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

Iowa News

Physician assistants want oversight rule eased
“You don’t need to be a brain surgeon to take care of strep throat. And you don’t need to pay for a brain surgeon to take care of strep throat,” said physician assistant Ed Friedmann, whose work in Redfield is overseen by a physician 19 miles away in Dallas Center. A state regulation requires the doctor to travel to the Redfield clinic at least every other week to go over cases. But Friedmann is helping lead an effort to get rid of the state requirement that such reviews be done in person. (Des Moines Register)

Iowa lawmakers skeptical of closing mental health facilities
Lawmakers’ reaction to a proposal to phase out services at the Mount Pleasant and Clarinda mental health institutions ranged from skepticism to opposition as they listened to an explanation from the Department of Human Services Thursday. (Sioux City Journal)

Insurance commissioner files petition for CoOportunity liquidation
Iowa Insurance Commissioner Nick Gerhart on Thursday filed a petition in Polk County District Court seeking the liquidation of CoOportunity Health, a nonprofit health insurer serving Iowa and Nebraska residents. The insurer currently has an estimated $150 million in claims, which under the liquidation order would be paid by state guaranty funds operated by Iowa and Nebraska. (Des Moines Business Record)

Big city care in small town clinics
Many Iowans know that Cedar Rapids, Iowa City and other urban areas across the state have access to big hospitals and high quality medical care. For rural Iowans, that care may be harder to come by, but it is available. (KGAN)

Local business leader donates $3 million to Webster City hospital clinic project
A Webster City business entrepreneur and civic leader, impassioned to give back to the community which has given support to his family and business enterprises over the years, has donated $3 million dollars to Van Diest Medical Center . The gift from Bob Van Diest and his wife, Mary, will go toward the construction of a new physician’s building and clinic to be located on the medical campus currently being developed on the hospital’s property. (Van Diest Medical Center)

Measles: highly contagious, easily catchable disease making comeback
“Measles is so infectious that if you walk into a room where somebody with measles left that room hours before, you can still be exposed to measles,” said Dr. Patricia Quinlisk, director of the Iowa Department of Health. With a virus that contagious, state health official is trying to spread the word about the first line of defense. (KCCI)

Siouxland residents turn to surgery to shed pounds
Bariatric surgery is a last resort for obese patients who have struggled to lose weight for years through diet and exercise. It’s a process that requires significant medical, dietary and behavioral education in addition to significant lifestyle changes. The number of Siouxlanders going under the knife to slim down is growing as the obesity epidemic is getting worse. (Sioux City Journal)

National News

CMS to shorten meaningful use reporting period in 2015
A new rule this spring will propose changes to the Medicare and Medicaid Electronic Health Record Incentive programs in 2015, including a shortened reporting period to make it easier for providers to comply with program requirements, a Centers for Medicare & Medicaid Services official announced. CMS is considering shortening the meaningful use program’s reporting period in 2015 from a full year to 90 days and changing the hospital reporting period from the fiscal year to the calendar year. (Bloomberg BNA)

Experiments with coordinating medical care get mixed results
Medical homes are a simple, compelling idea: Give primary-care doctors resources to reduce preventable medical crises for diabetics, asthmatics and others with chronic illness, and it will reduce hospital visits, improve lives and save money. But it’s not so easy in practice. (Iowa Public Radio)

Where are risk-based payment mechanisms taking health care?
The theory is that risk-based payment mechanisms like “accountable care, bundled payments and other contracts with the potential for rewards or penalties based on quality performance and better cost control” will bring about greater efficiency and higher quality in the health care system. It is argued that the current system, mainly based on fee-for-service schemes, leads to overtreatment and waste. In the midst of all the excitement, there are very few thoughtful observers who raise questions about the march. (Not Running a Hospital)

Murray: EEOC regs on wellness programs coming soon
The top Democrat on the Senate Health, Education, Labor and Pensions Committee said Thursday that federal guidance is forthcoming to help employers administer worker wellness programs so that they comply with both ObamaCare and the Americans with Disabilities Act. Sen. Patty Murray (D-Wash.) raised concerns in a committee hearing that some employers are going too far with their wellness initiatives and are ultimately discriminating against certain workers based on their health status. (The Hill)

Docs, hospitals, state health officials endorse opioid painkiller guidelines
Hospital and physician organizations in Connecticut have joined with state health regulators to back a series of “guidelines” aimed at reducing the inappropriate use of opioids. The suggested protocols endorsed by the Connecticut Hospital Association, Connecticut State Medical Society, state chapter of the American College of Emergency Physicians, and Department of Public Health, focus on the treatment of patients with chronic pain conditions who frequent emergency departments. (Manchester Journal Inquirer)

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

Iowa News

Clarke County Hospital telemedicine keeps patients on schedule
JoAnn Wilson of Osceola was one patient who used telemedicine when her specialist was unable to travel to Clarke County Hospital from Des Moines because of icy road conditions. “When I saw the weather, I thought I was going to get a call about changing my appointment,” Wilson said. “The telemedicine clinic was as good as if my doctor was sitting here. Like a normal appointment, she looked at me and answered all the questions I had. I definitely see the benefits of having it.” (Osceola Sentinel-Tribune)

CoOportunity never had a chance to succeed
Congress revisited Medicare repeatedly in subsequent years to ensure it worked. If they hadn’t made numerous and necessary tweaks, Medicare would not have survived. But things have changed in Washington. And not for the better. No major program is ever perfect upon creation. If lawmakers refuse to revisit, modify, perfect and adequately fund the program, it is doomed. That may end up being the case with Obamacare. If so, health insurance for millions of Americans is also doomed. (Des Moines Register)

UI researchers tout diabetes development
University of Iowa researchers say they’ve retrained human skin cells to produce insulin in mice, a discovery that they hope could someday help reverse the effects of diabetes in people. The researchers are working toward a day when people with diabetes could avoid the need for insulin shots or pancreas transplants. (Des Moines Register)

Advocate in Cedar Rapids pushes expansion of Iowa’s medical cannabis program
Maria La France, a driving force behind the state’s medical cannabidiol act that passed last year, is ready to expand the law. “It’s a symbolic law,” said La France of Iowans 4 Medical Cannabis, which advocates for safe and regulated access to medical cannabis. “This year we need to fix it.” (Cedar Rapids Gazette)

National News

Hospital groups to SCOTUS: Withdrawing subsidies would be ‘disaster’ for millions
Withdrawing health insurance subsidies in states with a federally facilitated Health Insurance Marketplace “would be a disaster for millions of lower- and middle-income Americans,” the AHA, Federation of American Hospitals, Association of American Medical Colleges, and America’s Essential Hospitals told the Supreme Court in a friend-of-the-court brief filed in King v. Burwell. (American Hospital Association)

If Supreme Court rules against insurance subsidies, most want them restored
A new poll finds that most people think Congress or states should act to restore health insurance subsidies if the Supreme Court decides later this year they are not permitted in states where the federal government is running the marketplace. The court in March is set to hear King v. Burwell, a lawsuit arguing that the wording of the Affordable Care Act means that financial assistance with premiums is available only in the 13 states that created and are running their own online insurance exchanges. (Kaiser Health News)

Seriously, Steven Brill? Hospitals make ‘gluttonous profits’?
Steven Brill is at it again, railing against “gluttonous” profits in the hospital sector. As we’ll see, actual profits in the hospital sector are quite modest. If we accept Mr. Brill’s flagrantly inaccurate premise that hospital profits are “gluttonous” how in the world will we label the profits earned by physicians, lawyers and media companies–each of which have profit levels that are 2 to 3 times as high as the “gluttonous” levels that he decries? (Forbes)

Health insurers may be finding new ways to discriminate against patients
One of the greatest promises of the Affordable Care Act is that if you are sick or get sick, health insurers can no longer charge you more or avoid covering you altogether. They have to provide coverage to anyone who wants it, and they’re not allowed to cherry pick healthier customers over sick customers. But patient groups say they’ve spotted an alarming trend of some health insurance plans designing drug benefits to purposefully keep out sicker, costlier patients. (Washington Post)

Under siege from storm, hospitals get creative
Hospitals took extraordinary measures — and faced tough choices — as New England was frozen into place Tuesday by howling winds and relentless snowfall. From ferrying patients home in four-wheel-drive vans to fashioning temporary rooms out of waiting areas, hospital administrators got creative. At South Shore Hospital, two Chevrolet Tahoes were rented to drive roughly two dozen discharged patients to their homes. (Boston Globe)

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

Iowa News

Rural health care systems adapt
Angela Mortoza walks the halls of Adair County Memorial Hospital, but she could be walking the aisle of a local grocery store with all the smiles, the friendly conversation, the jokes. It is a casual atmosphere that mimics the rural community surrounding the Southwest Iowa facility. “We have a very good, very caring community,” says Mortoza, CEO of Adair County Health System. (Iowa Farmer Today)

Flu hospitalizations dropping sharply in Iowa
We’re not suggesting folks put the Kleenex and Tylenol away just yet, but it looks like Iowa’s brutal flu season might finally be waning. Influenza was back in the spotlight this week, when a bout caused Gov. Terry Branstad to collapse during a speech Monday morning. Branstad joined hundreds of other Iowans to be hospitalized for the flu in the past two months. (Des Moines Register)

Officials hope to stem Iowa’s spike in suicides
More than 440 Iowans committed suicide in 2013, an increase of nearly 17 percent over the previous year, according to recently released data. The Iowa Department of Public Health reported 445 such deaths statewide in 2013, the most in any year since at least 1989, the last year for which data is available online. (Dubuque Telegraph Herald)

Measles is no walk in the theme park
Yet some parents refuse to immunize their children. They ignore science. The moon is not made of cheese. The Earth is not flat. And vaccines have not been credibly linked to autism. In fact, immunizations are among the greatest breakthroughs in medicine. They save lives and have eradicated deadly and crippling diseases like small pox and polio. When Americans are immunized, all places, including Disneyland, are safer for the rest of us. (Des Moines Register)

Unemployment rate drops in December, nearing ‘full employment’ level
The state unemployment rate dropped down in December, and a spokesperson for Iowa Workforce Development (IWD) says the state is getting close to full employment. IWD spokesperson, Kerry Koonce, said the December unemployment rate hit 4.1 percent, compared to 4.3 percent in November. “Four-point-one percent is actually the lowest rate we’ve had since June of 2008. The national rate is still standing at five-point-six percent for December,” Koonce said. (Radio Iowa)

National News

Major providers, insurers unite to shift more business to quality-of-care model
Several of the nation’s largest health systems and insurers are joining together in a new task force with the goal of shifting 75 percent of their business to contracts with incentives for quality and lower-cost healthcare. Ascension Health, the nation’s largest private not-for-profit health system, and Trinity Health, another of the nation’s biggest hospital operators, are among the systems, which also include prominent regional giants such as Partners HealthCare in Boston and Advocate Health Care in Chicago. (Modern Healthcare)

Obama administration on track to surpass health care goal
Some 9.5 million people have already signed up for 2015 coverage under President Barack Obama’s health care law, and the administration is on track to surpass its nationwide enrollment target set last year. The Health and Human Services Department said Tuesday that, through the middle of January, more than 7.1 million people had signed up in 37 states where the federal government is running the insurance markets. At least another 2.4 million signed up in states running their own exchanges. (Associated Press/St. Paul Pioneer Press)

Obamacare advocates refine their pitch to millennials
Gone are the splashy tweets about health coverage from Katy Perry and the “brosurance” ads featuring guys doing keg stands. Fliers in coffee shops and bars are in, as are partnerships with community colleges and job training centers. Millennials are still a critical demographic for Obamacare, but young adults are being wooed very differently in Year Two of enrollment. (Politico)

Senate bill introduced to remove 96-hour certification requirement for CAHs
Sens. Pat Roberts (R-KS) and Jon Tester (D-MT) today introduced a Senate companion to the Critical Access Hospital Relief Act (S. 258/H.R. 169), AHA-supported legislation that would remove the 96-hour physician certification requirement as a condition of payment for critical access hospitals. Medicare currently requires physicians to certify that patients admitted to a CAH will be discharged or transferred to another hospital within 96 hours in order for the CAH to receive payment under Medicare Part A. (American Hospital Association)

Rural hospital closures are a clear danger
Adam O’Neal, the Republican mayor of Belhaven, N.C., completed a 273-mile walk to Washington in July to shine a spotlight on the closing of his small town’s local hospital and the impact on residents, including the death of a 48-year-old who had suffered a heart attack, then died while waiting an hour for a helicopter to transport her to the closest hospital — now 75 miles away. (Denver Post)

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An ongoing series of studies by University of Iowa researchers shows that access to a variety of specialty health care fields are more accessible than thought in rural Iowa, but that access could be threatened depending on how health care reforms are implemented.

Previous studies in the series show that specialists in medical oncology and urology who are based in clinics in larger cities but regularly staff Visiting Consulting Clinics (VCCs) in rural areas can bring many more Iowans within a half-hour drive of those types of care.

OtolaryngologistThe latest study by the researchers – Tom Gruca, professor marketing in the Tippie College of Business, and Roger Tracy, retired assistant dean in the Carver College of Medicine and recipient of the IHA Iowa Hospital Heroes Award – looked at otolaryngology, or doctors specializing in conditions and diseases involving the ears, nose and throat. They found a similar pattern while mining a university database, that rural access to otolaryngology services in Iowa is more accessible if visiting clinics are taken into account.

“The doctors are getting out there and seeing patients and serving the public,” says Gruca.

Using data gathered by the Carver College of Medicine’s Iowa Physician Information Service (IPIS), Gruca and Tracy found that 49 otolaryngologists from Iowa and neighboring states staffed 87 separate VCCs in rural areas in 2013, with 67 percent of the clinics occurring monthly or more frequently.

While only 20 of Iowa’s counties have a resident otolaryngologist, 85 counties have access to their services when VCCs are considered. When those visiting clinics are taken into account, 92 percent of Iowa’s population lives within a 30-minute drive of an otolaryngologist.

Otolaryngologists treat such diseases and ailments as head and neck cancers, sinusitis, and adenoid infections, and also perform facial surgery and repair broken facial bones. Many of the conditions they treat – such as hearing loss or sleep apnea – are especially prevalent in the aged or obese, two trends that are particularly acute in rural areas, which makes improved access for rural residents even more important.

The studies also conclude that access to specialized health care through VCCs could be threatened by any kind of significant change in the reimbursement process implemented by the Affordable Care Act. The studies have found that specialists drive thousands of miles a year to staff VCCs – otolaryngologists drove more than 17,000 miles per month in 2013, for instance – for which they are not directly reimbursed under current Medicare and Medicaid rules.

But Gruca warns that a major change in reimbursement could prompt physicians to abandon VCCs and threaten rural health care access.

The data for Gruca’s and Tracy’s previous studies has all come from the IPIS, an annual census of every workplace in Iowa that employs licensed health care professionals. Iowa is the only state in the country to have such a comprehensive database, and the two researchers are currently using it to examine rural access to cardiology, orthopedic and gynecology care.

The latest study, “Reaching Rural Patients through Otolaryngology Visiting Consultant Clinics,” is published in the current issue of the journal Otolaryngology: Head and Neck Surgery, published by the American Academy of Otolaryngology. It was co-authored by Inwoo Nam of Chung-Ang University in South Korea.

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

Iowa News

Gov. Branstad released from hospital
Gov. Terry Branstad was discharged from the hospital at 9 a.m. on Tuesday after an overnight stay and treatment with intravenous fluids in response to flu and dehydration. Branstad, 68, was hospitalized Monday after falling ill at a public event in Johnston. On Tuesday, his personal physician ruled out more serious illnesses and allowed Branstad to return home to Terrace Hill. (Des Moines Register)

Story County response team helps sexual assault survivors
When someone reports being sexually assaulted, the last thing they want to worry about is paying for the medical tests or support services. That’s why the Story County Sexual Assault Response Team, or SART, offers free response services for those who report being sexually assaulted, said Steffani Simbric, Story County SART coordinator. Once an assault is reported at one of the SART agencies — Thielen Health Center, Mary Greeley and Story County Medical Center — a three-person response team visits the survivor on-site. (Iowa State Daily)

North Iowans encouraged to test for radon
North Iowa residents are being encouraged to test their homes for radon. “It’s very imperative that people check radon levels once a year,” said Dr. Arvind Vemula, who specializes in hematology/oncology at Mercy Medical Center-North Iowa. January is National Radon Action Month. Radon is a colorless, odorless and tasteless. It invades homes and buildings through foundation cracks and openings and even directly through concrete. (Mason City Globe Gazette)

National News

Medicare looks to speed up pay for quality instead of volume
The Obama administration said Monday that it wants to speed up changes to Medicare so that within four years half of its traditional spending will go to doctors, hospitals and other providers that coordinate patient care. The shift is being made to stress quality and frugality over payment by the procedure, test and visit. (National Public Radio)

A Philadelphia hospital makes a bet on Obamacare
Steve Klasko, the chief executive officer of Thomas Jefferson University Hospital in Philadelphia, wants to see fewer patients walking into his emergency room. Jefferson is investing $20 million to open two urgent-care centers, including one three blocks from the existing ER, to treat patients with routine medical needs, and build a program to allow physicians to perform consultations using video apps so that other patients never have to leave home. “The best way to save the system lots of money is to keep them out of the hospital,” Klasko says. (Bloomberg)

Three recommendations for Obama’s precision medicine initiative
Many of the challenges we face practicing symptom-focused intuitive medicine could be overcome by turning toward precision medicine, a process of precisely diagnosing and targeting disease. However, announcing the initiative is one thing. As with all policy discussions, the devil is in the details – and there are three details specifically that could make the difference between political rhetoric and a policy that truly improves the health of American citizens. (Healthcare Blog)

Indiana latest red state to opt into Medicaid expansion
As newly empowered Republicans in Washington are contemplating ways to unwind the president’s health-care law, another Republican governor with conservative credentials announced Tuesday morning he reached a deal with the Obama administration to accept Medicaid expansion funding in his state. Indiana Gov. Mike Pence, a former member of House leadership who’s viewed as a possible 2016 presidential candidate, announced he and the feds after months of negotiations agreed to a plan that will cover an estimated 350,000 low-income adult Hoosiers earning under 138 percent of the poverty level, or about $16,105 for an individual. (Washington Post)

What’s bigger than Texas? Health care
The fact that the health care sector didn’t shed jobs during the nation’s worst economic crisis in 80 years is something of a marvel. And as a result, the health care sector hasn’t had a down month in any jobs report since July 2003—a staggering run that no other industry can claim. (The Advisory Board)


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