Tuesday, February 14, 2017

On Call by Casey Ross & Max Blau
Good morning! We're here to catch you up on 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.

Texas experiment highlights the perils of privatizing Medicaid

Cutting Medicaid costs is a mantra in Washington these days. But five years after implementing a privatized program that transports poor Texans to medical appointments, the state found that it has instead increased costs by $316 million while serving fewer than half as many people, according to the Houston Chronicle.

Meanwhile, parents who rely on the Medically Dependent Children Program shared horror stories with the Dallas Morning News, which reported on children with severe health problems losing access to medications and basic services. One mother told the newspaper how delays prolonged her son's fasting before surgery: “You try to explain to a 9-year-old autistic boy — sorry, you can’t eat because someone has decided this isn’t worth it.”

Republican lawmakers in Washington have touted the budget benefits of giving states more leeway to run their Medicaid programs. But the Texas privatization experiment raises a salient question: How much leeway is too much?

Sponsor content by Tufts Medical Center

Father, son cardiologists change narrative on a once grim genetic disease

Fifty years ago receiving a diagnosis of Hypertrophic Cardiomyopathy (HCM) was virtually a death sentence. Categorized by thickening of the heart muscle, HCM may be best recognized as the most common cause of sudden death in young athletes. But due to the life’s work of a father and son physician team now at Tufts Medical Center in Boston, HCM is not only treatable, but patients with proper management can achieve normal life expectancy. Read more.

Today in STAT: Can dentistry kick its opioid habit?

Matthew Orr/STAT

Dentist Dr. Nelson Wood beat an opioid addiction that led to his arrest and nearly sank his career. But now, as he tries to rid his practice of Vicodin and Percocet, he’s confronting a disquieting reality: It’s not just patients who are hooked on opioids. It’s the entire field of dentistry.

Dentists prescribe about 8 percent of the opioids in America, but they are the top prescriber to adolescents, accounting for 31 percent of the opioids given to patients between age 10 and 19. STAT’s David Armstrong reports that curtailing opioid prescriptions might be good for patients, but it’s still bad for Wood’s business.


Trending on Twitter: #healthpolicyvalentines

Who says doctors can’t be poets? This Valentine’s Day, many are tweeting heartfelt odes to their favorite health policy ideas. If you’re looking for a wonky pick-me-up, check out #healthpolicyvalentines. Here are some of our favorite entries so far:

@RichDuszak dug deep and produced a gem on overutilization.

@D_Liebman tweeted sweet satire on Medicaid block grants.

And there’s also this beauty from @VarshneyMD:

Roses are red
Diamonds go on a ring
Social determinants of health
Are definitely a thing

New research: More seniors taking multiple brain-affecting drugs at once

The number of older Americans taking three or more medicines that affect their brains more than doubled between 2004 and 2013, according to a new study by researchers at the University of Michigan. Stigma associated with mental health drugs might be going down, but their use also raises safety concerns “because of the risks of combining these medications,” said Dr. Donovan Maust, the study’s lead author.

The study examined doctor visits by patients over age 65 using multiple drugs that act on the central nervous system, such as opioids, antidepressants, and tranquilizers. Those patients accounted for 1.4 percent of doctor visits in 2013, compared to 0.6 percent in 2004.

Maust said the increase, particularly pronounced in rural areas, points to the need for clinicians to carefully monitor patients and adhere to evidence-based prescribing guidelines. That advice might sound obvious, but he said it isn’t always followed: “Prescribing of benzodiazepines to older adults continues despite decades of evidence showing safety concerns, effective alternative treatments, and effective methods for tapering even chronic users.”

GOP governor backs tax extension to boost Georgia’s hospitals

Republican Georgia Governor Nathan Deal is expected to sign into law an extension of the state’s hospital provider fee to protect the “state’s most vulnerable citizens.” Georgia’s health department takes in around $300 million each year from hospitals through a 1.45 percent tax on net profits, which it uses to draw down nearly $600 million in matching federal Medicaid funds. Anti-tax advocates had tried to get conservative legislators to reject the “bed tax,” but they overwhelmingly supported the measure.


  • Back surgery is popular in Casper, Wyo. Why? (New York Times)
  • California regulators hold health insurers' "feet to the fire" over inaccurate doctor listings (California Healthline)
  • Using improv to help kids with autism learn to socialize (NPR)
  • GOP faces blowback on its own plans for the 'Cadillac Tax' (Wall Street Journal)  

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