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Brainstorm Health: Urine Testing Boom, Smartphone Ultrasound, Kentucky Sues Opioid Maker

November 7, 2017, 5:57 PM UTC

Good morning. Kaiser Health News published a fascinating investigation by Fred Schulte and Elizabeth Lucas into the lucrative realm of urine testing yesterday. (Yes, really.) The team sifted through reams of billing data from Medicare and private insurers with the help of researchers at the Mayo Clinic and “found that spending on urine screens and related genetic tests quadrupled from 2011 to 2014 to an estimated $8.5 billion a year—more than the entire budget of the Environmental Protection Agency.” In the last of those years, the reporters discovered, the federal government actually spent more on urine-based drug tests than it did on “the four most recommended cancer screenings combined.”

Some of this testing, to be sure, is medically appropriate—though it’s not clear how much. Last year, the CDC recommended that patients be tested when they begin opioid therapy and that long-term users be checked annually, though it left further testing decisions to the discretion of the health practitioner.

That discretion, it seems, has led to a financial boon for some pain clinics, Schulte and Lucas say. “In 2014 and 2015, Medicare paid $1 million or more for drug-related tests billed by health professionals at more than 50 pain management practices across the U.S.,” they report. The team also found 31 practitioners who “received 80 percent or more of their Medicare income just from urine testing”—a fact that federal officials who reviewed the findings called “troubling.”

Last year, Medicare imposed tougher scrutiny on urine testing and cut its reimbursement levels to providers, say Schulte and Lucas. But even so, many have continued to mine for this “liquid gold.” The story is definitely worth a read: Here’s another link.

Clifton Leaf, Editor in Chief, FORTUNE


The ultrasound that can attach straight to your phone. Jonathan Rothberg, entrepreneur and engineer behind the world's first DNA sequencer on a chip, is at it again. His startup Butterfly Network recently released a new product called the iQ, which can snap into an iPhone lightning jack and turn it into a mobile ultrasound that can be used by the everyday consumer, no lab technician training required. It even incorporates machine learning to help users figure out and pinpoint where they want to get their medical images. (WiRED)


Kentucky sues opioid maker Endo. Kentucky is piling on to the slew of states suing addictive opioid painkiller makers. State Attorney General Andy Beshear is bringing suit against Endo Pharmaceuticals, which makes the opioid Opana ER, for alleged fraudulent and deceptive marketing practices which have contributed to a rising tide of painkiller-related deaths in Kentucky. "Endo put its profits above the lives of our people and above patient safety," Beshear said in a statement. Endo, which has been sued by at least four other states for similar reasons, said it took offense to the statement and would defend itself in court. (CNN)


Insurers step up to hawk Obamacare enrollment amid Trump administration rollback. With a $90 million cut in Obamacare outreach funding by the Trump administration, insurance companies have been stepping up to inform Americans about the ongoing open enrollment period for plans sold under the Affordable Care Act. These companies', and other health care advocacy groups' efforts, may be working: Enrollment reportedly surged significantly in the first days of signups compared with last year. (Reuters)

Mumps on the rise in America, even among the vaccinated. There were 6,000 mumps cases reported in the United States in 2016—the most in the past 10 years. What's concerning is that the majority of cases in certain mumps outbreaks, like one last year in Arkansas, have been occurring in those who were vaccinated as children. The situation has raised some health experts to consider whether or not a third dose of the vaccine (beyond the recommended two) should be administered in high-risk areas. (Fortune)


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