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Wednesday, December 14, 2016

On Call by Casey Ross
Good morning! Here's the latest news on hospitals and health care. For more, follow @statnews on Twitter or like us on Facebook.

The Obama administration defends the president's legacy

As the Obama administration comes to an end, his top health aides are pushing a new report highlighting Obamacare's successes in pushing the nation's uninsured rate to the "lowest level on record." More tidbits credited to the ACA:
  • Hospitals' uncompensated costs fell by an estimated $7.4 billion. Expansion of Medicaid accounts for $5 billion of that drop.
  • Incentives for hospitals to improve care drove readmissions for Medicare beneficiaries down 8 percent, which translates into 565,000 fewer readmissions.
  • Accountable care organizations set up to coordinate care for Medicare patients now serve 8.9 million people.

Of course, the report skips over a few things, such as spiking insurance premiums in many states and an 5.8 percent rise in US health spending in 2015, the largest such increase in eight years. We'll be watching how the Republican alternative might change these numbers. 

Patient navigators help steer communication between families and caregivers

A hospital stay is often a dizzying experience for patients and families. It is easy to become anxious, confused, and disappointed, especially when dealing with super-specialized physicians who aren’t always skilled communicators.

In a First Opinion for STAT, Dr. Kelly Michelson writes that increasing use of patient navigators can help prevent communication breakdowns and improve care. She helped create such a program at her hospital, Lurie Children’s in Chicago.

Read more.

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Dropping in for a look at Indiana's trendsetting Medicaid expansion

STAT's Andrew Joseph visited Indiana last week to look at the state's Medicaid expansion, which was designed by Seema Verma, Trump's pick to run CMS. He reports:

Indiana's Medicaid expansion has been hailed as a model: It gives doctors higher payments and makes patients pay for some of their care. But a number of patients told me they had trouble figuring out its complicated requirements.

One of them was Ashley Brown, a 32-year-old mother of three. She said the state regularly made mistakes measuring her income and counting the number of people in her household, mistakes that threatened her coverage. 

"I literally cry out of frustration on the phone," Brown told me. "I swear, Indiana is the issue."

Read more

Breakthrough medicine: Paralyzed patient responds to a spinal stimulator

A 32-electrode stimulator is returning significant hand function and sensation to a California man who broke his neck after a biking accident five years ago.

Doctors at Ronald Reagan UCLA Medical Center implanted the device near the C-5 vertebrae of 28-year-old Brian Gomez. He hadn't been able to manipulate his hands before the surgery; within months, he was able to move all 10 fingers.

The experimental procedure is among the first to restore significant hand movement and muscle strength without the use of robotics. Dr. Daniel Lu, director of UCLA’s neuroplasticity and repair laboratory, is working with Gomez to program the stimulator to help maximize his dexterity and comfort.  "It is an ongoing process that retrains the spinal cord and, over time, allows patients to strengthen their grip and regain mobility in their hands," Lu said.

Gomez, who owns his own coffee company, told me the stimulator has improved circulation and sensation throughout his body, so he can feel even light touches. He has also gained enough arm and core strength to power up three flights of a parking garage in his wheelchair, a feat he accomplished recently after an elevator broke during a coffee delivery.

“Simple things have become much easier because of the strength I’ve gained,” he said. “I was a little skeptical of this at the beginning, but I’ve become more optimistic because of the things I’ve felt and been able to do.”

Referrals

  • A new tally of the dollars flowing to doctors from medical device and pharma companies (ProPublica)
  • Why would a Kentucky county vote for Trump after Obamacare dropped its uninsured rate by 60 percent? (Vox)
  • Hack of Quest Diagnostics endangers data of 34,000 patients (New York Times)
  • Her grandmother's heart attack changed the way Dr. Jennifer Okwerekwu practices medicine (STAT)

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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