Latest From California Healthline:
California Healthline Original Stories
Insurers Test New Way To Cut Maternity Care Costs: Bundling
More insurers are experimenting with paying health care providers one lump sum to cover the cost of maternity care. Physicians and insurers hope the model — known as bundled payments — will help improve health outcomes. (Carmen Heredia Rodriguez, )
Good morning! With impeachment dominating all the attention and energy of Washington, D.C., evidence mounts that progress on top legislative issues like drug pricing and gun violence could be derailed. More vaping news also rules the day as the FDA admits it should've done more, sooner; Juul's new CEO takes over; and two more deaths are reported. More on those headlines below, but first here are your top California health news stories of the day:
Kaiser Permanente, Unions Reach Contract Deal To Avert Strike: The four-year agreement, which covers 85,000 health care workers in seven states -- including 55,000 in California -- must still be voted on by workers. It would raise employee wages, offer new education programs and curb outsourcing of some jobs. Oakland-based KP did not specify the size of the pay hikes, but they are “strong across-the-board raises of 3% a year,” according the Service Employees International Union-United Healthcare Workers West local. Regional coverage of the deal can be read from James P. Feltz of the Los Angeles Times, Mallory Moench of the San Francisco Chronicle, Cathie Anderson of The Sacramento Bee, Fiona Kelliher of The Mercury News, Laura Klivans at KQED , Cheryl Sarfaty of the North Bay Business Journal and Kevin Truong of the San Francisco Business Times.
‘Surprise’ Billing Law Is Protecting Patients, Angering Doctors: The New York Times' Upshot looks at California's efforts to outlaw surprise medical billing, and how lessons learned could inform national legislation. " The parties who have watched California’s performance disagree, sometimes vehemently, on whether the prospect is rosy or grim," write Sarah Kliff and Margot Sanger-Katz. Read their full story.
Funding Helps California Take Lead On Climate Threats: With environmental health dangers influenced by the globe's changing climate, two stories today report on money flowing to the state to help monitor that impact. Billionaires Stewart and Lynda Resnick are expected to announce a grant of $750 million to the California Institute of Technology -- the second-largest donation ever to an American university -- to study and combat climate change. Dana Goldstein of The New York Times has more on this story. And former New York City Mayor Michael Bloomberg will team up with California and the San Francisco Earth-imaging company Planet to use satellites to track climate pollutants. Kathleen Ronayne of The Associated Press reports.
Below, check out the full round-up of California Healthline original stories, state coverage and the best of the rest of the national news for the day.
More News From Across The State
Stat:
FDA Chief: Agency ‘Should Have Acted Sooner’ On E-Cigarettes
The Food and Drug Administration “should have acted sooner” to rein in the e-cigarette industry but pledged to “catch up,” acting commissioner Ned Sharpless said Wednesday during a congressional hearing that quickly became a referendum on federal regulation of e-cigarettes. Sharpless said the agency is expected to finalize draft guidance in the coming weeks that will “dramatically impact” the market of flavored e-cigarettes, which are widely seen as fueling the popularity of vaping among young people. But Sharpless faced tough questions about why the agency hadn’t acted sooner — or done more — to grapple with the growing e-cigarette industry. (Thielking, 9/25)
San Francisco Chronicle:
Juul’s New CEO Is From Big Tobacco. That May Help It Survive
Juul announced Wednesday it will immediately replace Kevin Burns with K.C. Crosthwaite, a senior vice president at Altria, the company that owns Philip Morris U.S. and last year bought a 35% stake in Juul for $12.8 billion. Burns led Juul since late 2017 and oversaw rapid growth as the company catapulted from 200 to roughly 3,800 employees — all while catching heat for Juul’s wildly popular e-cigarettes and the youth vaping epidemic powered by nicotine pods. (Ho, 9/25)
Read More Coverage Of This Story: The New York Times | The Washington Post | Bloomberg | Los Angeles Times | Stat | The Hill | NPR
The San Diego Union-Tribune:
County Health Officer Joins State In Urging The Public To Stop Vaping
As the number of vaping-related deaths and illnesses mount, health officials nationwide are warning of severe consequences, though most have stopped short of declaring an emergency. State health administrators on Tuesday implored people to immediately stop using the vaping devices, which they said posed an “imminent public health risk,” and the governor issued an executive order directing his staff to draft strict rules for the sale of the electronic cigarettes. (Pearlman, 9/25)
The Associated Press:
High-Flying Marijuana Vapes Take Hit From Health Scare
Vaping products, one of the fastest-growing segments of the legal marijuana industry, have taken a hit from consumers as public health experts scramble to determine what’s causing a mysterious and sometimes fatal lung disease among people who use e-cigarettes. The ailment has sickened at least 530 people and killed nine. Some vaped nicotine, but many reported using oil containing THC, marijuana’s high-inducing ingredient, and said they bought products from pop-up shops and other illegal sellers. The only death linked to THC vapes bought at legal shops occurred in Oregon. (Flaccus and Peltz, 9/26)
Bloomberg:
Vaping Health Risks, Early Illness Signs Were Missed Or Ignored
Scientists, regulators and e-cigarette proponents missed, ignored or downplayed signs that vaping could significantly damage the lungs for nearly a decade, a review of medical literature, government documents and interviews with doctors shows. At least 15 incidents of lung injuries linked to vaping occurred prior to this year’s epidemic, a review by Bloomberg News found. The cases — spanning the globe from Guam to Japan to England to the U.S. — include reports of mysterious pneumonia and fatal bleeding from tiny air sacs. (Langreth and Etter, 9/25)
The Hill:
Altria, Philip Morris Call Off Potential Merger Amid Vaping Crackdown
Tobacco giant Philip Morris has called off talks of an impending merger with Altria, the companies said Wednesday, amid the nationwide crackdown on vaping products and electronic cigarettes. Instead, the companies said they will focus on launching IQOS, the "heat not burn" tobacco product from Philip Morris. (Weixel, 9/25)
The Associated Press:
What We Know (And Don't) About Juul, Teen Vaping And Illness
An outbreak of vaping illnesses. A surge in teens using electronic cigarettes. They’re often spoken of in the same urgent breath, but it’s not clear how — or even if — they are connected. Following a shakeup at Juul Labs Inc., the largest U.S. seller of e-cigarettes, here are some questions and answers about vaping. (Stobbe, 9/25)
Stat:
Hearing On Pelosi’s Drug Pricing Plan Mired By Partisan Bickering
Just months after lawmakers on the Energy and Commerce Committee lavished praise on each other for passing a slew of drug pricing bills, that committee’s efforts to deal with the issue are quickly descending into partisan chaos. At a hearing Wednesday, Republicans accused Democrats of sabotaging bipartisan efforts to lower the cost of prescription drugs. At times, both parties were tripping over themselves to lob attacks and complain. And at one point, they were openly bickering about their respective speaking time. (Florko, 9/25)
Modern Healthcare:
Politics Threatens Drug Pricing Deal Between Congress, Trump
A congressional effort to reach a deal to lower prescription drug prices this year seemed on a path to derailment Wednesday amid political escalation on several fronts. House Republicans took a hard line against a major plan from House Speaker Nancy Pelosi (D-Calif.), in the first committee hearing on her proposal to authorize government negotiation of certain high-priced drugs. Later in the afternoon, Senate Finance Committee Chair Chuck Grassley (R-Iowa) acknowledged his effort with ranking member Sen. Ron Wyden (D-Ore.) to get their embattled proposal on the Senate floor may not happen this year. (Luthi, 9/25)
Politico:
Chuck Grassley: Drug Pricing Reform Key To Keeping GOP's Senate Majority
Passing a bill to control drug prices will be essential to Republicans "keeping a majority in the Senate," Senate Finance Chairman Chuck Grassley (R-Iowa) told reporters Wednesday. But he predicted the task will probably slip into next year. Grassley said he was optimistic he could sell GOP lawmakers on the sweeping bipartisan bill he and Sen. Ron Wyden (D-Ore.) developed, even though most Republicans opposed when the Finance committee advanced it on a 19-9 vote this summer. (Karlin-Smith, 9/25)
Stateline:
Community Health Centers Teeter On Financial Cliff, Courtesy Of Congress
As happened in 2017, Congress is on the precipice of failing to meet the Sept. 30 deadline for reauthorizing the Community Health Center Fund that supports nearly 1,400 community health centers, which treat more than 27 million predominately poor patients. As a result — according to a recent survey of community health centers conducted by the Kaiser Family Foundation — nearly 60% of centers have frozen hiring or are considering doing so; 42% already have or might reduce staff hours; and 42% have laid off staff or are contemplating it. Many may delay planned renovations or expansions, reduce operating hours or shutter locations. (Ollove, 9/26)
Politico Pro:
Newsom Administration Awards $28.5M To Counteract Past Drug Policies
Gov. Gavin Newsom’s administration announced Wednesday that it has awarded $28.5 million in grants to organizations that support communities damaged by the past criminalization of marijuana. Nearly 70 nonprofits and local health departments from across the state will receive amounts ranging from $150,000 to $650,000. The grants are part of the California Community Reinvestment Grants program, which began when voters legalized adult-use cannabis through Proposition 64. (Nieves, 9/25)
California Healthline:
As Health Care Costs Rise, Workers At Low-Wage Firms May Pay A Larger Share
Health insurance premiums and deductibles for job-based coverage edged upward in 2019, surpassing increases in both wages and inflation, according to an annual employer survey of more than 2,000 employers released Wednesday. But the results were uneven, and many workers least able to afford it were confronted with higher-than-average costs. People at companies with large numbers of lower-wage employees faced bigger deductibles for single coverage and were asked to pony up a larger share of their incomes to pay premiums than those at firms with fewer people with low earnings, according to the annual employer health benefits survey by the Kaiser Family Foundation. (KHN is an editorially independent program of the foundation.) (Andrews, 9/25)
Read More Coverage Of This Story: The New York Times | The Wall Street Journal | Bloomberg | Modern Healthcare
Los Angeles Times:
Trying To Shop For Medical Care? Lots Of Luck With That
High-deductible health plans, which are fast becoming the dominant form of coverage for U.S. workers, were supposed to empower patients. Backers said the plans would create engaged shoppers who would check prices and compare providers, forcing hospitals, doctors and drugmakers to control costs. Deductibles have more than tripled over the last decade for people who get insurance through their jobs, but the promised consumer revolution never materialized. (Levey, 9/26)
Los Angeles Times:
L.A., Other Cities Target Boise Ruling That Allows Homeless Camps
As California and other states in the West continue to wrestle with an explosion of homelessness, a growing number of local governments have set their sights on a court decision that has allowed people to legally bed down on sidewalks overnight. On Wednesday, the city of Los Angeles will join L.A. County and dozens of other municipalities in submitting an amicus brief urging the U.S. Supreme Court to hear a challenge to Martin vs. City of Boise — a landmark lawsuit involving seven homeless people who were cited for camping on public property in Boise, Idaho. (Oreskes, 9/25)
Sacramento Bee:
California Cities Ask SCOTUS To Review Boise Homeless Decision
In a 36-page amicus curiae, or “friend of the court,” brief, the California State Association of Counties and 33 local governments have asked the nation’s highest court to consider hearing an appeal of the Martin v. City of Boise case. The 9th U.S. Circuit Court of Appeals ruled last September that municipalities cannot punish people for sleeping on the streets if there are no available shelter beds. (Yoon-Hendricks and Clift, 9/25)
Capital Public Radio:
For The Homeless, Medical Insurance Often Falls By The Wayside
An estimated 130,000 people are homeless in California, according to the last statewide count in 2018. Virtually all would qualify for Medi-Cal, but it’s unclear how many have actually enrolled and are receiving care. The limited data available, coupled with anecdotal evidence, show that enrollment rates vary from region to region, depending on local agency practices and county priorities. (Hayden and Bharath, 9/25)
Los Angeles Times:
Laguna Beach And Santa Ana Are Latest Cities To Settle In Landmark Orange County Homelessness Case
Laguna Beach and Santa Ana have reached settlement agreements on a federal lawsuit that continues to shape the way Orange County deals with spiraling homelessness. The two cities joined several others in the county that have already agreed to provide shelter beds as well as take a “healthcare-first” approach to dealing with the homeless. (Brazil, 9/25)
San Francisco Chronicle:
Mayor Pulls Out Of Talks On San Francisco Mental Health Overhaul
After two months of talks, San Francisco Mayor London Breed said Wednesday that she’s pulling out of negotiations with two supervisors over their sweeping proposal to overhaul the city’s mental health care system. City officials met five times since July over Supervisors Hillary Ronen and Matt Haney’s proposed ballot measure — dubbed Mental Health SF — but could not reach consensus over how to fix the city’s behavioral health system. (Fracassa, 9/25)
Los Angeles Times:
Officials Warn Of Possible Measles Exposure At LAX
A Los Angeles County resident may have exposed others to measles while traveling through Los Angeles International Airport last week. Officials with the county Department of Public Health said Wednesday that the person showed signs of measles shortly after returning to Southern California. The departure city was not immediately provided. (Shalby, 9/25)
Capital Public Radio:
The First Transgender Job Fair In Sacramento Comes To Sol Collective
Living in the trans community has plenty of challenges, from dealing with internal confusion and family tension to hostility in the community. On top of that, it’s also difficult to find a job, even when the labor market favors job-seekers. Herine Palacios with Sol Collective organized the first Trans Job Fair in Sacramento on September 6. They wanted to help people trying to earn a living while also expressing their true identity. (Ruyak, 9/25)
Sacramento Bee:
Opioid Prescription Rates Fall Sharply In Sacramento Region
Doctors prescribed fewer opioids to local patients last year as legislators passed laws designed to fight rising overdose rates. Doctors wrote about 1.5 million opioid prescriptions to Sacramento-area patients in 2018, down by about 180,000, or 11 percent, from the previous year, the latest figures from the California Department of Public Health show. (Reese and Yoon-Hendricks, 9/26)
The Associated Press:
Report: Opioids Settlement Won't Fix Areas Hardest Hit
OxyContin maker Purdue Pharma’s tentative legal settlement over the toll of the nation’s opioid crisis is unlikely to reverse the consequences of the epidemic in the hardest-hit towns and regions, according to a report released Wednesday. Purdue reached a tentative deal this month to resolve the lawsuits it faces. It could be worth up to $12 billion over time, with a portion of the benefits coming in savings on opioid antidotes for governments rather than cash. It would be up to a bankruptcy court judge to approve the plan, which continues to face significant opposition. (Mulvihill, 9/25)
California Healthline:
In Tiny Doses, An Addiction Medication Moonlights As Treatment For Chronic Pain
As the medical establishment attempts a huge U-turn after two disastrous decades of pushing long-term opioid use for chronic pain, scientists have been struggling to develop safe, effective alternatives. When naltrexone is used to treat addiction in pill form, it’s prescribed at 50 milligrams. But chronic pain patients say it helps their pain at doses of less than a tenth of that. (Smith, 9/26)
Bloomberg:
Teladoc Investors Sweat Launch Of Amazon’s Telemedicine Service
Teladoc Health Inc.’s shares caught a little chill after Amazon.com Inc. announced the start of a virtual healthcare service for its workers in the Seattle area. Shares fell for a second day after the e-commerce company’s launch of “Amazon Care,” with Wednesday’s decline the most intraday in a month. The pilot program is an online primary care clinic that also offers in-home nurse visits and prescription delivery. (Anisha Sircar, 9/25)
The Associated Press:
Walmart's Sam's Club Launches Health Care Pilot To Members
Walmart’s Sam’s Club is teaming up with several health care companies to offer discounts on everyday care its customers might delay or skip because of the cost. Starting early October, Sam’s Club members in Michigan, Pennsylvania and North Carolina, will be able to buy one of four bundles of health care services ranging in annual fees from $50 for individuals to $240 for a family of up to six members. The pilot program could potentially be rolled out to members in all the states, says Lori Flees, senior vice president of Sam’s Club Health and Wellness. (D'Innocenzio and Murphy, 9/26)
The Associated Press:
Best Buy Sees Growth In Health Care Technology For Elderly
The nation’s largest consumer electronics chain, known for selling TV sets, cellphones and laptops, is looking to health care as a big source of its future growth. Best Buy Co. said Wednesday that in five years it hopes to provide 5 million seniors with health monitoring services, which can range from sensors placed throughout a home to a pendant worn around the neck. It currently provides the service to 1 million. It’s part of the chain’s deeper push into the $3.5 trillion U.S. health care market and essential to its goal of reaching $50 billion in annual revenue by 2025. (D'Innocenzio, 9/25)
California Healthline:
Uber And Lyft Ride-Sharing Services Hitch Onto Medicaid
Arizona Medicaid Director Jami Snyder heard many complaints about enrollees missing medical appointments because the transportation provided by the state didn’t show or came too late. So this summer she hatched a solution familiar to millions of Americans looking for an efficient ride: She turned to Uber and Lyft. Arizona became the first state to revamp its Medicaid regulations to make it easier for ride-sharing companies to participate in its nonemergency transportation benefit. (Galewitz, 9/26)
Modern Healthcare:
Traditional Devicemakers Struggle In Fast-Growing Ambulatory Market
Business is booming for the ambulatory surgery industry, but traditional device makers are having a hard time tapping into it, according to a new report from Bain & Company. In the desperate race to cut costs out of healthcare, ambulatory surgery centers have emerged as a promising solution. ASCs performed more than half of all outpatient surgeries in 2017, up from 32% in 2005, the report found. Orthopedic, spine and cardio procedure volumes are projected to see the most growth through the mid-2020s. (Bannow, 9/25)
Stat:
23andMe, Moving Beyond Consumer DNA Tests, Is Building A Clinical Trial Recruitment Business
Consumer genetics giant 23andMe announced Thursday that it would move deeper into the business of clinical trial recruitment, partnering with a fast-growing startup to help match its customers with nearby study sites based on their diseases, demographics, and DNA. The Silicon Valley company has for months been quietly making inroads into clinical trial recruitment by emailing customers who’ve opted in with recommendations about studies that might be appropriate for them. It has recruited for studies, both interventional and observational, in disease areas including Alzheimer’s, Parkinson’s, attention-deficit hyperactivity disorder, eczema, and liver disease, a spokesperson for the company confirmed. (Robbins, 9/26)
Stat:
Tariffs On Pharma Ingredients Call For Smarter Business Planning
The trade conflict with China seems to escalate, although it can change with a tweet. The first of two rounds of tariffs on billions of dollars’ worth of Chinese goods is now in effect, even as the final positioning or even talk of deals and delays are in flux. These tariffs have implications for pharmaceutical companies’ supply chain planning for active pharmaceutical ingredients (APIs), the components of drugs that produce their therapeutic effects. Tariffs on APIs imported from China pose risks for pharmaceutical companies, both for generic and name-brand products. (Roddy Martin, 9/25)
Bloomberg:
Zantac’s Original Maker Halts Shipping On Carcinogen Concern
GlaxoSmithKline Plc, the original branded maker of Zantac, halted global distribution of the popular stomach medicine, adding momentum to actions aimed at stopping access to drugs that are tainted with a potential human carcinogen. Glaxo will also recall the drug in India, where it’s known as Zinetac, and Hong Kong. The recalled medicine is made with an active ingredient from two India-based suppliers, Dr. Reddy’s Laboratories Ltd. and Saraca Laboratories Ltd., Kristen Neese, a spokeswoman for Glaxo, said in an email Wednesday. (Edney, 9/25)
Bloomberg:
After Shingles Standout, Glaxo Hunts For The Next Big Vaccines
GlaxoSmithKline Plc is taking aim at a virus that causes serious lung infections and kills tens of thousands of children each year, hoping to replicate the success of its last blockbuster vaccine. Experimental shots targeting respiratory syncytial virus, or RSV, are the top pipeline priority for Glaxo’s vaccines unit, Emmanuel Hanon, its research and development head, said in an interview. Glaxo plans to move those vaccines into the final stage of testing by the end of 2020, he said. (Paton, 9/26)
California Healthline:
The Delicate Issue Of Taking Away A Senior’s Smartphone
At first, Dr. Robert Zorowitz thought his 83-year-old mother was confused. She couldn’t remember passwords to accounts on her computer. She would call and say programs had stopped working. But over time, Zorowitz realized that his mother — a highly intelligent woman who was comfortable with technology ― was showing early signs of dementia. Increasingly, families will encounter similar concerns as older adults become reliant on computers, cellphones and tablets: With cognitive impairment, these devices become difficult to use and, in some cases, problematic. (Graham, 9/26)
Atlanta Journal Constitution:
PTSD In Nursing: Women More Likely To Suffer PTSD
Women are two to three times more likely to have PTSD than men, which leaves nurses particularly vulnerable. Not only do women make up nearly 91 percent of the nursing profession, but also the battles involved in the nursing experience – military or not – increase a person's risk of PTSD. (Kennedy, 9/25)