GOP health care bill dies, straight repeal unlikely

Late Monday, with the defection of two more senators, Sen. Mitch McConnell effectively pronounced the GOP health bill dead. He said the Senate will now focus on repeal. However, although repeal legislation passed (and was vetoed) in 2015, it seems unlikely this time around, given that three moderate GOP senators have expressed opposition. Sen. John McCain--not one of the three--says Congress must “return to regular order, hold hearings, receive input from members of both parties, and heed the recommendations of our nation's governors…” ( Kaiser Health News; Fierce Healthcare)

Medicaid expansion costlier than anticipated
The projected cost of Medicaid expansion is increasing beyond expectations, Charles Blahous of the Mercatus Center and the Hoover Institution, warns in a commentary. CMS now expects that through 2022, Medicaid expansion costs will be $7,436 per person, compared to the $4,875 projected in 2013. He also argues that expansion has “made Medicaid spending more poorly targeted. We’re already spending a far greater share than expected on Medicaid’s relatively less needy participants, and this poor targeting is expected to grow worse.” ( E21)

PCPCC: Evidence largely supports PCMH

At a Capitol Hill briefing hosted by the Congressional Primary Care Caucus, the Patient-Centered Primary Care Collaborative unveiled its latest report highlighting evidence that links the patient-centered medical home and other forms of advanced primary care with improved outcomes. “This year’s report uses a more rigorous research design and resulted in positive results overall with respect to the PCMH and other advanced primary care models, particularly those that have been in place for four or more years,” said Ann Greiner, PCPCC president and CEO. ( PCPCC)

To avoid errors, don't handwrite opioid prescriptions
Electronic prescriptions for opioids are safer, according to research published in the Journal of Opioid Management. Researchers looked at 510 opioid-medication prescriptions written in June 2016. Errors occurred in 89 percent of handwritten prescriptions but none of the EHR-generated prescriptions. What constituted “error?” Deviation from DEA “best practice” guidelines and/or missing at least two forms of patient ID information. “Inconsistencies in opioid prescribing remain common. Handwritten prescriptions continue to demonstrate higher associations of errors, discrepancies, and variation from ideal practice and government regulations,” researchers concluded . ( Journal of Opioid Management; HealthLeaders Media)

HHS fraud takedown may be largest ever
The Department of Health and Human Services Office of Inspector General, along with state and federal law enforcement, have executed what’s being called the largest health care fraud takedown in history. It charged 412 people—including 115 doctors and other health care professionals—with participating in fraud schemes involving about $1.3 billion in false billings to Medicare and Medicaid. OIG also issued exclusion notices to 295 doctors, nurses, pharmacists and other providers based on conduct related to opioid diversion and abuse. (OIG; CNN)

Medication errors at home have more than doubled
The frequency of serious medication errors by patients or their caregivers at home (or otherwise outside of a medical setting) more than doubled from 2000 to 2012, according to research published in Clinical Toxicology. The most common errors involved taking or giving the wrong medication or incorrect dosage and inadvertently taking or giving the same medication twice. “These errors represent an important burden on the health care system, with one-third of the 67,603 exposures included in this study resulting in hospital admission. Most non-health care facility medication errors are preventable,” the researchers conclude. ( HealthLeaders Media; Clinical Toxicology )

Ambassador Doc: The VA recently launched its Physician Ambassador Program, an effort to recruit volunteer medical providers at the more than 1,700 VA health care facilities across the nation. ( VA announcement; Physician Ambassador Program)