I-Team In-Depth

Can Independent Primary Care Doctors Survive Dominance of Hospital Health Systems?

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Every day, Dr. Leslie Miller of Fairfield thinks about selling her practice to a hospital health system. “Everybody who is in this environment thinks every day of throwing in the towel and joining a hospital,” said Miller, a sole practitioner in primary care for 20 years. “The business side is the problem,” she said, referring to expensive and time-consuming requirements of medical insurance and government regulations. Dr. Khuram Ghumman took the unusual route of working in a hospital system first, then going into private primary care practice because he objects to the “corporatization” of health care. He said conflicts of interest can arise if an owner and its employed physicians have different objectives.

I-Team In-Depth

Affordable Prescription Pricing, Public Insurance Option Among Legislature’s Health Care Goals

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Although Gov. Ned Lamont said nothing about health care policy in his inaugural speech to the General Assembly, it’s likely to be a major theme of at least his early months in office. Why? Depending on how it’s calculated, health care makes up 25 to 30 percent of the state budget, according to the Office of the State Comptroller. Lamont will have to balance the need to save money with the desire of many inside and outside the General Assembly to expand and improve health care coverage and lower costs for consumers. “There’s almost two levels,” said Patricia Baker, president and CEO of the Connecticut Health Foundation, which focuses on assuring health equity and access to affordable care for all.

Women's Health

ADHD Drug Use Rises Sharply Among Young Women

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A growing number of reproductive-age women are taking prescription medication to treat attention-deficit/hyperactivity disorder (ADHD), data show, but doctors warn the effects of such drugs on pregnancies are largely unknown. The number of privately insured women nationwide between the ages of 15 and 44 who filled a prescription for an ADHD medication soared 344 percent from 2003 to 2015, from 0.9 percent to 4 percent, according to Centers for Disease Control and Prevention (CDC). ADHD medication use increased among all age brackets within that group and in all geographic regions, data show. The biggest spikes were seen in women ages 25 to 29, among which medication use jumped 700 percent, from 0.5 percent in 2003 to 4 percent in 2015. The second-largest increase was among women ages 30 to 34, which had a 560 percent increase from 0.5 percent to 3.3 percent, according to the CDC.

health care

Drug Prices Keep Rising Despite Efforts To Reduce Out-Of-Pocket Costs

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Michael Baudin of Manchester retired eight years ago after a career in auto repair, but now the 76-year-old is back working part time as a driver so he can afford prescription medications. “Every year premiums go up and my co-pay is increasing,” he said. “I take medication for cholesterol, hypertension, heart, prostate and digestion. My wife quit her job due to health issues and her medication is expensive too.”

Baudin says his out-of-pocket cost for a 90-day supply of just one drug, Creon from AbbVie Inc., which he takes for digestion, is $100. The drug does not have a generic equivalent.

Jobs study requested

Lawmakers Press For Thorough Review Of Two Health Insurance Mergers

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Seventeen lawmakers are asking the state’s insurance commissioner for a fair and thorough review of two pending colossal health insurance mergers and a study on how they could affect Connecticut jobs. “The proposed Anthem-Cigna and Aetna-Humana mergers are likely to have a negative impact on both the cost and quality of care in Connecticut, permanently changing our state’s health care system for patients, physicians, and other stakeholders,” according to the lawmakers’ letter sent to Insurance Commissioner Katharine L. Wade. In a conference call Wednesday, legislators led by state Rep. Gregory Haddad, D-Mansfield, said, that the “mega-mergers” could drive up consumer costs, concentrating more than 64 percent of the Connecticut health insurance market in their hands and restricting provider networks. Legislators, in the letter, asked Wade to hold multiple public hearings across the state, grant consumer advocates intervenor status in the proceedings and commission a study of the impact the mergers would have on consumers in terms of health care cost and quality.  Also, they want a review of how the mergers would impact Connecticut jobs. Haddad said there could be increases in deductibles, premiums and out-of-pocket costs and restrictions to provider choice as a result of the mergers.

Disparities

Despite Efforts, Black Women Deliver More Preterm Births

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Black women in Connecticut remain more likely than white or Hispanic women to deliver preterm babies, despite efforts to reduce the disparity, newly released data show. In 2014, 12 percent of all births by black women in the state were preterm, meaning they occurred before 37 weeks gestation, according to data compiled by the Henry J. Kaiser Family Foundation. That compares with 9 percent of all births by white women and 10 percent of all births by Hispanic women that were preterm during the same year. Nationally, the trend was similar with 13 percent of births by black women occurring preterm compared with 9 percent of white women’s births and 9 percent of Hispanic women’s births. In the vast majority of states, black women experience a higher rate of preterm births than whites or Hispanic women, according to the state-by-state comparison of the Kaiser data.

Women's Health

New Breast Cancer Screening Guidelines Rekindle Rage, Debate

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When the American Cancer Society announced new guidelines for mammograms a week ago, the response on the organization’s Facebook page was swift. “For adoptees, this just adds 5 more years of potential unknowing,” wrote Angela from Connecticut. “Without a medical history, we are denied mammograms through insurance carriers.”

And then Dr. Henry Jacobs, a Hartford area longtime OB-GYN who, among other duties, serves as the Connecticut State Medical Society president, took to Facebook, too, and posted a message that summarized the general rage: “It is clear that rationing care is the new sales pitch and sacrificing women that could live out their lives is considered acceptable. I think it is UNCONSCIONABLE!!!!!!! We can afford athletes, entertainers, CEOs, hedge fund scammers that make upwards of a 100 million $$$$$ a year, but we can’t provide decent medical care to people???

Disparities

Racial, Ethnic Disparities Common In CT Hospital Readmissions

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A black patient hospitalized for chest pain in Connecticut is 20 percent more likely than a white patient to be readmitted within 30 days after discharge. Similarly, a Hispanic patient hospitalized for heart failure is 30 percent more likely to land back in the hospital within a month. Those disparities in two of the most common reasons for hospitalizations among state residents point to larger problems in access to care, underlying health status and insurance coverage, according to a study published today in Connecticut Medicine, the journal of the Connecticut State Medical Society. The society is hosting a forum today to discuss ways to reduce disparities in readmissions of patients with heart failure, chest pain and three other conditions: joint replacement surgery, digestive disorders and uncomplicated childbirth. “We’re seeing large disparities in readmissions for a number of conditions,” said Robert Aseltine, the study’s lead author and professor of behavioral science and community health at the University of Connecticut Health Center.

Botox

CT Joins States Requiring More ‘Medical’ In Med-Spa Staffing

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Those who visit a medical spa in Connecticut for Botox, hair transplants or other cosmetic procedures can be assured they will see a licensed medical professional there, which hasn’t always been the case. Previously, consumers complained that med-spa procedures were sometimes performed by unlicensed providers, but a recently enacted state law has placed stricter requirements on the businesses. The law, which took effect Oct. 1, requires all medical spas to employ – either on staff or by contracting for services – a physician, physician assistant or advanced practice registered nurse (APRN). It also mandates that one of those medical professionals perform an initial physical assessment of every med-spa client before any procedure is done.

Disparities

CT Fails Consumers Seeking Info On Physician Quality

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Connecticut was among 41 states nationwide to earn a failing grade from health advocates for lacking public information about the quality of care provided by doctors. “Consumers should be able to find out if their local primary care physician is delivering good quality care without having to go through hoops,” said Francois de Brantes, executive director of the Health Care Incentives Improvement Institute in Newtown, which published the report. “Connecticut has no public reporting of physician quality.”

Only two states, Minnesota and Washington, received an ‘A.’ California received a ‘C’ and the remaining states earned a ‘D’ or ‘F.’

Mark Schaefer, the state’s new director of Healthcare Innovation, wasn’t surprised by the findings. “It’s widely recognized that consumers in the health care market don’t have accessible and reliable information about the cost of treatments across settings and the quality of providers at the clinical level,” he said. “Like most states, this is something Connecticut is working on.”