Kaiser Health News

A Paramedic Was Skeptical About This Rx for Stopping Repeat Opioid Overdoses. Then He Saw It Help.

Published

1 month ago

March 25, 2024

Lauren Peace, Tampa Bay Times
Mon, 25 Mar 2024 09:00:00 +0000

OCALA, Fla. — Fire Capt. Jesse Blaire steered his SUV through the mobile home park until he spotted the little beige house with white trim and radioed to let dispatchers know he'd arrived.

There, Shawnice Slaughter waited on the steps, wiping sleep from her eyes.

“Good morning, Shawnice,” Blaire said. “How are you feeling today?”

“I've been good, I've been good,” Slaughter said. “Much better.”

Three days earlier, Blaire — a paramedic who leads the fire department's emergency medical team — met Slaughter at a nearby hospital. She had overdosed on opioids. It took four vials of an overdose reversal medication and dozens of chest compressions to get her breathing again.

At the hospital, Blaire told Slaughter about a free program that could help. It wouldn't just connect her with a recovery center but would also get her doctors' appointments, plus rides there. More important, she would get medicine to alleviate withdrawal symptoms so she wouldn't search for drugs to ease the sickness. Blaire would bring that medication, daily, to her home.

“I have a son,” Slaughter, 31, told Blaire. “I need to be alive for him.”

Every morning since, Blaire had driven over for a check-in. He reminded Slaughter of appointments and took note of what she needed: clothes, food, help with bills.

And at the end of each visit, from a lockbox in the back of his car, he dispensed to her a couple of tiny, lifesaving tablets.

Those tablets — a medicine called buprenorphine — represent a tidal change in the way counties in Florida and other states are addressing the opioid crisis. The idea: Get addiction medication to people who need it by meeting them where they are. Sometimes, that's on the street. Sometimes, it's in the driveway of a big house with a swimming pool. Sometimes on the steps of a modest home like Slaughter's.

********

For a long time, many people who could benefit from buprenorphine, commonly known by the brand name Subutex, couldn't get it.

Until recently, doctors needed a federal waiver to prescribe it to treat opioid use disorder. Amid misconceptions about treating opioid use disorder with medication, only about 5% of doctors nationally underwent the training to qualify. And in 2021, only 1 in 5 people who could have benefited from opioid addiction medication were receiving buprenorphine or another drug therapy.

But as evidence supporting the drug's efficacy grew and the urgency mounted to curb opioid deaths, Congress axed the waiver requirement in late 2022, clearing the way for greater availability.

And in rare cases, such as in Ocala, medics on the front lines began bringing treatment to patients' front doors.

In Florida, the state-run Coordinated Opioid Recovery Network, known as the CORE Network, provides guidelines on medicine distribution to areas hit hard by overdoses. Services through the network are free for patients, funded by money from the state's opioid settlement.

The network looks different in each of its 13 counties. Not all hand-deliver buprenorphine. But the common goal is to create a single entry point for services that have typically been siloed and difficult for patients to navigate, such as mental health care and housing support.

In a recovery landscape rife with shoddy facilities and prohibitive price tags, simplifying the path for patients stands to make a meaningful difference.

“We know that the more people are in contact with services, the more they're treated with respect, the more likely they are to reduce or cease drug use,” said Susan Sherman, a public health professor at Johns Hopkins University.

As opioid settlement dollars continue to come in, state officials have said they hope to expand to more counties.

********

Becoming a firefighter and paramedic satisfied Blaire's craving for adrenaline and his conviction, informed in part by his Christian background, that he was put on this Earth to help others.

At 20, he imagined responding to car crashes and heart attacks, broken bones and punctured flesh. But after years on the job with Ocala Fire Rescue, the calls began to change.

At first, Blaire felt some resentment toward the people overdosing. His team was suddenly responding to hundreds of such calls a year. He viewed drug use as a moral failure. What if a grandmother had a heart attack or a kid drowned while his team was on an overdose call?

Unlike with other emergencies, he never really felt he was saving a life when responding to an overdose. It was more like delaying death.

Over and over, he'd pump a patient full of naloxone, an overdose reversal medication often known by one of its brand names, Narcan, and drop them at the hospital, only to find they'd overdosed again after being discharged. One Christmas, he said, he responded to the same person overdosing five times on a single shift.

“I didn't understand it. I thought that they wanted to die,” said Blaire, 47. “I'm embarrassed to say that now.”

About a decade ago, the scope of the epidemic had already come into full view to Blaire's crew. It seemed the team was responding to overdoses at big houses in wealthy neighborhoods nearly as often as they were in the park and under the bridge.

One week, his team went to a home on a cul-de-sac with two kids and a swing set — the kind of place families take their children trick-or-treating.

The dad had overdosed. The next week, it was the mom.

“Money can mask any problem, but we've seen it from the top to the bottom,” Blaire said.

Over time, Blaire began to understand addiction as the disease it is: a physiological change to someone's brain that traps them in a dangerous cycle. Maybe it started with a prescription painkiller after surgery, or an indulgence at a party, but the majority of people weren't using drugs to get high, he realized. They were using them to avoid being sick.

“Imagine the worst flu you've ever had, then make it a lot worse,” Blaire said.

When a person dependent on opioids stops taking them, their body goes into withdrawal, often accompanied by shakes, nausea, fever, sweating, and chills. Though rare, people can die from opioid withdrawal syndrome. Still, historically, the emergency health care system has focused on reversing overdoses, rather than treating the withdrawal side effects that keep people returning to drugs.

In the past, Blaire said, he saw patients released from the hospital with little more than a phone number for a recovery center. Getting an appointment could be challenging, not only because of wait times or insurance complications, but because the patients weren't stable — they were in withdrawal. To make it through the day, Blaire said, they'd often use again.

“‘Good luck, you're on your own,'” Blaire said. “That's how it was. And that doesn't work for somebody who is sick.”

Under Blaire's leadership, Ocala Fire Rescue sought to stop the revolving door by launching its Community Paramedicine program and the Ocala Recovery Project in 2020.

They modeled it after overdose quick-response teams around the country, which vary in makeup. These mobile teams, typically helmed by paramedics like Blaire, connect people who have overdosed with services aimed at stabilizing them long-term. On some, a registered nurse embeds with paramedics in an ambulance or SUV. Others have a therapist or peer recovery coach on board. Some are bare-bones: a single responder with a phone on 24 hours a day. Some get in touch with patients through a call or a home visit after a reported overdose.

Others, like Blaire's team, intercept patients at the hospital.

Blaire likens the system to that of a trauma alert — a message sent to medical centers to ready a response to near-fatal car wrecks or shootings. When a trauma alert goes out, operating tables are cleared, CT scanners are prepped, and responders stand by for arrival.

“We set the same system up for overdoses,” Blaire said.

Now, when somebody in Ocala overdoses, whether it's on opioids, alcohol, meth, or cocaine, an alert goes out, notifying Blaire and his team, a peer recovery coach, a behavioral health specialist, and a local recovery center.

His team usually beats the ambulance to the hospital.

The next day, team members follow up at the patient's home.

Then, last May, under the guidance of the EMS medical director, Blaire's team started offering addiction medication to opioid users, too.

Since then, Blaire said, his team has connected 149 patients with treatment. Only 28 of them have needed additional intervention, he said.

********

When Blaire first heard about buprenorphine, he was skeptical.

How could giving somebody with an addiction more narcotics help?

That common response misunderstands the reality of addiction, said Nora Volkow, director of the National Institute on Drug Abuse.

People perceive that one drug is being substituted for another, Volkow said. Instead, the use of medications like buprenorphine is more akin to those that treat other psychiatric conditions, like mood disorders or depression.

Research shows that opioid addiction medication — including drugs like methadone — can greatly reduce the risk of overdose deaths, and increase a person's retention in treatment. But a study out of the New York University Grossman School of Medicine found that nearly 87% of people with opioid use disorders don't receive any.

Such addiction medications work by stimulating opioid receptors in the brain.

Opioids — like oxycodone or fentanyl — are what experts refer to as “full agonists.” Imagine an opioid receptor as a rounded bowl. A full agonist — like fentanyl — fits perfectly in that bowl and latches tightly to the receptor.

Buprenorphine is a “partial agonist.” It fits in the bowl — and satiates a craving — but doesn't completely bind like a full agonist. Instead, it eliminates withdrawal symptoms so people won't get sick or crave illicit drugs, without producing a high. Second, it counteracts the effects of other drugs, so a person can't overdose on other opioids like fentanyl or heroin while taking it.

And for somebody who already uses opioids, overdosing from buprenorphine is nearly impossible.

“They help a person regain control of their everyday life,” Volkow said.

********

On this Monday in January, Blaire pulled into Beacon Point, a local treatment center, just past 2 p.m.

He'd spent his morning calling on people like Slaughter, but now he was meeting paramedics from his team. After nearly three weeks of home visits, a man in the recovery network program was set to have his first appointment with a doctor.

Blaire has found that once people are stable on buprenorphine, more often than not they want to get into a treatment program.

While Blaire waited, a woman walking out of the center approached, smiling.

“I just got my first clean urine analysis,” she said. “I'm doing great, I'm so excited.”

“That's awesome news,” Blaire said, a smile stretched across his face. He's often stoic, straight-laced, with combed hair and aviators. But when he lights up, his all-business exterior gives way to gentleness.

Jacqueline Luciano is sober for the first time in 30 years. She's proud, glowing, and Blaire is proud, too.

Luciano first came to Blaire through a referral when she was living at a women's shelter. She said she had $20 in her pocket and wanted to get high — needed to.

Fentanyl withdrawal had left her shaky and cold. Her stomach was seizing, her muscles spasming. To quell the agony that day in early January, she went on the hunt.

Luciano said she had first used drugs when she was 9. Her family had been torn apart by pills and powders, she said, a sickness she'd inherited.

But this time, a woman — “like an angel” — passed her a number for someone who she promised could guide her into a brighter future, blame-free. Luciano, 39, paused, skeptical.

Then she gave Blaire a call.

For about a week, Blaire delivered her a daily dose of buprenorphine using a Safe RX bottle — essentially a trackable pill bottle with a lock code to limit who can open it. He helped connect her with food and clothing donations.

And as Luciano started to feel more like herself, absent of cravings, she began to hope.

Blaire got her an appointment with doctors at Beacon Point, then drove her to her first screening. Now, in the parking lot, she thanked him for everything.

“It made all the difference in the world,” Luciano told Blaire. “I really didn't think that I could get better. I didn't. But I am.”

As a tear rolled down Luciano's face, Blaire's phone rang.

********

The call came from the health department. A man in his 40s or 50s had come some 40 miles from Gainesville, Florida, for help, steered through word of mouth.

He'd tried to get into a recovery center there but said he was turned away. Something about insurance and a criminal record had stood in the way.

It's a pattern that drives Blaire crazy. He'd seen it a lot before his team was formed. People would get a moment of courage or clarity, only to be told “not yet.”

“Your first answer has to be ‘yes,'” he said. “‘Yes, I can help you.'”

He knew about a woman who had come from 25 miles out of town, then was told to come back days later. She didn't have a car or a home to return to.

“They didn't even offer her a ride,” Blaire said. “Sometimes you only have one shot.”

Blaire has learned that building trust starts with a small offering. A car ride. A sandwich. Help getting a government ID. Anything to show that you care, that you're useful. That you see someone trying.

Outside the health department, a man in muddied jeans and a frayed T-shirt stood waiting on the curb. He introduced himself as Jetson and didn't give a last name. Blaire shook his hand before they loaded into the car.

“So what brings you this way?” Blaire asked, once both were buckled in.

“I heard there were services here,” Jetson said, his voice gruff, quivering. “I've tried to stop using so many times, but I keep messing it up.”

Jetson shook his head.

“Well, I'm glad you found us,” Blaire said. He asked the man if he wanted to go to the recovery center for a screening. He did.

Over the 10-minute drive to Beacon Point, Blaire and Jetson talked, not about drugs or meds, but life. Baseball. Cabbage (good when fried).

When they pulled up, Blaire handed Jetson a card.

“Please call me,” Blaire said. “If you need anything. We can get you help.”

For a moment, the men sat there. Jetson pulling at his fingers. Taking deep breaths.

Then, he got out of the car — Blaire's card in hand — and walked through the glass door.

This article was produced in partnership with the Tampa Bay Times.

——————————
By: Lauren Peace, Tampa Bay Times
Title: A Paramedic Was Skeptical About This Rx for Stopping Repeat Opioid Overdoses. Then He Saw It Help.
Sourced From: kffhealthnews.org/news/article/florida-buprenorphine-opioid-medication-treatment-recovery/
Published Date: Mon, 25 Mar 2024 09:00:00 +0000

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Kaiser Health News

Millions Were Booted From Medicaid. The Insurers That Run It Gained Medicaid Revenue Anyway.

Published

22 hours ago

April 26, 2024

Staff Editor

Phil Galewitz, KFF Health News
Fri, 26 Apr 2024 13:55:00 +0000

Private Medicaid health plans lost millions of members in the past year as pandemic protections that prohibited states from dropping anyone from the government program expired.

But despite Medicaid's unwinding, as it's known, at least two of the five largest publicly traded companies selling plans have continued to increase revenue from the program, according to their latest earnings reports.

“It's a very interesting paradox,” said Andy Schneider, a research professor at Georgetown University's McCourt School of Public Policy, of plans' Medicaid revenue increasing despite enrollment drops.

Medicaid, the state-federal health program for low-income and disabled people, is administered by states. But most people enrolled in the program get their health care through insurers contracted by states, including UnitedHealthcare, Centene, and Molina.

The companies persuaded states to pay them more money per Medicaid enrollee under the assumption that younger and healthier people were dropping out — presumably for Obamacare coverage or employer-based health insurance, or because they didn't see the need to get coverage — leaving behind an older and sicker population to cover, their executives have told investors.

Several of the companies reported that states have made midyear and retrospective changes in their payments to plans to account for the worsening health status of members.

In an earnings call with analysts on April 25, Molina Healthcare CEO Joe Zubretsky said 19 states increased their payment rates this year to adjust for sicker Medicaid enrollees. “States have been very responsive,” Zubretsky said. “We couldn't be more pleased with the way our state customers have responded to having rates be commensurate with normal cost trends and trends that have been influenced by the acuity shift.”

Health plans have faced much uncertainty during the Medicaid unwinding, as states began reassessing enrollees' eligibility and dropping those deemed no longer qualified or who lost coverage because of procedural errors. Before the unwinding, plans said they expected the overall risk profile of their members to go up because those remaining in the program would be sicker.

UnitedHealthcare, Centene, and Molina had Medicaid revenue increases ranging from 3% to 18% in 2023, according to KFF. The two other large Medicaid insurers, Elevance and CVS Health, do not break out Medicaid-specific revenue.

The Medicaid enrollment of the five companies collectively declined by about 10% from the end of March 2023 through the end of December 2023, from 44.2 million people to 39.9 million, KFF data shows.

In the first quarter of 2024, UnitedHealth's Medicaid revenue rose to $20.5 billion, up from $18.8 billion in the same quarter of 2023.

Molina on April 24 reported nearly $7.5 billion in Medicaid revenue in the first quarter of 2024, up from $6.3 billion in the same quarter a year earlier.

On April 26, Centene reported that its Medicaid enrollment fell 18.5% to 13.3 million in the first quarter of 2024 compared with the same period a year ago. The company's Medicaid revenue dipped 3% to $22.2 billion.

Unlike UnitedHealthcare, whose Medicaid enrollment fell to 7.7 million in March 2024 from 8.4 million a year prior, Molina's Medicaid enrollment rose in the first quarter of 2024 to 5.1 million from 4.8 million in March 2023. Molina's enrollment jump last year was partly a result of its having bought a Medicaid plan in Wisconsin and gained a new Medicaid contract in Iowa, the company said in its earnings news release.

Molina added 1 million members because states were prohibited from terminating Medicaid coverage during the pandemic. The company has lost 550,000 of those people during the unwinding and expects to lose an additional 50,000 by June.

About 90% of Molina Medicaid members have gone through the redetermination process, Zubretsky said.

The corporate giants also offset the enrollment losses by getting more Medicaid money from states, which they use to pass on higher payments to certain facilities or providers, Schneider said. By holding the money temporarily, the companies can count these “directed payments” as revenue.

Medicaid health plans were big winners during the pandemic after the federal government prohibited states from dropping people from the program, leading to a surge in enrollment to about 93 million Americans.

States made efforts to limit health plans' profits by clawing back some payments above certain thresholds, said Elizabeth Hinton, an associate director at KFF.

But once the prohibition on dropping Medicaid enrollees was lifted last spring, the plans faced uncertainty. It was unclear how many people would lose coverage or when it would happen. Since the unwinding began, more than 20 million people have been dropped from the rolls.

Medicaid enrollees' health care costs were lower during the pandemic, and some states decided to exclude pandemic-era cost data as they considered how to set payment rates for 2024. That provided yet another win for the Medicaid health plans.

Most states are expected to complete their Medicaid unwinding processes this year.

——————————
By: Phil Galewitz, KFF Health News
Title: Millions Were Booted From Medicaid. The Insurers That Run It Gained Medicaid Revenue Anyway.
Sourced From: kffhealthnews.org/news/article/medicaid-unwinding-insurer-revenue/
Published Date: Fri, 26 Apr 2024 13:55:00 +0000

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Kaiser Health News

California Is Investing $500M in Therapy Apps for Youth. Advocates Fear It Won’t Pay Off.

Published

1 day ago

April 26, 2024

Staff Editor

Molly Castle Work
Fri, 26 Apr 2024 09:00:00 +0000

With little pomp, California launched two apps at the start of the year offering free behavioral health services to youths to help them cope with everything from living with anxiety to body acceptance.

Through their phones, young people and some caregivers can meet BrightLife Kids and Soluna coaches, some who specialize in peer support or substance use disorders, for roughly 30-minute virtual counseling sessions that are best suited to those with more mild needs, typically those without a clinical diagnosis. The apps also feature self-directed activities, such as white noise sessions, guided breathing, and videos of ocean waves to help users relax.

“We believe they're going to have not just great impact, but wide impact across California, especially in places where maybe it's not so easy to find an in-person behavioral health visit or the kind of coaching and supports that parents and young people need,” said Gov. Gavin Newsom's health secretary, Mark Ghaly, during the Jan. 16 announcement.

The apps represent one of the Democratic governor's major forays into health technology and come with four-year contracts valued at $498 million. California is believed to be the first state to offer a mental health app with free coaching to all young residents, according to the Department of Health Care Services, which operates the program.

However, the rollout has been slow. So slow that one of the companies has missed a deadline to make its app available on Android phones. Only about 15,000 of the state's 12.6 million children and young adults have signed up for the apps, and school counselors say they've never heard of them.

Advocates for youth question the wisdom of investing taxpayer dollars in two private companies. Social workers are concerned the companies' coaches won't properly identify youths who need referrals for clinical care. And the spending is drawing lawmaker scrutiny amid a state deficit pegged at as much as $73 billion.

An App for That

Newsom's administration says the apps fill a need for young Californians and their families to access professional telehealth for free, in multiple languages, and outside of standard 9-to-5 hours. It's part of Newsom's sweeping $4.7 billion master plan for kids' mental health, which was introduced in 2022 to increase access to mental health and substance use support services. In addition to launching virtual tools such as the teletherapy apps, the initiative is working to expand workforce capacity, especially in underserved areas.

“The reality is that we are rarely 6 feet away from our devices,” said Sohil Sud, director of Newsom's Children and Youth Behavioral Health Initiative. “The question is how we can leverage technology as a resource for all California youth and families, not in place of, but in addition to, other behavioral health services that are being developed and expanded.”

The virtual platforms come amid rising depression and suicide rates among youth and a shortage of mental health providers. Nearly half of California youths from the ages of 12 to 17 report having recently struggled with mental health issues, with nearly a third experiencing serious psychological distress, according to a 2021 study by the UCLA Center for Health Policy Research. These rates are even higher for multiracial youths and those from low-income families.

But those supporting youth mental health at the local level question whether the apps will move the needle on climbing depression and suicide rates.

“It's fair to applaud the state of California for aggressively seeking new tools,” said Alex Briscoe of California Children's Trust, a statewide initiative that, along with more than 100 local partners, works to improve the social and emotional health of children. “We just don't see it as fundamental. And we don't believe the youth mental health crisis will be solved by technology projects built by a professional class who don't share the lived experience of marginalized communities.”

The apps, BrightLife Kids and Soluna, are operated by two companies: Brightline, a 5-year-old venture capital-backed startup; and Kooth, a London-based publicly traded company that has experience in the U.K. and has also signed on some schools in Kentucky and Pennsylvania and a health plan in Illinois. In the first five months of Kooth's Pennsylvania pilot, 6% of students who had access to the app signed up.

Brightline and Kooth represent a growing number of health tech firms seeking to profit in this space. They beat out dozens of other bidders including international consulting companies and other youth telehealth platforms that had already snapped up contracts in California.

Although the service is intended to be free with no insurance requirement, Brightline's app, BrightLife Kids, is folded into and only accessible through the company's main app, which asks for insurance information and directs users to paid licensed counseling options alongside the free coaching. After KFF Health News questioned why the free coaching was advertised below paid options, Brightline reordered the page so that, even if a child has high-acuity needs, free coaching shows up first.

The apps take an expansive view of behavioral health, making the tools available to all California youth under age 26 as well as caregivers of babies, toddlers, and children 12 and under. When KFF Health News asked to speak with an app user, Brightline connected a reporter with a mother whose 3-year-old daughter was learning to sleep on her own.

‘It's Like Crickets'

Despite being months into the launch and having millions in marketing funds, the companies don't have a definitive rollout timeline. Brightline said it hopes to have deployed teams across the state to present the tools in person by midyear. Kooth said developing a strategy to hit every school would be “the main focus for this calendar year.”

“It's a big state — 58 counties,” Bob McCullough of Kooth said. “It'll take us a while to get to all of them.”

Brightline's contract states that the company was required to launch downloadable apps for iOS and Android phones by January, but so far BrightLife Kids is available only on Apple phones. Brightline said it's aiming to launch the Android version over the summer.

“Nobody's really done anything like this at this magnitude, I think, in the U.S. before,” said Naomi Allen, a co-founder and the CEO of Brightline. “We're very much in the early innings. We're already learning a lot.”

The contracts, obtained by KFF Health News through a records request, show the companies operating the two apps could earn as much as $498 million through the contract term, which ends in June 2027, months after Newsom is set to leave office. And the state is spending hundreds of millions more on Newsom's virtual behavioral health strategy. The state said it aims to make the apps available long-term, depending on usage.

The state said 15,000 people signed up in the first three months. When KFF Health News asked how many of those users actively engaged with the app, it declined to say, noting that data would be released this summer.

KFF Health News reached out to nearly a dozen California mental health professionals and youths. None of them were aware of the apps.

“I'm not hearing anything,” said Loretta Whitson, executive director of the California Association of School Counselors. “It's like crickets.”

Whitson said she doesn't think the apps are on “anyone's” radar in schools, and she doesn't know of any schools that are actively advertising them. Brightline will be presenting its tool to the counselor association in May, but Whitson said the company didn't reach out to plan the meeting; she did.

Concern Over Referrals

Whitson isn't comfortable promoting the apps just yet. Although both companies said they have a clinical team on staff to assist, Whitson said she's concerned that the coaches, who aren't all licensed therapists, won't have the training to detect when users need more help and refer them to clinical care.

This sentiment was echoed by other school-based social workers, who also noted the apps' duplicative nature — in some counties, like Los Angeles, youths can access free virtual counseling sessions through Hazel Health, a for-profit company. Nonprofits, too, have entered this space. For example, Teen Line, a peer-to-peer hotline operated by Southern California-based Didi Hirsch Mental Health Services, is free nationwide.

While the state is also funneling money to the schools as part of Newsom's master plan, students and school-based mental health professionals voiced confusion at the large app investment when, in many school districts, few in-person counseling roles exist, and in some cases are dwindling.

Kelly Merchant, a student at College of the Desert in Palm Desert, noted that it can be hard to access in-person therapy at her school. She believes the community college, which has about 15,000 students, has only one full-time counselor and one part-time bilingual counselor. She and several students interviewed by KFF Health News said they appreciated having engaging content on their phone and the ability to speak to a coach, but all said they'd prefer in-person therapy.

“There are a lot of people who are seeking therapy, and people close to me that I know. But their insurances are taking forever, and they're on the waitlist,” Merchant said. “And, like, you're seeing all these people struggle.”

Fiscal conservatives question whether the money could be spent more effectively, like to bolster county efforts and existing youth behavioral health programs.

Republican state Sen. Roger Niello, vice chair of the Senate Budget and Fiscal Review Committee, noted that California is forecasted to face deficits for the next three years, and taxpayer watchdogs worry the apps might cost even more in the long run.

“What starts as a small financial commitment can become uncontrollable expenses down the road,” said Susan Shelley of the Howard Jarvis Taxpayers Association.

This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

——————————
By: Molly Castle Work
Title: California Is Investing $500M in Therapy Apps for Youth. Advocates Fear It Won't Pay Off.
Sourced From: kffhealthnews.org/news/article/california-youth-teletherapy-apps-rollout-slow/
Published Date: Fri, 26 Apr 2024 09:00:00 +0000

Post Views: 34

Kaiser Health News

KFF Health News’ ‘What the Health?’: Abortion — Again — At the Supreme Court

Published

2 days ago

April 25, 2024

Staff Editor

Wed, 24 Apr 2024 20:30:00 +0000

The Host

Julie Rovner
KFF Health News

@jrovner

Read Julie's stories.

Julie Rovner is chief Washington correspondent and host of KFF Health News' weekly health policy news podcast, “What the Health?” A noted expert on health policy issues, Julie is the author of the critically praised reference book “Health Care Politics and Policy A to Z,” now in its third edition.

Some justices suggested the Supreme Court had said its piece on abortion law when it overturned Roe v. Wade in 2022. This term, however, the court has agreed to review another abortion case. At issue is whether a federal law requiring emergency care in hospitals overrides Idaho's near-total abortion ban. A decision is expected by summer.

Meanwhile, the Centers for Medicare & Medicaid finalized the first-ever minimum staffing requirements for nursing homes participating in the programs. But the industry argues that there are not enough workers to hire to meet the standards.

This week's panelists are Julie Rovner of KFF Health News, Joanne Kenen of the Johns Hopkins University's nursing and public health schools and Politico Magazine, Tami Luhby of CNN, and Alice Miranda Ollstein of Politico.

Panelists

Joanne Kenen
Johns Hopkins University and Politico

@JoanneKenen

Read Joanne's articles.

Tami Luhby
CNN

@Luhby

Read Tami's stories.

Alice Miranda Ollstein
Politico

@AliceOllstein

Read Alice's stories.

Among the takeaways from this week's episode:

This week's Supreme Court hearing on emergency abortion care in Idaho was the first challenge to a state's abortion ban since the overturn of the constitutional right to an abortion. Unlike previous abortion cases, this one focused on the everyday impacts of bans on abortion care — cases in which pregnant patients experienced medical emergencies.
Establishment medical groups and doctors themselves are getting more vocal and active as states set laws on abortion access. In a departure from earlier political moments, some major medical groups are campaigning on state ballot measures.
Medicaid officials this week finalized new rules intended to more closely regulate managed-care plans that enroll Medicaid patients. The rules are intended to ensure, among other things, that patients have prompt access to needed primary care doctors and specialists.
Also this week, the Federal Trade Commission voted to ban most “noncompete” clauses in employment contracts. Such language has become common in health care and prevents not just doctors but other health workers from changing jobs — often forcing those workers to move or commute to leave a position. Business interests are already suing to block the new rules, claiming they would be too expensive and risk the loss of proprietary information to competitors.
The fallout from the cyberattack of Change Healthcare continues, as yet another group is demanding ransom from UnitedHealth Group, Change's owner. UnitedHealth said in a statement this week that the records of “a substantial portion of America” may be involved in the breach.

Plus for “extra credit” the panelists suggest health policy stories they read this week that they think you should read, too:

Julie Rovner: NBC News' “Women Are Less Likely To Die When Treated by Female Doctors, Study Suggests,” by Liz Szabo.

Alice Miranda Ollstein: States Newsroom's “Loss of Federal Protection in Idaho Spurs Pregnant Patients To Plan for Emergency Air Transport,” by Kelcie Moseley-Morris.

Tami Luhby: The Associated Press' “Mississippi Lawmakers Haggle Over Possible Medicaid Expansion as Their Legislative Session Nears End,” by Emily Wagster Pettus.

Joanne Kenen: States Newsroom's “Missouri Prison Agency To Pay $60K for Sunshine Law Violations Over Inmate Death Records,” by Rudi Keller.

Also mentioned on this week's podcast:

American Economic Review's “Is There Too Little Antitrust Enforcement in the U.S. Hospital Sector?” by Zarek Brot-Goldberg, Zack Cooper, Stuart Craig, and Lev Klarnet.
KFF Health News' “Medical Providers Still Grappling With UnitedHealth Cyberattack: ‘More Devastating Than Covid,” by Samantha Liss.

Credits

Francis Ying
Audio producer

Emmarie Huetteman
Editor

To hear all our podcasts, click here.

And subscribe to KFF Health News' “What the Health?” on Spotify, Apple Podcasts, Pocket Casts, or wherever you listen to podcasts.

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Title: KFF Health News' ‘What the Health?': Abortion — Again — At the Supreme Court
Sourced From: kffhealthnews.org/news/podcast/what-the-health-344-abortion-supreme-court-april-25-2024/
Published Date: Wed, 24 Apr 2024 20:30:00 +0000

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