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

Iowa News

To Obama: Save our Medicaid program
Every single Democrat in the Iowa Senate signed a letter sent to President Barack Obama this week asking to top Governor Terry Branstad from privatizing management of the state’s Medicaid program. In December, the Obama administration recognized numerous problems and delayed the governor’s planned January 1 implementation date. The senators expressed appreciation for that action, but noted everything they’ve seen and heard since indicates transitioning on March 1 would be no better. (Des Moines Register)

How many ombudsmen will be needed to privatize Medicaid in Iowa?
As Iowa gears up for transitioning its Medicaid system into private management by three for-profit companies, lawmakers are grappling with how many ombudsmen are needed to give recipients assistance and objective information. The Health Consumer Ombudsman Alliance Final Report proposes adding 154 additional ombudsmen, or one advocate for every 3,500 Medicaid recipients. Thus far, only two new staff have been hired. (Iowa Public Radio)

Iowa is not ready for Medicaid transition
Senate Democrats have submitted a letter to President Obama and other federal officials about our concerns over Governor Terry Branstad’s unilateral decision to privatize Iowa’s Medicaid program. Senator Dick Dearden (D-Des Moines) explains that since the delay by the Centers for Medicare & Medicaid Services more than 40 days ago, we have seen no evidence that the Iowa Medicaid Enterprise and the out-of-state companies picked to help privatize Medicaid have taken the steps necessary to ensure the health and well being of more than 560,000 Iowans. (Des Moines Register)

Listen to students to address mental health needs on campus
Good physical and mental health is closely linked to academic success and healthy environments and safety nets at the state’s institutions of higher learning are important public investments. Initiatives to improve mental health services clearly are necessary and should be led with meaningful input by the people with the most at stake. The increasing need for mental health resources on campus is part of a national trend. Addressing student mental health needs not only will require more resources, but also will take creative approaches tailored to our specific student populations. (Cedar Rapids Gazette)

Report ranks Iowa 14th best for well-being                 
Iowans’ well-being relative to the rest of the nation improved slightly over last year, according to annual national index results released today by the Iowa Healthiest State Initiative. Iowa ranks 14th among the states in the Gallup-Healthways Well-Being Index, up from 16th a year ago. Iowa’s overall score improved in all elements except community. (Business Record)

National News

Bill would require KanCare patients, doctors to first try lower-cost drugs
Gayle Taylor-Ford’s husband has been waiting two months for the treatment his doctor thinks is most likely to help with his multiple sclerosis, a wait she attributes to their insurer’s step therapy protocol. Through step therapy, doctors and patients must document that lower-cost drugs didn’t work before a more expensive prescription can be tried. Taylor-Ford and others spoke Wednesday at a hearing on Senate Bill 341, which would allow step therapy in the state’s privatized Medicaid program known as KanCare. (Kansas Health Institute)

10 Kentucky health systems band together in statewide collaborative
10 health systems operating in Kentucky are joining a collaborative they say will combat the state’s poor health outcomes by sharing best practices and reducing the costs of care. The news of the collaboration comes the same week as Governor Matt Bevin announced he plans to end Kynect, the state-operated health insurance exchange established by his predecessor. The health systems will remain independent and the collaboration will allow them to share and compare their best practices and outcomes with each other, Shepley said. (Modern Healthcare)

Innovative course teaches doctors how to deliver bad news
While medical school students traditionally receive heavy doses of technical information, very little is done to train them on how to break bad news. In the spirit of helping residents ‘do no harm,’ display compassion and avoid further traumatizing patients or families during a time of personal crisis, the Breaking Bad News program, a new curriculum at Morristown Medical Center in New Jersey, was designed to be as real as possible. The curriculum has also been extended to hospitals in such other states as Virginia and Florida through the group’s Breaking Bad News Foundation. (NJ.com)

California initiative aims to cap hospital executives’ pay
Supporters of the Charitable Hospital Executive Compensation Act of 2016 are attempting to cap the annual compensation of health care executives at $450,000 to match it to the level of the office of the president of the United States, in an effort to reduce the cost of hospital care. The initiative has created controversy between the Service Employees International Union-United Healthcare Workers West, which backs it, and the California Hospital Association (CHA), who opposes it. The CHA responded with a statement it would negatively impact hospitals throughout the state. (Healthcare Dive)

WHO warns of Zika virus ‘spreading explosively’
Yesterday, the World Health Organization (WHO) stated the Zika virus, which is transmitted by Aedes mosquitoes and has already spread to 22 countries, is “spreading explosively” in the Americas. While some cases of Zika have been identified in the U.S., they are believed to have been the result of travel to affected regions. WHO Director-General Margaret Chan stated, “WHO will…prioritize the development of vaccines and new tools to control mosquito populations, as well as improving diagnostic tests.” (Healthcare Dive)

White House kicks off efforts for ‘cancer moonshot’
President Obama on Thursday officially launched a cancer-fighting task force that he said will double the rate of progress in the nation’s fight against the disease. The highly anticipated efforts, spearheaded by Vice President Biden, will be called the White House Cancer Moonshot Task Force – a reference to Biden’s speech in the Rose Garden last year calling for a “moonshot” to cure the disease that led to his son’s death. (The Hill)

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

Iowa News

Myths about Medicaid privatization in Iowa
As Iowa’s 118 community hospitals and 71,000 hospital employees work daily to bring healing and wellness to all Iowans, the state’s reckless rush toward privatization of the Medicaid program has been a source of extreme concern. Most concerning are the myths about privatization perpetuated by the governor as he tries to promote what is simply a bad idea for Iowa and, especially, for 560,000 vulnerable Iowans who depend on Medicaid. (Cedar Rapids Gazette)

Report highlights confusion on private Medicaid oversight
It’s unclear how Iowa will give all Medicaid recipients an independent way to voice complaints about service under private management that goes into effect soon, lawmakers said Wednesday following a presentation on some proposed oversight of the system. Lawmakers in the Senate Human Resources Committee expressed concern that an independent system for all Medicaid recipients to file more serious challenges to insurance claims or treatment won’t be in effect in time for the privatization switch on March 1. (Charlotte Observer/Associated Press)

Iowa Dems ask Obama to weigh in on Medicaid transition
Iowa’s 26 Democratic senators on Wednesday wrote a letter to President Barack Obama expressing their “heartfelt concerns” regarding Governor Terry Branstad’s decision to move the state’s $5 billion Medicaid program over to a managed care system on March 1. The letter asks for the Centers for Medicare & Medicaid Services, the federal agency that must still approve the transition, to instead deny the application. (Cedar Rapids Gazette)

National debt needs to be controlled
Local business leaders called on politicians to work together to rein in the national debt Wednesday during a pre-caucus round-table discussion at the Greater Des Moines Botanical Garden. The looming $18 trillion deficit affects the ability of businesses to grow and innovate, they said. The gathering was part of the Greater Des Moines Partnership’s Iowa Caucus Consortium, a series of events leading up to Iowa’s first-in-the-nation Iowa caucus on Monday. (Des Moines Register)

State jobs agency releases plan for overhaul
Iowa Workforce Development has released its second draft of a plan for the state to implement the federal Workforce Innovation and Opportunity Act. The act, which took effect in July 2014, is the first federal legislation aimed at reforming the workforce development system in 15 years. The U.S. Department of Labor and U.S. Department of Education have to approve the state’s plan by March 2016. (Business Record)

National News

Reducing preventable harm in hospitals
Each year in the United States, millions of patients are harmed while receiving care in hospitals. The estimates of the number of people who die each year as a result of hospital errors have ranged from as many as 98,000 in a landmark Institute of Medicine report from 1999 to as many as 440,000 in a 2013 study. Many individual hospitals or health centers have made headway in improving safety. But the nationwide gains have been mixed, with wide variations across and within hospitals. (New York Times)

Family battles Medicaid managed care for access to specialist
As a mother, Anya Staton says her primary instinct is to feed her children. So when her oldest son developed an eating disorder she knew he needed help — help she didn’t know how to give. And care the family’s insurance company, through Florida’s Medicaid program, denied the boy needed. Her family’s experience is just one of several highlighted recently as part of a Sarasota Herald-Tribune series on Florida’s Medicaid program, one that has transitioned to a system where private companies manage care for low-income children, families and the disabled. (Health News Florida)

Hospitals prepare to see stars in April
The Centers for Medicare & Medicaid Services (CMS) has shared the methodology behind five-star hospital quality ratings that will be published this April on Medicare’s Hospital Compare website. The American Hospital Association (AHA) gives the methodology a low score. The AHA says the rating system “oversimplifies the complexity of delivering high-quality care” and should not be used. The association responded to the CMS document in an advisory to members posted online Wednesday. (Modern Healthcare)

Plain language replaces color-coded alerts at some North Carolina hospitals
Carolinas Medical Center and other hospitals across North Carolina have adopted what hospital officials call “plain language.” The goal is to reduce errors and promote safety of hospital staff, patients and visitors by using common-sense language instead of color codes that might differ from hospital to hospital. The recommendations were made by the North Carolina Hospital Association after reviewing best practices around the county. (Charlotte Observer)

Florida hospital emphasizes population health for optimal care delivery
Spotting a link between positive health behaviors and lower health care costs, Naples, Florida-based NCH Healthcare System is investing in expansion of its ambulatory and outpatient settings and care coordination for at-risk groups. To improve the health of its various patient segments, NCH crafted a strategy that provides care delivery tailored to targeted groups to address their different health concerns. (HealthLeaders Media)

Vermont officials outline bid for new health care system
Governor Peter Shumlin and other senior state officials are going ahead with plans to ask for changes to federal rules in order to create a new system for paying health care providers. The state is asking for changes to federal Medicaid and Medicare rules to enable it to institute an “all-payer model.” The aim is to get away from health providers being paid for individual visits and procedures, and instead give them a set budget with the goal of keeping a certain population healthy. (WAMC/Associated Press)

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

Iowa News

Families, Congressman Dave Loebsack share concerns about Medicaid plan
Local families say a plan to privatize Medicaid in Iowa lacks transparency and those in charge aren’t answering their questions. “It’s complicated, it’s hard to understand, you can’t get answers for it, so my son’s future is uncertain,” said Jeff Edberg. Edberg hosted Democratic Congressman Dave Loebsack and several other parents of special needs families in his home Friday to discuss their concerns. Loebsack said he will take his concerns back to Washington D.C. (KCRG)

Rocky Medicaid privatization rollout looms as a political issue in Iowa
Lots of attention has focused on the Iowa presidential caucuses coming up on February 1. But in Iowa, many health care providers, patients and public officials are more immediately concerned about Governor Terry Branstad’s Medicaid privatization effort, which he says will save money and improve care. “I would say it’s one of the top issues in Iowa, but I don’t know if it translates to the presidential candidates,” said Brian Johnson, a Republican lobbyist in Des Moines. (Modern Healthcare)

Get involved in Medicaid debate
Iowa is moving quickly to privatize Medicaid and Chet Culver, former Iowa governor, is deeply concerned for the more than 560,000 Iowans on Medicaid, including 120,000 coping with life-altering disabilities, whose quality of life and future depend upon accessible health care. But behind all of the big numbers are real people and Culver is urging Iowans to tell their Medicaid stories and share their concerns with legislators. (Des Moines Register)

Hospital in Grundy Center welcomes new technology
Staffers at Grundy County Memorial Hospital a few months ago rolled a relatively new weapon against infections into the operating room. And then they rolled it into patients’ rooms. The Steris pathogen disinfection system relies on ultraviolet light to kill germs — and it’s on wheels. Appropriately, the manufacturer calls its mobile device “Pathogon.” (Waterloo Cedar Falls Courier)

Book honors Percy Harris, first black physician in Cedar Rapids
When Ted Townsend, president and CEO of UnityPoint Health-St. Luke’s Hospital, first heard Dr. Percy Harris’ story, he knew he was hearing something special. Harris came to Cedar Rapids with his family in 1957 to complete an internship as the first black physician at St. Luke’s Hospital. He helped break down not just professional barriers for physicians of color, but housing barriers as well. Townsend spearheaded the effort to write the Harris story down. (Cedar Rapids Gazette)

National News

How New Jersey is Protecting Information in the Health Care Industry
Joe Carr welcomes the state and health care industry partnership to protect the 200-plus members of his New Jersey Hospital Association against cyber threats and hacking. “That kind of support is really important for us,” said Carr, chief information officer for the New Jersey Hospital Association. The newly formed New Jersey Cybersecurity and Communications Integration Cell is the state’s one-stop shop for cyber threats, attacks, analysis and incident reporting. It has 19 states and hundreds of public and private partners with which it shares information. (NJTV News)

Massachusetts hospital shows opulation health really does work
At self-insured Houston Methodist in Massachusetts, a population health pilot designed for staff members saw 50 percent of high-risk participants move into the low-risk pool within the first six months. Physicians, in addition to an employed cohort, make up the Physicians Alliance for Quality, an internal physician organization at Methodist. Employed and independent doctors work together to improve handoffs and the care continuum. The Alliance helps them with meaningful use targets, other pay for performance programs and helps them achieve financial incentives for quality care. (HealthLeaders Media)

Utah lawmakers get creative with Medicaid expansion
Utah lawmakers will again take on Medicaid expansion and various plans to implement it for the thousands of Utahns who remain uncovered by health insurance. And, while some lawmakers are taking approaches that have been tried before, others are trying new things — an indication of a potential desire to bring health care benefits closer to Utahns who can’t afford them. In his bill, Representative Robert Spendlove is looking to bypass the current federal administration and start working with “the next one” on a plan for Medicaid expansion in Utah. (Deseret News)

Tech execs see consumers drawing the line on privacy with health
Consumers have willingly traded some of their personal details for access to social sites like Google or Facebook, and suffer an occasional ad as a result. But once that sharing gets too personal, as with health care information, it could prompt people to retreat behind a wall of privacy, according to a panel of technology experts. Michael Gregoire, chief executive officer of software company CA Inc. said, “the thing that I think as being the catalyst for making us stop and pause and think about this is going to be health care.” (Bloomberg Business)

HHS on target to move 30 percent of Medicare payments to quality, value by year’s end
Last January, the U.S. Department of Health and Human Services (HHS) announced a timeline to move the Medicare program and the entire U.S. health care system toward paying providers based on the quality of the care they give to patients as opposed to the quantity of care, known as fee-for-service. HHS Secretary Sylvia Mathews Burwell said the agency will meet their goal of moving 30 percent of fee-for-service Medicare payments to value-based payments by the end of 2016. (Healthcare Dive)

Employee wellness programs use carrots and, increasingly, sticks
Workers increasingly are being told by their companies to undergo health screenings and enroll in wellness programs as a way to curb insurance costs. Many employees now face stiff financial penalties if they do not participate. The federal Equal Employment Opportunity Commission argues that employers have wellness programs that violate laws prohibiting them from demanding medical information from workers. In addition to bringing several lawsuits, the agency has also issued proposed regulations that would forbid companies to make health screenings a condition of insurance coverage. (New York Times)

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fact-myth_memeAs Iowa’s 118 community hospitals and 71,000 hospital employees work daily to bring healing and wellness to all Iowans, the state’s reckless rush toward privatization of the Medicaid program has been a source of extreme concern. Most concerning are the myths about privatization perpetuated by our own governor as he tries to promote what is simply a bad idea for Iowa and, especially, for 560,000 vulnerable Iowans who depend on Medicaid.

On behalf of those Iowans and the health care professionals who care for them, it’s time that all of Iowa sees these myths for what they are: misleading half-truths that cannot hide the failures of this ill-conceived plan.

Myth: The federal government held Iowa to a higher standard when it forced the state to delay its plan.

Fact: The governor and his staff knew exactly what was needed to satisfy federal officials and, with any exercise of due diligence, they should have also realized it would be impossible to make this wholesale transition in only a year. No other state has ever privatized even part of its Medicaid program in such a tight timeframe, let alone the entire program, as the governor is seeking to do.

It was obvious to everyone, particularly among frustrated Medicaid beneficiaries, that the state was not ready, but Governor Branstad chose to ignore them, the people who provide their health care and other state leaders. Federal officials did what they were supposed to do: protect beneficiaries and ensure program integrity.

Myth: Medicaid privatization is the only option for coordinated, accountable care.

Fact: With the full knowledge and endorsement of Governor Branstad, the state already supports alternatives through the Medicaid State Innovation Model, Integrated Health Homes and Accountable Care Organizations – and as far as reducing cost and improving efficiency, they are working. The state and hospitals have put cooperative effort into these programs and they have shown more savings in the past five years than private managed care for Medicaid has demonstrated in 30 years of so-called “innovation”. Then again, there is nothing innovative about denying and delaying care.

The bottom line is Iowa already has one of the most efficient Medicaid systems in the nation and the state and health care providers have been working, hand-in-hand, to make it even better. Privatization will simply interject a very expensive middleman who will extract millions of dollars to meet corporate goals while adding no value to the system.

Myth: Iowans will support clean water, strong public education or a community-based, efficient and patient-oriented Medicaid program, but not all three.

Fact: Iowans can and do support all three and the path hospitals and other health providers desire to take will further sustain Medicaid and other widely-held priorities. The people of this state would rightfully reject wholesale privatization of the public school system or water resources, so it’s no surprise that nearly eight out of 10 Iowans oppose privatizing health care coverage for a half million highly vulnerable citizens. Knowing that, Governor Branstad’s administration fired its plan through the Capitol with no legislative debate and then, with the throttle firmly planted to the floor, pretended to take input from a predictably skeptical public.

As of today, nothing has been done to assuage that skepticism, which is why IHA, along with thousands of health care professionals and even more every-day Iowans, continues to oppose this untenable, unnecessary plan that puts the health of impoverished, disabled and elderly Iowans at risk.

Health care providers across the state know we can do better. In fact, we already are.

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

Iowa News

In Iowa, governor can ignore lawmakers
Separation of powers in government is one of the most basic concepts in our democracy. Iowans frustrated with Governor Terry Branstad’s plan to privatize administration of Medicaid understandably turn to the Iowa Legislature for help. Lawmakers, however, seem to be at a loss for what to do. Short of holding the state budget hostage, they don’t have many options. The Obama administration is the only hope for stopping the governor by denying his application for a waiver needed to move forward. (Des Moines Register)

Lawmakers seek Medicaid oversight despite veto threat
Iowa legislators say they are building a plan to adopt at least part of a $17 million Medicaid oversight recommendation that Governor Terry Branstad has dismissed as “overkill.” Those developing the plan said Monday they know a veto could be in store. Roughly a dozen of Branstad’s agency or top officials put together the recommended oversight plan that calls for 134 long-term care ombudsmen. Currently the plan has two. (Des Moines Register)

Robert Young Center to expand mental health care services
In hopes of increasing access to mental health care services in five rural counties, the Eastern Iowa Mental Health/Disability Services Region announced on Monday a $3.1 million contract with UnityPoint Health-Trinity. The Iowa Department of Human Services selected Rock Island-based Robert Young Center for Community Mental Health to launch new behavioral health services. The grant will help fund services for the residents of Scott, Muscatine, Clinton, Jackson and Cedar counties. (Quad City Times)

SMCH hosts forum to address county-wide health care needs
Over 50 people representing city, county, educational and health interests in Calhoun County met at Stewart Memorial Community Hospital (SMCH) earlier this month for the Living and Working Well Together: Iowa Hospital and Employer Community Engagement Open Forum. While the webinar from the Iowa Hospital Association was designed to present health initiatives at the state level, the main focus for the open forum was to examine efforts at the local level. (KCIM)

Mumps outbreak spreads to Plymouth County
Johnson County is still recovering from the largest mumps outbreak since 2006 in Iowa, and now health officials in Plymouth County are also battling the airborne illness. “We have four confirmed cases in Plymouth County,” said Tara Geddes, Community Health Manager at Floyd Valley Hospital. The fast spreading virus first appeared on the campus of the University of Iowa. According to school officials more than 100 students tested positive for the virus from July to November of fall 2015 and it is likely the virus spread while students returned home over the winter break. (Siouxland Matters)

National News

Rural hospital struggles continue
Southern Palmetto Hospital in Barnwell announced that it will at least temporarily end “patient operations.” It’s the third rural hospital in South Carolina to close since 2011. In Georgia, four rural hospitals have closed since the beginning of 2013. Others are clearly struggling. Rural hospitals across the United States face some daunting challenges. Not only do they serve areas where potential patients are relatively few, but often those patients are likely to be unemployed, insufficiently insured or not uninsured at all. (Augusta Chronicle)

Meaningful use declaration mixed among rural health care providers
While rural providers have adopted health IT at the same time or at greater rates as their urban counterparts, meaningful use varies dramatically among them, according to a recent HealthAffairs study. “The study demonstrates that although rural providers’ overall initial health IT adoption rates were higher than those of urban providers, substantial adoption disparities exist within the rural community,” the study’s author and public health analyst for the ONC, Dawn M. Heisey-Grove said. (Healthcare IT News)

Incentives for quality a challenge for ACOs
Pediatricians in accountable care organizations (ACOs) who received small incentives to improve quality did so, but not as significantly as doctors employed by a hospital, a new study found. According to the results, doctors employed by the hospital saw the greatest improvement. Hospital physicians improved more significantly on eight quality measures compared with community doctors who received an incentive. The findings underscore the challenge that policymakers and the industry face finding ways to tie payment to performance. (Modern Healthcare)

Maryland’s bold payment reforms blaze a path, but will others follow?
The state started setting hospital rates for private payers in 1974 and three years later won permission from the federal government to also set rates under Medicare and Medicaid. Maryland policymakers say that move has erased the cost-shifting that most U.S. hospitals rely on to make up for low rates from public payers. This model could be used in other states, but would take significant political will by states to more actively regulate hospitals. (Modern Healthcare)

Zika virus set to spread across Americas, spurring vaccine hunt
The mosquito-borne Zika virus, which has been linked to brain damage in thousands of babies in Brazil, is likely to spread to all countries in the Americas except for Canada and Chile, the World Health Organization said on Monday. Zika transmission has not yet been reported in the continental United States, although a woman who fell ill with the virus in Brazil later gave birth to a brain-damaged baby in Hawaii. (Reuters)

Drug shortages in American ERs have increased more than 400 percent
Emergency rooms (ERs) are health care’s front line — in the United States, there are nearly 45 ER visits per 100 people in any given year. But there’s an issue brewing behind the scenes in emergency medical facilities, one that can’t be fixed by a simple stitch or bandage. A new study published in the journal Academic Emergency Medicine shows that drug shortages in ERs across the United States increased by more than 400 percent between 2001 and 2014. (Washington Post)

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