments are 19 times higher than for seniors without Alzheimer's and other dementias. Unless a concerted effort to change the ...

 

Across the river in Mississippi … a Medicaid deficit approaching $900 million; this is going to be tough … Miss. Medicaid funding challenge getting steeper, The Oshkosh Northwestern (WTW) — Efforts to hold the line on Mississippi's Medicaid spending are getting more daunting. The state Medicaid agency told House members Wednesday that without changes, it now needs almost $884 million for the budget year that begins July 1…

 

A reminder, assuming the Affordable Care Act survives the Supreme Court, it will take a full 10 years, well into at least one future president's term, to fully implement ... If Obama's health law survives Supreme Court, it will take nearly a decade to put into effect,  Chicago Tribune, WASHINGTON (AP) — It took only a year to set up Medicare. But if President Barack Obama's health care law survives Supreme Court scrutiny, it will be nearly a decade before all its major pieces are in place. And that means even if Obama is re-elected, ...

 

Should the Supreme Court toss out the Affordable Care Act? This article details industries like managed care firms that stand to lose billions in expected Medicaid revenue. Of considerable note … the state of Texas stands to pull down a whopping 22% of all new Medicaid money in the nation under the law's intended Medicaid expansion ...  Medicaid Providers Could Lose Billions if Supreme Court Tosses Health Overhaul Law, By Matt BarryBloomberg Government released a study today which examines the size and scope of the projected revenue that the Medicaid program will direct to companies doing business in the 27 states that have filed suit over the constitutionality of the ...

 

Terrific summary of the issues the Supreme Court will consider in hearing the constitutionality, or lack of, for the Affordable Care Act. Really breaks it down nicely, best I’ve seen ... Kaiser Health News: The Health Law And The Supreme Court: A Primer For The Upcoming Oral Arguments — How big is the constitutional challenge to the Obama health care law, which the Supreme Court will hear on March 26-28? For starters, it's big enough for the justices to schedule six hours of arguments -- more time than given to any case since 1966. After all, the Affordable Care Act is arguably the most consequential domestic legislation since the creation of Medicare in 1965 (Taylor, 3/15).

 

Will the future see your health information in the clouds? Cloud technology - that is where the data is stored offsite on the storage servers of IT giants? Seems likely, but little discussed to date ... (1) Do Hospital CIOs Plan To Invest in Cloud-Based EHR or Health Data Exchange ... iHealthBeat — Among CIOs of hospitals with electronic health record systems and health information exchange tools, 36% said their hospital plans to invest in cloud-based systems for both EHR and HIE technology, according to an Optum Institute for Sustainable Health ...

(2) EHRs Become More Popular With Small Medical Practices, InformationWeek — Cloud services, help from feds, and backing from parent institutions all credited for recent surge in adoption of electronic health records by small physicians' offices. By Ken Terry InformationWeek Small medical practices are starting to use ...

 

Not a surprise, but sobering given 16 to 18 million new Medicaid insured starting in 2014 … people already on the program struggle to see a PCP and visit the ER at twice the rate of the privately insured. The reasons are complex, i.e. prohibitive ER co-pays for insurance, little or none on Medicaid, low fees in some states, need for education and certainly need to increase primary care work force ... Medicaid Patients Struggle to Get Primary Care, Visit ERs More, MarketWatch (press release) WASHINGTON, March 14, 2012 /PRNewswire via COMTEX/ -- Twice as many people insured by Medicaid as by private insurance report barriers to primary care and Medicaid patients are twice as likely to visit the emergency department as their privately ...

 

Where can an oil boom drive up a state’s Medicaid cost? In North Dakota, where a booming oil-drilling push has raised the state's per capita income, requiring more than $100 million in state funds to draw down federal matching dollars. Arkansas has been affected by this same formula as its per capita income grew ahead of some other states … ND oil prosperity boosts state Medicaid spending, The Oshkosh Northwestern, By Dale Wetzel, AP BISMARCK, ND (WTW) — North Dakota's oil prosperity will require the state to spend $113 million more on Medicaid and other human services programs to keep the state's present level of aid to the poor, the state budget director said ...

 

“Exhibit A” from Mississippi on how a state can be very strongly opposed to the Affordable Care Act but still supportive of building an Insurance Exchange ...  (1) Mississippi Public Broadcasting's Jeffrey Hess, working in partnership with Kaiser Health News and NPR, reports: "Mississippi, a deeply red Southern state that is part of the Supreme Court case against the health law, is moving full speed ahead with one of the key provisions of that law: an online health insurance exchange" (Hess, 3/14). Read the story.

(2) Then on a related front, the federal taxpayers seem the losers in South Carolina … the state took a $1 million grant to build an exchange, then decided never mind, it wouldn’t build one, and the feds say, “just keep the money”...  Politico Pro: : South Carolina Won't Have To Refund 'Non'-Exchange Planning, South Carolina won't have to pay back its health insurance exchange planning grant after Gov. Nikki Haley instructed an advisory committee not to consider a state-based exchange. Federal auditors had been exploring whether South Carolina misused a $1 million HHS grant to plan a state-based exchange, but decided to drop the investigation this week (Millman, 3/14).