Archive for January, 2015

Health Wonk Review: Super Bowl Edition

Thursday, January 29th, 2015

Jason Shafrin, our favorite Healthcare Economist, is hosting Health Wonk Review: Super Bowl Edition, the best of the recent postings from blogging health policy wonks. Jason cuts right to the chase in a compact, digest version of posts that will keep you up to date on issues related to healthcare costs, policies, IT developments and safety. Oh, and kindness – which should be a de facto component of healthcare, no?

Speaking of football … we hate to be the Debbie Downer of the sport’s big weekend, but a new study on concussions was just released to coincide with the Super Bowl – it sheds more light on the seriousness of concussions In youth football, demonstrating that NFL players who began playing before age 12 are more susceptible to cognitive difficulties. “The difficulty faced by the former players, who reported an average of nearly 400 concussions each during their lifetimes, is separate from the problem of chronic traumatic encephalopathy, which can only be diagnosed after death.”

Is the focus on concussions having an impact on football? Justin Rodriguez of the Times Herald-Record reports on how the concussion crisis is a big blow to football.

Highway regulators calling for better truck safety

Wednesday, January 28th, 2015

Since 2009, fatalities related to large truck road accidents have increased by 17%. In 2013, that number rose to 3,964 fatalities, the fourth straight year of increases. This bucks the trend of vehicle-related fatalities overall, which have been steadily decreasing. Fatalities involving large trucks and buses represent about 4% of the overall annual vehicle-related fatality total.

The increase in fatalities has prompted the National Transportation Safety Board (NTSB) to call for tighter commercial trucking regulations.

Despite the annual uptick, NTSB says that more than 100 recommendations for improved truck safety have not come to fruition. And worse, instead of strengthening measures, it would appear that legislators rolled back safety-related regulations:

“Congress last year weakened regulations designed to reduce trucker fatigue. Lawmakers targeted a portion of a rule closing a loophole that kept some drivers from working 82 hours over eight days, according to Transportation Secretary Anthony Foxx. That provision won’t be enforced for at least a year as regulators conduct research to see if it had an unintended effect of forcing more trucks onto the road during rush hours. “

NTSB has included the need for a strengthening in commercial trucking on it 2015 Most Wanted List. Among some of the recommendations, NTSB says:

“Regulators have taken initial steps by maintaining science-based hours of service rules and are in the process of rulemaking mandating electronic logging devices that can help assure that drivers are adequately rested. Other important rulemaking initiatives include requirements to screen drivers for obstructive sleep apnea, other potentially impairing medical conditions, and potentially impairing drugs.”

Truck driver safety
According to the Bureau of Labor Statistics (BLS) truck drivers are six times more likely to be killed on the job than other workers. The trucking Industry is among the top 5 most catastrophic occupations. According to a 1992 article in the Journal of Public Health Policy:

“In the 1992 study, over one thousand long haul tractor-trailer drivers were interviewed by a research team over four months, and almost three-quarters of the respondents said they self-reported violations of Hours-of-Service rules. Two-thirds said they “routinely” drive more than legal weekly maximums. Those long hours in the driver’s seat lead to decreased attentiveness and heightened rates of fatigue, creating prime conditions for unwanted accidents and catastrophic injuries.”

One excellent resource for trucker safety is TIRES (Trucking Injury Reduction Emphasis), a research project developed by the SHARP program at the Washington Department of Labor & Industries. SHARP’s research shows that trucking has some of the highest claims rates and costs in the State of Washington.

In addition to a wide range of training and safety information, TIRES an excellent Keep Trucking Safe Blog that we’ll be adding to the sidebar.


“Shake the Winter Blahs” Edition of Health Wonk Review

Thursday, January 15th, 2015

Hot off the press – Vince Kuraitis posts the first Health Wonk Review of the new year, “Shake the Winter Blahs” Edition at the e-Care Management Blog. There’s the usual grab-bag of topics from some smart heath policy bloggers: Did you know that there’s a brouhaha over Hepatitis C Drugs? You can find out more about it in this edition. You can also get the latest in digital health trends, an update on how ACA and Medicaid expansion are playing out, and much more.

Graveyard shift may be living up to its name: shift work & nursing health risks

Wednesday, January 14th, 2015

The night shift is commonly referred to as the graveyard shift and a new study about associated health risks shows that it might be aptly named.

Previously, the World Health Organization has linked working the night shift to cancer, based on studies with nurses. Now, a new study published in the American Journal of Preventive Medicine this month, shows that nurses who worked night shifts over an extended number of years experienced an increase in mortality rates for all cause (11 percent higher) and cardiovascular disease (19 percent higher.) In addition, women who worked rotating night shifts for 15+ years had a 25 percent higher risk of lung cancer.

Kim Krisberg summarizes the study findings in her post at The Pump Handle.

“To conduct the study, researchers analyzed data from the Nurses’ Health Study, which was established in 1976 and involved nearly 122,000 nurses. The night shift analysis was based on 22 years of health and behavioral data follow-up among nearly 75,000 of the participating nurses. In a press release about the findings, study co-author Schernhammer, an associate professor at Harvard Medical School and associate epidemiologist at Brigham and Women’s Hospital, described the study as “one of the largest prospective cohort studies worldwide with a high proportion of rotating night shift workers and long follow-up time. A single occupation (in this case, nursing) provides more internal validity than a range of different occupational groups, where the association between shift work and disease outcomes could be confounded by occupational differences.”

The full study can be accessed here: Total and Cause-Specific Mortality of U.S. Nurses Working Rotating Night Shifts (PDF). In the summary conclusions, the authors say that the study results “add to prior evidence of a potentially detrimental effect of rotating night shift work on health and longevity.”

Related links:

TRIA, mining fatalities, FL repackaged drugs, 2015 trends, 2014 recap & more noteworthy news

Monday, January 12th, 2015

Senate Passes TRIA; Bill Goes to President Obama’s Desk – “In addition to reauthorizing the TRIA program for six years, the bill raises the trigger amount needed in total losses before the TRIA program kicks in from the current $100 million to $200 million, over five years, beginning in calendar year 2016. Also over five years, starting Jan. 1, 2016, the mandatory recoupment rises from $27.5 billion to $37.5 billion, increasing by $2 billion each year. For all events, the bill raises the private industry recoupment total from the current 133 percent of covered losses to 140 percent of covered losses.”

Additional sources:

What Happens To Uber Drivers And Other Sharing Economy Workers Injured On The Job?
Ellen Huet inForbes: “As much as workers like Omar may think of themselves as employees of peer-to-peer marketplaces like Uber, Lyft, TaskRabbit, Instacart, Postmates or Homejoy, they’re not, legally speaking. Companies are under no obligation to provide the same worker protections for independent contractors as they are for employees — protections like overtime, paid sick days, health insurance and workers’ compensation.”

Do Not Fail to Care, Roberto Ceniceros, Risk & Insurance: “With the predicted spread in pricing — as some insurers reduce policy prices to gain market share while others tighten up their offerings — it stands to reason that those employers that manage their claims experience well will receive the better policy renewal deals and a broader range of coverage choices when arranging insurance.
Employers that fail to support safety programs that prevent injuries, or fail to take care of their workers once they are hurt, will eventually pay the cost of more complex claims and the increased services those claims require.”

MSHA Says Coal Mining Deaths at Historic Low – “Preliminary data released by MSHA show 40 miners died in work-related accidents at the nation’s mines during 2014, two fewer than the previous year, according to the agency’s news release. Coal mining deaths dropped from 20 in 2013 to 16 in 2014, the lowest annual number of coal mining deaths ever recorded in the United States.” Related – Ken Ward, Coal Tattoo: Is a record low for mining deaths enough?

OSHA orders pilot to be reinstated after being illegally fired for refusing to fly unsafe medical transport helicopter – “Faced one night with a trip over mountainous terrain in a medical transport helicopter with a faulty emergency locator transmitter, a pilot refused to fly the unsafe aircraft and was later terminated in retaliation for doing so. An investigation by the U.S. Department of Labor’s Occupational Safety and Health Administration followed. As a result, Air Methods Corp. was ordered to reinstate the pilot, pay $158,000 in back wages and $8,500 in damages, and remove disciplinary information from the employee’s personnel record. In addition, the company must provide whistleblower rights information to all employees.”

Quicker Care with Telemedicine, Katie Siegel, Risk & Insurance – “Telemedicine can help combat an impending physician shortage and possibly lower cost of care for workers’ comp payers. ”

Florida repackaged drug payments to physicians dropped in 2013: Report – Stephanie Goldberg, Business Insurance: “Physician repackaged drug payments in Florida fell by nearly 39% in 2013, according to a recent report by the state Division of Workers’ Compensation.”

NH: Final Report of the Commission to Recommend Reforms to Reduce Workers’ Compensation Costs (PDF) Related: NH Governor Hassan Issues Statement on Workers’ Comp Commission Report
721 Hospitals Penalized For Patient Safety – “Medicare is penalizing 721 hospitals with high rates of potentially avoidable mistakes that can harm patients, known as “hospital-acquired conditions.” Penalized hospitals will have their Medicare payments reduced by 1 percent over the fiscal year that runs from October 2014 through September 2015.”

Did agents go too far in trying to catch a claimant in workers’ comp fraud? – “A federal judge in Portland chided government agents Friday for running a series of elaborate ruses to catch a U.S. mail carrier they accuse of fraudulently obtaining workers’ compensation benefits.” Perhaps setting up a phony business, luring a claimant into a deep sea fishing expedition, posing as a vocational rehab specialist and setting up 1,000 hours of surveillance is a bit over the top?

More news of note

2015 Forecast & predictions

Recapping 2014