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

Iowa News

Branstad signs off on $11.6 million mental health fund
Among the 14 bills Iowa Gov. Terry Branstad signed into law Thursday was an $11.6 million appropriation to counties in need of financial assistance for their mental health care budgets. Branstad signed off on the appropriation to the mental health transition fund despite the fact he called for just $3.8 million in his budget plan. (Dubuque Telegraph Herald)

CoOportunity Health approved to operate in Iowa
CoOportunity Health, a Des Moines-based nonprofit established to offer health insurance coverage to Iowans and Nebraskans, has received state approval to operate in Iowa, the organization announced today. CoOportunity, which was funded last year with a $112 million low-interest federal loan, was granted a certificate of authority by the Iowa Insurance Division. CoOportunity aims to provide additional competition in the Iowa and Nebraska health care markets through the new federal-state partnership insurance exchange set to begin operating this fall. (Des Moines Business Journal)

Iowa unemployment rate holds steady at 5 percent
Iowa’s seasonally adjusted unemployment rate held steady at 5 percent in February even as more workers entered the labor force. The February jobless rate compared with 5.4 percent for February 2012. Meanwhile, the national unemployment rate for February dropped to 7.7 percent from 7.9 percent in January, falling to its lowest level since December 2008. (Corridor Business Journal)

National News

Kasich rules out one GOP alternative to Medicaid expansion
As Gov. John Kasich and fellow Statehouse Republicans try to navigate a delicate situation related to expanding Ohio’s Medicaid program, Kasich has made it clear that he will not use state tax dollars to provide some access to insurance for the poor, as conservatives are urging. Kasich said, “People who are in poverty, people who are discriminated against, we have to stand up for them. Pretty interesting to hear a Republican governor talk this way for some of you, huh? But we’re all in it together.” (Columbus Dispatch)

Will GOP’s plan to fight Obamacare in the states backfire?
Republicans, however, haven’t quite given up the fight against . Their slogan, “repeal and replace,” has given way to “resist and annoy.” Unable to get rid of Obamacare, many have settled on a strategy of making it function as poorly as possible. At the national level, House Republicans have refused to appropriate funds for implementation. At the state level, most Republican governors have refused to set up insurance exchanges, and many have refused to expand Medicaid. The question, though, is whether governors who purposefully do a very bad job implementing Obamacare will hurt the law, or just themselves and their states.

Expanding Pennsylvania Medicaid would increase federal revenue to state
The increased federal spending on health care in Pennsylvania would provide a $3 billion boost in economic activity and sustain more than 35,000 jobs, according to the analysis. But the expansion of Medicaid would not be without cost. Expanding Medicaid would require an additional $53 million in state spending in 2014, with the cost rising to $611 million in 2020 as the federal government trims its support for the Medicaid expansion. (Medical Express)

Expanding Medicaid is the right thing to do for Michigan
It’s not rocket science: Expanding Medicaid in Michigan will save money, and it will save lives. What’s going on in Lansing, however, is political science. Funny thing about political science is that facts aren’t always welcome or relevant. And morality — well, that’s apparently relative. People suffering from lack of access to medical care isn’t an abstraction in our community, but an everyday reality. (Battle Creek Enquirer)

Talk of Medicare changes could open way to budget pact
As they explore possible fiscal deals, President Obama and Congressional Republicans have quietly raised the idea of broad systemic changes to Medicare that could produce significant savings and end the polarizing debate over Republican plans to privatize the insurance program for older Americans. While the two remain far apart on the central issue of new tax revenue, recent statements from both sides show possible common ground on curbing the costs of Medicare, suggesting some lingering chance, however small, for a budget bargain. (New York Times)

Hospital association: No more patient satisfaction surveys, please
Hospitals are exquisitely sensitive to their patients’ satisfaction levels. They are, after all, being graded on them. Low marks can be expensive, as a portion of hospitals’ Medicare reimbursement rides on them. So when the federal government suggested adding another tool for measuring the patient experience, the industry reacted the way students might if the teacher proposed a new test: a big no thanks. (Cincinnati Business Courier)

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

Iowa News

Officials promote Medicaid expansion
The only logical choice to replace an expiring health care system is to expand Medicaid, supporters say. While the Democrat-controlled Iowa Senate approved a Medicaid expansion on a straight party-line vote on Monday, it has yet to pass through the Republican-controlled Iowa House. Medicaid expansion is the right choice, supporters said, because it would provide health care services to those at or below 138 percent of the poverty level. (Ottumwa Courier)

Medicaid expansion debate heating up in Iowa
Medicaid expansion would mean providing health care to more than 100 thousand people at zero cost to the state for the first three years. The governor is pushing back with a plan that’s actually more expensive* for Iowa taxpayers while covering fewer people. But he insists it’s the responsible choice. Not everyone can afford health insurance. “Hospitals are being hit with more and more people who have no insurance. Medicaid would take care of them,” says Jim Wharton, vice president of Mercy Medical Center in Sioux City. (KMEG)

IPOST gives patients a voice in their care
A document that allows people with serious medical conditions to control their medical care has debuted in Webster County. The Iowa Physician Orders for Scope of Treatment is filled out by patients and informs doctors of the level of medical intervention they want in cases when they are unable to speak for themselves. The Rev. Phil Somsen, chaplain and coordinator of pastoral care at Trinity Regional Medical Center, who serves as the county’s lead IPOST facilitator, said IPOST is a result of laws that allow patients to refuse life-sustaining medical treatment if they wish. (Fort Dodge Messenger)

Half of adults text while driving
Forget teenagers. Adults are the biggest texting-while-driving problem in Iowa and the rest of the U.S. What’s worse — they know it’s wrong. Almost half of all adults admit to texting while driving in a survey by AT&T provided to USA Today, compared with 43 percent of teenagers. More than 98 percent of adults — almost all of them — admit they know it’s wrong but still do it. Six in 10 say they weren’t doing it three years ago. (Des Moines Register)

National News

How Fortune 500 companies plan to cut health costs
As General Electric’s director of health services, Robert Galvin was the guy responsible for managing the health insurance costs of about 150,000 employees. The job wasn’t easy ? and, about five years ago, Galvin stumbled on some data that helped explain his challenges. “I looked through all our contracts and the data, where we were spending $1.5 billion on health care,” Galvin, now CEO of Equity Healthcare, remembers. “One percent of those payments were based on value. The rest was just pure volume.” (Washington Post)

FAQ on Obamacare’s impact on insurance claim costs
It’s too early to know how much individual health insurance policies will cost once the online marketplaces created under the Affordable Care Act launch Jan. 1. But that hasn’t stopped experts and interest groups from making predictions. The latest analysis comes from the Society of Actuaries. It’s attracting attention because of the group’s expertise and nonpartisanship. What actuaries do for a living — predicting future expense based on multiple squishy factors — is at the core of figuring out what will happen under Obamacare. (Kaiser Health News)

Maryland officials outline huge changes to payment system for state hospitals
Maryland health officials on Wednesday outlined major changes to how hospital costs are paid in an effort to keep the state’s unique Medicare waiver agreement with the federal government — a deal that has provided enormous financial benefits to the state in recent decades. Joshua Sharfstein, the state’s health secretary, and John Colmers, chairman of the state’s Health Services Cost Review Commission, briefed lawmakers about the proposal, which was submitted to the federal Center for Medicare and Medicaid Services on Tuesday. (Washington Post)

Legislation would allow Maine hospitals to determine patients’ ability to pay
Saying state rules and federal law would soon be in conflict, Maine hospitals are supporting a resolve in the Legislature that could allow hospitals to do an income means test before providing a patient with free or “charity” care. The resolve doesn’t allow hospitals to refuse care, but it does allow them to determine if patients without health insurance can pay for all or part of their medical costs based not only on income but also assets. The resolve directs the state’s Department of Health and Human Services to make a rule change that permits hospitals to determine a person’s ability to pay. (Bangor Daily News)

It’s not exactly the Mayo Clinic
The operating rooms are dark and gloomy, the power outages far too frequent; the layout is chaotic, and the recruitment of good doctors difficult. Running a rural hospital in India is a labor of love marked by shortages, budget deficits and stiff competition from witch doctors and superstition , a tiny slice of the challenge India faces as it tries to lift hundreds of millions of people out of poverty. The hospital is at the end of a steep, bad road beside Ranthambore National Park, one of India’s most famous tiger reserves. (Los Angeles Times)

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Here in Iowa and across the nation, arguments for Medicaid expansion have weighed heavily on those who have taken the opposite stand.  The problem for them is the facts keep getting in the way of their rhetoric.

IHA’s media campaign is flooding the radio waves and providing persuasive video presentations to listeners and viewers across the state.  These carefully crafted messages are making the expansion argument point-by-point, showing how expansion will benefit individual Iowans and improve mental health access, for example.  The videos also make the business case for expansion and dispel the myths that have been propagated by opponents.

Meanwhile, independent research is providing further evidence to support the hospital position.  A report from George Washington University shows expansion will bring nearly $2.2 billion to the state and create as many as 2,362 jobs – more than 14 times the jobs promised by the widely heralded state economic development project in Southeast Iowa.

medicaid-rally1_t600x400Research has also shown that a solid majority of Iowans back expansion in all parts of the state.  Those same Iowans overwhelmingly want to ensure that their neighbors have access to preventive and mental health care, so when they realize expansion provides exactly that, they are even more supportive.  And when they learn of the economic benefits, their support becomes even greater.

Such mounting evidence has been very persuasive to newspaper editorial boards across the state.  Practically every major Iowa daily newspaper has endorsed IHA’s position, from Council Bluffs to Des Moines to the Quad Cities – and back again to Iowa City (including the university’s newspaper), Cedar Rapids, Mason City and, most recently, Sioux City.  At the same time, hospital leaders have stepped forward to amplify and localize the case for expansion (examples here, here and here.)

There is still much work to be done.  The Iowa business community has been, for the most part, noncommittal on the question, even as the business, economic impact and popular opinion data have clearly favored expansion.

More evidence came to light recently as an analysis showed $17 billion in federal Disproportionate Share Hospital funding will be cut, with the expectation that Medicaid expansion would cover the difference.  For states that don’t expand?  Well, that’s just another hit (along with exploding uncompensated care) that private payers (meaning employers) will have to help offset.

Also this week, Jackson Hewitt Tax Service reported that Iowa’s failure to accept expansion would cost state businesses between $12.7 and $19.1 million a year in “shared responsibility” penalty payments related to uninsured Iowans seeking coverage through the state’s insurance exchange.  Bottom line: “State government efforts to constrain Medicaid costs growth in and after 2017 may lead to higher net taxes for employers…beginning in 2014.”

Meanwhile, another analysis shows Medicaid expansion will benefit our military veterans.

These are the pro-expansion realities that eclipse the oppositional rhetoric.  These are the facts that bear repeating to legislators and locals because understanding has done nothing but nurture support.

Medicaid expansion remains a win-win-win for Iowans, Iowa government and Iowa businesses.  But the argument will not be won until everyone understands just how much is at stake.

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

Iowa News

Cresco hospital breaks ground for renovation and expansion project
Regional Health Services of Howard County kicked off its capital campaign, entitled “Create Tomorrow’s Care” at the Laura Rose Lobby last Friday. Campaign organizers, lead donors, staff, and other dignitaries gathered for check presentations and a ceremonial groundbreaking. The event marks the public phase of the campaign. Of the capital campaign goal of $2.5 million, over $1.6 million is raised to date. (Cresco Times Plain Dealer)

Manning hospital obtains $21M from USDA for replacement
Manning Regional Healthcare Center has obtained $21 million in federal direct loans from the U.S. Department of Agriculture to help fund a $24.8 million replacement hospital, according to a news release. The health system, which includes a 17-bed critical access hospital, obtained the USDA Communities Facilities program funding with help from banking firm Lancaster Pollard, who managed the short-term financing because the federal loans cannot be used to fund construction. (Becker’s Hospital Review)

Counties deserve praise for improved health rankings
No report is 100 percent accurate, and numerous factors can play into what results show. But it’s evident that Cerro Gordo County and others in North Iowa are getting better health report cards, even though there are and always will be areas of concern to work on. Being involved in the Blue Zones program will help in that regard, raising Mason City’s awareness of ways to achieve healthier lifestyles and offering avenues to accomplish them. Organizations such as the YMCA, United Way and others, private and non-profit, can play key roles. (Mason City Globe Gazette)

Antibiotic-resistant germs on the rise
Dr. Ricardo Arbulu, infectious diseases director of Mary Greeley Medical Center, says CRE are resistant to a large majority of antibiotics. “Twenty years ago (carbapenem) was considered the most potent way to kill bacteria. CRE are resistant to that,” Arbulu said. “Usually when [bacteria] are resistant to carbapenem they are resistant to more commonly used and less strong antibiotics. There are still a few [antibiotics] that can kill them, but some of the CRE are absolutely resistant to everything.” (Iowa State University Daily)

National News

Analysis finds Medicaid expansion will benefit veterans
Veterans stand to benefit substantially from President Obama’s healthcare law, particularly in states that choose to expand their Medicaid programs, a new analysis found. Researchers with the Urban Institute reported that as many as 40 percent of uninsured U.S. veterans would be eligible for health care under the law’s insurance exchanges or its expanded Medicaid program. There are currently about 1.3 million uninsured veterans, the report said, but fewer than half of those who would qualify under broader Medicaid eligibility live in states that will accept the expansion. (The Hill)

Slow progress on efforts to pay docs, hospitals for ‘value,’ not volume
For decades, reformers have sought to change how doctors and hospitals are paid to reward quality and efficiency, efforts that accelerated as a result of the health care overhaul. But surprisingly little progress has been made to date, a consortium of large employers reported today. Only 10.9 percent of health care spending last year by employer-sponsored plans was based on “value,” as opposed to “volume,” or the number of services performed, according to the study by Catalyst for Payment Reform, a nonprofit group which represents 21 U.S. employers, including Verizon, Walmart, eBay and Boeing. (Kaiser Health News)

Re-engineering health care
The chief executive of Kaiser Permanente, which is often hailed as a model of health care reform and cost control, said in a Times article recently that “the future of health care is going to be rationing or re-engineering.” Consumers tend to dislike the idea of rationing, but would it be better than the alternatives? If “re-engineering” means consolidation and vertical integration, is that a good thing for patients? For the industry? (New York Times)

Doctors, non-physicians battle over medical turf
A series of bills to expand the roles of nurse practitioners and other healthcare professionals has set off a turf war with doctors over what non-physicians can and can’t do in medical practices. Citing the state’s doctor shortage, a California legislator has proposed legislation that would redefine professional boundaries for nurse practitioners, pharmacists and optometrists to help treat what is expected to be a crush of newly insured Californians seeking care next year under the federal healthcare law. But physicians are pushing back, arguing that the proposed “scope of practice” changes would radically alter longstanding medical standards and jeopardize patient safety. (Los Angeles Times)

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

Iowa News

Iowa Senate passes Medicaid expansion bill
Democrats in charge of the Iowa Senate approved a major expansion of Medicaid coverage for at least 100,000 needy Iowans Monday over the objections of Gov. Terry Branstad and some of his GOP allies in the split-control Legislature. Senators voted 26-23 along party lines to offer Medicaid services provided for by the federal Affordable Care Act for adults between the ages of 19 and 64 with income up to 138 percent of the federal poverty level and for foster care children up to age 26 beginning next Jan. 1. That would equate to a single person making about $15,856 a year or a family of four with an income under $32,488. (Waterloo-Cedar Falls Courier)

National News

Arkansas Medicaid plan attracts attention
Since the Supreme Court made the Medicaid expansion under the federal health law optional last year, states’ decisions have largely split along party lines. States run by Democrats have been opting in; states run by Republicans have mostly been saying no or holding back. But now Arkansas — at the suggestion of the federal government — has suggested a third option: Enroll those newly eligible for Medicaid in the same private insurance plans available to individuals and small businesses. And some think that could shake things up. A lot. (National Public Radio)

Nurses can practice without supervision in many states
For years, nurses have been subordinate to doctors — both in the exam room and the political arena. But aided by new allies ranging from the AARP to social workers and health-policy experts, nursing groups are pressing ahead in a controversial bid to persuade state lawmakers to shift the balance of power. In 11 states, they are pushing legislation that would permit nurses with a master’s degree or higher to order and interpret diagnostic tests, prescribe medications and administer treatments without physician oversight. Similar legislation is likely to be introduced soon in three other states. (Washington Post)

Gunshot deaths pushing some ER doctors to activism
In Colorado, where more people die from gunshots than car crashes, the victims have a profound effect on the physicians who treat them. For some of the doctors on the front lines, the experiences lead to a strong opposition to guns, questions about gun laws and even activism. Dr. Chris Colwell, an emergency department physician in Denver, says he sees gun-violence victims on a weekly basis. And when those cases are fatal, they are hard to forget. “These are the injuries that the [patients] will come in, and they’ll look at me, and they’ll talk to me, and then they’ll die,” says Colwell, who’s been at Denver Health, the city’s biggest public hospital, for 20 years. (PBS NewsHour)

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