Maternal Mortality Investigation Series

News At A Glance

National Permanent repeal of the Affordable Care Act’s (ACA) medical device tax bill passes House– After being put off twice, the 2.3 percent medical device tax may be repealed through a bill that has recently been approved by the House with bipartisan support. The funds collected from the tax were meant to pay for the health insurance expansion. ACA’s reinsurance programs to be reinstated– The reinsurance programs stabilize the ACA marketplace by transferring funds from insurance companies with healthier than average patients to insurance companies with sicker than average patients. Hospitals were recently notified that they would not be receiving the payments. The Centers for Medicare and Medicaid Services (CMS) administrator announced last week, however, that the payments would be reinstated. CMS proposes rule for a flat fee for Medicare payments– Under this new rule, offices would have just one form to complete for one flat fee rather than working with four different forms for the four payment levels currently in place. Some physicians fear that specialists will see large reductions in net income from Medicare patients. Other critics argue that this will lead to perverse incentives for physicians to cut down on time spent with patients or reduce the number of new patients with complex issues. The comments for this new rule will be accepted until September. Trump administration gives approval for company to publish blueprint for 3D guns– Eight states have filed a lawsuit against the administration and a federal judge has temporarily placed a restraining order on the company to prevent them from putting the blueprints online. The attorneys general are arguing that this will aid terrorists and provide them with easy access to dangerous weapons which cannot be traced. Thousands of blueprints have already been downloaded. The timing of this news coincides with the release of a Centers for Disease Control and Prevention (CDC) report that found that firearm homicides increased by 31 percent from 2014-2016 after 4 years of stability (2010-2014).

August 1, 2018 | Issue 24

Healthcare

ProPublica, NPR, and USA TODAY are some of the news sources that have created their own series on maternal mortality stories from around the United States.

A new story uncovered that hospitals are failing to perform basic safety measures that are contributing to the rise in maternal mortality in the US. USA TODAY investigated over 150 reports of adverse experiences during childbirth and found that in multiple cases, the mother’s blood pressure and amount of blood loss were not tracked throughout the time the mother was in the hospital. Multiple women died in the hospital as a result of internal bleeding, and some were even discharged with dangerously low blood pressure and passed away a few days later.

To learn more, read our issue brief on maternal mortality.

Addressing Misconduct in Healthcare

Recently, the University of Southern California faced allegations of failing to protect patients from a former gynecologist who is accused of sexually abusing and harassing over 200 women.

California State Senator Jerry Hill (D-San Mateo) has re-introduced a transparency bill that failed twice over the last two years. Senate Bill 1448 will require physicians to provide patients with a form that includes information about any former or current probations along with contact information for their licensing board.

Last week, the Medical Board of California released a smartphone application that allows users to track changes to physicians’ licensing for up to 16 physicians in California.

Critics argue that the app will not be useful in increasing transparency because it is an opt-in feature that requires knowledge about the app in the first place, saying the best way to ensure that patients get the information is for the physicians to disclose it.

California

Other States

Nearly 38,400 veterans in Ventura County do not qualify for veterans long-term care services– The veteran services officer of Ventura County told the subcommittee of the House Committee on Veteran’s Affairs that veterans are not fully aware of their options for long-term care, and many believe they will receive the VA long-term care services when, in fact, they do not qualify, shedding light on an unmet need and lack of awareness.

Audit finds that San Diego County does not have enough public health nurses for children, leaving current workforce overworked– The audit found that 12 percent of the job slots for public health nurses serving foster, chronically ill, and severely disabled children were vacant. Despite this, the health outcomes were relatively good with a majority of the children receiving proper health exams and follow-up care. The San Diego state senator who issued the audit plans to introduce policies to tackle excessive workload problems for public health nurses throughout the state.

Officials warn residents to be cautious of potential health issues from poor air quality due to recent fires– The Department of Resource Management at Shasta County found that air quality levels for surrounding counties are beginning to cause concern due to the devastating Carr Fire and Mendocino Complex Fire. The fires can release small particulate matter into the air that can then cause respiratory conditions if inhaled. People in the surrounding areas are advised to wear specialized masks (N95) that are being offered at public libraries and to stay indoors as much as possible.

Officials from different backgrounds gathered in Sacramento to discuss how to address trauma faced by minority children– One prominent discussion topic was the high rate of suspension of children of color and the young ages at which they were being suspended (starting from the age of 3) in California schools. One of the goals formed was addressing institutional racism and implicit bias by providing trauma-based services at various levels of care. Another strategy discussed was organizing community-based events to bring members of a community together in a safe and relaxed environment.

Around 11 percent of children in Cleveland screened as part of city project to expand lead screening found to have high blood lead levels– After data was released from Ohio’s health department showing that 12 percent of children 6 years and over had high blood lead levels in 2016 and 2017, the city developed a collaborative partnership with schools to expand lead screening and were able to confirm these results. The 11 percent is nearly 4 times higher than the national average. The project’s goal is to screen children in at least half of the schools between kindergarten and eighth grade by 2020.

Massachusetts Attorney General looking into e-cigarette companies’ potential failures to prevent minors from acquiring products– Juul Labs Inc is at the center of a Massachusetts AG investigation to determine whether the company has failsafe methods in place to prevent minors from acquiring their products. Earlier this year, the Food and Drug Administration (FDA) issued warnings to retailers over illegal sales of e-cigarettes and tobacco products to minors.

Massachusetts Governor Charlie Baker (R-MA) signs multiple healthcare-related bills–Last week, the governor signed An Act Relative to Disability Benefits into law which recognizes cancer as a work-related injury and will provide paid leave to support firefighters who are unable to work due to a work-related illness. The new policy will help support the costs of treatment for work-related cancer. The governor also passed the Negating Archaic Statutes Targeting Young Women Act last week which officially repealed a set of old anti-abortion bills that were unenforced and predated Roe v. Wade. Additionally, he is expected to sign a bill this week that will raise the minimum age for purchasing tobacco products from 18 years to 21 years.

Smoke-free public housing, shortage of prescription drug monitoring programs, and insurance coverage of 3D mammograms in Missouri– In November 2016, the United States Department of Housing and Urban Development (HUD) changed their policies to prohibit smoking in public housing. This policy, which also prohibits smoking (cigarettes, hookahs, and cigars) within 25 feet of public housing buildings, went into effect this week in Missouri where over 30,000 people live in public housing. Free smoking-cessation will be offered to residents to help them with the transition as more than one-third of the residents of public housing in Missouri are estimated to be current smokers. In other news, a report found that many rural areas in Missouri could not participate in prescription drug monitoring programs that are used to ensure that patients are not overprescribed narcotics and other dangerous substances. Finally, Missouri health insurers will be required to cover a 3D mammogram through the passage of House Bill 1252 which also decreases the mammogram screening age that must be covered by insurers from 50 to 40 years.

Oral Health

Hunger as a Health

Issue

Mental/Behavioral

Health

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Newsbytes Relevant to Our Strategic Priorities

Three Bills Introduced to Tackle Pharmaceutical Prices

To bring focus to our work, the Institute for Health Policy and Leadership has identified three strategic priorities: oral health, mental health and hunger as a health issue. This segment highlights news articles relevant to these priorities.

A Kaiser Health News article reminds the nation that many college students starting this Fall will face food insecurity– A study published by Sage Journals found that nearly 50 percent of students in their sample (30,000 undergraduates) were food insecure and between 11-19 percent of 4-year college students were housing insecure. Some schools are makingefforts to address this issue by creating meal voucher transfers between students with leftovermeals and students without meals, creating food pantries, and offering students witheducational programs on cooking on a budget. In California, CalFresh is available to a subsetof students, but there is a lot more that can be done to address this issue.

S. 2278Senate Bill 2278, also known as the Patient Right to Know Drug Prices Act, passed the Senate Health Committee last week. This bill would allow pharmacists to discuss instances where patients could save money by paying with cash rather than using their insurance, effectively banning “gag clauses.”

H.R. 6505 House Bill 6505 was introduced last week. If passed, the bill would give the federal government the ability to negotiate Medicare Part D drug prices directly with pharmaceutical companies, something that was prohibited when Part D was introduced in 2003.

New probiotic oral health products are gaining popularity– Probiotics are microorganisms that are meant to confer health benefits, typically to aid in digestion. The oral cavities also contain bacteria that promote good oral health. These products are utilizing this concept to provide probiotics for the oral cavities. The founder of Ask The Dentist, a website that offers education on oral health, says that while the early results seem to show promise, more research needs to be done to understand the effects of such products. They are already beginning to gain momentum.

Researchers at Pennsylvania State University find that one additional day of poor mental health every month leads to a nearly 2 percent drop in per capita income growth rate– The researchers analyzed the number of self-reported poor mental health days along with economic and demographic trends and found that poor mental health was translating to more than $50 billion of lost income every year. They found stronger associations in rural areas and concluded that we need to invest in mental health resources.

H.R. 6577 House Bill 6577, also known as the Price Relief, Innovation, and Competition for Essential Drugs (PRICED) Act was introduced last week. If passed, this bill will reduce the market-exclusivity for brand name biologics from 12 years to 7 years in order to allow for generics to enter the market more quickly.