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Tuesday, February 7, 2017

On Call by Casey Ross & Max Blau
Good morning! We're here to catch you up the latest news affecting hospitals and health care. For more coverage, follow us at @statnews, @bycaseyross, and @maxblau on Twitter, or like us on Facebook.

Today in STAT: An Iraqi doctor wins the trust of Trump country

jeff swensen for stat 

For five years, Dr. Chalak Berzingi, a Iraqi Kurdish refugee, has made his way to a remote Appalachian town three days a week to treat patients in need of cardiac care. Elkins, West Va., is a conservative place, nearly all white, and many residents don't have much contact with immigrants. But they've embraced the 52-year-old Muslim doctor — who chooses to work there because, he says, he feels needed.

STAT’s Max Blau headed to Elkins to learn how that relationship developed. He met patients who back President Trump's temporary travel ban on Iraqi immigrants — and who'd never realized that their trusted cardiologist would fall into that category. They want to keep America safe. But recognizing the impact that ban would have on their doctor — and their health care — gave them pause.

Read more.

Repealing ACA? Then restore hospital reimbursements, execs say

Hospitals executives are hoping patients keep their insurance under whatever plan replaces the ACA. If patients lose coverage, though, administrators want lawmakers to restore billions of dollars in federal funding phased out during the ACA’s implementation. This funding included Disproportionate Share Hospital payments, or DSH, which helped cover the costs of caring for the uninsured and underinsured.

Hospitals agreed to payment cuts amounting to $230 billion over a decade because they expected to make it up through insurance reimbursements. If patients lose insurance and Congress doesn’t bring back DSH payments, cash-strapped safety-net hospitals may suddenly find themselves in a financial bind.

Tweet of the Day: NFLPA takes to the field over ACA

"Every player leaves the National Football League with a pre-existing condition” because of injury,  DeMaurice Smith, executive director of the NFLPA, told CBS News' Face the Nation. “Hundreds of players would be going into retirement with a tougher and, in some cases, an impossibility to get insurance because every one of them has a pre-existing condition."

A vending machine helps a hospital support breastfeeding

Megha Satyanarayana
At Boston Children’s Hospital, there’s a vending machine by the main elevators. It sells chocolate and cookies, but also bottles, nipple shields and bras. Yes, bras.

Children’s installed the "milk pod" to dispense breastfeeding supplies in 2014, says Karen Sussman-Karten, a nurse and lactation consultant at the hospital. Who uses it? Employees who forget to bring a part for their breast pumps, and parents who might suddenly find themselves in the hospital without suppliest. The machine also sells bottles designed for children with cleft palates and for preemies who might need a very slow flow.

"We’re seeing more families arriving here with the intention of providing breast milk,” Sussman-Kartens says.

The most popular item? The chocolate bar, of course. “People want a nice treat,” she says.

A painful, costly fight for undocumented immigrants with renal disease


For undocumented immigrants in Colorado with end stage renal disease, life is a constant cycle of near-death experiences in which they get rescued at hospitals, released with no consistent care, and then readmitted when symptoms worsen. Their experiences are described in a new study published in JAMA Internal Medicine.

Researchers interviewed 20 undocumented immigrants in Colorado whose coverage through Medicaid was limited to emergent-only dialysis treatment. They found such patients face greater pain and psychological distress than those who get scheduled dialysis treatments. They also found that the emergent treatment is 3.7 times more expensive than scheduled dialysis.

The authors suggested those impacts should spur further study of this population (there are about 6,480 undocumented immigrants with end stage renal disease in the US), and a rethinking of coverage restrictions. “Comparing the experiences of different states and localities may aid in identifying more humane and higher-value solutions,” they conclude.

Referrals

  • States fear Medicaid, a weapon against opioid addiction, might get lost in GOP's health plans (Pew Trusts)
  • An ER charged $2,783 for liquid stitches and a bandage. Why? (Vox)
  • The day I zipped my lips and let my patients talk. (STAT)
  • Ordering lab tests yourself can be far cheaper than through a doctor (Forbes)

Have a news tip or comment you want to send me?

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Stay well, and come back tomorrow.
Casey

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