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

Iowa News

Republican unsure he’ll back Branstad’s Healthy Iowa plan
A key Republican lawmaker raised tough questions about Gov. Terry Branstad’s plan for wider health care coverage on Monday, but the measure advanced to the Iowa House floor for debate. Rep. Dave Heaton of Mount Pleasant, a resident expert on health care funding and policy in the House, offered unusually blunt criticism of Branstad’s Healthy Iowa Plan, even going so far as to suggest he might not support it in a final vote on the floor. (Des Moines Register)

Medicaid expansion in Iowa
Changes in how all Americans pay for health care, the Obama Affordable Care Act, is changing Iowa’s methods of providing health services to those who can’t afford it.  But Republicans and Democrats disagree on how to do it.  Generally, Democrats controlling the Iowa Senate favor accepting federal money for covering more Iowans with Medicaid.  Some Republicans controlling the Iowa House are working on Governor Terry Branstad’s Healthy Iowa Plan using state funds, emphasizing preventative care and covering fewer people.  We’ve invited two legislators managing the differing legislation. (Iowa Press)

Support groups, exercise help Iowans with Parkinson’s
Waverly Health Center, with Taylor Physical Therapy, has a Parkinson’s care team that will conduct a holistic evaluation intended to identify and offer tips for physical, occupational and speech therapy needs as well as emotional and mental well-being for both patient and caregiver. n recent years, families dealing with Parkinson’s disease in Northeast Iowa have more educational resources, support systems and services than ever before. Developments aim to address physical and emotional needs and even, hopefully, delay the disease. (Waterloo-Cedar Falls Courier)

National News

Mich. law enforcement call for Medicaid expansion
Law enforcement officials plan to call on state lawmakers to expand Medicaid coverage to more than 300,000 Michigan residents.  The group says Medicaid coverage for expectant mothers can help prevent children from being born with fetal alcohol syndrome or fetal alcohol effects. They will also advocate for Medicaid coverage for interventions such as substance abuse and mental and behavioral health issues as a way to cut crime. (Associated Press)

Blue Cross reimbursement cuts will plunge rural hospitals into the red
The Minnesota Hospital Association (MHA) is opposing a payment change plan by Blue Cross and Blue Shield of Minnesota (BCBS) scheduled to take effect May 1 that will slash payments to hospitals and have a particularly devastating effect on rural health care.  MHA CEO Lawrence Massa described the payment change as converting BCBS payments from a negotiated discount from a hospital’s charges — a payment methodology that has been used for small hospitals for decades — to a below-cost or marginally above-cost rate unilaterally set by BCBS. (Minnesota Hospital Association)

Health care experts propose $1 trillion in savings
A bevy of health care experts released recommendations Monday for cost-conscious reforms to Medicare, Medicaid and private insurance they said could save $1 trillion over two decades. In a Brookings Institution study, the experts urge Washington to embrace small, consensus-driven policy moves to lower health care costs rather than wait for a major deficit-reduction deal. “The time to act on these proposals is now,” study authors wrote. “It is time to put a sharp and direct focus on achieving both better health and cost savings.” The paper, “Bending the Curve,” outlined a series of reforms designed to reduce health care spending by improving care and promoting value-based payments. (The Hill)

Hospital patients need an advocate at their side to avoid medical errors
Wanted: an advocate for a hospital patient. Long hours, no pay. Must be articulate, assertive, able to ask tough questions and stay cool under pressure. Blood relative or close friend preferred. Knowledge about the health-care system a plus. It has become an unwritten rule of hospital care that patients should always have a friend or family member by their bedside to make sure they’re getting the right care and to be on the lookout for medical errors. But while there are some professional advocates out there and some organizations that offer training for family members, most people learn on the job, so to speak. (Washington Post)

To motivate patients to change, doctors stop scolding
Doctors who lecture or give scary warnings can cause patients to become defensive and disengage, says Stephen Rollnick, a professor of health-care communication at Cardiff University, in Wales, and a founder of the nonprofit Motivational Interviewing Network of Trainers, whose members provide training, coaching and consultation in 35 countries. “When people are struggling, they don’t like to be told what to do, and they dislike being labeled and blamed,” Dr. Rollnick says. Motivational interviewing “can bring patients back on board and empower them to consider difficult changes.” (Wall Street Journal)

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

Iowa News

Local lawmakers eye health care as Iowa session nears final days
Local legislators hope to reconcile two fundamentally different health-care proposals as the Legislature nears its final days in session. This means taking Gov. Terry Branstad’s health proposal and somehow managing to create a hybrid with Senate Democrats’ proposed expansion of Medicaid. “Senate Democrats are going to press like crazy to make sure we get something done [before we adjourn],” said Sen. Joe Bolkcom, D-Iowa City. “It’s hard for me to see a path to merging on the financial side.” (University of Iowa Daily Iowan)

Blue Zones adds another worksite
Another North Iowa establishment is being designated as an official Blue Zones worksite. Mercy Medical Center of North Iowa is cutting that blue ribbon in honor of the accomplishment. Mercy is the largest employer in the area, and has registered more than 400 employees to be a part of the “Blue Zones Project.” Hospital officials say this designation is helping the center to lead by example. (KIMT)

Mercy’s foundation awarded grant from Komen for the Cure
Mercy Medical Center-Sioux City’s Foundation has been awarded $25,402 from Susan G. Komen for the Cure. This funding will be used toward the “Promoting Breast Health” project at Akron Mercy Medical Clinic. “Promoting Breast Health” will target women ages 40-75 who have not had a mammogram in the last 14 months and who do not have adequate resources to pay for a mammogram. (Sioux City Journal)

Health initiative makes progress in Waterloo
The initiative was in response to the county’s low performance based on last year’s “County Health Rankings” compiled by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, Daley said. Black Hawk came in 77th out of Iowa’s 99 counties this year and 73rd overall in 2012. A partnership formed with the health department, Waterloo Blue Zones Project, YWCA of Black Hawk County, Waterloo Leisure Services, Northeast Iowa Family Practice Medical Education Foundation, faith-based organizations and neighborhood advocates. (Waterloo-Cedar Falls Courier)

Davenport hospital offers free photos to prom-goers
A local medical center is offering free photos for teens heading to prom. They want to help create good memories and stress one important message: “We want to see you before prom… Not after!” Teens and their dates can come to Genesis Medical Center in Davenport to have their photos taken in front of the fountains on the hospital’s campus. (WQAD)

National News

Be prepared for blowback if Medicaid expansion dies
Ohio legislators are choosing to create a different plan; however, it may potentially be less effective and create long term negative effects. Hospitals may resort to reducing services, shutting down and raising treatment fees for those who are insured to compensate for their losses. Public health will continue to decline, and fewer individuals will seek treatment until necessary generating increased costs, and impacting their family’s economic and social well-being. (Chillicothe Gazette)

Health care jobs saved Minnesota
Minnesota this year recovered the number of jobs it lost in the Great Recession. A deeper look at the data, though, paint an intriguing picture of winners and losers — and how our economy continues to shift. Bottom line: Health care jobs saved our bacon in the recession. The industry continued to grow jobs during the worst economic conditions in decades. Nearly 53,000 jobs were added in the education and health services sector from December 2007, the official start of the Great Recession, through February. That almost exactly makes up for the losses Minnesota suffered in manufacturing and construction. (Minnesota Public Radio)

80 million Americans didn’t use health care services due to cost
The Commonwealth Fund survey found 80 million people didn’t go to the doctor or access other medical services last year because of the cost. That’s five million more than two years ago and 17 million more than in 2003. The survey also found nearly half of all working-age U.S. adults, 84 million people, went without health insurance for a time last year or had out-of-pocket costs that were so high relative to their income they were considered underinsured. Those who were uninsured or had inadequate health insurance were most likely to have trouble affording care. (WEAR)

Hammurabi’s code and U.S. health care
Sometime around 1780-70 B.C., the Babylonian King Hammurabi promulgated the now famous Code of Hammurabi, covering both civil and criminal law. The code is said to have informed both Jewish and Islamic law. Remarkably, it has echoes also in modern health policy in the United States. Not all of these laws have survived the millennia. Relative to Hammurabi?s draconian medical malpractice code, for example, modern medical malpractice penalties represent mere slaps on the wrist. On the other hand, our modern, differentiated payment system for health care does resemble the Code of Hammurabi in some respects. (New York Times)

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

Iowa News

Iowa Q-C mental health finally gets $1.67 million payday
Governor Branstad’s Medicaid alternative would send state health expenses soaring, while actually reducing mental health services across Iowa. Branstad said he is philosophically against the health care expansion approved by Congress. Iowa lawmakers are in the final stretch of a wonderfully collaborative mental health reform. The best thing the governor could do would be to put Iowans first, support Medicaid expansion that can help improve services and reduce state and local taxpayer costs. (Quad-City Times)

Help support local mental health efforts
There still remain many unknowns about the consequences of last year’s reorganization of Iowa’s county-based mental health systems into regionally based systems. Yet it’s clear that local governments, providers and individual Iowans will continue to rely on groups such as the National Alliance for Mental Health to help support families, to encourage research and to advocate for mental illness causes. (Iowa City Press-Citizen)

Mayor issues volunteer awards
Dick Douglas has been a volunteer at Sartori Memorial Hospital for more than 30 years. He has served in many different areas of the hospital such as surgical waiting, the gift shop and the information desk. He has supported families waiting for loved ones having surgery and assisted the auxiliary to raise funds to support the hospital. Douglas also has served has the chaplain at Allen Hospital for many years. He assisted with the implementation of a night chaplain program at Sartori and served at the state, regional and national level in his church. (Waterloo-Cedar Falls Courier)

National News

SD hospital executives support expanding Medicaid
An expansion of South Dakota’s Medicaid program to provide health insurance to thousands of additional low-income people would reduce the number of people unable to pay their bills for medical care, hospital executives said Tuesday. South Dakota hospitals were unable to collect about $90 million last year from people who had no insurance or otherwise did not pay their bills, according to the South Dakota Association of Healthcare Organizations. (Prairie Business)

Obamacare exemption talk lights up Capitol Hill
The Obamacare war is on in Congress. A top aide to House Minority Leader Nancy Pelosi sent an email to Democratic offices Thursday afternoon, warning that “Republican trackers” are on Independence Avenue asking lawmakers about the effort to rework which health care insurance members of Congress must use. One Democratic leadership aide said trackers were asking lawmakers if they thought “it’s OK for members of Congress to be exempt from Obamacare?” (Politico)

Startup helps health insurance cards go digital
In an era of e-tickets, bitcoins and app-based banking, it seems pretty antiquated that we still have to fumble through our wallets for an insurance card each time we go to the doctor’s office. But a Philadelphia-based startup has a plan for making those flimsy pieces of cardboard digital — and the upside isn’t just the potential for going paper-free. With the rise of high-deductible plans, patients are increasingly on the hook for more of their medical expenses than they’ve ever been before. For patients, that means a bigger need for tools that provide more transparency about health care costs. And for doctors, particularly independent physicians, said Medlio co-founder and CEO David Brooks, that means a growing problem with collecting payment. (USA Today)

Disaster donations: Texas lags way behind Boston
More than $26 million has been raised in the wake of April 15 Boston blasts. And it appears that donations for West total well under $1 million. The Salvation Army, for example, has raised about $200,000 following the April 17 fertilizer plant explosion that killed 14 people, injured up to 200 and destroyed more than 100 homes. It has already spent about the same amount. The needs in 2,800-person West are vast: food, shelter and transportation for displaced families, medical help for blast survivors, and eventually assistance rebuilding an entire community — from houses and businesses to a school and nursing home. Property losses alone are expected to exceed $100 million, according to the Insurance Council of Texas. (CNN Money)

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

Iowa News

Medicaid expansion is right for Iowa
As an organization that takes its healing mission very seriously, we believe that expanding access to health care to an additional population of very low-income Iowans fits squarely within our mission to serve all who need medical care. We also believe our hospital’s mission reflects the priorities and values of the communities Spencer Hospital serves. (Spencer Daily Reporter)

‘Royce White gave me the courage to stand up,’ lawmaker with mental illness says
Royce White’s frank acknowledgement of his mental health struggles led one state lawmaker to come to terms publicly with her own illness during the former Iowa State basketball star’s appearance at the Capitol on Thursday. Rep. Ruth Ann Gaines, D-Des Moines, told assembled reporters at a press conference this morning that she, too, suffered from anxiety, as White does. She said her anxiety and a fear of flying prevented her from becoming the 1998 National Teacher of the Year, a designation that would have required regular travel. (Des Moines Register)

New UI center looks to improve child mental health services
The Iowa Board of Regents is considering a measure that could have a major influence on the way Iowa children receive mental health services. The University of Iowa is looking to establish a center dedicated to improving the state’s disability and mental health system. Thursday the Regents will decide whether to accept the recommendation for the plan. (KWWL)

Nearly 300 join cancer study in Sioux City
More than 280 Siouxlanders took a step in the fight against cancer this week by volunteering for a long-term nationwide cancer research study. Enrollment events for the American Cancer Society’s Cancer Prevention Study-3 were held Tuesday at UnityPoint Health-St. Luke’s and Wednesday at Mercy Medical Center. Barb Flynn, coordinator of community education at Mercy, said 157 people turned out to answer a short survey and have their blood drawn and their waists measured at the hospital. (Sioux City Journal)

Hospital name change becomes big recycling effort
Iowa Health System has changed its name to UnityPoint Health. Now it’s time to change all the pens, shirts, clocks and more with the old name. (KCCI)

National News

Why expanding Medicaid is good for Pennsylvania’s health, economy and state budget
Although the state will incur some increased costs to administer the expansion in Medicaid coverage, the increased tax revenue generated by the inflow of federal expansion funds will cover these costs and then some, say all three reports—most notably, Pennsylvania’s own Independent Fiscal Office. Medicaid expansion makes sense for the health and the economy of Pennsylvania. It’s an important decision, one that all Pennsylvanians, irrespective of income levels, have a stake in. (Philadelphia Inquirer)

Harkin blocks vote on Tavenner nomination
A Democratic senator has indefinitely blocked a Senate vote on Marilyn Tavenner’s nomination to head the CMS. Sen. Tom Harkin (D-Iowa), chairman of the Senate Health, Education, Labor and Pensions Committee, placed a hold on Tavenner’s nomination to keep the Senate from voting on it, his spokeswoman confirmed Wednesday. She declined to specify why Harkin blocked a vote on Tavenner but alluded to his concerns raised at an earlier hearing. (Modern Healthcare)

HHS would hike whistleblower awards to $10M
Forget Powerball. The odds of becoming a millionaire are much better for Medicare fraud whistleblowers. Health and Human Services Secretary Kathleen Sebelius this week unveiled a proposed rule that would pay rewards of nearly $10 million to Medicare beneficiaries and other whistleblowers whose fraud tips identify and recover funds. (HealthLeaders Media)

Health provider strives to keep hospital beds empty
On a stormy evening this spring, nurses at Dr. Gary Stuck’s family practice were on the phone with patients with heart ailments, asking them not to shovel snow. The idea was to keep them out of the hospital, and that effort — combined with dozens more like it — is starting to make a difference: across the city, doctors are providing less, but not worse, health care. For most health care providers, that would be cause for alarm. But not for Advocate Health Care, based in Oak Brook, Ill., a pioneer in an approach known as “accountable care” that offers financial incentives for doctors and hospitals to cut costs rather than funnel patients through an ever-greater volume of costly medical services. (New York Times)

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Dr. Richard Deming

Dr. Richard Deming

The following is testimony regarding Medicaid Expansion provided to Iowa legislators by Dr. Richard Deming, medical director of Mercy Cancer Center in Des Moines and president of the Mercy Medical Center medical staff.

I read with great interest Governor Branstad’s op-ed piece in the Des Moines Register describing his Healthy Iowa plan.  I appreciate that he quoted President Obama regarding health care reform and cost control.  I appreciate the governor’s concerns about the inadequacies of Medicaid.  I agree that Medicaid is far from a perfect program and is in need of improvement.

I applaud Governor Branstad’s efforts to develop “an improved health care program for the neediest Iowans.”  I agree with health care reform.  I am in favor of personal responsibility and accountability.  I am here to tell you that I would like to work with the governor and the state Legislature to help achieve this.

I am also here to speak in favor of Medicaid expansion.  My remarks this evening will fall into three categories: passion, practicality and compromise.

First, passion.  It’s all about access.  I’m in favor of patient accountability, but before we can have accountability, we need access.  Without access, there is no opportunity for accountability.

Each and every day I see individuals who do not have insurance who present with advanced cancer because they put off seeking medical attention until it’s too late. Without access, individuals do not get preventive services, do not get early detection screenings and do not obtain services when cancer is in an early stage.

Eventually they become ill as their cancer progresses and eventually they ask for help and eventually they come to see me with advanced cancer.  At that point, it’s often too late to be able to cure their cancer.

For me, this debate is not primarily about the finances and it’s certainly not about my pocketbook.  It’s about human dignity and social justice.  I have never ever turned down a patient because he or she wasn’t able to pay.  I never will, regardless of how this vote goes.

But if individuals don’t have access, they won’t attempt to obtain prevention and early detection.  They will come to me for free care when I can no longer cure them of their cancer because it is too advanced.

deming smSecond, practicality.  I truly believe that expanding Medicaid will be the most economical way for our state to provide health insurance to the most vulnerable.  Many of the other speakers this evening have covered the financial concerns, so I won’t elaborate.  I believe the Medicaid expansion bill will provide more coverage for more Iowans at considerable less expensive to the state than the governor’s Healthy Iowa Plan.

One aspect of the financial debate that I haven’t heard articulated is the fact that, as a result of the Affordable Care Act, in anticipation of the federal funding of Medicaid expansion, Medicare is withholding from Iowa hospitals 2 percent of the funding they should be receiving.  This amounts to $178 million a year.  For Mercy-Des Moines, it’s about $18 million a year.

That is money that is being held in Washington to pay for Medicaid expansion.  If we turn down Medicaid expansion, we will be left in the unthinkable situation of having “forfeited” $178 million and then using Iowa property tax revenues to pay for the Healthy Iowa Plan.  From a practical point of view, we need to accept the federal dollars and expand Medicaid.

Third, compromise.  I agree with the governor that we need to reform health care and make it more accountable.  We at Mercy are “all in” when it comes to accountable care.  We have already developed an accountable care plan for our own employees.  We have developed an accountable care plan for our Medicare patients and we have developed an accountable care plan for a segment of our privately insured patients.  We have already had a meeting with the Medicaid office to discuss developing accountable care around Medicaid.

Iowa needs to work with the federal government to develop a plan to provide accountable care for the Medicaid population. But this can be done through Medicaid expansion.

Governor Branstad and Iowa legislators, I promise you this:

If we expand Medicaid, Mercy will work with you and the Medicaid program to help develop a system of accountable care for Medicaid patients.  I will personally work with you to help bring health systems and physicians to the table to work on an innovative way for Iowa to create accountable care for our Medicaid enrollees.  As I said, we are already doing it for Medicare, we are doing it for our employees, we are doing it for some of our privately insured – and we can do it for Medicaid.

Cancer, health and well-being are not the domains of any one political party.

The Dalai Lama said, “My religion is compassion.”  I agree.  I’d also say, “My politics is compassion.”  I realize that one can spoil a child if one’s compassion becomes smothering without an attempt at discipline.  But I also understand that without compassion, children will not have the opportunity to thrive.

I agree with the need for both compassion and accountability.  But before we can have accountability we need access.  Without access, there is no opportunity for accountability.

Thank you for allowing me to speak to you this evening.

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