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The Trump administration will rebrand its Medicaid block grant program and look to safeguard the policy against an expected wave of legal challenges from patient advocates, according to two officials with knowledge of the plan set for release Thursday. The forthcoming block grant program comes with a new name — “Healthy Adult Opportunity” — but retains the original mission long sought by conservatives: allowing states to cap a portion of their spending on Medicaid, a radical change in how the safety net health program is financed. (Diamond and Roubein, 1/29)

More than 30 House Democrats are warning the Trump administration that it should not allow states to turn their Medicaid funding into block grants. The letter, led by Rep. Joe Kennedy III (D-Mass.) and signed by 35 other Democrats, argues that block grants are illegal. (Weixel, 1/29)

And in the states —

New York City and the state’s counties could be forced to pay over $800 million more a year under a proposal by Gov. Andrew Cuomo to change how New York funds its Medicaid program, which municipal officials around the state say has prompted confusion and concern among them. The Democratic governor last week proposed that localities should once again be on the hook for some of the growth in the cost of the Medicaid program, which provides health-care services to more than six million people. (Vielkind, 1/29)

For over three years, Missouri failed to adequately check that people enrolled in its Medicaid program were actually eligible. That’s what lawmakers and state officials said at a legislative hearing Tuesday where top staff from the Department of Social Services explained the state’s system for making those checks. (Stewart, 1/29)

New Food and Drug Administration commissioner Stephen M. Hahn rises at 4 a.m. each day for an hour of intensive strength and stamina training. On stressful days, he fits a second workout in during the late afternoon. Given the politically tricky waters ahead, those twice-daily workouts may soon become the norm. Dr. Hahn, 60, takes over an FDA under fire for failing to adequately respond to the health threat from growing use of e-cigarettes and vaping products. (Burton, 1/29)

The US Food and Drug Administration received its fourth consecutive failing grade on regulation of tobacco products in the American Lung Association's annual State of Tobacco Control report. A key factor in the grade was the Trump administration's decision to exempt menthol and tobacco-flavored e-cigarettes from the policy it finalized this month to clear the market of cartridge-based e-cigarette flavors. The final policy was a shift from its September announcement that it would clear the market of all e-cigarette flavors except tobacco. (Yu, 1/29)

The Bucks County District Attorney’s Office on Wednesday filed a lawsuit against e-cigarette maker Juul, alleging that the vaping giant used sweet flavors and slick marketing to lure kids as young as middle school age to nicotine addiction.“ Through the use of new technologies and deceptive and predatory marketing to children via social media, Juul has turned a generation into addicts unwittingly,” District Attorney Matthew D. Weintraub said at a news conference in Doylestown to announce the suit, the second filed by an area district attorney. “E-cigarettes are responsible for the largest increase in teen substance abuse in decades.” (Giordano, 1/29)

The CMS on Wednesday refreshed the overall hospital quality star ratings on Hospital Compare using the current methodology as it works to potentially change the program. The star ratings update was expected. The agency announced in August that it would refresh the ratings while planning to release proposed methodology changes through a public rulemaking this spring. Hospitals still oppose the decision and have urged the CMS to remove the ratings from Hospital Compare altogether until changes are made. (Castellucci, 1/29)

Look Up Your Hospital: Is It Being Penalized By Medicare? New Ratings Coming Today

In other news from the agencies —

HHS on Tuesday lifted a limit on fees that providers and companies are allowed to charge when a patient requests to send their health data to a third party after a federal judge nixed the policy. The judge ruled that some portions of a 2016 HHS guidance are impermissible under the Administrative Procedure Act, which governs how federal agencies develop regulations and conduct notice-and-comment rulemaking. (Cohen, 1/29)

Australians flown home from Wuhan, China, will be quarantined on an island for two weeks. Americans, also evacuated from Wuhan, will be “temporarily housed” on an air base in California. And in South Korea, the police have been empowered to detain people who refuse to be quarantined. For countries outside China, the time to prevent an epidemic is now, when cases are few and can be isolated. They are trying to seize the moment to protect themselves against the coronavirus outbreak, which has reached every province in China, sickening more than 7,700 people and killing 170. (Grady, 1/29)

The person-to-person spread of the new coronavirus in three countries - Germany, Vietnam and Japan - is worrying and will be considered by experts reconvened to consider declaring a global emergency, the World Health Organization said on Wednesday. (1/29)

It is for governments to decide whether to evacuate their nationals from Wuhan, the Chinese city at the epicenter of the coronavirus outbreak, the World Health Organization (WHO) said on Wednesday. (1/29)

The World Health Organization's Emergency Committee will meet on Thursday, the third time in a week, to evaluate whether the new coronavirus spreading from China now constitutes an international emergency, the WHO said. "The Committee will advise the Director-General on whether the outbreak constitutes a Public Health Emergency of International Concern (PHEIC), and what recommendations should be made to manage it," the WHO said in a statement issued in Geneva ahead of a news briefing by senior WHO expert Mike Ryan on return from China. (1/29)

An emergency declaration by the WHO would allow the agency to begin coordinating government responses. It also could recommend travel and trade restrictions to stop the spread of the infection. But MacIntyre pointed out that the regulations aren’t enforceable. (Gale, 1/29)

The leaders of the World Health Organization on Wednesday praised China’s response to the ongoing outbreak of a novel coronavirus that emerged there and has since spread to more than a dozen other countries, and said the agency would again convene its expert committee to weigh whether the outbreak amounts to a global health emergency. There have been reports from China questioning whether the country has been accurately documenting all deaths tied to the outbreak and how prepared it was to handle an emerging pathogen. But WHO Director-General Tedros Adhanom Ghebreyesus, who had just returned from meeting with Chinese leaders in Beijing, including President Xi Jinping, told reporters Wednesday that Chinese officials had shown they were committed to combating the transmission of the virus and demonstrated cooperation with other countries to stem its global spread. (Joseph and Thielking, 1/29)

Chinese scientists racing to keep up with the spread of a novel coronavirus have declared the widespread outbreak an epidemic, revealing that in its early days at least, the disease’s reach doubled every week. By plotting the curve of that exponential growth and running it in reverse, researchers reckoned that the microbe sickening people across the globe has probably been passing from person to person since mid-December 2019. Scientists in China are also closing in on the source of the aggressive new germ — bats. (Healy, 1/29)

Health officials in China, racing to try to contain a fast-growing coronavirus outbreak, are principally recording severe cases of disease, using a case definition that cannot capture patients with mild illness, according to experts familiar with the surveillance efforts. The approach, the experts told STAT, is likely resulting in both an underestimate in the total number of cases and flawed assumptions about fatality rates calculated by those who ignore the repeated caution that it’s too soon to do that math. (Branswell, 1/30)

The world is quickly realizing how much it depends on China. Apple is rerouting supply chains. Ikea is closing its stores and paying staff members to stay home. Starbucks is warning of a financial blow. Ford and Toyota will idle some of their vast Chinese assembly plants for an extra week. On Wednesday, British Airways and Air Canada suspended all flights to mainland China, and Delta joined the growing number of carriers reducing service. (Stevenson, 1/29)

President Trump announced a task force to address the fast-spreading coronavirus, which he said had been meeting daily since Monday. The task force is led by Health and Human Services Secretary Alex Azar and will include national security adviser Robert O’Brien, Deputy Secretary of State Stephen Biegun and Domestic Policy Council Director Joseph Grogan, among others. It also includes top experts on infectious diseases. (Ballhaus, 1/29)

U.S. officials on Wednesday got the go-ahead to travel to China to study the coronavirus, lawmakers told The Hill. The World Health Organization (WHO) has also received permission to send a team of experts to collaborate with the Chinese government. (Samuels, 1/29)

U.S. President Donald Trump said on Wednesday he had spoken with Chinese President Xi Jinping and the United States was working very closely with China on the coronavirus outbreak. "We're very much involved with them right now on the virus that's going around. ... I spoke to President Xi. We're working very closely with China," Trump said at a White House ceremony to sign a new North American trade deal with Canada and Mexico. (1/29)

President Donald Trump is trying something new with a global crisis: keeping quiet. The president, for now, is letting his public health experts take the spotlight on the Wuhan coronavirus — and hardly even tweeting about it — as the outbreak sends stocks tumbling, disrupts travel and stokes fears about a global pandemic. (Owermohle and Ehley, 1/29)

A former HHS emergency-response official explains what we know about the coronavirus outbreak and how the U.S. government fights to stop potential pandemics. (1/30)

There are 165 cases of novel coronavirus now under investigation in more than two dozen states, but the number of confirmed cases in the U.S. remains at five, the Centers for Disease Control and Prevention said Wednesday. On Sunday, health officials in the U.S. said they had diagnosed five patients with the flu-like virus in Washington State, Illinois, California and Arizona. On Monday, 110 people in 26 states had been identified as needing further monitoring. (Santhanam, 1/29)

The United States has announced a new evacuation flights for U.S. citizens trapped in Wuhan, the epicenter of the growing coronavirus outbreak in China. The World Health Organization will reconvene its emergency committee Thursday to determine whether the coronavirus outbreak amounts to a public health emergency of international concern, as the total number of people infected in mainland China surpassed those infected with SARS during the 2002-2003 epidemic. (Denyer and Schemm, 1/30)

The Lunar New Year Chinese Temple Bazaar in Queens typically attracts hundreds of spectators who come to watch an array of dancers and artists. But this year, before the event, a paper cutting artist who had recently returned from Wuhan, China, told the organizers she was quarantining herself at home, as a precaution against the new coronavirus. A hand puppet company also pulled out, the organizers said in an interview. (Goldstein and Singer, 1/29)

When Priscilla Dickey learned the U.S. government was planning an evacuation flight out of the Chinese city at the center of the largest quarantine zone in history, she was desperate to get a seat for her 8-year-old daughter, Hermione. Hermione was with her mother in Wuhan when authorities abruptly blocked transportation in and around the metropolis of 11 million people. The lockdown was China’s risky bid to slow the spread of a dangerous coronavirus—and Hermione had a fever. (Areddy, 1/29)

The plane was the only way out of the besieged Chinese city, and Americans clamored for seats. A couple with a 7-year-old daughter did not receive the coveted call from officials offering them seats on the plane. A 65-year-old man’s phone rang, but he gave up his spot because others needed it more. According to some Americans trying to escape, there seemed to be no rhyme or reason as to who was tapped by U.S. officials to board the flight early Wednesday, whisking them away from Wuhan, the center of a respiratory virus outbreak that has killed at least 170 people in the last two months. (Chang, 1/29)

If you live in the U.S, your risk of contracting the new strain of coronavirus identified in China is exceedingly low. So far, the only people infected in the U.S. have traveled to the region in China where the virus first turned up in people. And, though that could change, one thing is for certain: Another severe respiratory virus that threatens lives — the influenza or "flu" virus — is very active in the U.S. right now. (Aubrey, 1/29)

The emergence of the coronavirus could pose a tough test for a public health infrastructure that is fraying at the edges due to years of budget cuts and limited resources. While the number of public health issues facing the U.S. has increased in recent years, funding has not, stretching thin local and state health departments that are responsible for tracking and containing outbreaks while also addressing other health needs in their communities. (Hellmann, 1/30)

The 195 Americans who were evacuated from Wuhan, China, because of the coronavirus outbreak will remain at a military base in Southern California for three days while medical staff monitor their health, federal health officials said Wednesday, as the White House announced the formation of a special task force to handle the U.S. response to the outbreak. (Chappell, 1/29)

An infectious disease expert at UCSF is working on a quick diagnostic test for the deadly coronavirus, which has rapidly spread from Wuhan, China, to spark global concern and prompt public health preparations in at least two Bay Area counties. Dr. Charles Chiu, a professor of laboratory medicine and infectious diseases and director of a center that studies emerging pathogens, has partnered with San Francisco company Mammoth Biosciences to create a simple test that could diagnose the new coronavirus within several hours. (Bauman, 1/29)

The CDC Foundation has launched an emergency response fund to help the CDC address the novel coronavirus, a respiratory illness that has sickened more than 6,000 people in China and reached the United States and other countries. The Robert Wood Johnson Foundation has contributed $1 million to kick off that fund-raising effort, which started this week. (Miller, 1/29)

Emergency medical workers responded to Logan International Airport Wednesday afternoon to care for a passenger from China who was reportedly sick. But the patient did not meet the criteria for possibly suffering from the novel coronavirus that has sickened thousands in China, according to city health officials. The traveler was evaluated and declined transportation to a hospital. It’s not clear what symptoms the passenger had. (Freyer, 1/29)

Even though there are only five cases of Wuhan coronavirus in the United States, the mask hoarding has begun. Some pharmacies report being entirely sold out of masks. Some popular sellers on Amazon say deliveries will be delayed for weeks. Although masks actually do little to protect healthy people, the prospect of shortages created by panic buying worries some public health experts. (McNeil, 1/30)

People around the world are buying up protective face masks in hopes of keeping the new virus from China at bay. Some companies have required them for employees. Schools in South Korea have told parents to equip their children with masks and hand sanitizer when they return from winter vacation. But do the masks work? It depends. (Johnson, 1/30)

Johnson & Johnson on Wednesday became the latest drugmaker to begin work on developing a vaccine for a new coronavirus that has already killed more than 100 people in China, as health authorities race to contain the outbreak. J&J said its vaccine programme would utilise the same technologies used to make its experimental Ebola vaccine, which is currently being administered in the Democratic Republic of Congo and Rwanda. (1/29)

Artificial intelligence is not going to stop the new coronavirus or replace the role of expert epidemiologists. But for the first time in a global outbreak, it is becoming a useful tool in efforts to monitor and respond to the crisis, according to health data specialists. In prior outbreaks, AI offered limited value, because of a shortage of data needed to provide updates quickly. But in recent days, millions of posts about coronavirus on social media and news sites are allowing algorithms to generate near-real-time information for public health officials tracking its spread. (Ross, 1/29)

Ebola kills half of the people who get it. China’s last worrying viral outbreak, SARS, killed 10%. The new coronavirus that originated in the Chinese city of Wuhan appears far less fatal, with about 2% of the 6,000 confirmed cases dying. For many, the illness is about as serious as a cold or flu. (Cortez and Langreth, 1/29)

Amy Lee-Ludovicy was confused when she opened her email last week to find her children’s Mandarin class field trip had been canceled due to “safety concerns.” It wasn’t the typical low temperatures or an incoming snowstorm that had prompted school administrators to act, but a disease outbreak on the other side of the globe. In the email from Principal Marguerite Fusco of Warwick Valley High School in upstate New York, Lee-Ludovicy was told that her kids, who are in eighth and ninth grades, wouldn’t be headed to New York City’s Chinatown to celebrate the Lunar New Year as planned. The explanation was the recent coronavirus outbreak, which is believed to have originated in Wuhan, China, she told NBC News. (Shen-Berro and Yam, 1/29)

Airlines halt flights from China. Schools in Europe uninvite exchange students. Restaurants in South Korea turn away Chinese customers. As a deadly virus spreads beyond China, governments, businesses and educational institutions are struggling to find the right response. Safeguarding public health is a priority. How to do that without stigmatizing the entire population of the country where the outbreak began -- and where nearly a fifth of all humans reside -- is the challenge. (Pfanner, 1/29)

Life expectancy increased for the first time in four years in 2018, the federal government said Thursday, raising hopes that a benchmark of the nation’s health may finally be stabilizing after a rare and troubling decline that was driven by a surge in drug overdoses. Life expectancy is the most basic measure of the health of a society, and declines in developed countries are extremely unusual. But the United States experienced one from 2015 to 2017 as the opioid epidemic took its toll, worrying demographers who had not seen an outright decline since 1993, during the AIDS epidemic. (Tavernise and Goodnough, 1/30)

The latest calculation is for 2018 and factors in current death trends and other issues. On average, an infant born that year is expected to live about 78 years and 8 months, the CDC said. For males, it's about 76 years and 2 months; for females 81 years and 1 month. For decades, U.S. life expectancy was on the upswing, rising a few months nearly every year. But from 2014 to 2017, it fell slightly or held steady. That was blamed largely on surges in overdose deaths and suicides. (1/30)

Despite the encouraging elements of the CDC mortality report, the broader pattern for American health remains sobering. Life expectancy improved by the tiniest of increments, from 78.6 to 78.7 years. That figure remains lower than the peak in U.S. life expectancy, at 78.9 years, in 2014. It is also identical to life expectancy in 2010, and it appears unlikely that U.S. longevity will show any significant improvement over the entire decade of the 2010s. The United States is continuing to fall behind similarly wealthy countries — a phenomenon that experts refer to as the U.S. “health disadvantage.” (Achenbach, 1/30)

And while deaths from heroin and prescription opioids are down, public health officials are concerned by rising death rate from the synthetic opioid fentanyl — which increased 10 percent since 2017 — as well as cocaine and methamphetamine. The number of deaths involving psychostimulants like methamphetamine increased 22 percent, while deaths from cocaine, which can be laced with fentanyl, killed more than 14,000 people last year, up 5 percent from 2017 and more than double the number in 2015.Congress and Trump administration officials have started to address the surge of methamphetamine and cocaine deaths, but some experts say efforts should focus more broadly on addiction and less on a specific substance. (Ehley and Goldberg, 1/30)

"I think these numbers suggest that some positive news is starting to come out of the many efforts to try to stem the tide on overdoses," says Kathryn McHugh, a psychologist at McClean Psychiatric Hospital and Harvard University. Those efforts include improving access to treatment for opioid use disorder and access to overdose rescue, she notes. But the new data "need to be interpreted with the utmost caution," she says. "I don't think we can interpret this as a win based on one year." (Chatterjee, 1/30)

Life expectancy in the United States edged up for the first time in four years as the number of fatal drug overdoses and six of the 10 leading causes of death declined, according to two new government reports from the US Centers for Disease Control and Prevention's National Center for Health Statistics. Life expectancy in the United States in 2018 was 78.7 years -- an increase of 0.1 year compared with life expectancy of 78.6 years in 2017, the NCHS reported in a study published Thursday. The 2018 estimate remains lower than the peak of 78.9 years in 2014. (Howard, 1/30)

Still, experts noted that the report, from the CDC’s National Center for Health Statistics, is not all good news: The U.S. also saw an increase in suicide and flu death rates in 2018. (Sullivan, 1/30)

Provisional data from 2019, which isn't complete or finalized, paints a less rosy picture -- figures appear flat or increasing slightly from 2018. "We are not out of the woods yet," Beletsky noted. "This plateau still means we are at a very high level of overdose, while many communities are continuing to experience increases, especially among people of color. (Schumaker, 1/30)

For the first time, the United States has standardized maternal mortality data from all 50 states — a first step toward identifying ways to reduce pregnancy-related deaths across the country, experts say. The data, released Thursday by the National Center for Health Statistics, show that the national maternal mortality rate — deaths caused or aggravated by pregnancy — was an estimated 17.4 maternal deaths per 100,000 live births in 2018, when 658 women died. (Chuck, 1/30)

The number of women dying each year due to pregnancy or childbirth in the United States has remained steady and some women remain more at risk of death than others, according to a new government report. In 2018, the year with the most recent national data, a total of 658 women in the United States died while pregnant or within 42 days of the end of pregnancy, according to new data published in the US Centers for Disease Control and Prevention's National Vital Statistics Reports released on Thursday. (Howard, 1/30)

The spotlight on brain injuries suffered by American troops in Iraq this month is an example of America's episodic attention to this invisible war wound, which has affected hundreds of thousands over the past two decades but is not yet fully understood. Unlike physical wounds, such as burns or the loss of limbs, traumatic brain injuries aren’t obvious and may take time to diagnose. (1/30)

American soldiers who suffered moderate or severe traumatic brain injuries are more likely to experience a range of mental health disorders compared with soldiers with other serious injuries, according to a new study by researchers at the University of Massachusetts Amherst. The research was published in the journal Military Medicine and is believed to be the “largest and broadest look at severe combat injury in the military and associated mental health outcomes,” according to a UMass news release. (Sweeney, 1/29)

Screening for lung cancer reduces deaths among current and former heavy smokers, according to a new study published Wednesday that adds to the evidence supporting wider testing. The study, conducted by researchers in the Netherlands and Belgium and published online by the New England Journal of Medicine, found that scanning the lungs of heavy smokers reduced lung-cancer deaths by 24% in men and 33% in women over the course of a decade. (Abbott, 1/29)

Brain organoids, often called "minibrains," have changed the way scientists study human brain development and disorders like autism. But the cells in these organoids differ from those in an actual brain in some important ways, scientists reported Wednesday in the journal Nature. (Hamilton, 1/29)

A government report to be released in coming days says Southwest Airlines Co. failed to prioritize safety and the airline’s regulator, the Federal Aviation Administration, hasn’t done enough about it. Southwest pilots flew more than 17 million passengers on planes with unconfirmed maintenance records over roughly two years, and in 2019 smashed both wingtips of a jet on a runway while repeatedly trying to land amid gale-force winds, according to the Transportation Department report, reviewed by The Wall Street Journal. (Pasztor and Sider, 1/30)

We all had early experiences with inflammation: a splinter that turned the skin around it red, a sprained ankle that swelled and displayed disturbing bluish-black hues. We came to understand that these reactions, termed acute inflammation, are the body’s way of protecting us, by sending white blood cells to the site of an injury to ward off further damage, promote healing and fight infection. The five signs of acute inflammation — redness, heat, swelling, pain and loss of function — usually fade as the wound heals. (Burfoot, 1/29)

Fitness spending usually spikes in January, as the optimists among us kick off the new year by joining a gym. But few people stick with the program for long. By June, more than half of these new members will have dropped out. Although attrition remains stubbornly high across the industry, one fitness category is showing promise: On-demand, app-based fitness programs are retaining new customers longer than their brick and mortar counterparts, according to a new study by Cardlytics, a firm that tracks digital-spending habits of more than 128 million bank accounts. (Potkewitz, 1/29)

It powered Democrats to recapture the House in the 2018 midterms: the fear that President Trump and Republicans would kill the Affordable Care Act and with it, protections for more than 50 million Americans with pre-existing medical conditions. Yet even as Mr. Trump and other Republicans continue to try to overturn the law in court, Democratic presidential candidates have not made the issue central to their campaigns. Instead they have spent much of their time on the debate stage arguing among themselves over “Medicare for all” and other proposals to expand health coverage. (Corasaniti and Goodnough, 1/29)

Sen. Bernie Sanders (I-Vt.) is facing mounting scrutiny from fellow White House hopefuls for refusing to detail how he would pay for his signature “Medicare for All” plan. Sanders’s Democratic rivals are ramping up their attacks on him as he surges to the top of polls in early voting states like Iowa and New Hampshire. The criticisms are focused on the Vermont senator’s lack of explanation over the funding mechanism for a health care proposal that is estimated to cost $32 trillion over 10 years. (Sullivan, 1/29)

Democratic presidential candidate Bernie Sanders’ Medicare-for-All plan could expand the economy or shrink it by nearly a quarter -- it all depends on how it is paid for, according to new analysis. If Sanders were to fund his universal health plan with premiums individuals pay to the government, the economy could grow by about 0.2% by 2060, according to estimates from the Penn Wharton Budget Model. Cut out dental and long-term care from the services covered and that figure increases to 12% gross domestic product growth thanks to overhead savings. (Davison, 1/30)

A new poll from a centrist Democratic think tank of three battleground states shows “Medicare for All” is far less popular than a plan to build off the Affordable Care Act. The polling from Third Way, conducted in the “blue wall” states of Michigan, Pennsylvania and Wisconsin, shows a sharp divide between those who support Medicare for All and those who don’t. (Weixel, 1/29)

Kaiser Health News: A Guide To Following The Health Debate In The 2020 Elections
Health has been a top issue in the presidential campaign during the past year: Not only do the Democratic candidates disagree with President Donald Trump, but they also disagree among themselves. Voters have frequently complained that the debate has been confusing and hard to follow. Most of the attention so far has been focused on whether the U.S. should transition to a “Medicare for All” program that would guarantee coverage to all U.S. residents — and result in higher taxes for most people. But there is far more to the health debate than that. (Rovner, 1/30)

And in other election news —

Kaiser Health News: Trump’s Latest Health Care Challenge: Gaining Voters’ Trust
Far more Americans disapprove of President Donald Trump’s handling of several high-profile health care issues than give him positive marks, underscoring the challenge the president faces in claiming health care as a political asset in his reelection bid. The findings, from the latest Kaiser Family Foundation Health Tracking Poll, released Thursday, found Trump’s approval ratings on various health care topics — including how he has handled the cost of prescription drugs and protecting people with preexisting conditions — lag behind those on his overall job performance. (Pradhan, 1/30)

With more than 15,000 people killed by gun violence in the United States last year - not counting suicides - Democrats running for their party's presidential nomination are pointing to inaction in Washington as evidence they should be chosen to run against Republican President Donald Trump. Here is a look at gun control positions taken by Trump and the Democrats vying to unseat him. (1/29)

Anthem is starting the new year by forecasting earnings that could miss expectations even after the health insurer books gains from a new business. The Blue Cross-Blue Shield insurer also reported on Wednesday earnings from the final quarter of 2019 that missed forecasts, and its stock dropped in midday trading. (1/29)

The health insurer recorded a profit of $934 million, or $3.62 a share, in the fourth quarter of 2019 compared with $424 million, or $1.61 a share, in the year-ago quarter. Adjusted earnings were $3.88 a share, matching analysts’ expectations. Revenue was $27.41 billion, up from $23.37 billion. Anthem Chief Executive Gail Boudreaux said in a conference call that the company was delivering on its promised growth and was “poised for another year of success in 2020.” (Wilde Mathews and Sebastian, 1/29)

Earnings reports from providers, insurers and health technology companies for the quarter ended Dec. 31, 2019. (1/29)

On the heels of the Trump Administration relaxing its rules surrounding short-term health insurance plans, the North Carolina Department of Insurance said it saw an uptick in consumer complaints surrounding these low-cost, but limited, plans. The department logged 75 complaints related to short-term insurance in 2019, up from 48 the previous year, according to data obtained by NC Health News. More than half of the complaints involved issues surrounding denied claims, exclusions of pre-existing conditions and delayed payments to consumers. The DOI processes thousands of complaints per year, a spokesman said in an email, but the rise in consumer complaints indicates that more North Carolinians are opting for these plans. None of these complaints, he noted, have yielded violations. (Engel-Smith, 1/30)

The spectacle of the grand opening underscores the central role Walmart is hoping its new clinics will play in its expanding health business. Interviews with Slovenski and other leading Walmart health executives revealed new details about the company’s strategy for the clinics, which it sees not only as a low-cost, less intimidating way to get primary care, but also as a way to help pull in an entirely new customer base. So far, Walmart’s health care efforts haven’t drawn as much attention as the acquisition of insurer Aetna by its rival retail giant CVS, nor garnered as much intrigue as Haven, the mysterious health care startup promising to transform care for employees of Amazon, JPMorgan Chase, and Berkshire Hathaway. (Thielking, 1/30)

Syapse, among the highest profile companies in a wave of startups seeking to mine patient data stored in electronic medical records and other portals, last week laid off 18 of its San Francisco-based employees — a move the company attributes to a shift in focus toward data analytics and insights and away from its software business. The layoffs — which primarily affected Syapse’s engineering division, along with its product management and operations teams — represented about 10% of its workforce. The realignment comes just weeks after the pharma giant Roche prematurely terminated a precision medicine deal with Syapse centered around oncology data. (Robbins, 1/29)

Loretto Health & Rehabilitation in Syracuse, N.Y., was struggling with a nearly 65% turnover among certified nursing assistants, home health aides and licensed practical nurses, many of whom faced difficult challenges with transportation, child care and other issues. That’s a chronic and growing problem for nursing homes, home-care agencies and hospital systems, which rely on these staffers to provide the bulk of hands-on, nonclinical care for patients. Good post-acute and home care are key factors in achieving quality outcomes in value-based care, but research shows that high turnover hurts quality. (Meyer, 1/25)

Kaiser Health News: Appendicitis Is Painful — Add A $41,212 Surgery Bill To The Misery
Joshua Bates knew something was seriously wrong. He had a high fever, could barely move and felt a sharp pain in his stomach every time he coughed. The 28-year-old called his roommate, who rushed home that day in July 2018. The pair drove to the nearest emergency room, the Carolinas Medical Center in Charlotte, North Carolina. After several tests, including a CT scan of his abdomen, the emergency team determined Bates had acute appendicitis. (Appleby, 1/29)

Drug prices will rise an estimated 3.59% through next year, continuing a recent trend of moderate increases, although the high cost of some pharmaceuticals still rankle health systems and patients, according to research by one group purchasing organization. Advocacy and awareness as well as a more competitive market have contributed to more modest price increases over recent years, according to Vizient's outlook from July 2019 through June 2021. (Kacik, 1/29)

New drugs for multiple sclerosis and hemophilia drove growth at Roche Holding last year, a sign the company’s efforts to move beyond cancer treatments are paying off. The Swiss health-care giant on Thursday said sales rose 8% to 61.5 billion Swiss francs ($63.2 billion) in 2019. Core operating profit, a closely watched measure that strips out some one-time items, rose 10% to 22.5 billion francs. Net income climbed 30% to 14.1 billion francs, partly because of an impairment charge in the prior-year. (Roland, 1/30)

Zolgensma, the Novartis gene therapy for infants and the world’s most expensive medicine, continues to perform well commercially, bringing in $186 million during the fourth quarter, topping analyst expectations on Wednesday. Last June, Novartis secured U.S. approval for Zolgensma as a one-time treatment for spinal muscular atrophy, a rare and deadly neurological disease. It carries a record price tag of $2.1 million, or an annualized cost of $425,000 per year for five years. (Feuerstein, 1/29)

CVS Health said it has worked out a way for employers and insurers to cover the out-of-pocket costs of their members' diabetes medications while also saving money. Despite shouldering the added cost of their members' drugs, CVS' pharmacy benefit manager, CVS Caremark, said its clients will ultimately save money through its new plan, called RxZERO. CVS claimed the savings will come from a combination of adopting its formulary that steers patients toward generic drugs as well as simply having less expensive members. (Bannow, 1/29)

They are the biotech equivalent of the “missing girls” in countries with a skewed gender ratio: 40 to 50 companies that would have been spun out of research at MIT labs headed by women were it not for … That’s the multibillion-dollar question: Why don’t women biologists found biotech companies at the same rate as men? For the last year, three prominent Massachusetts Institute of Technology scientists have been collecting statistics, questioning venture capital partners, and meeting with leaders in academia, science, and business to find answers. (Begley, 1/29)

Tanya Perry was looking for relief from heavy bleeding during her period when her ob/gyn suggested endometrial ablation with the NovaSure device in May 2017. Her doctor told her it would be a quick and easy procedure, and she'd be able to go home the same day. The thin device would be inserted through her cervix into her uterus, and it would burn away her endometrial lining using radiofrequency (RF) energy. Less endometrium would mean less bleeding. (Fiore, Firth and Hlavinka, 1/29)

Attuned to the limitations of FDA Manufacturer and User Facility Device Experience (MAUDE) data, the MedPage Today investigative team was conservative in its evaluation of reports appearing in the database. Team members searched on the brand name NovaSure for the full years from 2009 through 2019. (Reports for 2009 were removed on Jan. 1, 2020, as the public database is trimmed annually to reflect only the previous 10 years.) (Fiore, Firth and Hlavinka, 1/29)

OxyContin maker Purdue Pharma LP and its controlling Sackler family have been negotiating with cities, counties and states on a proposed settlement worth an estimated $10 billion to resolve more than 2,600 lawsuits alleging they helped fuel the U.S. opioid crisis. Those negotiations could be complicated by a Reuters report on Tuesday that Purdue is the unidentified company that was involved in an alleged kickback scheme aimed at improperly boosting prescriptions of opioid medications, though it was not charged with wrongdoing and has said it is cooperating with Justice Department investigations. (1/29)

Confusion and inconsistencies about the government's opioid prescribing guidelines are in the spotlight again in a sweeping new FDA letter to the Senate responding to questions about the agency’s handling of the opioid crisis. Democratic Sens. Maggie Hassan and Ed Markey said that the CDC, Defense Department and VA have warned against prescribing opioids at doses that exceed 90 mg morphine equivalent per day and asked if FDA is considering any action, including drug labeling changes, to reflect that warning. (Karlin-Smith, 1/30)

Teenagers who land in emergency rooms after overdosing on opioids can benefit from adults who connect them to resources and addiction services right away. But that often doesn’t happen, according to a study published earlier this month in JAMA Pediatrics. (Bowen, 1/29)

Republican lawmakers in Kansas pushed a proposed anti-abortion amendment to the state constitution through the state Senate on Wednesday even as abortion rights advocates argued that it would lead to a ban on most abortions like a measure being pursued in Tennessee. The Kansas proposal, aimed at overturning a state Supreme Court decision last year protecting abortion rights, is modeled on a change that Tennessee voters approved in their state's constitution in 2014. (1/29)

New Hampshire is among the least restrictive states when it comes to abortion, but lawmakers are considering a package of bills that would swing it far in the other direction. Anti-abortion lawmakers and activists across the country have been pushing near-total bans on the procedure, hoping the new conservative majority on the U.S. Supreme Court will reconsider Roe v. Wade, the landmark 1973 ruling that legalized abortion nationwide. (Ramer, 1/29)

The Harvard University professor arrested and charged with lying to U.S. authorities about taking millions of dollars from the Chinese government is considered one of the fathers of a specialized field in nanotechnology. Charles M. Lieber has led a research lab at Harvard for nearly 30 years and generated in excess of $15 million in grants from government agencies since 2008. He was rated the top chemist of the aughts by one analytics organization that rated academic productivity. (Belkin, 1/29)

The federal government and states like Pennsylvania and New Jersey all share the blame for not taking action to stem the alarming rise in vaping among the nation’s youth last year, according to the American Lung Association’s annual report. The State of Tobacco Control 2020, released Wednesday, grades states on key policies that could affect the rate of tobacco use, such as funding for tobacco prevention programs, access to services to quit tobacco, and setting the minimum age for sale of tobacco products to 21. This year’s report gives mostly failing or near-failing grades to Pennsylvania and New Jersey. (Giordano, 1/29)

As striking Swedish Medical Center nurses and caregivers prepare to return to work Friday, they say there’s some confusion about who will be allowed back that day. About 7,800 Swedish workers began their three-day walkout Tuesday morning, with plans to return to their jobs starting Friday morning. Hospital management, however, said only certain caregivers should come back that day. (Takahama, 1/29)

Opponents of assisted suicide held a press conference Wednesday to reject legislation allowing patients with terminal conditions to request a life-ending substance from a physician. While supporters of the proposal say the choice to end one’s own life is a human right, speakers at the event called the practice unethical. (Ringle, 1/29)

Republican lawmakers on Wednesday proposed a bill to amend the Iowa Civil Rights Act by removing protections against discrimination for transgender people. Iowa law currently prohibits discrimination based on gender identity, race, creed, color, sex, sexual orientation, national origin, religion, ancestry and disability. Gender identity was added by lawmakers in 2007 when Democrats regained control of the Iowa Legislature and held the governor’s office with the election of Gov. Chet Culver. (Pitt, 1/29)

The archbishop of Hartford, along with the bishops of Bridgeport and Norwalk, said Wednesday that they encourage the use of vaccines among school-age children, but they stopped short of endorsing an effort to repeal the state’s religious exemption from mandatory immunizations. A week before the start of the legislative session, the religious officials said the use of vaccines is “not immoral according to church guidance.” (Carlesso, 1/29)

From an isolation cell in the Ottawa County Jail, Terral Ellis begged for someone to help him. He could not feel his legs and he could not breathe, the 26-year-old told jail staff and the on-site nurse at the Miami, Okla., facility. It felt, he said, like his back was broken and he was bleeding internally. “I think I’m dying,” he said just after 10 a.m. on Oct. 22, 2015. (Mettler and Usero, 1/29)

According to the Environmental Working Group, PFAS chemicals have been found in drinking water in Ohio communities including Cleveland Heights and Struthers, and on military bases including Camp Ravenna and Wright Patterson Air Force Base. The organization says PFAS have been detected in more than 1,400 communities in almost every state, and estimates that more than 100 million Americans may be drinking water contaminated by them. (Eaton, 1/29)

Hundreds of volunteers, including city and state officials and clergy, fanned out across the streets of Boston Wednesday night to conduct an annual homeless count. For 40 years, volunteers have spent one winter night combing the streets, checking doorways, alleys, overpasses and MBTA stations for people. Those living in emergency shelters, transitional housing and special programs focused on homeless youth and veterans will also be counted on Wednesday. (Greenberg and McDonald, 1/29)

Tracking the city's progress. (1/29)

UMass Memorial Health Care in Worcester has agreed to acquire 119-bed Harrington Hospital in Southbridge, the two organizations announced Wednesday. The deal would extend UMass Memorial’s reach across Central Massachusetts while giving Harrington the financial security and increased name recognition that comes with being part of a larger system. (Dayal McCluskey, 1/29)

The Colorado Hospital Association announced Wednesday it was withdrawing a lawsuit alleging the state overstepped its bounds by asking hospitals to pay $40 million earlier than they’d planned. The issue centers around a fee on hospitals to support the state’s new reinsurance program. Reinsurance reduces how much insurance companies have to pay for their most expensive customers, so they don’t have to charge everyone as much to cover their costs. Monthly premiums for insurance bought on the individual market have declined about 20%, though some people may pay more because their subsidies also fell. (Wingerter, 1/29)

Kaiser Health News: Listen: Colorado Ski Area Opts For Novel Effort To Stop Avalanche Of Health Costs
Julie Rovner, the chief Washington correspondent for Kaiser Health News, joined WAMU’s “1A” host Todd Zwillich and Colorado Insurance Commissioner Michael Conway on Wednesday to talk about an innovative program to cut health care costs being used by Summit County, home to some of the state’s premier ski resorts. They also discussed how some states, including Colorado, are exploring sponsoring a health plan — or a public option — open to residents that could cut costs. They also took questions from listeners. (1/29)

The U.S. Environmental Protection Agency has awarded Oregon $1.1 million to help identify sources of lead in drinking water in schools and child-care facilities. “Ensuring access to clean drinking water and protecting children from exposure to lead are critically important to EPA,” EPA Region 10 Administrator Chris Hladick said Wednesday in a statement. “This funding will support our states’ efforts to keep children in schools and child care programs safe from the adverse health impacts of lead in drinking water.” (The Oregonian/OregonLive Politics Team, 1/29)

After the media vans had moved on and Christmas Hill Park finally re-opened in the wake of the July mass shooting at the Gilroy Garlic Festival, a community was left to mourn those who died, and devote their attention to those who were wounded. Thousands of residents invested immense emotional capital trying to bring normalcy back to their world, and put off their own trauma to help restore their city’s spirit. With those examples in mind, Santa Clara County’s criminal victim advocates launched the Gilroy Strong Resilience Center, which opened Tuesday in the city’s downtown. (Salonga, 1/28)

The number of unvaccinated or undervaccinated students in the Des Moines area rose sharply in the past year, according a report from the Polk County Health Department. In 2019, 2,937 of 88,901 students in Polk County were not fully vaccinated, the immunization report released Tuesday states. Though that's 3.3% of all county schoolchildren, it's a nearly 13% increase from 2018 in the proportion of children without full vaccinations. (Davis, 1/28)

Hundreds of hopefuls are expected at job fairs for the medical marijuana industry within the next week, but one legal hiccup may stand in their way of employment. Last May, the Federal Bureau of Investigation (FBI) informed the Missouri Department of Health and Senior Services (DHSS), which licenses and regulates the state’s fledgling medical marijuana industry, that it will not have access to its national fingerprint background check database. (Thomas, 1/30)

A 2015 Commonwealth Fund brief showed that — before the major provisions of the Affordable Care Act were introduced — the United States had worse outcomes and spent more on health care, largely because of greater use of medical technology and higher prices, compared to other high-income countries. By benchmarking the performance of the U.S. health care system against other countries — and updating with new data as they become available — we can gain important insights into our strengths and weaknesses and help policymakers and delivery system leaders identify areas for improvement. (Tikkanen and Abrams, 1/30)

The share of Americans who say they cannot afford to see a doctor has increased over the last two decades, even with some coverage gains stemming from the Affordable Care Act. Working-age adults who reported being unable to see a physician due to cost increased from 11.4% in 1998 to 15.7% in 2017, according to a new analysis of nationwide survey data collected by the Centers for Disease Control and Prevention. The findings were published Monday in JAMA Internal Medicine. (Johnson, 1/27)

Using data from US adults aged 18 to 64 years in 1998 (n = 117 392) and in 2017 (n = 282 378) who responded to the Centers for Disease Control and Prevention Behavioral Risk Factors Surveillance System, this study found that from 1998 to 2017 the inability to see a physician because of cost increased 2.7 percentage points owing to worsening access to care among the insured. In contrast, the proportion of chronically ill adults receiving checkups did not change; results for receiving guideline-recommended preventive services were mixed. (Hawks et al, 1/27)

Eating fermented soy products may reduce the risk of premature death, researchers report. Some soy products, like tofu, are not fermented. But others — miso, natto and tempeh, for example — are made using bacteria or mold in a fermentation process. Soy sauce, if made in the traditional way, is also fermented. The study, in BMJ, followed the diets and health of 92,915 Japanese men and women aged 45 to 74 for an average of 15 years. During this time, 13,303 of the study participants died. (Bakalar, 1/29)

The Democratic presidential primary campaign featured extensive discussions of different health care reform proposals. As Democratic primary voters in early primary states begin casting their ballots to select their nominee, the latest �鶹Ů�� tracking poll finds that a majority of Americans favor a national Medicare-for-all health plan (56%) but a larger share favors a government-administered “public option” (68%). Notably, nearly half of adults (48%) favor both of these proposals. (Lopes, 1/30)

Providing a disposal method nudged parents to dispose of their children’s leftover opioids promptly after use, whereas STOMP boosted prompt disposal and reduced planned retention. Such strategies can reduce the presence of risky leftover medications in the home and decrease the risks posed to children and adolescents. (Voepel-Lewis, 1/1)

harmaceutical companies spend more on clinician office visits (also known as detailing) and free drug samples (also known as sample closets) than any other forms of professional marketing in the United States (totaling $18.5 billion in 2016). Detailing and free samples affect prescribing quality and expenditures, often by promoting new and expensive brand-name drugs over equally effective, older, and less expensive options. Some hospitals and medical centers have restricted these activities. We surveyed a national sample of US outpatient practices delivering primary care to determine the prevalence of detailing and sample closets. (King et al, 1/27)

A new CMS-funded study suggests surgeons are overpaid for certain bundled procedures and proposes a solution it says could save the agency billions of dollars annually. The New England Journal of Medicine report found that just a fraction of post-operative visits the CMS pays for as part of procedure bundles actually take place. The report says reducing the payments accordingly would have saved Medicare $2.6 billion in 2018 by decreasing payments for 10- and 90-day global procedures by 28%. (Bannow, 1/22)

It was a Thursday evening in the fall of 2014, the end of one of those hectic days in the clinic at Bellevue Hospital — hardly a moment between patients and the computer system having epileptic fits. When I finally made my way out of the hospital’s atrium, my head was still swimming in all my patients’ issues. Suddenly I found myself up against a phalanx of news trucks parked in front of the hospital. There was a cackle of urgency in the air, with reporters and camera crews shooting live broadcasts up and down the block. And then I realized: Ebola had arrived at Bellevue. (Danielle Ofri, 1/30)

Coronavirus is starting to freak me out — not the illness itself but the amped-up, ill-considered way our frightened world might respond to it. Yes, the novel virus appears to be spreading quickly at the outbreak’s epicenter in the Chinese province of Hubei, but after a late start the Chinese government is now imposing unprecedented measures to contain it. As the World Health Organization declared last week, it remains too early to call the outbreak a global public health emergency. (Farhad Manjoo, 1/29)

Five cases of the mysterious Wuhan coronavirus have been confirmed in the United States, giving rise to concerns about a potential global pandemic. We’ve seen this story before, as health authorities working with threadbare data try to walk the line between epidemic readiness and needless panic. Is this new outbreak poised to become the next AIDS pandemic or a new SARS, which was stopped in its tracks after 774 deaths? To cut through the headlines, we can use a simple concept called the “epidemic triangle.” Employed by epidemiologists since the discipline’s earliest days, it is indispensable in predicting whether localized outbreaks will transform into full-blown epidemics. (Dan Werb, 1/30)

When most people get the flu, they don’t see a doctor. That’s why any measure of how many have been infected with the Wuhan virus will tend to be relatively misleading. America’s biggest Chinatown is in New York City. More than a million Chinese tourists visit the city every year; dozens of locals likely return weekly from trips to see family and business associates in Wuhan. The Wuhan virus reportedly can take 14 days to incubate; according to Chinese reports, carriers have been identified who can spread the disease without appearing sick. If you are a New York resident, are you taking comfort that, as of Tuesday, no cases have been confirmed in the city? Of course not. (Holman W. Jenkins, Jr., 1/28)

The coronavirus outbreak, which began in early December in the Chinese city of Wuhan, had as of Wednesday sickened more than 6,000 people across at least 15 countries and claimed more than 130 lives, all of them in China. Experts don’t yet know how contagious, or how deadly, this new virus is. But the growing crisis has inspired panic. Cities around the world are bracing for a potential wave of infections. Stock and oil prices are tumbling. And experts in just about every global industry are fretting over the many supply chains that could be disrupted — from prescription drugs and surgical masks to rare earth metals — if the outbreak grows into an even wider epidemic. (1/29)

When President Trump and Republicans in Congress failed in their 2017 attempt to repeal the Affordable Care Act, it was in no small part because repeal would have wiped away the ACA’s expansion of Medicaid. They probably believed that it wouldn’t be such a big deal. After all, it’s a program for poor people, right? Who cares about them? What they found out, through an outpouring of protests and angry responses from constituents, was that Americans care quite a bit about Medicaid. (Paul Waldman, 1/29)

The U.S. government has initiated a double-barreled attack on the health and nutrition of our school children using the same sinister strategies previously employed by workhouses and witches. The USDA is trying to deny essential food access to over half a million children by modifying the Supplemental Nutrition Assistance Program (SNAP). Those without SNAP may become non-participants in the National School Lunch Program (NSLP). Limiting access to secure healthful meals will promote food insecurity and hunger, and encourage consumption of cheap, calorically dense, processed foods by families for whom every penny counts. (Michael Rosenbaum and William H. Dietz, 1/29)

On Sept. 7, 2017, my 31st wedding anniversary, a date marked by happy memories turned tragic. That was when I learned that my 23-year-old son, Garrett, had died by suicide. Two-and-a-half years later, the news that brought me to my knees rings in my memory as if it were delivered just yesterday. Garrett was popular, talented and loved by his many friends and family members. Yet he felt alone in his struggles. Despite our fervent efforts to get him help, he slipped through our grasp. My husband and I had to come to terms with the most brutal outcome for a parent: We could not save him. (Julie Halpert, 1/30)

On Monday, Mississippi Gov. Tate Reeves (R) announced the closing of a unit at Parchman, the epicenter of a crisis in its prison system, as well as other broad reforms. These moves were precipitated by 13 deaths in the Mississippi penal system in less than a month, nine of them at Parchman, the state’s oldest penitentiary. Several of the deaths resulted from violence during what authorities called a “major disturbance” and altercations. Three men were found hanging in their cells, in apparent suicides that are under investigation. Two people have also managed to escape. (Shobana Shankar, 1/29)