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Tuesday, January 24, 2017

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

Today’s agenda: Tom Price’s HHS confirmation hearing

With last week’s warm-up behind him, President Trump’s HHS pick, Georgia Congressman Tom Price, faces the main event today — a 10 a.m. confirmation hearing before the Senate Finance Committee. Trump’s Friday order to roll back parts of the ACA has set the stage for a dramatic piece of political theater, as whoever runs HHS would have wide latitude to tweak Obamacare rules affecting providers and insurers. Democrats and Republicans will use the hearing to prod Price on his plans. But judging from his courtesy hearing last week, it may be hard for them to elicit any concrete answers.

Price will also likely face more sharp questions over his investments and other potential conflicts; a Kaiser story on Monday pointed out his history of challenging CMS on behalf of doctors and and the drug industry.

Turmoil in Iowa: Discord over Seema Verma's Medicaid experiment 

Iowa expects to save $110 million this fiscal year after switching to a Medicaid managed care program designed by Seema Verma, President Trump’s pick to run CMS. But it's sparking complaints. The three for-profit managed care organizations running the plan say the state is vastly underfunding the $4.2 billion program. Meanwhile, providers are complaining that lower reimbursements are depriving them of hundreds of thousands of dollars even though they are delivering the same level of service.

Using managed care to pare down Medicaid costs is hardly an outlier in the US; 39 other states do something similar. But Iowa tried to turn its program on a dime, and it appears few stakeholders are pleased.

Read more.

A federal judge blocks the Aetna-Humana merger and the market responds

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Well, Monday didn’t exactly go as Aetna hoped. A federal court blocked the company’s massive $37 billion merger with Humana over antitrust concerns. The merger would have made Aetna the nation’s largest provider of Medicare Advantage plans. But in his ruling, US District Court Judge John Bates said the deal would likely “lessen competition” in health insurance markets. His decision comes six months after the Department of Justice sued to block the deal to prevent seniors from facing a price hike.

A spokesperson for Aetna, whose stock fell 2.72 percent to $119.20 on Monday, told reporters the company would give “serious consideration to an appeal after putting forward a compelling case." Otherwise, Aetna owes Humana a $1 billion break-up fee.  

Looking forward, Bates’ ruling doesn’t seem to bode well for the even more massive $54 billion deal between Anthem and Cigna. The Obama administration challenged that mega-merger last summer. A federal judge is expected to rule soon.

American Medical Association President Dr. Andrew Gurman praised the decision as an "extraordinarily well-documented, comprehensive, fact-based ruling."

Sponsor content by The Leukemia & Lymphoma Society

Precision Medicine Master Trial aims to find new treatment for AML

There have been few advances in the treatment of acute myeloid leukemia patients for more than 40 years. The Leukemia & Lymphoma Society’s collaborative clinical trial, Beat AML, is designed to change the treatment paradigm by developing more individualized, effective treatment approaches. Read more.

New research: Cracks found in ACA coverage for the chronically ill

Despite Obamacare’s expansion of insurance coverage, 1 in 7 chronically ill patients in the US still lacked coverage following the law’s implementation, according to a new study by researchers at Harvard Medical School. Minorities were even worse off: 1 in 5 chronically ill black people lacked coverage, and it was 1 in 3 among Hispanic people. The researchers examined data for more than 600,000 adult patients, ages 18 to 64, with chronic medical problems in 2013 and 2014.

The authors argue a "Medicare for All" program is the best way to eliminate cracks in coverage, but they also acknowledge the incredibly long odds that such a proposal faces in Washington these days. Their research was promoted Monday by Physicians for a National Health Program, which advocates for a single-payer health care system, but the group did not fund or otherwise support the study.

A proposed Florida teaching hospital sparks a rift among providers

Can Orlando become a world-renowned medical mecca? University of Central Florida officials say yes — so long as they can build a teaching hospital.

In a recent Orlando Sentinel column, UCF Board of Trustees chairman Marcos R. Marchena argues a university-affiliated hospital would improve education for med students and attract better faculty. 

But the plan involves partnering with Hospital Corporation of America, one of the nation’s largest for-profit health care companies. That's drawn the ire of Orlando-area hospital operators Florida Health and Orlando Health. In a December 2016 letter to state officials, Orlando Health raised concerns that UCF-HCA plan did not have “any condition or binding commitments” that would require the hospital to train medical students. They're concerned that a new hospital will eat into their bottom lines. 

Marchena, however, is dreaming big. “Johns Hopkins. Harvard. Cleveland Clinic,” he writes. “And with our community's support…we will fulfill our promise to become a hub of innovation and foster a healthier Orlando."

Referrals

  • Why patient hand-offs between caregivers are so precarious (Washington Post)
  • Trump revives policy blocking funding to foreign groups that provide abortions (STAT)
  • Andy Slavitt’s next mission: save Obamacare (Politico)
  • A rare disease causes a tragic turn for a pregnant doctor (Houston Chronicle)

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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