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

Iowa News

Iowa Senate committee passes Medicaid expansion
Calling it “the moral thing to do,” Senate Democrats pushed a Medicaid expansion bill out of committee on a strict party-line vote Wednesday. The move came the same day the Iowa Hospital Association released a poll that showed a majority of Iowans favor expansion — 56 percent to 32 percent — of the program as called for in the Patient Protection and Affordable Care Act. (Sioux City Journal)

Mercy group to advocate for Medicaid expansion
A delegation of about 60 staff members and volunteers from Mercy Medical Center-North Iowa will travel to Des Moines today to advocate for the expansion of the Medicaid program, Mercy officials reported. They are part of an estimated 500 hospital and health-care advocates from around the state participating in the Iowa Hospital Association Legislative Day. (Mason City Globe Gazette)

When stopping crime begins with mental health
More than 30 percent of the inmates in Iowa’s prisons have some form of serious mental illness. Many thousands more are on probation or parole. Last month, State Department of Corrections Medical Director Dr. Harbans Deol called corrections “the largest mental health institute in Iowa.” But only a fraction of those offenders are what we would consider true lawbreakers. Most are Iowans who have fallen through the cracks. “Most times, what we’re seeing is that people with mental health issues don’t wish to be criminals, they just do things that make them criminals,” said Gary Hinzman, director of the 6th Judicial District Department of Correctional Services. (Cedar Rapids Gazette)

Sioux City hospitals add $233.2 million to local economy
Two local hospitals generate 2,589 jobs that add nearly $233.2 million to Siouxland’s economy each year, according to a study released Wednesday by the Iowa Hospital Association. The study examined the jobs, income, retail sales and sales tax produced by hospitals and the rest of the state’s health care sector. “In most Iowa counties, hospitals are among the three or four largest employers, but it’s more than just providing jobs,” said IHA President and CEO Kirk Norris. (Sioux City Journal)

New liver center will improve care
A new partnership between the University of Iowa Organ Transplant Center, Mercy Medical Center-Des Moines and the Iowa Digestive Disease Center is helping improve care for the growing number of patients diagnosed with complex liver disease. Patient convenience is the main factor in implementing The Iowa Liver Center. Previously, some patients in central and western Iowa have left the state seeking liver care or for transplants, said Dr. David E. Elliott, professor and director of the division of gastroenterology and hepatology at the University of Iowa’s Carver College of Medicine. (Des Moines Register)

Iowa breaks into top 10 states for well-being
Iowa now ranks as the ninth-healthiest state in the nation, according to the 2012 Gallup-Healthways Well-Being Index released this morning. The state moved up seven places from No. 16 in the 2011 rankings. The national index, based on daily telephone interviews conducted by Gallup with more than 350,000 Americans in 2012, is being used by Iowa to gauge its progress in its Healthiest State Initiative. (Des Moines Business Record)

National News

Chris Christie takes Obamacare Medicaid expansion
New Jersey Gov. Chris Christie threw his support behind Medicaid expansion under the president’s health care law Tuesday, becoming the eighth GOP governor to buck his party and align himself with President Barack Obama on the issue. “Accepting these federal resources will provide health insurance to tens of thousands of low-income New Jerseyans, help keep our hospitals financially healthy and actually save money for New Jersey taxpayers,” he said, estimating it would save state residents $227 million in the next fiscal year. (Politico)

Groups says expanded Medicaid will add W.Va. jobs
Expanding Medicaid will do more than provide coverage to 100,000 West Virginians, supporters of the federal health care overhaul argued Tuesday: It would also create 6,200 jobs while spreading $664 million through the state’s economy by 2016. The advocacy group Families USA hired Regional Economic Model Inc. to develop the estimates, and presented the findings with West Virginians for Affordable Health Care at a state Capitol press conference. The jobs number reflects those directly employed by hospitals, doctors’ offices and other health care settings, but also assumes that the increased spending would spur jobs in the other sectors of the state’s economy. (Bloomberg Businessweek)

Indiana Senate approves Medicaid expansion
The Indiana Senate voted Tuesday to expand Medicaid using a state-run program, as lawmakers and Gov. Mike Pence continue negotiating how the state should cover an estimated 400,000 low-income residents.  (Clarksville News and Tribune)

Majority of Tennesseans favor Medicaid expansion
A majority of Tennesseans believe Gov. Bill Haslam should agree to expand the state’s Medicaid program, according to a new poll funded by the Tennessee Hospital Association. The Patient Protection and Affordable Care Act provides federal funding for states that expand their Medicaid programs. According to the poll of 600 registered voters, 59 percent believe Tennessee should accept the federal funding, compared to 35 percent who do not. The THA says the additional funding would help offset $5.6 billion in Medicare cuts facing Tennessee hospitals. (Nashville Business Journal)

Partnership for Patients initiative cites major safety gains
Hospitals participating in HHS’ Partnership for Patients campaign have made significant progress in reducing patient harm, but much work still remains to be done, according to the leaders of the $1 billion patient-safety initiative. Hospitals have seen sizable drops in early elective deliveries, a practice that can increase complication rates for mothers and babies. They have also made progress on reducing 30-day readmission rates, CMS officials said during a webcast held by Irving, Texas-based VHA, a quality improvement and group purchasing organization. (Modern Healthcare)

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A new poll shows a majority of Iowans support expanding the state’s Medicaid program so that it would cover more low-income residents.

pollchartAccording to the poll, which was conducted by Essman/Research in Des Moines and funded by the American Hospital Association, 56 percent of Iowans support expansion while 32 percent said they are against it.  Specifically, those polled were informed that an estimated 125,000-150,000 low-income adults would be covered under Medicaid expansion in Iowa.  They were then asked, “Would you support the expansion of the Medicaid program in Iowa?”

In response to that question, a majority of adults in every Iowa congressional district supported expansion by a margin of at least 18 points.  And while urban-dwelling Iowans are much more likely to support expansion (64 percent), a majority of rural Iowans (54 percent) also backs the idea.

Beginning in 2014, the Affordable Care Act (ACA) makes federal funding available to provide adults earning up to 133 percent of the federal poverty level ($14,856 for an individual; $30,657 for a family of four in 2012) with health coverage through Medicaid.  Right now, the only non-disabled Iowa adults eligible for Medicaid coverage are parents at or below 82 percent of the federal poverty level.

The new poll shows Iowa Republicans are split over the question, with 43 percent in support and 45 percent against.  However, when asked if Iowa should expand Medicaid to prevent losing the state’s share of federal funds to other states, far more Republicans support expansion (47 percent) than oppose it (37 percent).  Whether to provide insurance to more needy Iowans or to ensure Iowa gets its share of funding, better than eight out of 10 Democrats support expansion.

“Most Iowans clearly want to expand insurance coverage through the Medicaid program,” said Kirk Norris, president and CEO of the Iowa Hospital Association.  “What’s also clear is that the more Iowans know about the ramifications of either supporting or rejecting this opportunity, the more likely they are to get behind it.”

One benefit of expansion is that more Iowans will receive coverage for mental health care.  According to the survey, more than three out of four Iowans, including 74 percent of Republicans, believe better access to mental health benefits is needed in the state.

“There is broad recognition both in our communities and at the Statehouse that we must improve access to mental health care,” Norris said.  “We all know what’s at risk when that access falls short.  Expanding Medicaid is our best opportunity to give more Iowans the coverage we all agree they need.”

Medicaid expansion would also provide more Iowans with access to preventive health care, such as yearly physicals, immunizations and diagnostic testing.  According to the survey, nine out of 10 residents believe that every Iowan should have access to these benefits.

“Iowans know the importance of routine care and having a primary health care provider,” Norris said.  “When you are uninsured, you don’t have those benefits and depend on the emergency room for your health care.

“As a state, we have no hope of becoming the healthiest place in the nation when so many Iowans have no insurance.  Expanding Medicaid is the opportunity Iowa must accept if we are to reach that goal.”

To gather data for the poll, Essman/Research conducted 502 random telephone surveys in early February with Iowans age 19-64 years old in all 99 counties.  Essman/Research developed the questionnaire and the random sample, collected the survey data, coded the open-ended verbatim responses, analyzed the data and prepared the survey report.  On the total sample of 502 random telephone surveys, at the 95 percent confidence level, the maximum margin of error is +/- 4.4 percent.

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

Iowa News

It’s time for lawmakers to act on Medicaid
Gov. Terry Branstad has a lot in common with Florida Gov. Rick Scott. Both are Republicans. Both have worked in the health field. Both have been staunch opponents of the federal health reform law. Both repeatedly vowed not to implement a provision in the law to expand the eligibility for Medicaid and provide health insurance to more low-income people in their states. The difference between the two governors: Scott found his moral compass; Branstad has not. (Des Moines Register)

Branstad promises changes to IowaCare program to improve health-care delivery
IowaCare will be Iowa’s vehicle for expanding access to health care, Gov. Terry Branstad said Tuesday. IowaCare also draws state and federal dollars to provide coverage to poor Iowans, but currently does so on a more limited basis. It’s due to expire this year, however, and Branstad is using the process of renewing and extending the program to make changes he says will improve Iowans’ health in a more affordable manner than the Medicaid expansion. (Des Moines Register)

National News

Don’t blame hospitals for all diagnostic errors
The patient safety movement has long focused on errors in acute and long-term care settings. But now investigators are pointing their research tools at the diagnostic skills of primary care physicians because too often, they’re getting it wrong, causing avoidable and significant patient harm as a result. By backtracking patients whose deterioration necessitated that they be admitted to a hospital or another care setting, researchers could see how clinicians in their office practices forgot or missed certain critical steps that could have averted emergencies that ensued days after patients left the doctors’ offices. (HealthLeaders News)

3 Hill panels examining changes to Medicare
There are small signs that Democrats and Republicans are beginning to wrestle with the issue of what role Medicare should play in deficit reduction. Three Capitol Hill committees with jurisdiction over health care have scheduled hearings this week to examine Medicare’s current benefit design and to review provisions in the 2010 health care law aimed at making the program more efficient. (Kaiser Health News)

For docs, hospitals, ‘sorry’ is a hard word to say
When a physician or hospital screws up, sometimes all a patient wants is an apology. But they often don’t get one, because the apology could be construed as an admission of negligence—and could become fodder for a future malpractice lawsuit. The state Legislature has once again taken up bills that would make inadmissible in medical malpractice lawsuits any admissions of liability that doctors and other health care providers make to patients while apologizing or extending “benevolent” gestures of compassion. (Pittsburgh Post-Gazette)

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

Iowa News

Hospital volunteers to head to Capitol for Iowa Hospital Association Legislative Day
Dozens of local hospital volunteers and staff members will head to Des Moines Wednesday for the Iowa Hospital Association Legislative Day. Methodist Jennie Edmundson expects to bus 53 to 55 people to the Iowa State Capitol for the event, and Alegent Creighton Health Mercy Hospital is saving seats for about 40, hospital officials said. The contingent will meet with area legislators and ask them to approve an expansion of the state’s Medicaid program. (Council Bluffs Nonpareil)

Branstad must fight for, not against, the uninsured
Rather than sending out a fundraising letter that slams the Des Moines Register’s Editorial Board for daring to urge state leaders to expand Iowa’s Medicaid program, Gov. Terry Branstad would be better off spending some time with the uninsured Iowans who will be most impacted by this decision. Barbara Vinograde of the Iowa City Free Medical Clinic has been hearing from uninsured Iowans nearly every day that the clinic has been open for the past 20 years. “I would ask (the governor) to come to our waiting room, talk with the patients and hear their stories,” said Vinograde. (Iowa City Press-Citizen)

Medicaid expansion is the healthiest choice
In response to comments about an expansion of Medicaid in Iowa, Gov. Terry Branstad has offered this: “Governor Branstad and Lt. Governor Reynolds believe Iowans deserve health care reform that improves care, lowers costs, and most importantly, makes people healthier. However, the governor and lieutenant governor are concerned that Medicaid expansion proposals will not give Iowans the proper or efficient health care services they need to improve their health.” Branstad should seriously reconsider his position, because an expansion of Medicaid would improve care, lower costs and, most importantly, make people healthier. It also makes good sense for Iowa’s economy. (Ames Tribune)

Branstad’s Medicaid declaration disappoints Democrat
Gov. Terry Branstad has told a top federal health official he will not support an expansion of Medicaid, reiterating his opposition to a cornerstone of President Barack Obama’s health care reform effort. Branstad, a Republican, met with U.S. Health and Human Services Secretary Kathleen Sebelius in Washington, D.C., to discuss potential compromises on adding Iowans to Medicaid, the joint state-federal program providing health care to people with low incomes. But in an interview Saturday with the Associated Press, the governor said he again rejected an expansion, and pressed Sebelius instead for a federal waiver to continue IowaCare. (Des Moines Register)

Iowa receives $1.3 million for Medicaid ACO
Iowa’s Medicaid program has received a $1.3 million federal grant to create an accountable care organization (ACO) designed to increase quality and lower costs, the Iowa Department of Human Services announced Thursday. The six-month grant from the Centers for Medicare & Medicaid Services will enable Medicaid to coordinate with other major Iowa health insurers, especially Wellmark Blue Cross and Blue Shield, in developing the plan. (Des Moines Business Record)

Reaching out to the community is one DMU goal
Des Moines University educators spend the majority of their time preparing health care professionals to go into the world to enhance and save lives. To its administrators, there’s nothing insular about that mission: extending services to the community is a key way the university prepares its students and gives back to local residents as well. Angela Walker Franklin, DMU’s president, said one of the university’s ongoing goals is continuing and strengthening its outreach to the community. (Des Moines Register)

UIHC works to curb side effects of prescription abuse
With the national prescription drug abuse trend rising to what some call “epidemic” levels — new data shows such drugs accounted for 60 percent of overdose deaths in 2010 — experts are encouraging doctors and pharmacists to take even more precautions to prevent patients from abusing medications and their own employees from diverting them for their own use. UIHC officials, meanwhile, say they’re confident in their system, citing what they say is a low rate of lost and stolen medication — 14 cases in the past five years. (Iowa City Press-Citizen)

National News

Medicaid Expansion to boost access to mental health services
State funding and investment for mental health services have significantly decreased in recent years, even as demand for these services has increased. But there may be a glimmer of hope for advocates of expanded access to mental health coverage. In participating states, the upcoming Medicaid expansion under the Affordable Care Act will increase both the number of eligible enrollees and the list of treatments and services covered, including mental health coverage. (PBS News Hour)

Health care braces for sequester
Every corner of the health care world has something—and potentially a lot to lose from the $85 billion in automatic spending cuts set to hit the government on March 1. Doctors and hospitals say the sequester’s Medicare cuts will cost their industries more than 200,000 jobs just this year. With the cuts looking increasingly inevitable, health care industries that have spent the past year lobbying Congress to cancel the sequester are now turning their attention toward absorbing its cuts. (The Hill)

Rochester MN ponders $6B Mayo expansion
There are company towns, and then there’s Rochester—where waiters make meal recommendations based on what sort of blood work you’re having drawn at Mayo Clinic the next morning. So when Mayo announced this month that it wants to spend billions of dollars to expand its facilities and remake this quietly prosperous city of 100,000 into a vibrant destination spot for Mayo’s global clientele, that hit the top of Rochester’s agenda, too. Mayo employs more than 34,000 people—one-third of the city’s population. If you try to play the Mayo version of six degrees of separation with anyone in Rochester, it’s going to be a pretty short game. (Minneapolis Star Tribune)

HHS awards $300M for innovation
The government will award nearly $300 million to 25 states to improve healthcare delivery. Called State Innovation Model awards, the funding is made available under the Affordable Care Act. The awards are intended to provide flexibility and support to states to help them deliver high-quality healthcare, lower costs and improve their health system performance, HHS Secretary Kathleen Sebelius said in a news release. (Healthcare IT News)

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

Iowa News

Iowa Senate panel advances Medicaid expansion bill
An Iowa Senate subcommittee today agreed to advance plans for a bill that would add thousands of Iowans to the state’s Medicaid rolls under President Barack Obama’s health care reform initiative. The move was supported by health care providers and advocates for low-income people, but it puts the Democratic-controlled Senate at odds with Republican Gov. Terry Branstad and the GOP-led Iowa House, both of which have declined to endorse Medicaid expansion efforts. However, Branstad left today for Washington, D. C., where he is scheduled to meet Friday with Health and Human Services Secretary Kathleen Sebelius, about Iowa’s health care programs. (Des Moines Register)

Medicaid needs expanding
What would you say if I told you that we have the opportunity to give health insurance to 150,000 uninsured Iowans this year? Would you be interested? Maybe, but you probably would want to know how much it would cost. Well, to be honest, it wouldn’t cost state government a cent for three years, and after that, the federal government would pay up to 90 percent of the cost from year to year. Seem like a good deal to you? You’re not the only one. (University of Iowa Daily Iowan)

Branstad: Register editorial board’s ‘vicious smears’ on Medicaid won’t work
Gov. Terry Branstad is using the Des Moines Register’s editorial board’s call for Medicaid expansion in Iowa as a reason to raise campaign money. In a letter emailed to supporters today, Branstad’s campaign notes that the Register has repeatedly called on him to expand the Medicaid insurance program next year to cover tens of thousands more poor adults. The letter states: “They have written 14 editorials on Medicaid expansion – just since January 22! Quite an obsession. It’s time to fight back. Will you donate $14 to battle their vicious smears? That’s just one dollar for every editorial they’ve written attacking this governor.” (Des Moines Register)

Mercy’s Dave Vellinga steps up, not down
Dave Vellinga will step down from his role as the Des Moines’ hospital’s president after his successor is named in the coming weeks. Vellinga last year also became the chairman of the board of the newly formed University of Iowa Health Alliance, a collaboration of Mercy Health Network, Mercy Health Care in Cedar Rapids, Genesis Health System based in Davenport and University of Iowa Health Care. The alliance’s key goal is to help Iowa’s hospital systems collaborate so they can improve and standardize health-care quality, lower costs, and increase patient satisfaction, Vellinga said. (Des Moines Business Record)

Johnson County officials skeptical of mental health regionalization plans
Johnson County officials were apprehensive on Thursday about the state’s plans to regionalize Iowa mental-health services into multi-county hubs that will provide core care. The Johnson County Board of Supervisors voted 3-1 on Thursday in favor of the Resolution of Intent to Regionalize Mental-Health and Disability Services. This resolution stated the intent for Johnson County to team up with eight other counties — Benton, Bremer, Buchanan, Delaware, Dubuque, Iowa, Jones, and Linn — to serve as a hub for mental-health and disability services. (University of Iowa Daily Iowan)

National News

HHS Secretary Sebelius says states are finding Medicaid expansion too good to pass up
A day after Florida’s Republican governor endorsed a key part of the federal health care overhaul, the Obama administration says it’s encouraged by the progress. Health and Human Services Secretary Kathleen Sebelius says that states are deciding the Medicaid expansion is, quote, “simply too good to pass up.” Nationally, 21 states plus Washington, D.C., plan to expand Medicaid. Fourteen are declining. And 15 are still mulling options. (Associated Press/Washington Post)

Most states on track with health law’s technical demands
Thirty-five states will be ready with new health care eligibility and enrollment systems by Jan. 1 of next year, according to a new federal report. The Health and Human Services (HHS) Inspector General surveyed states in March and April 2012 about their readiness to comply with a variety of technical requirements under President Obama’s healthcare law. These requirement include simple, streamlined application systems for Medicaid, CHIP and the healthcare law’s new insurance exchanges. (The Hill)

An interview with Marilyn Tavenner, Obama’s pick to head Medicare
For over a year now, Marilyn Tavenner has run the federal government’s largest agency: the Centers for Medicare and Medicaid Services. With a budget of nearly $1 trillion, Tavenner oversees everything from the implementation of the Affordable Care Act to programs that already administer health benefits to more than 80 million Americans. The White House nominated Tavenner for the post in November 2011, but with the fight over the Affordable Care Act still winding its way up to the Supreme Court, she never received a confirmation hearing. (Washington Post)

Activist ignites a movement for patients through art and story
Regina Holliday bounds across the stage at the old Sam’s Town casino, jumps onto a grey cinder block and flings her arms open wide in welcome. Holliday, an artist and patient advocate from Washington, balances there for just a moment, beaming before the small cadre of advocates, doctors and tech gurus who are as determined as she is to make patients equal participants in every area of health care. They are here, on the banks of the Missouri River early on a Saturday morning, for a conference she has organized in just weeks. They burst into applause. (Kaiser Health News)

Robot docs will even make health insurance less painful
IBM’s Watson—the same machine that beat Ken Jennings at Jeopardy—is now churning through case histories at Memorial Sloan-Kettering, learning to make diagnoses and treatment recommendations. This is one in a series of developments suggesting that technology may be about to disrupt health care in the same way it has disrupted so many other industries. Are doctors necessary? Just how far might the automation of medicine go? (The Atlantic)

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