Insurers Begin Denying Payment for 'Unnecessary' ED Care

https://goo.gl/j6wFn8

In May 2017, Blue Cross Blue Shield (BCBS) of Georgia announced it will no longer cover "unnecessary" emergency department (ED) care, starting July 1. According to BCBS Georgia President Jeff Fusile, "...we have got to find a better way to do some of this stuff, taking some unnecessary spending out of the system." Fusile would rather patients use urgent care, retail clinics, and their online app, instead of costly EDs for conditions treatable in those settings. The BCBS policy follows similar ones enacted by Anthem in New York, Kentucky, and Missouri.

To many, these policies seem well-intentioned for a fiscally responsible insurer in a country with out-of-control healthcare costs. The simple goal: drive low-acuity illness to cheaper settings, which will control costs and in turn, allow for lower premiums.

Insurers are partly right: inefficient setting selection is a real issue. It is not uncommon for emergency physicians to face situations where a panicky ED patient realizes their perceived health emergency was a false alarm. Some well known examples: a toddler with a fever and listlessness who perks up after a weight-appropriate dose of ibuprofen; a bout of severe, unrelenting abdominal pain that resolves spontaneously right after the patient is triaged and passes gas; the allergic reaction which initially felt like "throat closing" with not even a hive after some Benadryl.

Some ED patients could potentially be served elsewhere. Some patients come to the ED when they didn't need any medical attention at all. But the reality is there is no systematic way for patients to reliably and safely determine whether their symptoms represent an emergency. Many patients are referred to the ED by their doctors, others have no easy access to physicians, and many do not know about or think they should use telemedicine during a potential health emergency.

Bottom line, it is playing with fire for BCBS and Anthem to systematically discourage ED use. Sometimes, fever and listlessness is meningitis, unrelenting abdominal pain can be a bursting appendix, and allergic reactions occasionally result in life-threatening anaphylaxis. All are potentially lethal if untreated. Insurers' new ED deterrent policies create a new, unfair responsibility for patients: self-diagnose accurately, or else. Patients choosing incorrectly face steep financial penalties after seeking care in settings deemed "non-ideal," decided after the fact by their insurer using their final


Tool for journalists: Mercury, for audio transcription and translation

https://goo.gl/qFfkfh

Funded by the Google Digital News Initiative, this web based tool will help journalists and publishers to translate videos and audio into multiple languages.

Publishers are constantly looking for new ways to increase their video output in a fashion that is effective and not time-consuming.

New tool Mercury, which is free and funded by the Google Digital News Initiative, has been designed to help news organisations use video and audio in their day-to-day work, and make it more accessible to audiences around the world.

Get started by signing into the tool with your Google account, before uploading a video or audio file from your computer. The file will then save to your Google Drive, in a folder which stores all the material you've uploaded within the tool. Note that only files uploaded through Mercury will be visible in Mercury, so you'll have to re-upload any videos already on your account.

Mercury is designed for users to work with shorter video segments and audio interviews, preferably in MPEG4 or M


As Trump calls Obamacare a 'disaster,' experts tout successes in Michigan

https://goo.gl/pmLqFd

"Michigan is a poster child for the successes of the ACA," said Allan Baumgarten, an independent analyst who studies insurance markets in nine states. "Michigan has benefited significantly from the two major expansions in coverage."

Almost 700,000 Michiganders are now enrolled in Healthy Michigan, the Medicaid expansion program for low-income residents age 19 to 64.

Meanwhile, the ACA marketplace drew more than 300,000 enrollees for 2017. About 81 percent received tax credits to offset premium costs, and 50 percent qualified for additional "cost-sharing" subsidies that reduced deductibles and co-pays. 

In addition, an estimated 73,000 young adults in Michigan have benefited from the ACA provision that allows them to stay on their parents' health insurance up to age 26.

Since 2010, the number of uninsured Michigan residents has dropped from 1.3 million to less than 600,000.


STATEMENT BY SASC CHAIRMAN JOHN McCAIN ON TRANSGENDER AMERICANS IN THE MILITARY

https://goo.gl/G2RBU2

U.S. Senator John McCain (R-AZ), Chairman of the Senate Armed Services Committee, released the following statement today on President Trump’s tweet regarding transgender Americans in the military:

“The President’s tweet this morning regarding transgender Americans in the military is yet another example of why major policy announcements should not be made via Twitter.

“The statement was unclear. The Department of Defense has already decided to allow currently-serving transgender individuals to stay in the military, and many are serving honorably today. Any American who meets current medical and readiness standards should be allowed to continue serving. There is no reason to force service members who are able to fight, train, and deploy to leave the military—regardless of their gender identity. We should all be guided by the principle that any American who wants to serve our country and is able to meet the standards should have the opportunity to do so—and should be treated as the patriots they are.

“The Department of Defense is currently conducting a study on the medical obligations it would incur, the impact on military readiness, and related questions associated with the accession of transgender individuals who are not currently serving in uniform and wish to join the military. I do not believe that any new policy decision is appropriate until that study is complete and thoroughly reviewed by the Secretary of Defense, our military leadership, and the Congress.

“The Senate Armed Services Committee will continue to follow closely and conduct oversight on the issue of transgender individuals serving in the military.”


Senate Rejects Slimmed-Down Obamacare Repeal as McCain Votes No

https://goo.gl/dFBsbz

The Senate in the early hours of Friday morning rejected a new, scaled-down Republican plan to repeal parts of the Affordable Care Act, derailing the Republicans’ seven-year campaign to dismantle President Barack Obama’s signature health care law and dealing a huge political setback to President Trump.

Senator John McCain of Arizona, who just this week returned to the Senate after receiving a diagnosis of brain cancer, cast the decisive vote to defeat the proposal, joining two other Republicans, Susan Collins of Maine and Lisa Murkowski of Alaska, in opposing it.

The 49-to-51 vote was also a humiliating setback for the Senate majority leader, Mitch McConnell of Kentucky, who has nurtured his reputation as a master tactician and spent the last three months trying to devise a repeal bill that could win support from members of his caucus.