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CMS pushes back big changes to home health agencies

A major overhaul of rules governing home health agencies was set to go into effect this week — but now, the Centers for Medicare and Medicaid Services have pushed off the new regulations until January 2018. More than 5 million seniors and adults with disabilities receive care through home health agencies. The regulations, which were released shortly before former President Obama left office, lay out new conditions those agencies have to meet to be reimbursed by Medicare and Medicaid. They'll be required to inform patients of their rights and will have to notify the patient, caregiver, and physician any time a change is made to their care plan. The new rule will also require agencies to evaluate a caregiver’s ability to help out and their schedule when creating a patient’s care plan.

Inside STAT: Fraud scheme targets addiction patients

The Sunrise Sober Living home in Delray Beach where SanAngelo lived just before he died. (ANGEL VALENTIN FOR STAT)

Drug users desperate to break their addictions have become pawns in a massive network of insurance fraud, an investigation by STAT and the Boston Globe has found. Patient brokers pocket a fee to place insured people in treatment centers which are often hundreds of miles from their homes. Those treatment centers provide expensive, but often shoddy, care, and pocket thousands of dollars in claims for each patient in the process.

“This whole thing began from a place of deception,” said Samantha Herring, whose cousin Peter SanAngelo died of a drug overdose three months after a patient broker helped send him to a treatment center in Florida. “Peter had an honest desire to get better and they had an honest desire to make money.” Read here.

Delaying an emergency surgery can be costly

A new case study of a hospital in Ottawa highlights the problem of delayed emergency surgeries, which affect both patient outcomes and hospital costs. Between 2012 and 2014, 19 percent of patients who had emergency surgery at the Ottawa Hospital had their procedures delayed. The most common cause: There wasn’t an operating room or surgical staff available. Those patients had a 5 percent mortality risk during their hospital stay, compared to a 3 percent risk for patients whose emergency surgeries started on time.

The patients also stayed in the hospital a day longer on average, running up an additional $1,409 in medical costs. In response the hospital started spreading out elective surgeries more evenly and set aside dedicated OR time for emergency surgeries. So far, the tweak in protocols has helped the hospital get to more emergency surgeries on time.

HUBweek, a festival for the future, returns Oct. 10-15, 2017

Let your curiosity run wild and join Boston's creators and innovators at HUBweek, a festival for the future founded by The Boston Globe, Harvard, Mass. General Hospital and MIT. On October 10-15, 2017 HUBweek will feature speakers including Malcolm Gladwell, Atul Gawande, Juliette Kayyem, Deepak Chopra and more. Connect with some of the world's most inventive minds and organizations creating the future at the intersections of art, science, and technology. Curious? Passes are on sale now.

ICYMI: FDA approves first sickle cell therapy in 20 years

On Friday, the FDA approved the first new treatment for sickle cell disease in nearly 20 years. An estimated 100,000 people in the U.S. alone have the inherited blood disorder, which can deprive the body’s tissues of oxygen and cause severe pain and organ damage. The new drug, Endari, reduced the frequency and length of hospital stays for sickle cell-related pain in clinical trials. But drug maker Emmaus Medical might run into trouble trying to obtain insurance coverage for the drug, because its active ingredient is an amino acid called L-glutamine that can already be purchased over the counter.

How can the health system care for high-need patients?

The National Academy of Medicine is out with a new report on how the health system can better support high-needs patients who run up steep medical bills and require a significant amount of care. Here are highlights of the findings:

§ High-needs patients are more likely to be on public insurance than the general patient population. They’re also disproportionately older, white, and female.

§ They often get bounced around within the health care system without much coordination. The authors of the new report say fixing that issue is critical to improving care while cutting costs. Their suggestion: Connect patients with community support and social services while also addressing their medical needs.

§ There isn’t one right way to care for high-needs patients. The authors pinpointed 14 programs that are doing it right. But some models work better for particular high-needs patient groups — such as frail elderly patients or kids with complex medical problems — than others.

Study finds Holocaust survivors had higher cancer rates

A new study of Holocaust survivors suggests they might have faced a consistently higher risk of developing cancer over time. Researchers wanted to see whether the starvation, overcrowding, psychological stress, and disease that Holocaust survivors had to endure impacted their cancer risk later in life. So they studied the health data of 152,622 Holocaust survivors who were followed for more than 45 years. The researchers looked at two definitions of exposure: whether an individual's country was occupied by Nazi Germany and whether that person was deemed eligible for compensation after the war. Individuals from occupied countries had an 8 percent higher risk of developing any type of cancer, and those who received compensation had a 6 percent higher risk. The study’s authors say their findings point to the impact of population-level tragedies on overall health.