The Rundown | Week of 12.17.2018

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ACA in Jeopardy Due to Texas Ruling

In Texas, a federal judge declared the Affordable Care Act (ACA) unconstitutional on the grounds that the act cannot be upheld without the individual mandate, which is set to expire in January following a congressional tax bill. District Court Judge Reed O’Connor decided that, if the mandate is not enforced — and thus there is no penalty for not enrolling — then the entire law violates the Constitution. The ruling led to serious drops in healthcare stocks, which are expected to bounce back. On Monday, California Attorney General Xavier Becerra formally filed a motion to enact a stay, which requires government entities to uphold the existing law or to certify in order to hasten the appeal process.
>> Read More: What to Expect After Whirlwind ACA Ruling

Nurse Burnout Surges

Hard-to-use electronic health records and lack of autonomy are often cited as the drivers of physician burnout, but often these findings overshadow rates of burnout among nurses. According to a new study from RNnetwork, 49 percent of nurses surveyed considered leaving the profession within the past two years. In fact, more than half of nurses reported overworking negatively affected their mental health, and many responded that this negative impact was detrimental to their work performance. The ongoing — and growing — shortage of nurses has negatively affected workloads for 88 percent of nurses, 16 percent more than a 2016 survey.
>> Read More: RNnetwork 2018 Portrait of a Modern Nurse Survey

Anxiety, Depression as Harmful as Obesity, Smoking

A study in Health Psychology indicated that depression and anxiety significantly increase one’s risk of cardiovascular disease, stroke, and arthritis. “These increased odds are similar to those of participants who are smokers or are obese,” said Aoife O’Donovan, Ph.D., the senior author of the study. Researchers from University of California, San Francisco examined data from 15,418 retirees with an average age of 68 across a four-year period and found that participants with high levels of anxiety and depression were 65 percent more likely to have a heart condition, 50 percent more likely to have high blood pressure, and 87 percent more likely to have arthritis when compared to participants without anxiety or depression. Interestingly, there was no correlation between levels of anxiety and depression with cancer. “On top of highlighting that mental health matters for a whole host of medical illnesses, it is important that we promote these null findings,” O’Donovan said. “We need to stop attributing cancer diagnoses to histories of stress, depression, and anxiety.”
>> Read More: Depression, Anxiety May Take Same Toll on Health as Smoking and Obesity

Is Wisdom the Cure for Loneliness?

Researchers may have discovered a cure for the “Loneliness Epidemic”: wisdom. The study, which was published in International Psychogeriatrics, found that loneliness is nonlinear and peaks at three ages: late 20s, mid-50s, and late 80s. The study comprised 340 individuals living in San Diego between the ages of 27 and 101 with a mean age of 62. There were no relevant differences between male and female participants for the 76 percent that experienced “moderate-high levels of loneliness.” Three relevant factors that were correlated with loneliness were living alone, mental well-being, and wisdom. “The strong negative association of wisdom with loneliness highlights the potentially critical role of wisdom as a target for psychosocial/behavioral interventions to reduce loneliness,” researchers concluded. “Building a wiser society may help us develop a more connected, less lonely, and happier society.”
>> Read More: High Prevalence and Adverse Health Effects of Loneliness in Community-Dwelling Adults Across the Lifespan: Role of Wisdom as a Protective Factor

$67 Billion Cigna-Express Scripts to Close

According to a filing with the Securities and Exchange Commission (SEC), Cigna is expected to close the $67 billion before the end of the year. Last week, regulators from California and New York approved the deal but with conditions such as a promise not to raise premiums to offset the transaction’s cost as well as keeping premium rate increases “to a minimum.” On Tuesday, “Cigna and Express Scripts received regulatory approval from the State of New Jersey for the transaction,” according to the filing. “All required regulatory approvals now have been received and the parties expect to close the transaction on December 20, 2018, subject to the satisfaction of all other closing conditions.” The megamerger epitomizes the trend of insurers and pharmacy benefit managers (PBMs) partnering to vertically integrate. Analysts speculate this integration can lower costs, particularly for specialty drugs.
>> Read More: Cigna-Express Scripts Clears Final Regulatory Hurdle

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