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

Iowa News

Concerns over Medicaid plan are justified
Perhaps the most maddening aspect of Governor Terry Branstad’s ill-conceived and poorly executed rush to privatize the Medicaid program is the manner in which he and the private contractors he has hired to take over the program dismiss the concerns of others. The reproachful, condescending responses to legitimate, justifiable concerns over the health and welfare of more than half a million low-income and disabled Medicaid beneficiaries demonstrate just how little regard the Branstad administration has for the people of Iowa, only 22 percent of whom support his privatization plan, according to an Iowa Poll in April. (Des Moines Register)

Judge: Toss WellCare out of Iowa Medicaid program
WellCare of Iowa, one of four companies chosen by state officials to receive lucrative contracts for privately managing Iowa’s $4.2 billion Medicaid program, should be bounced from the mix, according to a ruling proposed Wednesday by an administrative judge. The judge heard testimony last month about meddling by the insurance company to secure the work. WellCare also did not initially disclose all its past legal troubles. The company has faced millions of dollars in fines in other states. Last year, three former WellCare executives went to prison for fraud. (Cedar Rapids Gazette)

Branstad: No reason to delay Medicaid privatization
Iowa Governor Terry Branstad said Monday that an administrative law judge’s recommendation to throw out one of the state’s four managed care contracts is no reason to slow the move to Medicaid privatization. He said he has appointed Iowa Department of Administrative Services Director Janet Phipps to decide whether to follow the judge’s recommendation or to move forward as planned. “There’s a lot of evidence to review, and I have every confidence that she will do that in a very thoughtful and methodical way,” Branstad said. (Des Moines Register)

Doctors signal more warnings about Iowa’s Medicaid plan
Multiple Medicaid payment and service questions posed by health providers Wednesday, during the state’s Medical Assistance Advisory Council, went unanswered or would be discussed “offline” by state officials who nonetheless asserted that Iowa will be ready to transfer the $4.2 billion annual program to private managers on January 1. Some of the questions hit on issues that could potentially derail Governor Terry Branstad’s plan to launch the largest privatization effort in Iowa government history. (Des Moines Register)

Governor’s plan to privatize Medicaid in Iowa still concerning to hospitals and care providers
Iowa is about to go through a huge undertaking, a complete re-vamp of the state’s Medicaid system. Five weeks remain until the new plan is supposed to start. Insurance packets have arrived but the plans aren’t in place. “No other state in the country has tried to move to managed care in this compressed timeline,” says Greg Boattenhamer of the Iowa Hospital Association. (WOI/Siouxland Matters)

National News

Value-based payment poses challenge to rural hospitals
The challenges facing rural hospitals today are many. Marty Fattig has been CEO of Nemaha County Hospital, a 20-bed, county-owned Critical-Access Hospital (CAH) in Auburn, Nebraska since 2002. Fattig serves on the CAH Advisory Board on Quality and the federal health information technology coordinator’s Health IT Policy Committee’s meaningful use workgroup. Fittig explains challenges posed to rural hospitals, including recruiting staff, the problems created by Nebraska’s refusal so far to expand Medicaid to low-income adults and how he motivates his employees. (Modern Healthcare)

Top value-based care rule changes for 2016
The march toward value-based care continues, powered in part by regulatory changes of varying degrees of complexity and effectiveness. The final Medicare Physician Fee Schedule and the Outpatient Prospective Payment System for Calendar Year 2016 rules released by the Centers for Medicare & Medicaid Services have hospital leaders thinking about how they’ll tackle challenges and seize opportunities in the New Year. (HealthLeaders Media)

As rural hospitals face uncertainty, lawmakers look to clinics
Some rural hospitals in Mississippi are fighting to keep their doors open. The question now is, how. Earlier in November, the Associated Press reported Pioneer Community Hospital in Newton will close because a change in federal classification would mean a loss of income. The hospital had been considered a Critical Access Hospital, a label applied to rural hospitals that means higher payouts for Medicare patients. However, the Centers for Medicare & Medicaid Services have requested certain hospitals re-apply for certification. (Picayune Item)

How telemedicine is propelling change around the hospital experience
Telemedicine will no doubt increase patient engagement, because patients who receive care when and where they want are more motivated to participate in self-care. And on the provider side, being able to identify what is important to the patient and providing those services will go a long way to establishing a partnership outside of the office visit. From reviewing medical records to charting treatment plans, from reading x-rays to home health care, telemedicine is making health care more available to everyone. (MediaPost Communications)

Region works against ongoing doctor shortage
In southwest Kansas, doctors are spread thin, but rural health care providers are finding ways to meet primary care needs by using mid-level providers and by sharing resources. In its Primary Care Health Professional Underserved Areas Report for 2014, the U.S. Department of Health and Human Services designates Hamilton, Kearny, Haskell and Gray counties as Primary Care Health Professional Shortage Areas. In those counties, there are more than 3,500 people for every full-time equivalent primary care physician. (Garden City Telegram)

How patient-centered care helped an Arkansas hospital cut readmissions by 90 percent
One Arkansas hospital system has cut readmissions nearly 90 percent by addressing both direct and indirect contributing factors, according to Executive Insight. In seeking to address readmissions, the majority of hospital leaders concentrate on an internal approach, using methods such as follow-up calls to patients after discharge, writes Labray Merkel, health coordinator at CHI St. Vincent’s Hospital. (Fierce Healthcare)

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

Iowa News

Minnesota offers startling glimpse into privatization
David Feinwachs was, for nearly 30 years, the general counsel for the Minnesota Hospital Association. For the past five years he has been investigating and examining the issues surrounding managed care involvement in publicly funded health care programs such as Medicaid. Managed care has been used in Minnesota for more than three decades and Feinwachs outlines lessons that Iowa can learn from Minnesota. (Iowa City Press-Citizen)

Parents hope cannabis oil study helps children
Tina McDermott lays her 9-year-old son Ryan down flat on the living room floor and places her leg on his chest. He has a seizure as the cocktail flows through a tube straight into his abdomen. After a few seconds, his body loosens back up. She has every hope cannabis oil will eliminate her son’s seizures and she can eventually ween him off pharmaceuticals. Ryan is one of a handful of children participating in a clinical trial at University Hospitals, Iowa City. (Quad-City Times)

Several thousand children now immunized against flu
The 2015 Genesis Flu-Free Quad-Cities initiative resulted in 8,800 vaccinations given to schoolchildren in the Quad-City region. The Flu-Free effort began almost a decade ago and involves an effort to inoculate children across the region. This year it reached 97 elementary schools. (Quad-City Times)

Knoxville Hospital & Clinics begins demolition of old clinic
With a swipe from facilities director John Gotta, demolition of the old clinic at Knoxville Hospital & Clinics began Monday. Gotta earned first swipe at the building after winning the silent auction prize at the Knoxville Hospital & Clinics Foundation Gala last month. CEO Kevin Kincaid says the demolition of the old clinic will make way for completion of the new clinic, which is only about three-quarters of the way done. (KNIA/KRLS)

National News

Fight over Medicaid managed care tax punches hole in California budget
California lawmakers are staring down a $1.1 billion hole in next year’s health budget after failing to come up with a way to replace the state’s “managed care organization tax” on health insurance plans that serve Medi-Cal managed care recipients. It’s a hole big enough that state Governor Jerry Brown recently used it as a reason to veto 15 health care and other bills sent to him by the state legislature. (Kaiser Health News)

Boy dies of Ebola in Liberia, first fatality in months
A 15-year-old boy has died of Ebola in Liberia, the first such fatality for months in a country declared free of the disease in September, its chief medical officer said on Tuesday. The boy tested positive last week and died late on Monday in hospital in Paynesville near the capital, where his father and brother are also being treated for Ebola, officials said. Liberia has placed under surveillance 153 people who may have come into contact with the boy. A further 25 health care workers are being monitored, of whom 10 are identified as high-risk, chief medical officer Francis Kateh said. (Reuters)

Coordinated, multihospital effort improves ED patient flow
A collaborative effort by 42 hospitals in 16 U.S. communities to improve patient flow in their emergency departments (EDs) led to measurable improvements at two-thirds of the hospitals, according to a study published in the December issue of The Joint Commission Journal on Quality and Safety. During the 18-month effort, organized by the Aligning Forces for Quality program, hospitals reduced their discharged length of stay by 26 minutes, their admitted length of stay by 36.5 minutes and their boarding time by nearly 21 minutes, according to the study. (Fierce Healthcare)

NYC announces $850M mental health services program
New York City recently announced an $850 million program called ThriveNYC, with 54 different initiatives, to improve mental health services and expand access to such care. The plan involves training 250,000 New Yorkers in mental health first aid to identify and respond to individuals with mental health and substance abuse issues. The city will also launch a public awareness campaign to reduce the stigma of mental health and educate residents where they can access services. (Healthcare Dive)

Health care mergers: Good, bad or both?
While two major merger deals involving the four largest health insurers in the U.S. are being investigated by the Department of Justice, industry experts are debating whether consolidation is good for business and for patients. Currently, the nation’s four largest health insurers control roughly 80 percent of the private insurance marketplace, said Ed Howard, president of the Alliance for Health Reform. In 2014, the health care sector witnessed a total of 1,299 mergers and acquisitions, a small jump from 1,035 in 2013. (MedPage Today)

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

Iowa News

Another Medicaid math puzzler: Who has the contracts?
The Iowa Hospital Association on Monday questioned whether Iowa has reached agreements with heath care providers on more than 12,000 contracts to provide Medicaid services through for-profit management companies. The hospital association, which represents more than 100 Iowa hospitals, claimed Monday it has found discrepancies between the list of health care providers the Iowa Department of Human Services released last week and the businesses that have actually signed contracts. (Des Moines Register)

Group of Medicaid recipients plan trip to statehouse
As Rhonda Shouse sat listening in on a disorderly phone call with the Centers for Medicare and Medicaid Services on November 10 that had hundreds of Medicaid recipients and advocates on the line — all speaking over one another in the hopes to have their complaints heard and who were periodically put on mute by the moderator — she had one thought. “Being on that chaotic call, I realized how important it was to get up to that meeting,” she said. The meeting she means is the December 7 Health Policy Oversight Committee meeting in Des Moines. (Cedar Rapids Gazette)

Branstad asks agencies to submit status quo budgets
Governor Terry Branstad said Monday he has asked state agencies to submit budgets with no spending increases for the coming fiscal year. Branstad is in the midst of holding budget hearings with various state departments. The governor then will craft his budget and present it to the Legislature in January. Iowa is expected to see another modest increase in state revenue, according to the state’s fiscal estimating agency. (Cedar Rapids Gazette)

About 4,800 students vaccinated for mumps
University of Iowa health specialists said Monday that after eight vaccination clinics held over two weeks, about 4,800 students have received a third dose of the measles, mumps and rubella vaccine. The university on November 6 announced that it would hold the vaccination clinics in response to the growing number of confirmed cases of mumps on campus. (Iowa City Press-Citizen)

National News

‘Flying ICUs’ part of rural health care strategy
Air transport is a key part of the region’s health care strategy when it comes to traumatic injuries, strokes and heart attacks, said Dr. Mark Monte, chief of trauma surgery at St. Luke’s Hospital in Minnesota. Life Link III, the helicopter intensive care unit (ICU) system, now incorporates nine hospital systems in Minnesota, Wisconsin and North Dakota and its helicopters can reach all but farthest points of northwestern Minnesota within an hour, as well as large chunks of the Dakotas, Wisconsin, Iowa and Ontario. (Duluth News Tribune)

Small coastal California town fights to keep hospital afloat
Board meetings for the Mendocino Coast District Hospital are usually pretty dismal affairs. The facility in remote Fort Bragg, California, has been running at a deficit for a decade and barely survived a recent bankruptcy. Across the country, rural communities share similar fears. Small, rural hospitals everywhere have been struggling to survive. Many people who live in these areas are older or low income — not a great customer base for a hospital that needs to make money. (Kaiser Health News)

Hospitals must take proactive approach against violence
Hospital violence is on the rise, but health care leaders face the difficult task of taking measures to prevent it without compromising the open, healing environment of their organizations. The key, according to an article by StatNews, is to develop effective strategies that go beyond simply reacting to individual incidents. The Joint Commission is taking a closer look at institutions and agencies developing innovative anti-violence strategies. (Fierce Healthcare)

Hospitals broaden scope of community-benefit work
Dignity Health, which owns St. Francis Memorial, is one of a number of hospitals and health systems across the country targeting funds to address societal ills such as poverty, violence, hunger, poor nutrition and lack of housing. While not-for-profit hospitals have always been expected to offer programs that improve health or increase health care access, that work has traditionally focused on training new doctors, conducting research and providing charity care for the poor and uninsured. Critics, joined by some health system leaders, argue that hospitals can and should do more to address broader health issues in their communities. (Modern Healthcare)

FDA targets inaccurate medical tests, citing dangers and costs
Inaccurate and unreliable medical tests are prompting abortions, promoting unnecessary surgeries, putting tens of thousands of people on unneeded drugs and raising medical costs, the Food and Drug Administration (FDA) has concluded. The findings come at a time when the use of laboratory-developed tests is booming, the Obama administration is seeking new regulatory powers and even Republicans in Congress are working on legislation to set stricter standards. (New York Times)

Doctors, hospitals still oppose revised bill to limit out-of-network charges
A measure intended to rein in the cost of out-of-network medical services has gone through a number of changes as it makes its way through the New Jersey Legislature. And despite the fact that a key provision has been dropped, which would have eliminated surprise medical bills for many patients, consumer advocates say they still back the bill due to the provisions it has retained. The legislation came under heavy fire in the Assembly earlier this year, when the largest trade groups representing doctors and hospitals criticized it for giving too much negotiating power to health insurers. They renewed that criticism at a hearing yesterday. (NJ Spotlight)

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employee wellnessIHA and Iowa Business Council have partnered to produce a new report designed to help businesses, health care providers and employees work better together to improve health and control health care costs.

Using case studies from 19 large Iowa employers, “Partners for Health: How Iowa Businesses, Health Care Providers and Employees are Collaborating to Create Value” offers specific real-world examples of successful programs Iowa businesses have implemented to engage employees in their health and improve individual and organizational wellness. Sectors represented in the report include manufacturing, retail, health care, education and energy.

“Iowa businesses are deeply invested in the health of their employees,” said Michael Wells, chair of the IBC board and president and CEO of Wells Enterprises Inc. in Le Mars. “But we realize we must do more than provide health care coverage. We must engage employees in their health, incent and support good habits and work with health care providers. These case studies show collaboration is crucial.”

We applaud Iowa businesses that have joined with their employees and health care providers to ensure good health,” said Marie Knedler, chair of the IHA board and president of CHI Health Mercy Council Bluffs. “We know in the health system that coordination of care is necessary for successful outcomes. We also realize that coordination not only involves providers, but our patients and their employers working together toward prevention and wellness. That is how value is cultivated in health care.”

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

Iowa News

Branstad should delay Medicaid plan
Late last week, Governor Terry Branstad sent out a news release touting Iowa’s success in getting 12,000 providers to sign contracts with managed care organizations (MCOs) as the state hurtles toward implementation of its “Medicaid Modernization” plan on January 1. “We are proud of our progress and we will keep working to serve Medicaid patients,” Branstad said in the release. Many Iowans don’t share the administration’s optimism and are skeptical that the state will be ready to transition to MCOs on January 1, putting the care of Medicaid patients at risk throughout the state. (Quad-City Times)

Iowa’s Medicaid providers plead: Delay switch
Dozens of Iowa’s health care providers voiced warnings to federal officials in meetings last week about Governor Terry Branstad’s plan to privatize Medicaid management, one calling it an upcoming “catastrophe of monumental proportions.” “Trying to accomplish this in a two-month time frame and shoving this down the throats of providers is outrageous, unreasonable and shows no concern for the provider community or the patients we serve,” Mitch Harris of the Oncology Center of Iowa said, regarding the short turnaround for his agency to review the contracts and implement the new system. (Des Moines Register)

Rural hospitals worry Medicaid transition could end essential funding
Virginia Gay Hospital is working hard to keep its head above water. The tiny hospital in Vinton is moving its medical records over to an electronic medical record system and, as with the rest of the health care industry, it switched to a new medical coding system on October 1 – both costly and time consuming processes. The hospital is trying to work within an accountable care organization and is pushing to have better care coordination for its patients. But Michael Riege, the hospital’s CEO, worries the state’s plan to transition 560,000 Medicaid enrollees to plans managed by four out-of-state companies by January 1 could be the tipping point. (Cedar Rapids Gazette)

Medicaid transition moving at slow pace in Iowa
Top staff for Iowa Governor Terry Branstad say he is “pleased by the progress” in the Medicaid managed care transition, even though none of the four for-profit companies has individually enrolled more than 40 percent of the current Medicaid provider network. Branstad’s administration released data Thursday afternoon showing the number of providers signed by each of the companies selected to take over the state’s $4.2 billion Medicaid system January 1, pending federal approval. Each of the state’s 560,000 Medicaid members will be required to choose one of the four companies for their health care. (Dubuque Telegraph Herald)

The struggles behind rural health care
With a population of around 2,500 people, every business matters in Rock Rapids, Iowa, including the hospital and clinic. “We have a large elderly population, so that accessibility to receive good medical care is very important. It alleviates them having to drive to Sioux Falls,” Sanford Rock Rapids Physician Assistant Brenda Vis said. Vis says the rural clinic is also essential for moms of young children, but now more than ever, the rural health care system is struggling. It’s dealing with larger percentages of under-insured patients and declining reimbursement rates. (Keloland TV)

National rural health day draws attention to health care access
Iowa is among the top 10 states with adults in excellent or good health, according to a survey by the Iowa Department of Health. In large part, that’s the result of Iowa’s rural health care system, since 43 percent of the state’s population lives in rural areas or small communities. Bill Menner, the U.S. Department of Agriculture Rural Development state director in Iowa, says it makes sense for his agency to be involved in rural health care. “Rural communities provide support to ag producers,” says Menner. “Without rural hospitals, our farmers and ranchers might not have access to critical health care.” (KMALand)

Mercy Medical Center donates life-saving equipment to 11 organizations
Mercy Medical Center donated automatic external defibrillators (AED) to eleven schools, one church and Waypoint Services on Friday. Mercy Medical Center said more than a year ago the library requested an AED, but they realized many places in the community also didn’t have them. “We definitely know that there are people in the community that have these electrical rhythm issues and so it is important that they have access in the event,” Melissa Cullum of Mercy, said. (KCRG)

National News

Hospitals checking security after St. Cloud shooting
Hospitals across Minnesota are re-examining their security precautions amid an increase in violence associated with unstable psychiatric patients and fallout from the October shooting of a deputy by a patient in St. Cloud. Hospital officials say the number of nurses and aides injured by patients or visitors spiked last year, and the St. Cloud Hospital shooting is the second hospital assault in 12 months that ended in a fatality. None had been reported by hospitals in 11 prior years. (Minneapolis Star Tribune)

CMS may impose minimum provider-network standards for ACA plans
The Centers for Medicare & Medicaid Services (CMS) has proposed mandating minimum network standards for health plans sold on the federal insurance marketplace in 2017 as part of an effort to handle the broad shift toward narrow provider networks. The Affordable Care Act (ACA) requires that all medical policies on the exchanges have enough in-network hospitals and doctors for members so that “all services will be accessible without unreasonable delay.” (Modern Healthcare)

Ebola crisis: WHO slammed by Harvard-convened panel over slow response
A panel of global health experts has strongly criticized the World Health Organization (WHO), saying it mishandled the response to the Ebola outbreak in West Africa. The panel, convened by Harvard Global Health Institute and the London School of Hygiene & Tropical Medicine, called for extensive reform in the way infectious diseases are managed around the world, but singled out the WHO in particular for criticism. (CNN)

Antibiotic resistance: World on cusp of ‘post-antibiotic era’
The world is on the cusp of a “post-antibiotic era”, scientists have warned after finding bacteria resistant to drugs used when all other treatments have failed. They identified bacteria able to shrug off the drug of last resort – colistin – in patients and livestock in China. They said that resistance would spread around the world and raised the spectre of untreatable infections. (BBC News)

Mental health care in OH shifts from hospitals to jails
In the aftermath of highly publicized issues, such as mass shootings and skyrocketing drug addiction, more scrutiny has been placed on services for those with mental health and recovery issues. In the past five decades, state-run psychiatric hospitals have been phased out with funds shifted into each community to create outpatient care and support services for those afflicted with any of a number of mental illnesses. The 112-bed Woodside Hospital was shuttered 19 years ago. Today, the Mahoning County jail handles an inordinate number of inmates who oftentimes find themselves incarcerated because there is no other facility available to help them balance their mental health needs. (Youngstown Vindicator)

The state of telepresence: Health care and telemedicine
Telemedicine is a rapidly growing field and, with the aid of telepresence robots, is quickly gaining traction in hospitals and homes around the world. In rural hospital settings where a medical specialist is physically unavailable, a robot can be deployed to check in on a patient with a physician from elsewhere. In the home, a nurse can check in with a patient while they recover in a comfortable setting. (Robohub)

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