Health Brief: Doctors From Lower-Tier Schools Prescribe More Opioids

Government Brief

  • At the summer meeting of the National Association of Insurance Commissioners in Philadelphia, state officials are agonizing over what to do if the White House decides to stop making key cost-sharing subsidy payments to insurers. (The New York Times)
  • Sen. Bernie Sanders (I-Vt.) has largely put his push for single-payer health care on the back burner, instead opting to campaign across the country to defend the Affordable Care Act from Republican efforts to undo the 2010 law. (Vox)
  • The Trump administration’s vow to give states more flexibility over their Medicaid programs is being tested in Maine, which last week submitted a section 1115 waiver that seeks to impose work requirements, mandatory premiums and asset testing. (Healthcare Dive)

Business Brief

  • Physicians who graduated from lower-ranked medical schools prescribe nearly three times as many opioids per year as those who attended top-tier institutions, according to a new study that sheds new light on how prescribing practices could contribute to the nation’s opioid abuse epidemic. (Stat News)
  • Private donors are pumping $30 million to expand a program in South Carolina that connects at-risk and teenage mothers with nurses to provide in-home services. It is the first statewide program designed in accordance with the “pay-for-success” model, which ties payment for social services to measurable outcomes. (Kaiser Health News)
  • Shares for Tenet Healthcare Inc. fell 11 percent after the hospital operator reported a bigger-than-expected quarterly loss as it struggled with fewer patient admissions. (Reuters)

Chart Review

Events Calendar (All Times Local)

National Association of Insurance Commissioners summer national meeting 8 a.m.
National Academy of Social Insurance event on health insurance 8:30 a.m.
National Business Group on Health event on large employers 10 a.m.
National Association of Insurance Commissioners summer national meeting 9 a.m.
Center for Global Development event on implementing clinical trials during epidemics 12:30 p.m.
No events scheduled.

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Inside Bernie Sanders’s campaign to save Obamacare
Jeff Stein, Vox

On three separate occasions this July, staffers for Sen. Bernie Sanders (I-VT) began preparing for the rollout of his new single-payer health care bill. But every time they started to do so, Senate Republicans would improbably revive their push to repeal Obamacare — and Sanders’s team would postpone the launch of their “Medicare-for-all” campaign, according to aides to the Vermont senator.

‘May you die in pain’: California GOP congressman gets an earful at town hall
Phil Willon, Los Angeles Times

“May you die in pain.” That was the nastiest moment of Republican Rep. Doug LaMalfa’s early morning town hall in the Northern California town of Chico on Monday.

Euro Extends Gain as Stocks Struggle; Gold Climbs: Markets Wrap
Samuel Potter, Bloomberg

Europe’s common currency edged higher and the dollar fell back in a lackluster trading session on Tuesday. European stocks dropped, while gold climbed with oil and bonds were mixed.


Facing Trump Subsidy Cuts, Health Insurance Officials Seek a Backup Plan
Robert Pear, The New York Times

Congress is on vacation, but state insurance commissioners have no time off. They have spent the past three days debating what to do if President Trump stops subsidies paid to insurance companies on behalf of millions of low-income people.

Maine Medicaid waiver application includes work requirements, asset testing
Shannon Muchmore, Healthcare Dive

Maine submitted its request for a section 1115 Medicaid waiver last week, and it includes work requirements, mandatory premiums and asset testing. The application states Maine is trying to “preserve limited financial resources” and encourage individual responsibility for healthcare costs.


S.C. Taps Private Donors To Expand In-Home Services For At-Risk Moms
Michelle Andrews, Kaiser Health News

Deona Scott was 24 and in her final semester at Charleston Southern University in South Carolina when she found out she was pregnant. She turned to Medicaid for maternity health coverage and learned about a free program for first-time mothers that could connect her with a nurse to answer questions about pregnancy and caring for her baby.

Tenet Healthcare cuts forecast on weak patient admissions
Divya Grover, Reuters

Tenet Healthcare Corp (THC.N) slashed its full-year forecasts and reported a bigger-than-expected quarterly loss as the U.S. hospital operator struggled with fewer patient admissions, sending its shares down about 11 percent after the bell. The company reported fewer patient visits in the quarter, continuing an industry-wide trend reported by rivals, including the largest hospital operator HCA Healthcare Inc (HCA.N) which said last month that its results were challenged by a softer growth in patient numbers.

Pharma, Biotech and Devices

Doctors who attend lower-tier medical schools prescribe far more opioids, study finds
Casey Ross, Stat News

A physician’s propensity to prescribe opioids could be affected by a range of factors relating to background and clinical experiences. But new research shows one variable may be especially influential: where the doctor went to medical school.

Health IT

Robots are not coming for physicians’ jobs — but that doesn’t mean new tech won’t change workflows
Jeff Byers, Healthcare Dive

The future is never executed exactly how it’s envisioned. Using pop culture texts as examples, hoverboards didn’t hit the mass market by 2015 as Back to the Future II had implied, but there is still time to reach The Jetsons’ flying cars by 2062 (I wouldn’t bet on it, though).

Opinions, Editorials and Perspectives

Medicare Advantage Spends Less on Care, So Why Is It Costing So Much?
Austin Frakt, The New York Times

The Medicare Advantage program was supposed to save taxpayers money by allowing insurers to offer older Americans private alternatives to Medicare. The plans now cover 19 million people, a third of all those who qualify for Medicare.

How to Compromise on Health Care
Michael Strain, Bloomberg

Progressives are understandably breathing a sigh of relief following the Senate’s failure to repeal Obamacare and replace it with legislation that would have scaled back health-insurance coverage. But they shouldn’t be too comfortable in their victory — it’s temporary.

How to save our miracle drugs
Editorial Board, The Washington Post

A MAJOR public-health danger that languished for too long is at last getting more attention. Antibiotic resistance, the tendency of bacteria to fight back against antibiotics, has been known to exist for decades but was often met with complacency, in part because new and effective antibiotics were discovered frequently.

Will Congress force me to deny health care to children once again?
Dorothy R. Novick, The Washington Post

It has been 20 years since I’ve had to tell a mother she had no options for insuring her child. At the time, I had been treating a little boy who was born prematurely and required developmental therapies.

Medicaid made the American dream possible for me. It should be there for all who need help
Hemal N. Sampat, Stat News

America needs a robust Medicaid program. I say that both as a physician who takes care of patients on Medicaid and as a man whose dream was made possible because of it.

An oral history of Obamacare’s 7 near-death experiences
Dylan Scott, Vox

The Affordable Care Act has lived in a constant state of mortal peril. Over the past seven years, Republicans have taken their best shot to take down Obamacare, a law they have painted as an unacceptable overreach of government and infringement on personal liberty and free enterprise.

Research Reports

Supporting The Individual Health Insurance Market
Michael Chernew and Christopher Barbey, Health Affairs

The status of the market for individual health insurance has attracted considerable scrutiny recently. Premiums are high and rising, and insurers are exiting the market. Some believe that this is evidence of a death spiral in the market, reflective of inherent problems with the Affordable Care Act (ACA).