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Friday, July 14, 2017

Morning Rounds by Megan Thielking

Congrats on making it to the end of the week! Here's what you need to know about health and medicine this morning. 

Justice Department charges 400 with health care fraud

The Justice Department has charged more than 400 people nationwide for their role in health care fraud schemes. Officials say the schemes resulted in $1.3 billion in false claims made to Medicare and Medicaid. The charges are part of a massive push to cut down on health care fraud. HHS officials also issued exclusion notices — which prohibit health care providers from participating in Medicare or Medicaid — to 295 doctors, nurses, and other providers for conduct tied to opioid abuse and diversion, or transferring opioids to people other than the patient who was prescribed the drugs.

Your rundown of the key health bill revisions

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There's still a big partisan gap in public opinion. (kaiser family foundation)

The Senate released its latest version of the health bill hoping to win over the GOP lawmakers on the fence. But two of them, Sen. Susan Collins and Sen. Rand Paul, have already said they're still not convinced. Here’s what changed:

  • It adds $45 billion in funding to address the opioid crisis through 2026. That could help to swing moderate Republicans such as Ohio Sen. Rob Portman and West Virginia Sen. Shelley Moore Capito, whose states have been hit hard by the epidemic. It also includes $250 million in funding over five years for research into addiction and pain.

  • States will get an additional $70 billion to help lower premiums through cost-sharing programs, health savings accounts, and cost-cutting initiatives. That’s on top of the $112 billion for those programs in the original bill. It would also allow people to use their health savings accounts to pay their premiums.

  • The bill would give health plans the option of providing bare-bones coverage as long as they offer at least one plan that meets ACA requirements. That proposal, pushed by Sen. Ted Cruz, is widely opposed by the insurance industry.

A new poll out this morning from the Kaiser Family Foundation finds that 61 percent of the public has an unfavorable view of the plan to repeal and replace the ACA, though the poll was conducted before the latest revisions. 

How labor units are run affects their C-section rate

A new study suggests that the way labor and delivery units are run might impact a healthy woman’s risk of having a C-section. Public health researchers interviewed nurse and physician managers who help run labor and delivery units at 53 hospitals. The management practices varied from one hospital to the next — from how nurses are assigned to patients to how providers communicate with one another — and some of those disparities seem to increase the risk that a healthy woman in labor will need a C-section or experience heavy bleeding.

 “The hospital you choose to deliver your baby at matters just as much as the doctor or midwife you choose to see,” Dr. Neel Shah, one of the study’s authors and an obstetrician, tells me. Shah says he strongly recommends expecting parents ask hospitals what their C-section rate is for low-risk women — the ideal rate is at or below 23.9 percent, he said. 

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Inside STAT: Teaching docs to talk frankly about death

A doctor pulls up a chair next to his patient, a 74-year-old woman with lung cancer that has metastasized. Her doctor can't find the right words to tell her that she only has six months to live. “Are you saying I’m dying?” the patient asks. From the other side of a two-way mirror, Anna-Gene O'Neal listens closely to the simulation. Her Tennessee lab is part of nationwide push to improve end-of-life care by training doctors in how to frankly discuss death. STAT's Max Blau has the story

Under fire, Goop's doctors strike back 

The doctors featured on Gwyneth Paltrow’s wellness site Goop are striking back at its many critics. The site — which sells everything from wellness supplements and sun potions to an energy-clearing kit — has often come under fire for promoting health practices that aren’t backed by robust evidence. Now, the experts on the site are defending their role and their scientific credentials, calling critics "dismissive" of practices a patient might find empowering or healing. Goop and its doctors singled out obstetrician-gynecologist Dr. Jen Gunter, a persistent critic who has lambasted the site's claims about the health benefits of vaginal jade eggs, among other assertions. Gunter wasn't fazed, though. "I am just one doctor with a blog," Gunter tweeted to Goop, "so if I can get under your skin with facts so easily, you must have very weak ideas indeed." 

Long work days tied to risk of irregular heartbeat

Long work days might translate to an increased risk of developing an irregular heartbeat, according to a new analysis out this morning. Researchers culled health data from more than 85,000 individuals who participated in longitudinal studies, and they divided the patients into groups based on the average hours they worked each week. None of those patients had an irregular heart rhythm, known as atrial fibrillation, when the studies started. But ten years out, those who worked 55 hours or more each week were roughly 40 percent more likely to develop atrial fibrillation than those who worked 35 to 40 hours. Atrial fibrillation, in turn, can contribute to the risk of stroke and other heart problems. The caveat: it’s just an association, and doesn’t show a cause and effect relationship. 

What to read around the web today

  • A tide of opioid-dependent newborns forces doctors to rethink treatment. New York Times
  • How storytelling can improve the care of people with Alzheimer's. WAMU
  • Documents reveal Philip Morris' campaign to subvert the world's anti-smoking treaty. Reuters

More reads from STAT

The latest from STAT Plus

Thanks for reading! More tomorrow,

Megan

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