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

Iowa News

Celebrating Blue Zones in Spencer
For seven months, the Power 9 and Leadership teams involved in the Spencer Blue Zones project have been working hard to raise awareness and to brainstorm what Spencer would look like as a Blue Zones Certified community. Those seven months culminated into one event Thursday night, when the teams joined members of the community to celebrate Spencer becoming an official Blue Zones demonstration site in Iowa. “This is such a special night for Spencer,” Emcee Kevin Tlam said. (Spencer Daily Reporter)

Siouxlanders seeking care for cold, flu symptoms
‘Tis the season. One local physician said he’s seen quite a few patients with gastroenteritis — commonly called “stomach flu” — and that others with influenza are starting to show up. “Sometimes, the flu season is later on – in January or February – but we’re starting to see it in the area now,” said Joe Liewer, an emergency physician at Mercy Medical Center in Sioux City. (Sioux City Journal)

National News

A huge pay cut for doctors is hiding in the fiscal cliff
Included in the fiscal cliff is a 30 percent pay cut to doctors who treat Medicare patients. It’s set to kick in on Jan. 1. Lawmakers from both parties say they want to prevent the cut. But the cut is part of a plan Congress put in place 15 years ago to contain health care costs, then proceeded to postpone again and again. After he sees the patient, Dr. Murrow writes what he did on a form and then sends it to his billing guy, who turns the form into codes. The codes are what the doctor needs to get paid by Medicare. (National Public Radio)

Obama victory re-energizes HIE’s
In the wake of President Obama’s reelection and a favorable Supreme Court ruling, a growing sense of certainty about health care reform is helping to drive the health information exchange (HIE) market, according to a new report from Frost & Sullivan. In addition, the report notes, the stage 2 Meaningful Use requirements and market changes are increasing demand for HIEs. (InformationWeek)

The hidden costs of raising the Medicare age
It’s hardly surprising that the idea keeps finding its way into the conversation. That same increase is already being phased in for Social Security. Even President Obama reportedly had the idea on the table during his informal negotiations with House Speaker John Boehner during the summer of 2011. And why not? “It’s clear that it would reduce federal spending and it can do so in a very immediate sense, depending on how it’s phased in,” says Tricia Neuman, senior vice president of the nonpartisan Kaiser Family Foundation and director of its Medicare Policy Project. “However, while federal spending will go down, costs to others will go up. In fact, total spending will rise.” (Iowa Public Radio)

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

Iowa News

Health clinic, community health centers urge Medicaid expansion
Peoples Community Health Clinic and the Iowa Primary Care Association are urging Gov. Terry Branstad and state lawmakers to accept the federal government’s funding to expand the Medicaid program to help more low-income Iowans. “We see tremendous need for greater health care coverage in the Cedar Valley, and expanding Medicaid would ease the burden for many Iowans,” said Jennifer Lightbody, executive director of Peoples Community Health Clinic. (Waterloo-Cedar Falls Courier)

Hundreds show up for Cedar Falls Blue Zones kick off
Hundreds showed up at the Cedar Falls High School auditorium to hear from the men behind the initiative to help people live longer and healthier. Dan Buettner and Dan Burden have studied parts of the world with the most 100-year-olds. Now they are teaching these cultural attributes, like eating in moderation and moving more, to chosen communities. “There’s so many things that we can learn from all these other cultures. Just kind of flip-flopping the way we think of things, you know, we can come out so much better than we are,” said Mary Smith of Cedar Falls. (KWWL)

Medicare scam targets senior citizens
The Better Business Bureau serving southwest Iowa, Nebraska, South Dakota and the Kansas plains is warning senior citizens on Medicare to be aware of phone calls wanting to update their medical information or to send them a new card. “We need consumers to know that these are not legitimate phone calls. Scammers are looking for personal information under the ruse of information verification,” said BBB President Jim Hegarty. (Omaha World-Herald)

National News

Expanding state Medicaid plan would add jobs, study says
A study released Wednesday by the Missouri Hospital Association projects that more than 24,000 jobs could be created in 2014 if Missouri expands its Medicaid plan. The report, done by the University of Missouri and a Virginia company, said that expanding Medicaid could substantially cut unemployment in the state and could add $9.6 billion to the state’s economy in 2014. (Springfield News-Leader)

Obama takes ‘fiscal cliff’ battle to social media
Seeking to leverage the momentum of his reelection victory for a partisan budget battle, President Obama called on Americans to use social media to pressure Congress in his efforts to keep tax breaks for most Americans while raising taxes on the wealthiest 2%. The president’s attempt to rally public support Wednesday via Twitter, Facebook and email marks a new strategy for the Obama White House — a dramatic shift from the grinding legislative battles and political maneuvers used to pass healthcare reform in 2010. (Los Angeles Times)

The best medicine for fixing the modern hospital
To anyone not yet jaded by the American health care system, the idea that a hospital would provide a bathroom too tiny for an old person with a walker seems insane. But for decades, American hospital architecture was based on crude, now-outdated notions of efficiency and economy. Hospitals were designed for the wants and needs of doctors and hospital administrators. Patients weren’t ignored – but they weren’t top priority, either. Now, health care reform is fundamentally changing the way hospitals are run, and with it the way they look. (Healthcare Finance News)

Self-insured health plans on the rise for private-sector employers
Private-sector employers are increasingly choosing self-insured health plans to cover their employees, according to a new study. The nonpartisan Employee Benefit Research Institute  found that about 6 in 10 private-sector workers were covered by self-insured plans in 2011, up from about 4 in 10 in the late 1990s. Researchers predicted the trend may continue as employers look for ways to save money on their healthcare coverage. (The Hill)

Health care entitlements
Congressional Republicans are insisting that big cuts to Medicare and Medicaid be on the table in the negotiations over the so-called fiscal cliff and deficit reduction. That stance is largely a political move against two programs, which have been critical to the public welfare for the past half-century. Postelection polls show that large majorities of voters for both President Obama and Mitt Romney opposed making large Medicare cuts as a way to reduce the budget deficit. And, the fact is, the Obama administration has already pledged to extract more than $1 trillion in savings over the next decade from these programs. There is not much more that can be cut without hurting the most vulnerable Americans. (New York Times)

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

Iowa News

Vellinga will focus on network of hospitals
One of central Iowa’s two dominant hospital companies is looking for a new leader, saying that its chief executive officer will focus on other duties. Dave Vellinga has led Mercy Medical Center since December 1998. Before that, he ran Mercy Medical Center-North Iowa in Mason City. Vellinga also is CEO of Mercy Health Network, which includes Mercy and 10 other hospitals and is affiliated with 30 smaller hospitals and 142 clinics in Iowa, Illinois, Nebraska and South Dakota. Vellinga plans to work full time at that job, plus his position as chairman of the University of Iowa Health Alliance. (Des Moines Register)

Hundreds help Waterloo launch Blue Zones bid
The groundwork for a healthier, happier community has been laid. The phrases “Blue Zones” and “Power Nine” are already becoming popular refrains in the Cedar Valley. On Tuesday night, hundreds turned out to officially launch Waterloo’s bid to help Iowa become the healthiest state in the nation by 2016. More than 500 people attended the “Live Longer, Better” community rally at the Five Sullivan Brothers Convention Center in Waterloo. At least 200 additional people pledged their support to the Blue Zones movement. (Waterloo-Cedar Falls Courier)

Mail order prescriptions: Are they hurting local pharmacies?
Amber Bliss of Sergeant Bluff, Iowa gets a lot of things via mail, but not her prescriptions, anymore. She says, “I tried it, because that’s what they say you need to do, so I tried it. When I did do it, I just found it frustrating. Especially when it came to questions about her meds. She explains, “You know, when you call on the phone, it’s like ‘oh, thanks for calling, you have to push one to talk to somebody or 2.” You see, under her employer’s insurance coverage this was the only way she could receive her medication. It’s how many employers are choosing to take care of their own, including one of Sioux City’s largest: Mercy Medical Center. (KCAU)

Neurologist helps epileptics manage their disease
Dr. Wendy Waldman Zadeh is one of the few epileptologists in Iowa, helping patients with epilepsy find the right treatment for their condition. She has served patients at Broadlawns Medical Center for nearly six years. “I treat all neurology conditions, though I have built up a pretty large epilepsy population,” she says. “Almost half of my established patients have epilepsy. The demand is high for all neurological care as there is a general shortage of neurologists. Epilepsy management is no exception.” (Des Moines Register)

National News

Democrats harden budget positions
The White House and congressional Democrats hardened their budget positions on Tuesday and signaled they are prepared for partisan jockeying before any agreement to block impending spending cuts and tax increases can be reached with Republicans. Sen. Dick Durbin (D., Ill.), a rare liberal who has supported changes in Medicare and other entitlements as part of a broad budget deal, made clear he wouldn’t back them under a short-term agreement to avoid the fiscal cliff. (Wall Street Journal)

Salary growth lagging for primary care doctors
Despite rising spending on healthcare in the US, primary care doctors don’t seem to be reaping the rewards on their paychecks, a new study suggests. The findings could have implications for what some predictions say will be a primary care shortage in some parts of the country in the coming years. Researchers found that since the late 1980s, the average doctor’s earnings have grown more slowly than the salaries of other health professionals, such as pharmacists, dentists and registered nurses. (Reuters/Chicago Tribune)

How hospitals prevent VTE
“There has been a lot of movement, and hospitals are starting to see some results,” says Greg Maynard, MD, a nationally recognized champion in acute care VTE prevention and director of the Center for Innovation and Improvement Science for the University of California, San Diego, where he previously served as chief of hospital medicine. But in most hospitals across the country, this major problem persists. Maynard says that based on his success at UCSD, half of hospital-associated blood clots occurring today could be prevented with better patient risk assessment and tighter adherence to appropriate drug or mechanical prevention strategies. (HealthLeaders Media)

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

Iowa News

Report: Iowa would spend less on Medicaid if it agrees to expansion
Iowa is one of eight states that would spend less on Medicaid if it agreed to expand the health-insurance program, a national group says. Iowa Gov. Terry Branstad has voiced skepticism about expanding the program, saying he fears the state would wind up on the hook for millions of dollars in new costs. But the new report from the Kaiser Family Foundation estimates that if it expands Medicaid, Iowa would spend about $30 million less per year than it spends now. (Des Moines Register)

Sioux City medical group wants Iowa to expand Medicaid reach
A Sioux City-based health care provider has joined a host of health care groups to urge Gov. Terry Branstad and legislators to accept federal government funding to expand the Medicaid program to help more low-income Iowans. The Siouxland Community Health Center and others in the Iowa Primary Care Association said expanding Medicaid health care coverage to more people would save money, arguing fewer people without insurance would be treated in emergency rooms. (Sioux City Journal)

National News

Medicaid expansion poses ‘modest’ cost to states
President Barack Obama’s $1 trillion plan to expand Medicaid would raise state costs by only 3 percent and extend health coverage to more than 21 million low-income people as part of the new healthcare reform law, a study said on Monday. The report released by the nonpartisan Kaiser Family Foundation said states would spend an extra $76 billion over the next decade to implement the Medicaid expansion, or 2.9 percent more than they would without the reform law. The federal government would fork out more than $950 billion to cover nearly all of the costs, the study said. (Reuters/Chicago Tribune)

Hospitals face pressure to avert readmissions
The federal government is now using its financial muscle to discourage readmissions. Medicare last month began levying financial penalties against 2,217 hospitals it says have had too many readmissions. Of those hospitals, 307 will receive the maximum punishment, a 1% reduction in Medicare’s regular payments for every patient over the next year, federal records show. Medicare’s spending reached $556 billion this year. The readmission penalties will recoup about $300 million this year, but the goal is to pressure hospitals to pay attention to what happens to their patients after they walk out the door. (New York Times)

Is readmissions penalty off base?
If my hospital had made my readmission rate part of my performance evaluation, would I have sent Mr. Johnson home that weekend? Maybe not.  I could have easily strong-armed him into staying, and he would have listened.  He was what we call a “compliant” patient.  But if we had kept him in the hospital — he would have lost — lost the chance to watch the Pats game with his son.  His son and family would have lost – having the weekend with their dad and husband.  But, I would have “won”, coming across as a better doctor for having a lower readmission rate. (The Health Care Blog)

AMA delegates adopt physician employment principles
The principles, contained in an AMA Board of Trustees report the House of Delegates adopted, cover potential flash points in physician-employer relationships such as conflicts of interest, contracting, payment agreements, peer reviews, performance evaluations and medical staff-hospital relations. “The principles for physician employment provide a broad framework to help guide physicians and their employers as they collaborate to provide safe, high-quality and cost-effective patient care,” said AMA board member Joseph P. Annis, MD, an anesthesiologist from Austin, Texas. (American Medical News)

Learning to accept, and master, a $110,000 mechanical arm
Close hand, raise elbow, Cpl. Sebastian Gallegos says to himself. The mechanical arm rises, but the claw-like hand opens, dropping the sponge. Try again, the therapist instructs. Same result. Again. Tiny gears whir, and his brow wrinkles with the mental effort. The elbow rises, and this time the hand remains closed. He breathes. Success. “As a baby, you can hold onto a finger,” the corporal said. “I have to relearn.” (New York Times)

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With the sun setting, a nurse arrives at Lucas County Health Center in Chariton to start her shift.

Iowa’s hospitals and their 70,000 employees stand ready to care for their friends and neighbors 24 hours a day, seven days a week, 365 days a year.  Day and night, holidays and weekends, they ensure that patients have access to the care they need at the right time, in the right place.

But our hospitals’ ability to maintain the kind of access to services that their communities have come to expect is threatened.  In the wake of a critical national election, the debate over the national debt, the “fiscal cliff” and what to do about it has taken on particular urgency.

It’s sure to be the top issue as legislators return to Washington, D.C.  And as those discussions move forward, the possibility of cutting Medicare and Medicaid funding for hospital services as a means to reduce the deficit will be on the table.

A physician at Davis County Hospital in Bloomfield checks on a young patient.

These proposals come during an already challenging time for your community hospital and health care providers.  Among the most-pressing issues hospitals face:

  • The high cost of the latest technology, equipment, devices and pharmaceuticals.
  • The struggle to attract and train enough doctors, nurses and other caregivers to our state and in particular our rural areas.
  • Meeting the needs of the growing number of seniors and other patients with multiple chronic illnesses.
  • Underpayments from Medicare and Medicaid that shift the real costs of these programs to employers and other patients.
  • Providing care for the uninsured and patients with inadequate health coverage.  In 2011, Iowa hospitals provided nearly $600 million in charity care and dealt with more than $355 million in bad debt.
  • Complying with increasing regulatory and payer requirements that sap hospital resources and keep nurses and physicians away from the bedside.

Even as our hospitals grapple with these challenges, rest assured that they are working to keep health care affordable through innovations focused on improving the health of high-risk populations, such as people with diabetes or chronic heart conditions.  Hospitals are increasing the quality and efficacy of care and better managing transitions, case by case, as patients are served in different parts of the hospital, in physician offices or at home.

A patient is brought into the emergency room at St. Luke's Health System in Sioux City.

And we’re not alone in these endeavors.  For example, hospitals across Iowa have formed the Iowa Healthcare Collaborative with physicians and other providers to better coordinate care, to work together to improve health care overall and to be accountable to the communities they serve.  They are also carefully investing in technology such as electronic health records to improve care and efficiency.

Iowa’s hospital leaders understand the fiscal challenges our nation faces.  What additional cuts to Medicare and Medicaid funding for hospital services could mean to you:

  • Longer wait times for emergency room care.
  • Fewer doctors, nurses and other caregivers which squeezes access to care.
  • Less patient access to the latest and most effective treatments and technologies.
  • Fewer specialty services, particularly in rural areas, which compromises the delivery of community-based health care.
  • Increased charity care and bad debt.
  • Reduced financial capacity for continued hospital investments in community-based programs and services.

At the same time, these cuts threaten Iowa’s economy, where more than 136,000 jobs and nearly $6.2 billion are tied to hospitals.  Our hospitals depend on Medicare and Medicaid for more than half of all their revenue, meaning cuts to these programs would impact every hospital and every part of the state and reverberate throughout the Iowa economy.

Iowa hospitals are united on this front and ask that the people of Iowa join them.  The time is now for our elected officials to work together toward developing long-term fiscal solutions that will set Medicare and Medicaid on a path toward true sustainability for both their beneficiaries and the hospitals and providers who tirelessly serve their health care needs.

Our patients and communities deserve to know that the care they need will always be there.

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