RealClearHealth Morning Scan -- 03/28/2016

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Nearly All U.S. Doctors 'Overprescribe' Opioids
Alan Mozes, HealthDay
When American doctors give their patients narcotic painkillers, 99 percent of them hand out prescriptions that exceed the federally recommended three-day dosage limit, new research suggests. And some doctors exceeded that limit by a lot: Nearly one-quarter gave out month-long dosages, despite the fact that research has shown that a month's use of prescription narcotic painkillers can cause brain changes, the National Safety Council survey found.

Mom's Role in Caring for Drug-Dependent Newborns
Jeff Cohen, NPR
These fragile and fitful newborns present new challenges for hospitals. Some research suggests the children do best when they can be held for hours at a time, preferably by their mothers, in quiet, private rooms, as they go through the process of being weaned off the drugs. But delivering care that way requires changing the attitudes of many doctors and nurses about addiction.

Anti-Vaccine Film Yanked from Film Festival
Steven Zeitchik, L.A. Times
Facing a growing outcry, Tribeca Film Festival co-founder Robert De Niro has decided to remove a controversial anti-vaccine film from the gathering’s lineup. Just a day after the actor revealed that he had personally pushed for a showing of the film, titled “Vaxxed” and directed by the polarizing anti-vaccine activist Andrew Wakefield, De Niro reversed his position.

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Preserve Medicare Advantage to protect those with chronic conditions who need the quality, coordinated care it provides. Learn more.

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Medicaid Thrives More Than Exchange Plans
Kimberly Leonard, US News
The number of Medicaid enrollees are particularly remarkable because under Obamacare the expansion program was expected to be significantly larger. The health care law, formally known as the Affordable Care Act, made it mandatory for all states to expand Medicaid's eligibility to people making less than $16,243 a year. Several governors contested the law, however, and in 2012 the Supreme Court ruled that states could decide whether they wanted to participate in the program.

Cruz's Missing Obamacare Replacement Plan
Pradhan & Demko, Politico
Everyone knows how Ted Cruz feels about Obamacare. He’s the guy who shut down the government in a bid to kill it — and should he reach the White House, he’d take a blowtorch to the law. But Cruz isn’t very clear about what — if anything — he’d do to replace a law covering 20 million people.

Google's Bid to Transform Medicine Hits Turbulence
Charles Piller, Stat
Google’s brash attempt to revolutionize medicine as it did the Internet is facing turbulence, and many leaders who launched its life sciences startup have quit, STAT has found. Former employees pointed to one overriding reason for the exodus from Verily Life Sciences: the challenge of working with CEO Andrew Conrad.

Why Women Choose Double Mastectomies
Carey Goldberg, WBUR
Why would more and more women be choosing an operation that involves a long recovery and carries risks that include recurrent infections, chronic pain and the need for more surgery? Golshan’s own study offers a major clue: Far more women who have mastectomies are also undergoing breast reconstruction. The rate has risen from 35 percent in 2002 to 55 percent in 2012. Reconstruction itself has been improving significantly, he said.

EHRs Begin to Transform Health Care
Guy Boulton, Milwaukee Jour. Sent.
At Froedtert Hospital, a patient with stomach pain was spared from having to undergo a CT scan, with its heavy dose of radiation, and instead got a safer, less-costly ultrasound. At MetroHealth System in Ohio, medication errors involving heparin, a common but risky blood thinner, were eliminated in just one year. At ThedaCare in the Fox Valley, the fatality rate from sepsis, a complication from infections, has fallen sharply. All of these improvements stemmed from the wise use of electronic health records — computerized systems that are replacing paper charts in medical settings across the country.

Quality of Primary Care in Medical Homes
Berenson & Burton, HA Blog
We would suggest the current emphasis of PCMH demonstrations and models on the fourth C, care coordination, is partly a reaction to decline in primary care commitments to the three other C’s, contact, continuity, and comprehensiveness — decline that seems to have been simply accepted as facts of life by most PCMH architects. It’s no wonder the PCMH emphasizes care coordination — much of the care received by primary care clinicians’ patients is now being performed by others, without their involvement.

Subpar Care at Massachusetts Nursing Homes
Kay Lazar, Boston Globe
The Globe scrutinized the 2014 financial reports, the latest available, from 396 Massachusetts nursing homes and examined the money spent on nursing care, patient food, management, rent, and fees for therapy, office support, and other services. Also examined were health and safety violations for each nursing home. For-profit nursing homes, which constitute three-quarters of those in the state, frequently devote less money to nursing care, compared to nonprofit homes, the analysis showed.

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Millions are facing new cuts to Medicare Advantage that will undermine chronic care management for those who don’t qualify for both Medicare and Medicaid. That means fewer choices and higher costs. Proposed changes to Medicare Advantage should be delayed to find a solution that works for everyone. Learn more.

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