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Setting up a state exchange not as simple as some think, analyst argues


Jost
Some state officials and health policy experts argue it should be relatively easy for states that have not yet established their own insurance exchanges to find a legal workaround to retain federal premium subsidies following last week's ruling disallowing subsidies through the federal exchange.

But one noted legal expert who supports the Patient Protection and Affordable Care Act cautions that it will take a lot more than semantic maneuvers. In a Health Affairs blog post Monday, Washington & Lee University law professor and Obamacare analyst Tim Jost laid out five major steps states will have to take to “establish” their own exchange and enable their residents to keep their federal premium tax credits, if the Halbig ruling is ultimately upheld.
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Healthier school lunches popular with kids: study


New federal nutrition standards for school lunchrooms have become a lightning rod for Obama administration opponents, who criticize them for prompting lunchroom waste, higher food costs for school districts, and sending students home hungry.

But now proponents of the guidelines, designed in part to combat the childhood obesity issue, have some ammunition to counter such critics.
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Sovaldi likely to cost Medicare billions


The rising cost of hepatitis C drugs like Sovaldi and Olysio will increase Medicare Part D spending by $2.9 billion to $5.8 billion next year and could drive up premiums as much as 8.6%, according to a new report by the actuarial firm Milliman.

The findings are based on the assumption that 15% to 30% of the Medicare Part D population that's estimated to be infected with hepatitis C will receive an $84,000 course of Sovaldi in 2015.
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New England Quality Care Alliance pilots consumer data use for care management


Cantor
Michael Cantor, chief medical officer for the New England Quality Care Alliance, has a dilemma. Resources are scarce for care management of patients who the alliance would like to help with their weight, diabetes, or other complex or chronic conditions; and yet it's difficult to predict which patients will be receptive to a care manager.

So he needs to better predict who will use those services, and who will benefit most. That's why the Alliance is piloting a program to marry clinical data with consumer data. The combination, it thinks, might allow for better targeting and prediction.
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Medication reconciliation improvements needed: report


Medication reconciliation, a standard operating procedure at hospitals, remains a process in need of work, according to a report based on a study of 19 hospitals released by the National Institute for Health Care Reform.

Medication reconciliation was first added to the hospital accreditation process by the Joint Commission in 2005. After a suspension in 2009, a “streamlined, more flexible requirement” was restored in 2011, the report authors note.
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NQF clarifies info on trial on socio-economic factors


The National Quality Forum says its upcoming trial examining the effects of socio-economic factors may potentially include 30-day readmission measures, but that is not the sole focus. The quality improvement organization offered clarity Monday, amid confusion the trial would look exclusively at readmissions.

Modern Healthcare reported Thursday that the NQF would study how socio-demographic factors, like income, education, primary language and race, would impact 30-day readmissions. The trial period will examine the effects of risk-adjustments on various measures, but the report does not make recommendations about any particular one, explained Ann Greiner, vice president of external affairs for the National Quality Forum.
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Lou Gehrig's disease an extremely rare malady, CDC says


Lou Gehrig, the iconic New York Yankee slugger, was forced to retire from baseball in 1939 because of a rare neuromuscular disorder. New data from the Centers for Disease Control and Prevention gives a first-of-its-kind glimpse into just how rare that incurable disease is.

The CDC's Agency for Toxic Substances and Disease Registry found that a little more than 12,000 people between October 2010 and December 2011 were living in the U.S. with amyotrophic lateral sclerosis—better known as Lou Gehrig's disease.
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Google's Baseline project could have big implications

3 pm, Jul. 28 |

Google's latest healthcare research project, announced Friday, is so ambitious that even failure might represent an advancement over the status quo.

The aim is to corral 175 healthy human beings and create a healthy baseline: a set of genetic and biomarkers that define a healthy human being, according to a report in the Wall Street Journal.
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Healthcare leaders rolling with the punches in wake of subsidy rulings


Anderson
This week's court rulings that cast doubt on exchange subsidies in many states had the nation's great minds making big-picture pronouncements of what it all meant. In the trenches of the healthcare industry, leaders were asked to explain the perplexing developments to customers and local business constituents.

In North Dakota, the dueling rulings helped bolster the message Ruth Krystopolski delivered Tuesday at the Health Care Summit sponsored by the Fargo Chamber of Commerce on the day the rulings came down.
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Medtronic CEO addresses Covidien deal, plans to move to Dublin


Ishrak
Medtronic CEO Omar Ishrak is facing many questions about his plans for the medical-device maker—principally revolving around the deal announced in June to buy Irish medical supplier Covidien and move the company's headquarters to Dublin from Minneapolis.

Ishrak answered a few of these questions for us this week in a phone interview recorded for a podcast and a Q&A to appear soon in the print edition of Modern Healthcare. Here are some highlights previewing the full interview.
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