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

Iowa News

Mental health reform leads to local budget shortfall
The Iowa Legislature’s decision to regionalize mental health services has left many county mental health budgets — including Plymouth’s — in the red. That means services for individuals whose mental health needs are paid for with county dollars will face cuts starting July 1, the beginning of the 2012-13 fiscal year. Sharon Nieman, Plymouth County central point of coordination and general relief director, said the county is facing a $600,000 shortage in the next fiscal year. (Le Mars Daily Sentinel)

Supreme Court decision could open doors for 7,000 uninsured in Sioux City
The U.S. Supreme Court decision Thursday upholding President Barack Obama’s health care overhaul may mean as many as 7,000 uninsured Sioux City residents will receive medical coverage, a hospital official said. State officials expect to hold a summit to figure out how to move forward under the far-reaching law. About 366,000 Iowans — roughly 12 percent of the population — are uninsured, according to U.S. Census Bureau data from 2011. Mercy Medical Center-Sioux City CEO Bob Peebles said the number is closer to 13 percent, or 7,000 people, in Sioux City. He said the Supreme Court ruling gives residents more access to health care, especially preventative care. (Sioux City Journal)

Eyes now turn to making it happen
Dr. Jean Robillard, vice president for medical affairs at the University of Iowa, said that although there are too many unknowns to speculate how the Supreme Court’s ruling and the Affordable Care Act will affect University of Iowa Hospitals and Clinics, it will result in an “increase of access to care, and the decreased discrimination of care…I believe first of all that all health systems across the state and across the country have already made multiple changes that are impacting access, improving access, improving quality,” Robillard said.  (Iowa City Press-Citizen)

Medicaid’s future in Iowa
In the hours after the Supreme Court’s ruling on Thursday upholding much of the framework for the 2010 Patient Protection and Affordable Care Act, now states are scrambling to decide how to operate their Medicaid systems. “(This legislation) removes all of those categories and bases it on income,” said Keith Mueller, University of Iowa professor in the College of Public Health. “There is no asset test. It is what is reported on the IRS form…It will be up to the states between now and January 2014,” said Mueller, who noted the federal government will pay for all of the funding at the start before phasing out up to 10 percent for the states after a few years. (KCRG)

Iowa prepares to deal with health care ruling
The leader of the state’s dominant health insurer said no one can say generally how the Supreme Court’s decision will affect Iowans. “The question seems simple, but there are so many complications in this,” said John Forsyth, president of Wellmark Blue Cross and Blue Shield. For example, Forsyth said, a young woman might pay less for an insurance policy when the law takes full effect in 2014, but a young man might pay more than he does now. (Des Moines Register)

Plant’s closure not due to health law
A misquote in an Iowa newspaper sparked a flash point in the presidential campaign and gave rise to an ill-founded talking point from U.S. Rep. Steve King, R-Iowa. A story in the May 30 Sioux City Journal ran under the headline “Sioux Center plant blames closing on health care reform.” The company spokesman quoted in that story, though, says he never said any such thing. “You notice my words aren’t in quotes,” Schurman said of the story. “We have never drawn a connection between the plant’s closing and the specifics of any one health care reform proposal.” (Ames Tribune)

Plea for timeout on health reform battle
Since the Affordable Care Act’s passage, our health system has invested millions of dollars in carrying out provisions of the ACA — provisions that have nothing to do with the individual mandate, co-ops or Medicaid coverage expansion. Accountable care organizations, bundled payment projects and electronic health records are just a few of the health care delivery provisions of the law in which we’ve invested. The best kept secret about these provisions is that they embody concepts supported by Democrats and Republicans. (USA Today)

National News

Providers, payers largely favor PPACA decision
Most of the many-faceted segments of the healthcare industry appeared pleased with Thursday’s majority Supreme Court decision to uphold most provisions of the Patient Protection and Affordable Care Act, even as they vowed to work toward the repeal of pieces they still find objectionable. “Today’s ruling does give clarity to hospitals as they move forward to transform the way they provide care and work with patients and communities as well,” American Hospital Association president and CEO Rich Umbdenstock said. (HealthLeaders Media)

Health reform ruling reinforces importance of health IT, CIOs say
While the ruling doesn’t directly impact some of the larger healthcare IT efforts underway, such as Meaningful Use, which is part of the American Recovery and Reinvestment Act of 2009 and not the ACA–it is likely to have residual effects, says Stephen Stewart, CIO of Mount Pleasant, Iowa-based Henry County Health Center. “Health IT will only become more prominent as a result of this direction,” Stewart told FierceHealthIT via email. “Reform cannot be done without the prerequisite technology. Reform has to happen; it’s just a matter of what it looks like. Long term, it bodes well for health IT.” (Fierce Health IT)

States face a challenge to meet health law’s deadline
A number of largely Republican-led states that gambled on delay now face the unsettling prospect that the federal government could take over their responsibilities, particularly in setting up the health insurance marketplaces known as exchanges. Under the law, individuals must be able to buy insurance coverage through the new state exchanges by Jan. 1, 2014. But a more immediate deadline is less than six months away, on Jan. 1, 2013, when states must demonstrate to the Department of Health and Human Services that the exchanges will be operational the next year. (New York Times)

Something wicked this way comes
“Wicked problems” are messy, ill-defined, more complex than we fully grasp, and open to multiple interpretations based on one’s point of view. They are problems such as poverty, obesity, where to put a new highway—or how to make sure that people have adequate health care. They are the opposite of “tame problems,” which can be crisply defined, completely understood, and fixed through technical solutions. Tame problems are not necessarily simple—they include putting a man on the moon or devising a cure for diabetes. They are, however, solvable. Solutions to tame problems either work or they don’t. (New Yorker)

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

Iowa News

Iowa health systems launch collaboration to improve care, reduce cost
An hour after the Supreme Court upheld the Affordable Care Act, leaders of four of Iowa’s top healthcare organizations announced they’re creating a first-of-its-kind health care alliance aimed at improving care across the state while decreasing patient costs. The alliance, which will be called the University of Iowa Health Alliance, will include more than 50 hospitals and more than 160 clinics in a collaboration to not only advance health care services but improve the health status of patients and communities. (Cedar Rapids Gazette)

Mental health scramble under way
Des Moines County officials are continuing to scramble to make preparations for the statewide mental health redesign, a piece of legislation that as of July 1 will strip the county of state funding for non-Medicaid mental health services. Central Point of Coordination Administrator Ken Hyndman presented potential changes to the county’s management plan to the board of supervisors during a public hearing Tuesday morning. Once implemented, Hyndman said, the changes to the plan will focus on finding funds to pay for people not covered by Medicaid. (Burlington Hawk Eye)

Hospital CEO weight-loss challenge benefits Y
It was a battle of the bulge between two Sioux City hospital CEOs. Mercy Medical Center’s Bob Peebles and St. Luke’s, Peter Thoreen went head-to-head in a weight loss challenge that lasted three months. With a goal of a 10 percent drop in bodyweight, Thoreen walked away the champion. Tipping the scales at nearly 223 pounds, Thoreen lost about 21 pounds. Conceding defeat, Peebles awarded his opponent a $500 dollar check to the charity of his choice, which Thoreen matched, giving a total of $1,000 to the Norm Waitt Senior Y. (KCAU)

Local hospitals treat the uninsured for hepatitis C
People with hepatitis C may have problems finding health insurance — because the virus is a pre-existing condition — if the U.S. Supreme Court deems the Affordable Care Act unconstitutional. However, Iowa City hospitals offer alternative programs for uninsured people infected with the virus. Both Mercy Hospital and the University of Iowa Hospitals and Clinics treat people who are infected with no insurance. Vivek Mittal, a gastroenterologist and herpetologist at Mercy Hospital, said the facility has an entire team devoted to helping people without insurance. (University of Iowa Daily Iowan)

$11 million to help preterm babies
The National Institutes of Health has awarded a University of Iowa team $11 million to treat diseases affecting babies born prematurely. The grant—the fourth renewal obtained by the research team led by John Widness, UI professor of pediatrics—will test a novel alternative for delivering life-sustaining supplies of red blood cells to preterm infants. (University of Iowa)

Doctors have an easier way to perform surgeries
Representatives from the Ottumwa Regional Health Center gynecological department held an open house at the Days Inn in Kirksville Wednesday afternoon to show their the DaVinci Robotic System. The staff was there to demonstrate the robot and how it works using its robotic arms on major surgery procedures such as a hysterectomy. (KTVO)

National News

Supreme Court upholds Obama’s health care law
Chief Justice John G. Roberts Jr. on Thursday joined the liberal wing of the Supreme Court to save the heart of President Obama’s landmark health-care law, agreeing that the requirement for nearly all Americans to secure health insurance is permissible under Congress’s taxing authority. Even as it upheld that central component of the Patient Protection and Affordable Care Act, however, the court modified another key provision of the law, ruling that the federal government cannot withdraw existing Medicaid funding from states that decide not to participate in a broad expansion of Medicaid eligibility. (Washington Post)

U.S. will need 5.6 million more health care workers by 2020
The health care economy is expected to grow at twice the rate of the national economy between now and 2020 and will create an additional 5.6 million jobs over those eight years, according to a report released by the Georgetown University Center on Education and the Workforce. The report further notes that the demand for a post-secondary education for the bulk of the new health care jobs will grow faster than other fields except STEM (science, technology, engineering, and mathematics) and jobs in Education. (Healthcare Finance News)

Hospital groups blast ‘flawed’ inpatient payment rule
The major hospital associations are blasting the Centers for Medicare & Medicaid Services for its methodology behind the hospital inpatient prospective payment system proposed (IPPS) rule for fiscal 2013. Called “flawed” by the American Hospital Association (AHA) and the Federation of American Hospitals (FAH), the current proposal would cut inpatient prospective payments by 2.7 percent during fiscal 2013. That includes a 1.9 percent cut to offset the documentation and coding changes that occurred between the 2007 and 2009 fiscal years. It also would include an additional 0.8 percent reduction to eliminate other changes that were made during fiscal 2007 and 2010. (Fierce Healthcare)

AHA: Leapfrog ‘manipulated’ safety data
Patients should not use The Leapfrog Group’s Hospital Safety Score, which gives hospitals an A to F letter grade based on their likelihood of causing harm, because it’s inaccurate, the American Hospital Association said this week. The scoring applies a 26-measure questionnaire that is biased, uses unreliable measures, applies variable weights to the same measures for different groups of hospitals, and contains significant errors, AHA President and CEO Rich Umbdenstock said in a five-page letter to Leah Binder, Leapfrog President and CEO. (HealthLeaders Media)

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Four of Iowa’s largest health care organizations have announced the creation of a health care alliance in Iowa and contiguous areas.  The new alliance, called the University of Iowa Health Alliance (UIHA), will include more than 50 hospitals and more than 160 clinics.  Alliance members “will work together to advance the high quality of health care services, to improve the health status of patients and communities and to achieve  efficiencies that will help member organizations reduce the rising cost of care for their patients,” according to a press release.

UIHA will create a platform for sharing expertise, selected support services and information technologies needed to succeed in the emerging “accountable care” systems and payment programs.  Working together in UIHA, members will strive to increase the value of services provided, improve clinical integration between the members, provide more streamlined and coordinated care to patients and ultimately improve the health of people in Iowa and other regions served.

The four entities involved are: Mercy Health Network (MHN), a statewide system comprised of 11 owned and 27 contract-affiliated hospitals and 142 physician clinics with 625 physicians; Genesis Health System,with four owned medical centers in Davenport, DeWitt and Silvis, Ill., two affiliated hospitals and numerous outpatient centers including urgent care clinics and ambulatory surgery centers;  Mercy-Cedar Rapids, a health care system serving the eastern Iowa corridor that includes Mercy Medical Center, the Hall-Perrine Cancer Center, Mercy Health Plaza, multiple outpatient centers and a network of 13 family practice clinics; and University of Iowa Health Care in Iowa City, the state’s only comprehensive academic medical center, which includes University of Iowa Hospitals and Clinics, the University of Iowa Roy J. and Lucille A. Carver College of Medicine and University of Iowa Physicians, the state’s largest multi-specialty physician group practice with 1,432 physicians, residents and fellows.

Members describe the arrangement as the “best of both worlds,” allowing each organization to maintain its legacy and independence, while promoting clinical integration and care coordination.  It does not involve a merger of assets or changes in ownership or control.

The structure is designed to sustain and honor the members’ local missions and governance authorities, while participating in a larger effort to lead needed changes in the health care system.  The alliance also is designed to encourage additional health care providers in Iowa and contiguous states to join and participate in these important initiatives.  Examples of specific UIHA efforts will include:

  • Strengthening primary care to ensure Iowans have access to a “medical home,” through which they can receive preventive services and improved coordination of care across settings and levels of clinical services and specialties.
  • Assisting members in developing performance metrics and comparative reporting to support improvement efforts, i.e. using comparative data to identify and share best practices and reduce the variations in care, which will improve quality and lower costs.
  • Developing programs to determine and address the health status of communities served.
  • Developing educational programs for health care providers, patients and consumers.
  • Developing techniques and systems for improving patients’ engagement in managing their health.
  • Sharing the high costs of the information systems and experts needed to analyze clinical data and convert it into information that can be used by physicians and others to improve care and better manage populations of patients with chronic diseases.
  • Sharing expertise and operational costs associated with development of “accountable care” initiatives, enabling the members to evaluate and participate in new payment programs offered by governmental and commercial insurance programs.
  • Collaborating in research initiatives.

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

Iowa News

Iowa hospitals use 340B savings to expand drug coverage
Two safety net hospitals in Iowa have found a way to help low-income, uninsured adults obtain access to prescription drugs and medical care. With savings from the 340B program, Broadlawns Medical Center, an acute care public hospital in Des Moines, and University of Iowa Hospitals and Clinics, a 729-bed tertiary hospital in Iowa City, are offering an outpatient prescription drug benefit as a supplement to the state’s public health insurance program, IowaCare. (Safety Net Hospitals for Pharmaceutical Access)

Hospitals hand out infant CPR kits to parents
Hundreds of new parents in central Iowa are receiving special infant CPR training kits thanks to a grant provided to the American Heart Association. The effort is made possible through a $15,000 donation from the local Alma Pedretti Charitable Foundation. In all, 546 CPR Anytime kits will be dispersed through August at six hospitals. The kits contain a DVD, inflatable manikin, towelettes, quick set-up guide and a replacement lung. The manikin helps parents practice how deep compressions should be if they were faced with an actual emergency. (Des Moines Register)

Employee reflects on 40 years at UIHC
At 16 years old, Nancy O’Brien knew she wanted to work in the hospital but did not feel cut out to be a doctor or a nurse. She knew at a young age that she was more interested in behind-the-scenes work. Although she does not have much patient interaction as a medical professional, O’Brien’s job in health information management is still challenging in that she must make sure the hospital is operating efficiently. “I look forward to the challenge every day,” she said. “Because whatever it is, we have to be knowledgeable, and the job that I do is take every diagnosis and procedure when [patients] are admitted until they’re discharged.” (University of Iowa Daily Iowan)

National News

Health deals going strong
Despite uncertainty tied to the Supreme Court’s coming health-care decision, the industry is moving forward. Recent deals reflect strategies linked to the federal health overhaul, the sweeping 2010 law that could be struck down by the Supreme Court, in whole or in part, in a ruling expected on Thursday. The continued momentum underscores the belief among leaders of hospitals and health plans, as well as investors, that certain underlying economic and policy directions are unlikely to change, regardless of the ruling. Among the trends: consolidation, new payment methods, digitization and greater focus on individual consumers. (Wall Street Journal)

Harkin talks about Democrats’ health care contingency plan
A top Senate Democrat says his party has been doing some contingency planning in case the Supreme Court spikes some or all of the health reform law on Thursday—even though they’ve insisted that the law will be upheld. “We have different proposed drafts for different contingencies,” Senate HELP Committee Chairman Tom Harkin told reporters when asked about a response to the court ruling. Harking suggested it would be wise for his colleagues to react quickly, with the goal of “getting in the mix right away so that the American people know we have something that if [the justices] remove it, we could take care of whatever the Supreme Court did.” (Politico)

Seeking ROI via population health management
When it comes to population health management, prevention may be the financial cure for skyrocketing healthcare costs. PHM is more than an all-encompassing term for prevention, wellness, and chronic care; it’s at the core of healthcare reform and it offers hospitals and health systems a pathway to long-term patient care cost reductions. However, aside from a willing participatory patient population, a successful PHM program needs three elements: collaboration, communication, and data. (HealthLeaders Media)

Doctor shortage raises rural C-section rate
The lack of doctors in outstate Minnesota is affecting how rural women have babies. Because there are so few physicians in some rural counties, women there are more likely than urban women to give birth via Cesarean section, data compiled by a work group advising the Minnesota Department of Health show. The information, included in a report from the state Office of Rural Health and Primary Care, was presented by a panel Monday that was part of a two-day Minnesota Rural Health Conference. Health providers can’t count on being able to mobilize a team of doctors and nurses quickly enough for a more spontaneous natural birth, according to the work group. (Minnesota Public Radio)

Texas teen fights for benefits as Medicaid contractor says no
Melody and Steve Lancaster’s 16- year-old foster son, who’s paralyzed from the neck down, needed a mechanized ceiling lift to help him get into the bathtub or his favorite beanbag chair. While Texas Medicaid officials had already paid as much as $13,000 for similar devices for others, the company that the state hired to look after the teenager’s health needs refused. Superior Health, a unit of Centene Corp. that covers about 800,000 Texas Medicaid recipients, also rejected at least two other requests for lifts, state records show. The Lancasters’ foster son and another patient appealed, and won. The third case is pending. (Bloomberg Businessweek)

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

Iowa News

County mental health changes
Local counties are looking at a new approach when it comes to mental health care in the state. Monday morning, Hancock County was one of several area counties signing a 28-E agreement. It will mean that Cerro Gordo, Hancock, Floyd, Kossuth and others will all combine the mental health funding they get from your tax dollars. Then they’ll combine the money, and resources, creating a more unified system for patients. (KIMT)

New mental health facility in Carroll to open by July 1
Patrick Smits, with Plains Area Mental Health Center discussed a few minor details with the Carroll County Board of Supervisors Monday as the board approved the contract with Plains Area to become the county’s new mental health provider.  Smits concerns centered on who would cover costs to repair the heating and cooling system for the entire building since his company would only be using one suite.  Smits also informed the board that rates would be the same for Carroll County as all other counties Plains Area serves. (KCIM)

Blue Zones reps visit Spencer
In order for Spencer to be a Blue Zones demonstration site, local leaders must have a plan — or Blueprint — for how to make the community a healthier and happier place to live. Blue Zones representatives were on hand Saturday afternoon to begin the Blueprint phase. “Instead of going in and pretending we know all, the idea is to learn first and to listen before we make suggestions,” Blue Zones founder Dan Buettner said. (Spencer Reporter)

They know how to handle falls at Lakes hospital
With all the falling-down people in the emergency room at Lakes Regional Healthcare in Spirit Lake, Iowa, it’s a sign that summer has come to the Iowa Great Lakes. “In the summer, we have a whole different world than it is in the winter time because we see a lot of people visiting,” said Dr. Darrel Forslund, the hospital’s medical director and one of the busy ER docs. “And when people come and visit, they …” “…Have fun,” said nurse Lois Hahn, director of outpatient services, when Forslund hesitated. “Have fun, yeah, falling down,” Forslund continued. “And what else? Crashing? Crashing and falling down.” (Sioux City Journal)

Mercy-Dubuque sends images electronically
Mercy Medical Center – Dubuque is now able to send x-ray images electronically to University of Iowa Hospitals and Clinics (UIHC) for emergency patient transfers. A link is in place between Mercy and UIHC to transmit files containing radiologic DICOM data through a virtual private network.  The images take only minutes to send, and an emergency department physician or trauma surgeon at UIHC review the images before the patient is even in the helicopter. (Mercy Medical Center-Dubuque)

National News

Hospitals focus on worker wellness savings, population health
Hospitals increasingly are formalizing population health management programs with most health leaders planning to launch such programs in the next two to five years, according to a white paper from business solutions provider Aegis Health Group. Hospital leaders are making the health of the community a priority in the organizational strategy, promoting well care rather than sick care, Aegis Health Group noted. Because they are the logical central coordination point, hospitals are in the position to manage population health and therefore control costs. (Fierce Healthcare)

Better medical homes come at a higher cost
Running a better patient-centered medical home (PCMH) healthcare center may be more costly, researchers found. Centers with a quality score that was 10 points higher than a mean score had a $2.26 higher operating cost per patient per month, Robert Nocon, MHS, of the University of Chicago, and colleagues reported online in the Journal of the American Medical Association. That translates to an annual cost of $508,207 for the average PCMH, though that cost “is relatively small compared with the potential cost savings from averted hospitalization and emergency department use observed in some preliminary studies,” they wrote. (MedPage Today)

Why don’t more hospitals use electronic health records?
When Kaiser Permanente has to deal with other health care groups, it confronts the same problems as the rest of the profession. For instance, it has a large clinic in Denver that works closely with two non-Kaiser hospitals. A few years ago, those hospitals decided to buy an EHR system. “We thought they should choose Epic. They said, ‘We don’t think we should.’ ” says Jack Cochran, a plastic surgeon who is executive director of the Permanente Federation, which oversees Kaiser’s physicians. Sure enough, when the hospitals installed their software, Kaiser couldn’t communicate with them electronically. Thankfully, the hospitals had fax machines. (Bloomberg Businessweek)

University of Washington program tries to give rural medicine a boost
The Washington, Wyoming, Alaska, Montana and Idaho (WWAMI) regional medical education program through the University of Washington School of Medicine was formed 40 years ago, in part to address disparity in rural health care. WWAMI receives funding from each of its participating states to provide reduced tuition rates. In 2009, the Idaho State Board of Education made it a goal to double the number of seats funded for Idaho residents in WWAMI. That commitment was made just before the national economy went into a recession. (Idaho Statesman/Moscow-Pullman Daily News)

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