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Obamacare ruling ends threat to U.S. hospitals, insurers

Obamacare ruling ends threat to U.S. hospitals, insurers | Healthcare and Technology news | Scoop.it

The U.S. hospital and health insurance industries breathed a collective sigh of relief on Thursday after the U.S. Supreme Court upheld subsidies for individuals under President Barack Obama's signature healthcare law.


Shares in hospitals surged, with several hitting all-time highs, on the expectation that patients would be able to continue paying for services. Health insurer stocks also gained. Wall Street analysts called the ruling positive for an industry on the edge of consolidation.


Health economists have estimated $15 billion to $22 billion in healthcare spending was at risk with the decision. About 10 million Americans have insurance through the healthcare law's insurance exchanges and, of those, 6.4 million have subsidies.


The court ruled 6-3 that the 2010 Affordable Care Act (ACA), widely known as Obamacare, did not limit subsidies to states that establish their own online healthcare exchanges. It marked the second time in three years that the high court ruled against a major challenge to the law.


Trinity Health, one of the largest not-for-profit health systems, was holding a board meeting when the ruling hit.


"There was a ‘Yahoo!’ and a big round of applause," Dr. Richard Gilfillan, chief executive of the Livonia, Michigan-based hospital chain said.


Insurers said subsidies were key to bringing in new customers.

"For a lot of the individuals who were depending on these subsidies in order to have coverage, I think it is a major sigh of relief," said J. Mario Molina, chief executive of insurer Molina Healthcare.


Annie Wisecarver, 53, of Shepherdstown, West Virginia, receives a monthly subsidy of about $200 to buy Obamacare insurance.

"I really only purchased insurance for an emergency, like if I fell off a mountain and broke my leg," Wisecarver said. "I can’t see myself spending $300 or $400 a month on insurance just because I might have an accident."


The ruling could remove uncertainty for the insurers who are seeking deals, like Anthem Inc and Aetna Inc, Leerink Partners analyst Ana Gupte said.


Anthem is pursuing an acquisition of Cigna even after being rejected, while sources previously told Reuters that Humana put itself up for sale last month, with Cigna and Aetna making offers. Bloomberg reported on Thursday that an Aetna-Humana deal could be reached as soon as this weekend.


Humana jumped 7.5 percent. Aetna Inc gained 3.6 percent, Anthem Inc 1,1 percent, Cigna Corp 2.6 percent, and UnitedHealth Group Inc rose 2.7 percent.


Among hospitals, shares of Community Health Systems were up 13.3 percent, HCA Holdings rose 8.5 percent and Tenet Healthcare jumped 12.2 percent. HCA, Universal Health Services and LifePoint Health hit lifetime highs.


'PEACE OF MIND'


Since the subsidies were introduced last year, they have helped hospitals reduce the losses from covering the cost of uninsured patients.


"It's just a very positive thing because it takes away the overhang on the company and the industry," said Alan Miller, CEO of Universal Health Services, which has hospitals in 37 states.


Bill Carpenter, chief executive of Lifepoint Hospitals, which has 64 hospitals in 20 states, was at an offsite patient safety event and said everybody in the room was excited about the ruling.


"We are just are so pleased that those people who have secured coverage through state exchanges will have the peace of mind to know that their coverage is going to continue," Carpenter said, calling on states to expand Medicaid to more income levels, another goal of the ACA. "In many states, this has been about politics and not policy."


In Florida, one of the biggest remaining issues is expanding Medicaid, said Jim Nathan, president and chief executive of Lee Memorial Health System in Fort Myers, one of Florida's largest public, not-for-profit health systems.


Jason Montrie, president of Land of Lincoln Health, a non-profit CO-OP health insurance company launched in 2013 with the government funding of the Affordable Care Act, said subsidies are vital to most of its more than 50,000 members.


"We're relieved that our court made the right decision here," Montrie said.


Options activity had been sanguine in the days and weeks leading up to the ruling, with many traders betting on a rally in the hospital names after the Supreme Court decision.


The S&P 500 healthcare sector is up 11.3 percent in 2015 so far. The sector accounts for about 15 percent of the S&P 500 index.

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Margarito Cruz's curator insight, December 10, 2015 10:05 PM

The role being discussed in this article is about Cheif Executive. I didnt realize that so many people were under Obama's Obamacare. I agree with these actions because of all the accidents that happen everyday. People who dont have insurance face the same dangers that the people that do have it. It would be nice to know that theres something that will pay for the ones not as wealthy. Obama is the organizer of Obamacare.

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Quake overwhelms Nepal's weak healthcare system

Quake overwhelms Nepal's weak healthcare system | Healthcare and Technology news | Scoop.it

A massive earthquake in Nepal has exposed the woeful state of its medical facilities as hospitals struggle to treat vast numbers of injured with limited supplies and staff.


The country of 28 million has only 2.1 physicians and 50 hospital beds for every 10,000 people, according to a 2011 World Health Organization report.


The situation is worsening a humanitarian crisis triggered by Nepal's worst earthquake in 81 years. The 7.9 quake, which struck just before noon on Saturday, has killed more than 2,200 people and injured more than 5,400.


Casualties are expected to rise, as many more people are feared trapped in debris across the country, from the capital Kathmandu to remote villages and mountain peaks.


So far many of the seriously injured in Kathmandu were being referred to Bir Hospital's Trauma Centre, which opened in February this year with 200 beds.


Doctors said they needed more than 1,000 more beds to treat the patients that were being brought in ambulances and taxis.

"The earthquake has exposed that Nepal's best public hospital infrastructure has crumbled at a time when it should serve more people in a hurry," said Sarvendra Moongla, a senior surgeon there.


Children with multiple injuries were laid on the dusty marble floors of the hospital, while hundreds of other patients with fractured and bloodied limbs lay on the ground outside the hospital under tents as family members struggled to find drinking water and food for them.

A lack of morgue facilities meant that 13 bodies lay outside the hospital, one of the oldest in Nepal.


Many patients were prematurely discharged to accommodate the waves of injured survivors: Doctors shifted wheel-chair bound patients and several quake survivors with multiple injuries to a playground opposite the hospital.


Anita Dhungana, 31, said she was admitted to the trauma center last week and operated on just hours before the quake. Doctors had advised 48 hours of bed rest in the hospital.


"My father begged and pleaded before the doctor to keep me in the hospital. I am still bleeding and cannot walk but there is no one to examine me," Dhungana said.


Her father pitched a tent near a sewage pit where survivors washed their faces and cooked rice with lentils on kerosene stoves.

Outside the Kathmandu Medical College, about half an hour's drive east from Bir Hospital, Khile Sherpa, 20, sat in the street waiting to be treated. His right eye was lacerated, and he wore a bandage around the head, covering half his face.


He said he had been evacuated from Mount Everest base camp, where an avalanche triggered by the quake killed at least 17 climbers and injured scores.


While Nepal's healthcare facilities are limited, they quickly become much worse outside its major cities. Remote regions have only very basic medical centers that are ill-equipped to handle serious injuries.


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California measles cases top 100

California measles cases top 100 | Healthcare and Technology news | Scoop.it

The number of confirmed measles cases in California has grown to 103, the state's health department said Friday.

Many of the cases -- 32 -- are in Orange County, home to Disneyland, where an outbreak of the disease began in mid-December.

Eight of the children who have contracted measles are younger than 1, the California Department of Public Health said on its website.

Dozens of those cases occurred in the last month of 2014, a record year for measles in the United States since measles was considered to be eliminated in 2000.

Since January 1, there have been 110 confirmed cases in 16 states, including California, and the District of Columbia, according to the Centers for Disease Control and Prevention and health departments in four of those states.

Officials in New Jersey are awaiting test results in a suspected case involving a 1-year-old who has already recovered from what made the child sick. Health officials told residents of the same apartment building where the baby lives they would be in the clear if they didn't get sick by this weekend.

On Thursday, officials in Cook County, Illinois, announced two children from a day care center have measles and three other youngsters were diagnosed but awaiting definitive test results that would confirm they had the disease.

Measles hit Illinois day care

Measles is a highly contagious respiratory disease. It causes fever, red and sore eyes, runny nose, cough and a rash. It can cause deadly health complications including pneumonia and encephalitis.

Measles is spread by contact with an infected person through coughing or sneezing. It can remain in the air and on surfaces for up to two hours.


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Cases of Wish-Bone ranch dressing recalled

Cases of Wish-Bone ranch dressing recalled | Healthcare and Technology news | Scoop.it

The makers of Wish-Bone Ranch Salad dressing are recalling thousands of bottles of the popular product because they contain blue cheese dressing instead.

Because blue cheese dressing contains eggs, those accidentally-filled products could be dangerous for anyone with an egg allergy.

New Jersey-based Pinnacle Foods Group said blue cheese dressing was accidentally filled into 8,678 cases of 24-ounce bottles labeled as Wish-Bone Ranch Salad Dressing.

"Those people who have allergies or severe sensitivity to eggs run the risk of serious or life-threatening allergic reaction if they consume this product," Pinnacle said. But it is still safe to eat for people who are not allergic to eggs.

Egg allergies strike mostly children and usually lead to skin rashes, nasal congestion or vomiting,according to the Mayo Clinic, but there is little danger of life-threatening anaphylaxis.

The bottles of dressing affected were filled on April 23, 2015, by a contract company, Pinnacle said. Consumers can identify them by their "best by" date of "Feb 17 16," and may return them for a full refund.

    Pinnacle said it notified the Food and Drug Administration about the issue, and has advised distributors and retailers of the product to remove affected bottles from their assortments.

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    Superbug linked to 2 deaths at UCLA hospital; 179 potentially exposed

    Superbug linked to 2 deaths at UCLA hospital; 179 potentially exposed | Healthcare and Technology news | Scoop.it

    Nearly 180 patients at UCLA's Ronald Reagan Medical Center may have been exposed to potentially deadly bacteria from contaminated medical scopes, and two deaths have already been linked to the outbreak.

    Update: FDA issues warning on contaminated medical scopes

    The Times has learned that the two people who died are among seven patients that UCLA found were infected by the drug-resistant superbug known as CRE — a number that may grow as more patients get tested. The outbreak is the latest in a string of similar incidents across the country that has top health officials scrambling for a solution.

    Caption FDA attributes spread of superbug to endoscope
    More than may have encountered 'superbug'

    UCLA said it discovered the outbreak late last month while running tests on a patient. This week, it began to notify 179 other patients who were treated from October to January and offer them medical tests. By some estimates, if the infection spreads to a person's bloodstream, the bacteria can kill 40% to 50% of patients.

    At issue is a specialized endoscope inserted down the throats of about 500,000 patients annually to treat cancers, gallstones and other ailments of the digestive system.

    These duodenoscopes are considered minimally invasive, and doctors credit them for saving lives through early detection and treatment. But medical experts say some scopes can be difficult to disinfect through conventional cleaning because of their design, so bacteria are transmitted from patient to patient.

    These instruments are not the same type used in more routine endoscopies and colonoscopies.

    The procedure in question is known as ERCP, or endoscopic retrograde cholangiopancreatography. The superbug is carbapenem-resistant Enterobacteriaceae.


    UCLA said it immediately notified public health authorities after discovering the bacteria in one patient and tracing the problem to two of these endoscopes. The university said it had been cleaning the scopes “according to standards stipulated by the manufacturer,” and it changed how it disinfects the instruments after the infections occurred.

    Dale Tate, a university spokeswoman, said “the two scopes involved with the infection were immediately removed and UCLA is now utilizing a decontamination process that goes above and beyond the manufacturer and national standards.”

    Tate declined to provide details on the two people who died, citing patient confidentiality.

    State and federal officials are looking into the situation at UCLA as they wrestle with how to respond to the problem industrywide.

    Since 2012, there have been about a half-dozen outbreaks affecting up to 150 patients in Illinois, Pennsylvania and most recently at a well-known Seattle medical center, according to experts.

    These outbreaks are raising questions about whether hospitals, medical-device companies and regulators are doing enough to protect patient safety. Some consumer advocates are also calling for greater disclosure to patients of the increased risks for infection before undergoing these procedures.

    Lawrence Muscarella, a hospital-safety consultant and expert on endoscopes in Montgomeryville, Pa., said the recent number of cases is unprecedented.

    “These outbreaks at UCLA and other hospitals could collectively be the most significant instance of disease transmission ever linked to a contaminated reusable medical instrument,” he said.

    Officials at the U.S. Centers for Disease Control and Prevention said they were assisting the L.A. County Department of Public Health in its investigation of the UCLA infections.

    Dr. Alex Kallen, an epidemiologist in CDC's Division of Healthcare Quality Promotion, said the outbreaks are serious given how difficult this superbug can be to treat and the fact that additional cases might be going undetected.

    “This bacteria is emerging in the U.S. and it's associated with a high mortality rate,” Kallen said in an interview. “We don't want this circulating anywhere in the community.”

    Last month, Virginia Mason Medical Center in Seattle acknowledged that 32 patients were sickened by contaminated endoscopes from 2012 to 2014 with a bacterial strain similar to CRE. Eleven of those patients died.

    But Virginia Mason said other factors may have contributed to their deaths because many of them were already critically ill.

    The duodenoscopes typically involved in the outbreaks have an “elevator channel” that doctors use to bend the device in tight spaces and allow for attachments such as catheters or guide wires. Experts suspect bacteria build up in that small area.

    This bacteria is emerging in the U.S., and it's associated with a high mortality rate. We don't want this circulating anywhere in the community

    Kallen, the CDC official, said he hasn't found any breaches in cleaning protocol at hospital outbreaks he has investigated, but he said the problem probably is more complicated than just a design issue.

    “There isn't an obviously easy solution to employ,” Kallen said. “There is action on a lot of different fronts.”

    Virginia Mason instituted a new quarantine process that sets the endoscopes aside for 48 hours so evidence of any bacterial growth can be found before reusing them.

    That has increased the time for equipment cleaning from a couple of hours to more than two days. Virginia Mason said it had to purchase 20 additional endoscopes to compensate for that down time.

    “There is either a design issue to be addressed or a change to the guidelines for the cleaning process,” said Dr. Andrew Ross, section chief of gastroenterology at Virginia Mason. “It's the role of the federal government to make some of those decisions.”

    In the wake of the Seattle cases, Sen. Patty Murray (D-Washington) pressed the FDA to issue guidelines for hospitals on how best to sanitize these scopes and devise a way to better track infections.

    Some patient-safety advocates say regulators and industry officials have been too slow to respond.

    “Hospitals and manufacturers often take months to assess what to do, with the infected patients being the last to know,” Muscarella said. “Bringing patients into the loop and answering their questions is important for hospitals to prevent outbreaks.”

    A spokeswoman for the FDA said the agency was working to reduce the incidence of infections while maintaining access to a crucial medical tool.

    The agency said it was “actively engaged with the manufacturers of duodenoscopes used in the U.S. and with other government agencies such as the CDC to develop solutions to minimize patient risk associated with these issues.… The FDA believes the continued availability of these devices is in the best interest of the public health.”

    Olympus Medical Systems Group, a major manufacturer of these endoscopes and UCLA's supplier, said it was working with the FDA, physician groups and hospitals regarding these safety concerns.

    The company said all of its customers who purchase Olympus duodenoscopes “receive instruction and documentation to pay careful attention to cleaning.”

    UCLA said it moved quickly to protect patients once the problem surfaced. It said it alerted state and county health officials as soon as the bacteria were detected.

    It is notifying 179 patients and their primary-care doctors by phone and letter. UCLA said it was offering to send patients a free home testing kit for a rectal swab, or they could come in to be tested.



    Even before this incident, UCLA has struggled at times with patient safety. An influential healthcare quality organization gave the Ronald Reagan Medical Center a failing grade on patient safety in 2012.

    The hospital's score improved to a C in the latest ratings from Leapfrog Group, a Washington nonprofit backed by large employers and leading medical experts.

    Meanwhile, some doctors worry the outbreaks might deter patients from seeking care they need.

    “ERCP is a common and critical procedure in most hospitals today,” said Dr. Bret Petersen, a professor of medicine at Mayo Clinic's division of gastroenterology and hepatology in Rochester, Minn. “It's not a procedure we can allow to be constrained, so this is a serious issue we need to address.”


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    China bans U.S. poultry, eggs imports amid avian flu fears: USDA

    China bans U.S. poultry, eggs imports amid avian flu fears: USDA | Healthcare and Technology news | Scoop.it

    China has banned all imports of U.S. poultry, poultry products and eggs amid recent reports of highly pathogenic strains of avian influenza found in the Pacific Northwest, the U.S. Department of Agriculture said Monday.

    All poultry and poultry related products shipped from the United States after Jan. 8 would be returned or destroyed, according to the agency and the U.S. trade group USA Poultry & Egg Export Council.

    The ban, effective as of Jan. 8, also applies to poultry breeding stock, which includes live chicks and hatching eggs.

    From January through November last year, U.S. exports of poultry products sent to China reached nearly $272 million, said Toby Moore, spokesman for the trade group.

    U.S. chicken exports to China from January-November 2014 was 239.768 million lbs, consisting primarily of chicken feet or paws. During that same period, China imported 55.923 million lbs of U.S. turkey.

    The country's import of eggs from the United States is marginal, according to industry sources.

    "This move is somewhat hypocritical as there have been zero findings of high pathogenic avian influenza in a commercial poultry flock in the U.S. and, China already has a variety of avian influenza strains," said Brett Stuart, chief executive of Global AgriTrends in Denver, Colorado.

    China's actions came after Hong Kong in late December suspended imports of certain U.S. poultry and poultry products after two separate virus strains were identified in Whatcom County, Washington, including H5N2 in northern pintail ducks, according to USDA.

    This same strain has killed thousands of birds on two Canadian farms in British Columbia.

    Additionally, the highly pathogenic 85N8 strain was confirmed in guinea fowl and chickens in a backyard poultry flock in the city of Winston, Oregon.

    Neither virus has been found in U.S. commercial poultry. No human cases involving either viral strain have been detected in the United States or Canada, and there are no immediate public health concerns, said USDA.


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