Health Connector: Insurance Signups Up, But Many Unpaid

The Massachusetts Health Connector is preparing for a signup surge as the state’s deadline for enrolling in 2015 insurance coverage approaches.

The agency says more than 100,000 residents who must pay some or all of their premiums have registered online, but so far, only 18 percent have chosen a plan and paid.

Still, those 18,000 people are double the number who had paid a week ago.

The deadline is Tuesday for those who want to be covered on the first of the year. The site’s director, Maydad Cohen, is urging residents to take action this weekend.

“Because we expect high, high volumes Monday and Tuesday,” Cohen said. “High volume typically results in longer wait times. And we do want to make sure people can access health insurance, and make sure that they pick and pay for that plan.”

The Connector office will be open during the day for residents who do not have access to a computer.


Doctors In Massachusetts Now Required To Offer End-Of-Life Counseling

With a new state law taking available, this information will be offered for end-of-life care. (Robin Lubbock/WBUR)

Under new state regulations, patients with a terminal condition will be offered end-of-life information like this sample brochure, as well as counseling about their options. (Robin Lubbock/WBUR)

About nine months ago, John Polanowicz was in a hospital room at Brigham and Women’s watching his 44-year-old brother-in-law Bobby struggle to breathe. Bobby had advanced lung cancer. Now, with a tube down his throat, he was trying to respond to questions about his end-of-life wishes using a marker on a white board.

“We were all trying to decide,” Polanowicz recalled, “would we keep him trached and vented, and hope against hope that there would be some change in the disease process?”

Bobby was losing the battle with cancer. He had wanted to fight to the end, but no one had talked to Bobby about how to deal with the end.

“It would have been much easier for the family to have had some of these conversations before 4 in the afternoon on the day that he passed,” Polanowicz said.

On Friday, Polanowicz, Massachusetts’ secretary for health and human services, posts regulations designed to help patients like his brother-in-law avoid describing their final medical wishes with an erasable marker. Doctors, hospitals, nursing homes and other health providers in Massachusetts are now required to offer end-of-life counseling to terminally ill patients. The requirement, part of a 2012 law, takes effect Friday with the posting of rules about how it will work.

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Gov. Patrick Announces $1M Grant To Help Develop Faster Ebola Test

Dr. Rick Sacra, a Massachusetts doctor who contracted the Ebola virus in Liberia, and Gov. Deval Patrick converse Tuesday at the State House. (Stephan Savoia/AP)

Dr. Rick Sacra, a Massachusetts doctor who contracted the Ebola virus in Liberia, and Gov. Deval Patrick converse Tuesday at the State House. (Stephan Savoia/AP)

The Massachusetts Life Sciences Center, a quasi-public agency, will issue a $1 million grant to help develop a faster, more accurate test for diagnosing Ebola, Gov. Deval Patrick announced Tuesday.

Also Tuesday, a Massachusetts doctor who had Ebola announced he’s returning to Liberia, where he contracted the virus, to resume his work.

The grant will support a partnership of local life sciences companies, nonprofits and academic institutions that will try to speed up the launch of an Ebola detection tool already in development by Diagnostics For All, a nonprofit organization.

Officials on hand for the State House announcement promised the new tool — which will accept a “single finger-stick of blood” and provide a clear “yes” or “no” response in 45 minutes — will be cheaper, easier to use and lead to earlier diagnosis than current tests.

They said current tests are time- and labor-intensive and not always sensitive enough to detect Ebola at its earliest onset, which they said is critical to containing and effectively treating the disease. Continue reading

Brigham And Women’s Vivek Murthy Confirmed To U.S. Surgeon General Post

A Brigham and Women’s physician will become the next U.S. surgeon general.

Democrats squeaked out a 51-43 vote Monday to confirm Dr. Vivek Murthy, 37, in the waning days of their control over the U.S. Senate.

Dr. Vivek Murthy is an internist at Boston’s Brigham and Women’s Hospital. His nomination for U.S. surgeon general has stalled, largely due to his advocacy of gun control. (Charles Dharapak/AP/File)

Dr. Vivek Murthy (Charles Dharapak/AP/File)

Murthy’s nomination stalled earlier this year when the National Rifle Association raised objection to Murthy’s characterization of guns as a health issue. Murthy said he would focus on childhood obesity, not guns, if approved as the nation’s top doctor. Many public health leaders and physicians fumed about the NRA’s influence, but the White House did not press for a vote and many of Murthy’s supporters assumed the nomination was dead.

Then on Saturday, Senate Majority Leader Harry Reid, using a procedural move, put Murthy’s nomination back in play. And on Monday he was approved by a single vote majority a year after being nominated and 17 months after the position was vacated.

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Teen Birth Rate In Mass. At Historic Low

The birth rate among teens in Massachusetts is at its lowest recorded level in the state’s history, a report out Friday says.

The birth rate of teens ages 15-19 fell 14 percent last year, from 14 births per 1,000 women in 2012 to 12 births per 1,000 women in 2013, the Massachusetts Department of Health reported.

“This is terrific news for all Massachusetts families, and a dramatic indication that our decisions to invest in our young people — through education, support and resources — can have a real and lasting impact on their lives and in their communities,” Gov. Deval Patrick said in a statement.

According to the report, there were 2,732 babies born to teen mothers between 15 and 19 years old in 2013, down from 3,219 the previous year. The number of children born to teen mothers in that age bracket is significantly lower than the 7,258 births reported in 1990. Continue reading


Mass. Officials Say Most Have Yet To Pay For Health Plans

State officials say about 150,000 people have determined eligibility for insurance plans on the state’s overhauled Health Connector website. But less than 1 percent has paid for 2015 coverage with a deadline fast approaching.

The connector rolled out its new website on Nov. 15 to replace the one that was crippled by technical problems, forcing hundreds of thousands of people into temporary Medicaid coverage.

Residents eligible to buy insurance through the connector have until Dec. 23 to make their first payment. The Boston Globe reports that few have sent checks so far, but state officials aren’t worried because people historically wait until the last week to pay.

The head of the Massachusetts Association of Health Plans has expressed concern about the low enrollment and the prospect of many people going uninsured.


Audit Questions $35M In State Medicaid Payments

A state audit has identified $35 million of what were called “questionable and unallowable” payments by the state’s Medicaid program.

Massachusetts State Auditor Suzanne M. Bump (Josh Reynolds/AP)

Massachusetts State Auditor Suzanne M. Bump (Josh Reynolds/AP)

Auditor Suzanne Bump said Wednesday that her office and MassHealth disagree in their interpretations of federal and state rules that govern the program.

The audit focused on MassHealth’s Limited Program, which covers eligible non-citizens.

While federal land state rules are supposed to restrict coverage under the program to emergency medical services, Bump says auditors found that MassHealth often paid claims even when a provider indicated that a service was not of an emergency nature.

She says MassHealth “regularly substituted its own judgment for that of the medical profession.”

State officials strongly disputed the findings, saying they disagreed with the auditor’s definition of emergency medical services.

Tufts Medical Center And Boston Medical Center In Merger Talks

The wave of Massachusetts hospital consolidations is building.

Tufts Medical Center and Boston Medical Center (BMC) issued statements Wednesday night confirming that the two not-for-profit institutions are discussing a merger.

“Tufts MC is our neighbor, we know them, we respect them, and we share a common geography and a commitment to providing high quality care to all patients,” said Jennifer Watson, chief of staff at BMC. “Like the rest of the health care community we have considered strategic partnerships, and with Tufts MC we have recognized that the combination of our individual strengths could create a partnership uniquely positioned to improve health care in Massachusetts.”

“Our organizations share a commitment to high quality, lower cost health care and to serving every patient with the greatest respect and compassion,” Tufts Medical Center Vice President Brooke Hynes said in a statement. “We also share a mutual commitment to our academic missions of clinical excellence, teaching and research.”

It’s not clear how close the hospitals are to an agreement. They have separate medical schools that would not be part of the deal. The buildings are just over a mile apart (Tufts in Chinatown, BMC in the South End). Their missions have traditionally been somewhat different, with BMC as a major trauma and safety net hospital and Tufts striving to model the low cost, high quality alternative to other, more expensive Boston hospitals.

But it sounds like the talks are going well. Continue reading

If Guns Threaten Health Like Smoking Or HIV, What Should Doctors Do?

The idea that guns are dangerous to your health is not new. But it is arguably as explosive as it was in 1985, when the Institute of Medicine first made the link between guns and health.

Pediatricians have established guidelines for asking parents: Do you have guns in the home, and if so, are they locked and out of reach of children?

Some physicians and gun rights groups that oppose such questions have pushed back and say they have momentum. In July, an appeals court ruled in favor of a 2011 Florida law, nicknamed Docs v. Glocks. It bans doctors from asking their patients questions about gun ownership unless the question is deemed medically necessary. Montana and Missouri have passed similar laws.

Against this backdrop, a new Massachusetts-based group, the National Medical Council on Gun Violence, says it’s time to go beyond asking patients if they have access to a gun.

Ray Duggan, 32, a former Young Bloods gang member from Providence, told physicians at the conference about the 2004 shooting that left him paralyzed, and his work now to break up gang feuds and street violence. (Martha Bebinger/WBUR)

Ray Duggan, 32, a former Young Bloods gang member from Providence, told physicians at the conference about the 2004 shooting that left him paralyzed, and his work now to break up gang feuds and street violence. (Martha Bebinger/WBUR)

“If people don’t know what to do when they get a ‘yes,’ then they’re never going to screen for it,” said Dr. Megan Ranney, an emergency room physician at Rhode Island Hospital in Providence. Ranney helped organize the first continuing medical education course on gun violence, held at the Massachusetts Medical Society this past Saturday.

Ranney says it’s time to clarify the questions doctors should ask patients at risk for domestic violence, homicide, suicide or accidental gun violence, and establish the steps doctors should take to reduce the threat.

Take this example, which Dr. Ron Gross, chief of trauma and emergency surgery at Baystate Medical Center in Springfield, presented to a panel of physicians at the conference.

“A mother with a chief complaint of anxiety shows up in the emergency room,” he said. “She has three kids: 5, 7 and 9. Among the things discussed is her husband’s loaded, unlocked handguns.” Continue reading


MGH Patient Monitored For Possible Ebola ‘Cleared Medically,’ Discharged

A patient who was being monitored for possible Ebola and then tested positive for malaria was “cleared medically” and discharged from Massachusetts General Hospital Friday morning, hospital officials announced in a statement.

The patient’s release and current condition are not a threat to anyone else, MGH officials said. The patient, who has not been identified, had been under the hospital’s care since Tuesday.

“As we noted previously this patient had been definitively diagnosed with malaria and is responding well to anti-malaria treatment,” hospital officials said in the statement. “The patient has had no fever or other symptoms for the past 24 hours.”

In a press conference Wednesday, Dr. David Hooper, the head of Mass General’s infection control unit, said the patient had traveled to Liberia in recent weeks, but worked in an administrative role.

Hooper said he did not have the patient’s permission to disclose where he worked while in Liberia, but said the patient “did not have direct contact with Ebola patients” and was tested “out of an abundance of caution.”

MGH officials also noted in the statement that screening the patient for Ebola afforded them the “opportunity to see firsthand the benefits of the extensive preparations that have been under way through the hospital for the past several months.”

Officials praised their response and said preparations included carefully following Centers for Disease Control and Prevention protocols for treating possible Ebola cases.