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Featuring hospital and health care headlines from the media and the Web.

Iowa News

Branstad’s vetoes highlight ideological gap
Gov. Terry Branstad’s veto this week of tax breaks for Iowa’s poor and his rejection of a legislative mandate that would have kept 36 unemployment offices open have created a political firestorm. One of the state’s top union leaders vowed retribution in the 2012 elections against GOP candidates who have supported the governor. And Democrats began a push Thursday to gather the required two-thirds support needed in both the House and the Senate to call a special session to override Branstad’s move to close the unemployment offices. That’s a tall order, since Republicans control the House 60-40, and Democrats hold only a slim majority in the Senate, 26-24. (Des Moines Register)

Guest opinion underscores need for mental-health facilities
We have to recognize that we have to invest in the building of safe havens for these mentally ill people, and we must educate the people to care for them. It takes years to become a psychiatrist, and now most nurse practitioners and physician’s assistants entering any phase of medical practice are going to be required to have a doctorate — a huge debt load for the students. It’s only reasonable to acknowledge that these people are going to have to be decently compensated. (University of Iowa Daily Iowan)

UIHC predicts $933 million budget
The University of Iowa Hospitals and Clinics will likely see a 7.5 percent increase in its fiscal 2012 budget in comparison with 2011, according to the state Board of Regents. UIHC’s upcoming budget is predicted at $933.4 million, including more than $70 million in state appropriations from IowaCare. Regent Robert Downer said the budget was designed partially to offset growing outpatient activity. (University of Iowa Daily Iowan)

Dubuque mayor: Even those on hilltops have water in basements
Dubuque County residents mopped up and wrung out Thursday after overnight storms dumped as much as 15 inches of rain in places in the eastern Iowa region. An unusual combination of upper atmospheric moisture mixed with slow-moving clouds deluged the area beginning shortly before 7 p.m. Wednesday and lasting into early Thursday. The Wednesday-Thursday rains forced more than 40 people to flee a mobile home park, many by boat, and flooded basements across Dubuque. (Des Moines Register)

National News

U.S. may be able to pay bills beyond debt-ceiling deadline
Obama administration officials have been adamant for weeks that Tuesday is the date the Treasury Department no longer will be able to pay the nation’s bills if the debt ceiling isn’t raised. But the government might be able to buy some more time. Some analysts now project the Treasury won’t run out of money until Aug. 8 at the earliest and as late as Aug. 15, reducing the necessity for the White House and Congress to strike a deal in the next few days. (Los Angeles Times)

Medicare at 67: The next big change?
Now the idea of raising the eligibility age has gotten the support of President Obama and House Speaker John Boehner. While the age change is not expected to be part of the latest debt ceiling compromises, the idea is now likely to be a permanent fixture in the Medicare debate and, someday, to become a reality. The idea has been loosely supported by Republicans in the past. (Politico)

Hospitals boost IT spending plans
The federal incentive program for Meaningful Use of electronic health records seems to be having its desired early effect by spurring healthcare organizations to adopt more than just basic EHRs, according to a new study. And many hospitals are making plans to spend more on other forms of IT in the next few years, suggesting that EHRs are becoming integral to the overall organizational strategy. (InformationWeek)

HHS officials explain $47.9 billion in improper Medicare payments
The federal government issued $47.9 billion in improper payments to Medicare fee-for-service and Medicare Advantage in fiscal 2010, and Thursday officials from the Office of Inspector General, the Centers for Medicare & Medicaid Services, and the Government Accounting Office went before a House subcommittee to explain why. The House Subcommittee on Government Organization, Efficiency, and Financial Management heard testimony attributing the improper payments to a number of causes, primarily improper documentation. (HealthLeaders Media)

Robotic pharmacies fill prescriptions faster
At Molina Medical Group clinics in Southern California, a vending machine rather than a pharmacist dispenses prescription drugs. Molina officials say the machines make life simpler for patients, but their use has drawn objections from some pharmacists. The kiosks are the size of a large refrigerator. They hold a stock of medications for common ailments such as colds, flus and rashes, so patients can have their prescriptions filled before leaving the clinic. (Los Angeles Times)

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Featuring hospital and health care headlines from the media and the Web.

Iowa News

UI docs help riders out along the way
University of Iowa resident doctors are getting a firsthand taste of emergency medicine, a tour of Iowa and a sample of the Register’s Annual Great Bicycle’s Ride Across Iowa all at once this week. Amy Maule, 26, of Monroe, La., has spent hours cruising Iowa’s country roads in one of Iowa City’s Care Ambulance rigs with paramedics Mike Aguilar and Darrin Hayes. She’s never experienced anything quite like the colorful bike ride that takes cyclists from one side of the state to the other over a week. (Iowa City Press-Citizen)

States brace for cash cutoff
Nebraska’s budget director, Gerry Oligmueller, and Iowa’s management department director, David Roederer, are following developments regarding the national budget debt ceiling closely. But they have little information with which to plan. Roederer anticipates Iowa would continue federally funded programs with state dollars. The state could manage for about a month with no federal funds, longer if the federal government makes some payments. (Omaha World-Herald)

Rural areas are hit by higher insurance costs
When it comes to health insurance, small businesses have long been at a disadvantage. They lack the size to negotiate cheaper plans for workers. Coverage is more expensive and less comprehensive. How could a business have it worse? It could be in rural Iowa. A new report from the University of Iowa College of Public Health’s Healthier Workforce Center for Excellence and David P. Lind and Associates exposes the rural-urban disparities in employer-based health insurance. (Des Moines Register)

Missouri River flooding expected to end by October
Authorities say it will be late September or early October before the Missouri River returns to its banks. Upstream water releases at Gavins Point Dam near Yankton, S.D., are scheduled to be cut starting Saturday, then again on Monday. The Army Corps of Engineers has said it must reduce the dam’s releases slowly, lest a quick drop in water level raise the risk of downstream levee breaks. (Sioux City Journal)

National News

Boehner, other GOP leaders ramp up pressure on Republicans to pass debt plan
House GOP leaders continued their furious bid Thursday to win support for legislation designed to ease the nation’s debt crisis, setting up a white-knuckle vote for the early evening, well after the nation’s financial markets have closed. As House Speaker John A. Boehner (R-Ohio) delivered a final pep talk Thursday morning to the Republican Conference, Senate Majority Leader Harry M. Reid (D-Nev.) again vowed to thwart the GOP legislation if it makes its way to the Senate late Thursday. Boehner’s bill would increase the federal debt limit in two stages into next year in exchange for major spending cuts. (Washington Post)

Medicare drug benefit trims spending on hospitals, study finds
Offering prescription drug coverage to the federal Medicare program’s elderly beneficiaries reduced spending on hospitals and nursing homes, a study found. The effort increased access to medicines and improved patients’ adherence to drug regimens, according to the study published today in the Journal of the American Medical Association. (Bloomberg)

Poll finds Americans gloomy on some promises in health law
Americans are pessimistic that the new health care law will improve the quality of medicine, do a better job protecting consumers or lower costs, a new poll shows. Only 20 percent of people believe consumer protections will get better under the law, while most others think protections will stay the same or get worse, according to the poll from the Kaiser Family Foundation. (Kaiser Health News)

Justices asked to hear challenge to health care law
The petition submitted Wednesday was an appeal from a divided decision last month by a three-judge panel of the United States Court of Appeals for the Sixth Circuit, in Cincinnati. The decision was the first appeals court ruling on the constitutionality of the law, the Patient Protection and Affordable Care Act. The decision was also notable because Judge Jeffrey S. Sutton, a prominent conservative judge who had served as a law clerk to Justice Antonin Scalia, joined the majority in upholding the law. (New York Times)

U.S. health care tab to hit $4.6 trillion in 2020
The nation’s health care tab is on track to hit $4.6 trillion in 2020, accounting for about $1 of every $5 in the economy, government number crunchers estimate in a report out Thursday. How much is that? Including government and private money, health care spending in 2020 will average $13,710 for every man, woman and child. By comparison, U.S. health care spending this year is projected to top $2.7 trillion, or about $8,650 per capita, roughly $1 of $6 in the economy. (Associated Press/Washington Post)

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Featuring hospital and health care headlines from the media and the Web.

Iowa News

What Iowa’s delegation says about debt ceiling
Sen. Chuck Grassley’s office reported a steady flow of calls, about 500, to his six Iowa offices and his Washington, D.C., office about the budget talks. Callers expressed frustration that the deficit-reduction negotiations haven’t been resolved. Sen. Tom Harkin’s office said it received more than 700 emails or letters overnight and experienced high call volume Tuesday. Older and infirm Iowans fear they will not receive their Social Security or Medicare benefits if action isn’t taken, his office staff said. (Des Moines Register)

Des Moines woman says her efforts to aid mentally ill son were in vain
Linda Hill learned Sunday evening that her son Brian, 43, who wrestled with mental illness, most likely jumped off a bridge to his death. Over the past five or so years, Iowa policymakers and others repeatedly have shone a light on what they describe as a fractured mental health system. The state has a shortage of mental health physicians and ranks near the bottom of the nation in psychiatric beds per capita, studies have shown. (Des Moines Register)

Oncology nurse thrives on bonds with patients
Rachael Johnson never intended to become an oncology nurse, but she took a job in the field thinking it would be a way to get her foot in the door. She became passionate about it, and says that forming relationships with patients has been a highlight of her career. Johnson has been the oncology nursing unit director at Mercy Medical Center for the past seven years, overseeing an average of 60 staff members. She enjoys teaching patients and their families as well as staff members and new nursing students interested in the field. (Des Moines Register)

Review of Mercy-Des Moines medical facilities ordered
The federal government has ordered a team of state inspectors to conduct a comprehensive review of Mercy Medical Center in Des Moines and its affiliates. The inspection was prompted by the state’s discovery of a major deficiency related to inadequate monitoring of patients. Mercy released a statement that said, “The current visit is a follow-up to a May survey and is conducted to validate all suggested changes have been made. Their team will also ensure all additional areas within Mercy are in full compliance with their standards.” (Des Moines Register)

National News

At age 46, is Medicare ripe for a change?
Medicare was signed into law by President Lyndon Johnson 46 years ago this week. Changes to the program, such as raising its eligibility age or requiring wealthier seniors to pay more for coverage, have been discussed in the debate over raising the federal debt ceiling and also by several commissions charged with finding ways to reduce federal spending, including on entitlement programs.  It remains unclear what role, if any, Medicare will play in the debt ceiling talks. The two proposals currently being considered – from House Speaker John Boehner and Senate Majority Leader Harry Reid – do not include significant changes to Medicare. (Kaiser Health News)

Obama’s ‘70 million checks’ per month: Actually, it’s even more than that
If nothing else, the crisis over the debt ceiling is reminding the country of the astonishing reach of the federal spigot, encapsulated by a figure that President Obama tossed out recently: The government sends out “70 million checks” every month. That works out to 27 payments per second, day after day — not just to the expected recipients, such as contractors, federal workers and Social Security beneficiaries, but also to those you might not think of, such as the victims of black lung disease and their widows (50,032 checks in June), and pensioners supported by the Railroad Retirement Board (613,912). (Washington Post)

Rural areas face more health care hurdles
Residents of rural areas in Minnesota and across the nation are more likely to have chronic diseases and face hurdles to getting quality care, according to a UnitedHealth Group report that calls for new approaches to rural care. A study the Minnetonka-based insurer is releasing Wednesday documents an increasingly urgent need to recruit caregivers to less populated outposts and to explore ways that technology can be used to enhance care. (Minneapolis Star Tribune)

Hospitals take cultural sensitivity seriously
Hospitals across the region are seeing more people with different languages, cultural sensitivities and religions that can confound doctors, nurses and caregivers and hinder patients’ best possible care. Interpreters have been deployed by many hospitals, but more expansive measures now are being considered inside the hospital and to communities with large ethnic populations. Ann Cho, while continuing as a nurse practitioner and an advocate for Korean patients, will educate hospital staff on cultural sensitivities and reach out to members of the Korean community who may be wary of American hospitals. (Chicago Tribune)

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Featuring hospital and health care headlines from the media and the Web.

Iowa News

Feds want reviews of Iowa small employers’ health insurance rates
Iowa is one of 10 states whose reviews were deemed too weak. Susan Voss, the state’s insurance commissioner, disputes the determination and told her federal counterparts this month that Iowa doesn’t need their help. The dispute comes as health-insurance rates continue to climb in Iowa and across the nation. Employers faced average health-insurance cost increases of 13 percent last year and 11 percent in 2009, according to David P. Lind and Associates, a Clive insurance broker that studies the market. The largest increases were seen by companies with 10 to 19 employees, which saw increases of 17 percent last year and 16 percent in 2009. (Des Moines Register)

Oskaloosa hospital now offers PET/CT Scanning
Mahaska Health Partnership Radiology will offer patients a powerful new diagnostic imaging system known as PET/CT, beginning August 2. This hybrid technology combines the strengths of two well-established imaging modalities in one imaging session to more accurately diagnose, locate, and stage cancers while increasing patient comfort. (Oskaloosa News)

Lutheran Hospital starts demolition project
Some of the oldest parts of one of Iowa’s oldest hospitals are falling to the wrecking ball to pave the way for the future look of Iowa Lutheran Hospital in Des Moines.  The project includes taking down the old nursing school dorms, which haven’t been used for decades.  For now, after the demolition teams finish their work, the space will be left open as the hospital makes its plans. (WHO-TV)

North Iowa hospital helps with heat health
Doctors at Mercy Medical Center North Iowa tell us they see, on average, 10 to 15 patients a day for heat related issues. Fewer than half of those are admitted into the hospital. Dr. Sreelu Dega says, watch out for those muscle cramps, headaches and dizziness, those are the first signs of heat related illness. (KIMT)

National News

Parties head to showdown as Obama warns of a ‘crisis’
The Democratic-led Senate and Republican-led House on Monday barreled toward a showdown on competing plans to cut spending and raise the debt limit as a resolution to the intensifying crisis remained farther from sight just one week before a possible federal default. (New York Times)

As state of play in debt talks changes by the moment, even lobbyists struggle to keep up
Advocacy groups that have spent months anticipating exactly the stalemate Washington has now reached are working to apply pressure to nudge political leaders engaged in talks on raising the nation’s debt ceiling. But with the state of play changing by the moment, advocates are able to offer only the broadest of thoughts about how to proceed. For once, that most self-certain of Washington institutions — lobbying — has been left in the same state as the financial markets, the economy and the rest of the country: confused. (Washington Post)

Lawsuit says drugs were wasted to buoy profit
One of the nation’s largest providers of kidney dialysis deliberately wasted medicine in order to reap hundreds of millions of dollars in extra payments from Medicare, a former clinic nurse and a doctor are charging in a whistle-blower lawsuit. The lawsuit says that the company, DaVita, used larger than necessary vials of medicine knowing that Medicare would pay for the unused portion of each vial if it were deemed unavoidable waste. DaVita, which treats nearly a third of the nation’s dialysis patients, denies the accusations. (New York Times)

Hospitals make palliative care a priority to improve patients’ quality of life
In the controlled chaos of an hospital emergency department, ensuring that patients are pain-free and can make informed choices about their care often takes a back seat to assessing and stabilizing them and moving them through the system as fast as possible. But now some experts say that providing palliative care — which focuses on patients’ quality-of-life issues — can and should be a priority in emergency departments, and they’re putting together a program to help hospitals better address those issues. (Washington Post) 

Preparing Americans for death lets hospices neglect end of life
As hospice care has evolved from its charitable roots into a $14 billion business run mostly for profit, patients like Covington and their families have paid a steep price, according to lawsuits and federal investigations. Providers have been accused of boosting their revenues with patients who aren’t near death and not eligible for hospice — people healthy enough to live a long time with traditional medical care. In hospices, patients give up their rights to “curative” measures because they are presumed to be futile. (Bloomberg)

Cash sought to prevent diabetes
Though the week before the August 2 debt ceiling deadline may seem like a bad time to ask for funding, a group of industry experts and policymakers is planning to do just that Tuesday on Capitol Hill: briefing members of Congress and arguing that now is the time to fund diabetes prevention in order to save lives and money later. (Politico)

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Featuring hospital and health care headlines from the media and the Web.

Iowa News

Iowa health insurers get more time to meet rule
Federal regulators will give health insurance companies in Iowa extra time to comply with a new rule meant to curb profits, but not as much time as the Iowa Insurance Division requested. Part of the Obama administration’s health care legislation requires that if individual insurers don’t spend at least 80 percent of premiums on health care in 2011, they must refund customer premiums until the math works out. If the rule were instituted this year, consumers would have received $6.5 million in rebates over three years. (Des Moines Register)

Robotic surgery makes debut at Ottumwa hospital
When Janine Miller undergoes surgery today, her doctor may not even touch her. “He gave me the option and I said, yes, I’d gladly do the robotic surgery because it’s the least invasive surgery they have,” said Miller, 36 of Eddyville. “He explained all these options to me and asked which option I liked.” Miller will be the first patient in Ottumwa to undergo robotic surgery using the da Vinci surgical robot purchased by Ottumwa Regional Health Center. (Ottumwa Courier)

DNR: Heat wave bringing more boaters and more accidents
Dubuque County DNR Conservation Officer Nathan Johnson says this is the third accident on this area of the Mississippi this summer. “For whatever reason this summer, this being the third accident we’ve had, that’s more than what I experienced when I was here five or six years ago,” Johnson said.  The conservation officer says the heat wave sweeping the Midwest maybe partly to blame with more people flocking to local beaches, lakes and rivers to cool off. (Eastern Iowa News)

National News

Boehner plan would raise debt ceiling in two stages
During a closed-door meeting Monday with rank-and-file Republicans, House Speaker John Boehner is expected to outline a two-step process for raising the debt ceiling — an approach rejected by President Obama — as congressional Democrats prepare to unveil their own proposal for reducing deficits. Both the House and Senate are heading toward Wednesday votes on competing frameworks for reducing deficits, as Congress struggles to coalesce around a plan to raise the nation’s debt limit by next week. (Los Angeles Times)

Health care providers embracing cost-saving groups
Health care providers are embracing accountable care organizations, a key part of last year’s health care law, as they try to control rising Medicare and health care costs. Hospital administrators and health care experts across the country say they’re creating the organizations, despite concerns about federal rules, because they realize they are the only way to remain profitable as a large portion of the nation’s population moves toward old age. (USA Today)

Hospitals offer self-imposed fee to avoid Medicaid cuts
Facing a federal law that forces them to care for uninsured patients even if they lose government reimbursements, the hospitals want to temporarily cover the state’s one-third match on thousands of Medicaid enrollees so the federal government will continue to pay the other two-thirds. Arizona hospitals stand to lose a combined $530 million in revenue this fiscal year if the feds approve the state’s cuts, on the heels of $700 million worth of state hospital payment cuts and rate freezes since 2008.  (Prescott Daily Courier)

Low health literacy links to health care spending confirmed
If health care providers are serious about reducing readmissions and improving outcomes, they must address health literacy, the lack of which leads to more emergency care and hospitalizations, less use of preventive services and poorer medication compliance. That’s not exactly news; researchers have described similar results in 2004. But it has been reinforced by an updated and exhaustive analysis of 96 studies, described in the Annals of Internal Medicine by researchers for the federal Agency for Healthcare Research and Quality. (HealthLeaders News)

Small-town doctors made in a small Kansas town
A new medical school campus opened in Salina, Kansas to provide a novel solution to the persistent problem: an inaugural class of eight aspiring doctors who will receive all their training in exactly the kind of small community where officials hope they will remain to practice medicine.  The new school, operated by the University of Kansas, is billed as the smallest in the nation to offer a full four-year medical education. More important, supporters say, the students will remain personally and professionally rooted in the agricultural center of the state — a three-hour drive from the university’s state-of-the-art medical and research facilities in Kansas City. (New York Times)

Shriners end free care for all
For 89 years, Shriners Hospitals have provided free medical care to children in Minneapolis and around the country. But no more. By month’s end, all 20 U.S. hospitals will be billing insurance companies and charging some families copayments, marking a major shift in the charity’s mission. Shriners leaders say the change is necessary to save the iconic name amid rising health care costs, flat donations and declines in a multibillion-dollar endowment that has been ripped apart by the whims of the stock market. (Minneapolis Star Tribune)

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