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hospital closedIt’s a town like hundreds of others scattered across the nation’s midsection. The county seat with about 9,000 people, tiny by coastal urban standards, but not quite “small” by local standards. An economic base in manufacturing and agriculture. Ninety minutes to the nearest city of 50,000. An attractive Main Street and a Walmart bring regional shoppers. A state park with a good-sized lake brings in regional tourists.

There’s also a hospital and its stats are also familiar. Forty beds and 170 employees. About 1,000 annual admissions and an average census of 10. Fifty thousand outpatient visits and 200 births a year. But it’s not enough – this hospital is dying.

In fact, it’s slated to close in October. The reasons are familiar: a shrinking population that is leaving behind the old, the poor, the uninsured and the under-insured. And shrinking reimbursements from Medicare and Medicaid that are failing to be offset by other revenue streams. All made worse by a state government that refuses to expand Medicaid – even while hospital leaders have issued countless warnings about the consequences and even as this hospital has foundered in financial straits.

There are those who will shrug away this hospital’s demise. “It was just one hospital,” they will say, even though it is also hundreds of jobs (both in and out of the hospital) and millions of dollars and the only hospital in an entire county and beyond. “It was just one hospital,” they will say, even though there will be no replacing its community benefits, its community support or its community leadership – ever.

Some will say this is the natural evolution of the marketplace, as if the marketplace was as pure, organic and free from manipulation as the Serengeti (well, the Serengeti of 300 or more years ago). But that’s not how health care works and there’s no going back.

For better or worse, this nation has chosen to treat the business of health care differently as a matter of priority and policy. A commitment has been made to accessible care. Through public policy, generations have worked to safeguard that access, particularly for vulnerable populations, most recently with the Affordable Care Act (ACA) and Medicaid expansion. When a hospital closes, it is a failure to uphold that commitment.

Advocates in the state where this hospital is slipping away are continuing to fight for Medicaid expansion, just as IHA successfully did three years ago. That “win” was a big one for Iowa hospitals, but other threats are still out there and the financial straits hospitals are sailing today are as perilous as ever.

Right now, charting a course through the state’s rollout of Medicaid managed care tops the IHA agenda. IHA continues to monitor, analyze, respond, provide resources and gain allies on this enormous and complex issue. It isn’t going away anytime soon, no more than Medicaid, Medicare or ACA are going away.

Just like hospitals, these policy behemoths are not only a major part of the U.S. health care system, they are at the foundation of the nation’s economic and social infrastructure. They are like tectonic plates, constantly in motion as they are pushed and pulled in all directions by the forces of Congress, state and local governments, regulators, courts and countless others whose lives and livelihoods are inextricably connected to that infrastructure.

When those plates move, it can rock a hospital’s world. That’s why IHA exists. There is much at stake, many stakeholders, many challenges – and many opportunities. That is why hospital-focused advocacy and advocates are so important, to tell the hospital story again and again – as many times as it takes.

Because that story should never be allowed to end with, “It was just one hospital.”

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

Iowa News

Iowa Healthcare Collaborative granted $32.5 million
The Iowa Healthcare Collaborative has been selected by the U.S. Department of Health and Human Services to participate in a four-year quality-of-care initiative that will support clinicians in Iowa and five other states. The collaborative, a nonprofit formed in 2004 by the Iowa Medical Society and the Iowa Hospital Association, will receive up to $32.5 million over the next four years through the Transforming Clinical Practice Initiative announced today by Health and Human Services Secretary Sylvia Burwell. The Iowa Healthcare Collaborative was among 39 regional and national health care networks that will receive $685 million in awards to provide support to more than 140,000 clinicians. (Des Moines Business Record)

New community initiative focuses on preventing childhood trauma
The Connections Matter community initiative launches on Wednesday with the public message that caring connections develop healthy brains, supportive relationships, and strong communities. “This has been about a year in the making,” said Sarah Welch, Prevent Child Abuse Iowa. The effort focuses on building relationships to develop healthy brains and strong communities. The initiative is inspired by recent research showing that trauma, especially in childhood, can dramatically change the brain and increase the risk of health and social problems throughout a lifetime. (WHO-TV)

Iowa hoops coach urges Congress to protect cancer funding
Fran McCaffery, accustomed to putting the press on his opponents on the basketball court, turned his attention to lawmakers in Washington on Tuesday to urge Congress to maintain funding for cancer research and prevention programs. The University of Iowa head basketball coach joined cancer-fighting supporters and basketball coaches from Princeton University, the University of Oklahoma and the University of Notre Dame to remind lawmakers that federal investment in cancer is crucial to helping people prevent and fight the disease. (Des Moines Register)

National News

Scott’s transparency charade is rhetoric instead of health care reform
The Florida Hospital Association says it’s already working on proposed legislation that would improve transparency in the health care industry. But Florida Governor Rick Scott didn’t stop at making a reasonable and justifiable call for more transparency. In his release, the governor also threw in some pejorative terms, unwarranted threats and unfounded accusations — with the apparent intent to intimidate rather than seek common ground. (Sarasota Herald-Tribune)

New Jersey makes progress on cutting rate of hospital readmissions
Avoidable complications and preventable readmission cost the health system extra dollars. A new report shows that certain “hospital-acquired” illnesses now happen less often in New Jersey medical centers. Aline Holmes, senior vice president of clinical affairs at the New Jersey Hospital Association, led a three-year, federally funded initiative to make hospital care safer and, ultimately, to drive down the number of patients who bounce back to the hospital. (Newsworks)

Five ways individualized medicine is impacting health care
The core of Dr. Gianrico Farrugia’s talk highlighted five areas in which the knowledge and know-how from the human genome will be most impactful in patient care, not just at Mayo Clinic, but anywhere in the nation and globally. What’s in it for you?” he asked the crowd of health providers at the Mayo Civic Center in Rochester, Minn. “Individualized or precision medicine offers help for your medical practice today. You can take advantage of these advances to help your patients, to better diagnose, treat or prevent illness right now.” Here is his short list of “value adds” to the practice of medicine. There are many more, but these are the most pervasive and applicable at the moment. (Mayo Clinic)

A nurse with fatal breast cancer says end-of-life discussions saved her life
I am a nurse, a nationally recognized expert in care of the aged. Yet my perspective is not simply professional. For, you see, I live with Stage 4 (end-stage) inflammatory breast cancer. And while this metastatic cancer will one day kill me, the advanced-care planning conversations I have had with my health-care team have been lifesaving since my diagnosis. I use the word “lifesaving” advisedly because that is what these conversations are truly about. When done well, they can shape care in ways that give people with serious illness a chance at getting the best life possible. (Washington Post)

Texas Tech U. med students create their own clinic
Future doctors are getting their first hands-on experience with patients through a student-run clinic in Sparks, Texas. Medical students from the Texas Tech Health Sciences Center of El Paso Paul L. Foster School of Medicine have created a free clinic to help residents in this rural community near Horizon City. “We hope to establish ourselves as the primary care clinic for those in the community who have no other means of getting health care, whether they have no health insurance, are unable to afford health care elsewhere, or are undocumented,” said Victoria Nuñez, one of the clinic founders. (El Paso Times/USA Today)

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

Iowa News

Iowa Healthcare Collaborative selected for national patient safety initiative
The Iowa Healthcare Collaborative has been selected as one of 17 national, regional or state hospital associations and health system organizations to continue efforts in reducing preventable hospital-acquired conditions and readmissions. Through the Partnership for Patients initiative — a nationwide public-private collaboration that began in 2011 to reduce preventable hospital-acquired conditions by 40 percent and 30-day readmissions by 20 percent — IHC will participate in a second round of Hospital Engagement Networks to continue working to improve patient care in the hospital setting. (Des Moines Business Record)

Tackling the behavioral health challenge
It’s becoming “a financial imperative” for hospitals to find ways to provide behavioral health services that truly meet patients’ needs, says Gregory Pagliuzza Jr., chief financial officer at UnityPoint Health–Trinity, a four-hospital, 584-licensed-bed integrated delivery system based in Rock Island, Illinois. The system is part of UnityPoint Health, headquartered in West Des Moines, Iowa. “As the cost structure gets tighter, we have to manage patients with behavioral illnesses more effectively. The old model—where we outsource behavioral health patients elsewhere—is not going to work anymore. (HealthLeaders Media)

Workgroup studies child mental health in Iowa
Issues involving mental health among Iowa children stepped into the spotlight this week as a workgroup was formed to address concerns facing young victims of mental illness and their families. Story County Supervisor Wayne Clinton said he believed the first meeting of the Children’s Mental Health and Well-Being Workgroup on Thursday was a great step toward addressing mental health issues for children of the state. (Ames Tribune)

Storm Lake hospital project progressing
If you drive along 5th Street you have probably noticed the construction at the Buena Vista Regional Medical Center. It began in July of last year with the groundbreaking ceremony, and it’s projected to be finished in August of next year. The new construction was “conceived with a long term vision to accommodate future growth and replacement of older buildings and advancements in technology” according to Katie Schwint, executive director of communications. (Storm Lake Pilot-Tribune)

New senior-health center opening in Windsor Heights
A new center focusing on seniors’ health will open next Thursday in Windsor Heights. The Immanuel Pathways PACE Center will include a medical clinic, rehabilitation services, palliative care, and nutrition and exercise counseling. It also will have a daytime activity center and offer in-home services. The center is being formed by a partnership of Immanuel Pathways, which is based in Omaha, and Mercy Medical Center-Des Moines. (Des Moines Register)

Cross-cultural nurse exchange benefits all
The Coe College nursing program has an exchange with the country of Swaziland. Swaziland, for those not up on African geography, is a small, landlocked country surrounded by South Africa and Mozambique on the continent’s southern tip. It has 1.4 million people and is ruled by King Mswati III, Africa’s last absolute monarch. Students from Cedar Rapids go there for a few weeks each year to shadow nurses. The professor in charge of the program, Anita Nicholson, also raises money to bring Swazi nurses and practitioners to Iowa. (Cedar Rapids Gazette)

National News

A health care model in coal country
A hospital system in Pennsylvania’s coal country has become a national poster child for the kind of carefully coordinated, data-driven health care that experts say one day could right the nation’s troubled medical system, providing better care at lower costs. Geisinger Health System, whose decades of investment in technology and integration have made it a pioneer in the use of electronic medical records and other data, dominates most of the rural markets it serves. (Wall Street Journal)

Health care big data analytics keeps small hospitals independent
Conventional wisdom may predict a bleak future for independent community hospitals, critical access hospitals, and other smaller organizations without the financial and technological muscle to push through tough times in a hyper-competitive environment. As larger medical centers gobble up primary care providers and competing acute care facilities to extend their footprint within their local communities, few independent hospitals seem likely to resist the overwhelming pull of a merger or acquisition for very long. (Health IT Analytics)

Gov. Scott riles Florida hospitals with proposals to fight ‘price-gouging’
Rick Scott, a former hospital company executive, has battled many in his old industry along with the state Senate over expanding Medicaid. On Monday, in an announcement of a plan to seek what he called anti-price gouging legislation, Scott said he will push hospitals to provide more pricing information on their websites. His statement came as his Commission on Healthcare and Hospital Funding met in Tampa to continue its work examining hospital costs. (Palm Beach Post)

Hospital workers find solace in pausing after a death
For trauma workers like Jonathan Bartels, a nurse who has worked in emergency care and palliative care, witnessing death over and over again takes a toll. Over time, they can become numb or burned out. But about two years ago, after Bartels and his team at the University of Virginia Medical Center in Charlottesville tried and failed to resuscitate a patient, something happened. “We had worked on this patient for hours and the chaplain came in and kind of stopped everyone from leaving the room, and I’m like, ‘Wow, that’s really bold,’ ” he said. (Kaiser Health News)

Children in foster care aren’t getting to see the doctor
On any given day, about half a million children are living in foster care. They’ve been removed from violent or abusive households; many suffer physical and mental health problems that have gone untreated. Their need is acute but the response is often dangerously slow, according to a policy statement from the American Academy of Pediatrics. The recommendations, published Monday in the journal Pediatrics, are intended as a wake-up call for pediatricians who care for foster kids. (Iowa Public Radio)

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

Iowa News

Is Branstad behaving like an autocrat?
Now he is seeking to privatize Iowa’s $4 billion Medicaid program by handing over its operations to managed care companies. Without evidence this would improve the health of Iowans or details about how exactly it would save money, his administration has moved forward to transform the government health insurance program for 560,000 Iowans. It sought bids from companies and sent out a press release announcing the “winners.” “The governor never approached the Legislature,” about sweeping privatization, said Sen. Liz Mathis, D-Robins. (Des Moines Register)

Lawsuits shadow Iowa’s would-be Medicaid providers
Recent lawsuits detail allegations of fraud and unethical or illegal medical practices against three of the four corporations in line to manage Iowa’s $4.2 billion annual Medicaid program, a Des Moines Register investigation has found. Three former executives of one of the companies, Wellcare, were sentenced to federal prison last year for fraud after the company illegally kept an estimated $30 million of Medicaid money that should have been returned to the state of Florida, records show. (Des Moines Register)

Medicaid leaders explain changes to skeptical audience
Iowa Medicaid administrators tried to allay skepticism and concern Friday as they sought to explain dramatic changes about to take place in the huge public health-care program. At a Des Moines meeting with more than 100 people, administrators offered assurances that the quick shift to private management of Medicaid is workable. “We’ll be prepared. We’ll be ready to go,” said Lindsay Buechel, who works for a contractor that helps enroll Iowans into Medicaid. The $4.2 billion program is financed by the federal and state governments. It insures about 560,000 Iowans. (Des Moines Register)

‘A huge shift’ in care for Eastern Iowa hospitals
Mercy Medical Center broke ground on two major projects this summer — a 60,000-square-foot, three-story outpatient medical building in Hiawatha and a clinic near Kirkwood Community College — that will have urgent care and primary care services in addition to imaging and lab services. The construction illustrates a major shift in health care — hospitals pushing to care for patients outside traditional hospital walls through more preventive care, outpatient procedures and follow up services. (Cedar Rapids Gazette)

Iowa’s mental health bed-tracking database ‘not useful’ so far, hospitals say
The CareMatch database introduced last month at a cost of nearly $150,000 is intended to allow Iowa’s 29 hospitals that provide inpatient mental health services to post real-time bed availability so rural hospitals can find placement for patients having mental health emergencies. While nearly all inpatient psychiatric programs have logged into the system, most aren’t regularly updating their bed availability, said administrators at three rural hospitals that rely on the data. “The problem is, it’s not readily updated, so we don’t know if the information is completely accurate,” said Danae Tjeerdsma, emergency department nurse manager at the Waverly Health Center. (Cedar Rapids Gazette)

Area flexing health-care muscles with latest project
UnityPoint Health will bring a number of specialty practices under one roof in an area that will see the Cedar Valley’s largest population growth over the next 20 years. UnityPoint Health-Prairie Parkway will be a 90,000-square-foot primary care center that is scheduled to open in November 2016. It will staff the $30 million facility with 31 physicians and mid-level providers; about 40 nurses; and about 70 additional staff. Officials expect patients to come from a wide area of the Cedar Valley to the new center. (Waterloo-Cedar Falls Courier)

Officials hope program improves health in Montgomery County
Sue Drake is getting a little more help next month. The director of Montgomery County Health will welcome an AmeriCorps member to her office on Oct. 5 as part of the Iowa Community Health AmeriCorps Program. “It’ll be nice to have someone here. I’m excited,” said Drake, who’s the only nurse in her three-person office. The Iowa Healthiest State Initiative partnered with Drake University in Des Moines to create the Iowa Community Health AmeriCorps Program, which will place AmeriCorps members in host sites to work on a variety of public health and wellness initiatives. (Council Bluffs Daily Nonpareil)

National News

Two halves of California have wide gap in health costs
When it comes to health care costs, it’s clear: Where you live matters. And in California, the gap is especially sharp between the north and south. Take, for instance, common procedures like a cesarean section or a total knee replacement. The total average price tag for a typical C-section in the four-county Sacramento area is $28,828; in east Los Angeles County, it’s $17,567, according to a health care comparison tool unveiled last week by state officials and Consumer Reports magazine. And that knee replacement? It’s about $42,488 in the Sacramento Valley but drops to $27,276 in east Los Angeles County. (Sacramento Bee)

How hospitalists have innovated U.S. health care
The U.S. health-care system is often criticized for its failure to innovate. With our costs far higher than those of any other developed country and our outcomes, on average, no better, such critiques are not unfounded. However, over the past 20 years, a new specialty has developed that represents a substantial innovation. The story of this specialty–hospitalists–illustrates our great potential for innovation. As we consider all sorts of new innovations, from tele-visits, to precision medicine, to new delivery models such as accountable care organizations, it’s a story worth telling. (Wall Street Journal)

With Obamacare help, hospital capital spending rises again
More than half of the nation’s nonprofit hospitals expect to increase capital spending in coming years as the Affordable Care Act brings health facilities more revenue from patients in its second year of broader coverage, a new analysis indicates. Fitch Ratings said 53 percent of nonprofit hospitals expect to increase capital spending over the next five years. By comparison, 45 percent of nonprofit hospitals, which make up the majority of U.S. inpatient facilities, planned to increase capital spending in 2012, Fitch’s 2015 capital expenditures survey shows. (Forbes)

Health insurer mega-mergers may go through, but only in certain markets
This summer, the news was saturated with talks of mega-mergers among the big five health insurers. In early July, Aetna agreed to buy Humana, and Anthem inked a deal with Cigna that same month. The number of insurers currently in the market puts a type of equilibrium in place. But as the number of insurers has the potential to decrease due to mergers, the equilibrium will be upset. Mark Rust, managing partner of the Chicago office of Barnes & Thornburg, is an expert in transactional and regulatory issues surrounding health care. In light of the recent focus on health care insurers, Mr. Rust has his own predictions regarding the mega-mergers and their implications on the broader healthcare market. (Becker’s Hospital Review)

Health care chaplains use online chats to extend reach
The communication lines are modern, but the questions are often as old as mankind itself: Why am I in pain? Am I being punished? What happens after this life? Mirroring the move to telemedicine among physicians, health-care chaplains are listening to such concerns and offering spiritual support increasingly through Skype, FaceTime and other high-tech connections. Since launching its “Chat With a Chaplain” service last year, the HealthCare Chaplaincy Network, a New York-based nonprofit, has facilitated nearly 5,000 exchanges between its on-call chaplains and people all over the world. (Wall Street Journal)

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

Iowa News

UnityPoint-Allen to build consolidated clinic center in Cedar Falls
UnityPoint Health will bring a number of specialty practices under one roof in an area expected to see the Cedar Valley’s largest population growth over the next 20 years. UnityPoint Health-Prairie Parkway will be a “one-stop shop” for primary-care medicine, said Dr. Dan Glascock, family practitioner and director of the Waterloo Region UnityPoint Clinic. The 90,000-square-foot primary care center is scheduled to open in November 2016. UnityPoint will staff the $30 million facility with 31 physicians and mid-level providers, about 40 nurses and about 70 additional staff. (Waterloo-Cedar Falls Courier)

Siouxland demand for surgical technologists growing
Monique Johnson thought she would be designing websites for a living. A career fair at Western Iowa Tech Community College put her on an unexpected path — working as a surgical technologist at Mercy Medical Center. Johnson said she has always been interested in medicine. For nine years, she has been handing scalpels to surgeons, a task that the general public mistakenly thinks is performed by a registered nurse. (Sioux City Journal)

Stewart Memorial Community Hospital adds 3D mammography
Stewart Memorial Community Hospital is introducing a valuable new service for women with the addition of 3D mammography. Mary Reiter, radiology director says they expect to see an increase in the number of area women who will be routinely screened. The mammography system provides more comprehensive baseline screening, especially for women who have dense breast tissue or have a personal history of breast cancer. (KCIM)

Justice reform group studies system challenges in Iowa
Special drug and mental-health courts are cost-effective alternatives to prison for offenders battling addictions or other problems but funding challenges limit the scope and reach within and beyond the 12 communities currently served, members of a new task force were told Thursday. Lettie Prell, director of research for the state Department of Corrections, told the Governor’s Working Group on Justice Policy Reform, drug-court programs cost about $7,400 per participant per year but have proven that every dollar invested in treating offenders who are diverted from prison carries a $9.60 return over a decade. (Quad-City Times)

National News

Health systems bet on community outreach
As hospital and health system leaders look for ways to improve their population health management capabilities, it is becoming clear to some that they need to develop community outreach programs to assist patients in overcoming the social barriers that exist in many areas. Hunger and nutrition challenges, low literacy rates, and a lack of safe housing are among the biggest obstacles faced by many patients who are high utilizers of health care services. Through community-based initiatives, provider organizations can help patients get beyond these hurdles to be able to prevent and manage chronic diseases and other costly health problems. (HealthLeaders Media)

Audit finds slipshod cybersecurity at
The government stored sensitive personal information on millions of health insurance customers in a computer system with basic security flaws, according to an official audit that uncovered slipshod practices. The Obama administration said it acted quickly to fix all the problems identified by the Health and Human Services inspector general’s office. But the episode raises questions about the government’s ability to protect a vast new database at a time when cyberattacks are becoming bolder. (Associated Press/Boston Herald)

New drug stops deadly superbug infection
Researchers have developed a new drug to fight one of the deadliest infections: Clostridium difficile. It didn’t kill the bacteria and that’s a good thing, the researchers report. It’s not an antibiotic. Instead, it interferes with the toxic compounds made by the bug. A new drug to fight C. difficile is badly needed. C. difficile infections kill 29,000 Americans a year and make 450,000 sick. Right now, antibiotics can make patients even sicker because they kill not only the C. difficile, but so-called good bacteria that keep things in balance. (NBC News)

Illinois mental health cuts decried
Cook County Sheriff Tom Dart urged Illinois lawmakers on Thursday to find a way to fund a special training program designed to keep mentally ill people out of jail. In a hearing before the full House, Dart said the jail he oversees has become the largest mental health hospital in the state. “The numbers are staggering,” Dart said. At issue is a cut-off in funding for a training program that prepares police officers to deal with mentally ill people who are in crisis. (Quad-City Times)

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