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

Iowa News

Privatized Iowa Medicaid system needs oversight
It appears Iowa is headed toward private management of the state’s Medicaid system — a system that provides important services for about 560,000 of our most vulnerable residents. As Iowa makes the switch from a service run by the state government to one where profits and stock value are the driving force, it will be more important than ever that the system be closely monitored to make sure it is meeting the needs of its clients. It is vital now that privatization seems inevitable to put into place oversight safeguards and an effective appeals process. (Mason City Globe Gazette)

Medical errors and patient safety
Medical errors have been a topic of discussion for many years, especially since 1999 when a report by the Institute of Medicine showed that an estimated 98,000 Americans died every year due to medical errors. In Iowa, the Iowa Hospital Association and Iowa Medical Society formed the Iowa Healthcare Collaborative (IHC) to improve the quality of health care delivered to all Iowans and in the past 10 years, IHC has led many initiatives to improve quality, patient safety and transparency. (Ames Tribune)

Corporate-owned Medicaid clinics come to Iowa
The three corporations hired to manage Iowa’s Medicaid program each plan to open their own medical clinics, senior facilities or “wellness” centers, raising questions about the dual role of companies that reap the financial benefits as both insurance and medical providers. These sites will include doctors or other medical staff to assess or treat Medicaid patients. Many of those patients will have insurance through the same company as the physician’s corporate owner. The new information raises yet more concerns in the plan to privatize Iowa’s $4.2 billion Medicaid program. (Des Moines Register)

Cedar Rapids earns Blue Zones certification
Cedar Rapids will be officially certified as a Blue Zones community next month, according to the community wellness organization. Cedar Rapids was named a Blue Zones demonstration site in January 2013 and has been working since then to become certified by incorporating and upgrading a range of health and wellness-minded offerings through schools, restaurants and workplaces. (Cedar Rapids Gazette)

National News

OH law calls for transparency on out-of-pocket costs for patients
Starting as early as next January, an Ohio patient might receive, upon request, a “good-faith and reasonable” estimate of the procedure’s total cost; how much private or government-sponsored insurance would pay for the procedure and the patient’s personal share of the bill. It would represent one of Ohio’s broadest and most meaningful advances in health care cost transparency in several years. The Ohio Hospital Association has indicated a willingness to work with legislators and insurers to create ways to provide cost estimates to patients before major procedures in an inpatient setting. (Columbus Dispatch)

Casino proceeds eyed for health care, tax relief in Georgia
If casino gambling comes to Georgia, the state’s winnings may benefit more than just education. Representative Rusty Kidd (I-Milledgeville) proposes dedicating some of the extra money to local tax relief and health care, including aid to hospitals and mental health programs. Kidd said money is sorely needed for rural health care and local property owners who are the primary source of revenue for many rural governments. The proposed amendment, he said, will broaden support for allowing casinos in Georgia. (Valdosta Daily Times)

How a Pennsylvania hospital is addressing patients’ unmet needs
Main Line Health’s Lankenau Medical Center sits on the border of two Pennsylvania counties with wildly different average health outcomes, which galvanized the hospital’s focus on population health. Main Line started an annual colloquium, an event in which staff and leadership share updates on community needs. Hospitals that want to start a similar program should focus on language barriers, transportation and food insecurity, which are closely linked to higher hospitalizations and readmissions, said Akin Demehin, senior associate director of policy for the American Hospital Association. (Modern Healthcare)

Texas relying on nonprofit clinics for Zika defense
The walls at the Legacy Community Health clinic in Houston are plastered with signs urging pregnant patients to tell their doctor if they have traveled to Central or South America. But access to preventive health care in the state, with its high rate of uninsured people, can prove challenging for the state’s poorest residents, many of whom are at greater risk for contracting a mosquito-borne virus like Zika, experts say. To serve those Texans, the state is relying heavily on nonprofit community clinics to be the front line of public health defense. (Texas Tribune)

Readmissions, observation and improving hospital care
There has been a big focus on reducing hospital use and the Affordable Care Act’s Hospital Readmissions Reduction Program penalizes hospitals for higher than expected readmission rates. A new study says readmissions are down because fewer people are being readmitted to the hospital, not because people are being admitted to observation status. But now the real challenge is in figuring out whether patients are better off. (Health Care Blog)

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

Iowa News

Medicaid managed care year one: An Iowa family’s journey
Colin Edberg, a 13-year-old boy, resides at Hills and Dales, a Dubuque-based Intermediate Care Facility for children and adults with intellectual disabilities. Starting April 1 the Edbergs, along with hundreds of thousands of other families, will have a new health care system to navigate as the state transitions from a fee-for-service Medicaid program to a capitated managed care system. The Gazette will be following the Edbergs throughout the first year of managed care to see how this move affects their family as well as Hills and Dales. (Cedar Rapids Gazette)

Virginia Gay and the approval of private mangement of Iowa’s Medicaid system
Despite assurances by the Iowa Medicaid Director that she was “very confident” Iowa would be ready to implement Medicaid privatization as early as January 1, the process has again been delayed by the Centers for Medicaid & Medicare Services until April 1. Speaking on behalf of Virginia Gay Hospital and Clinics, and for the doctors and other providers delivering front-line care to Iowa’s Medicaid population, Mike Riege, administrator of the hospital, has repeatedly expressed great concern about Iowa’s plan for privatization of Medicaid. (Vinton Today)

Advocates want a mental health court in Scott County
Judges, elected officials and health professionals are discussing how a mental health court in Scott County could benefit the community. The QC Interfaith Restorative Justice Task Force hosted the event Thursday at Genesis Medical Center. Judy Collins, a volunteer with the Community Health Center Board, says mental illness isn’t always easily recognized and as a result, many people end up in jail. Some advocates at the event say whatever it would cost to get a system in Scott County would be worth the investment. (KWQC)

Partnerships key to improving care, cutting costs
Health care providers in Iowa are eager to adopt new cost models that incentivize public health, according to Wellmark CFO David Brown, although further coordination is needed to successfully implement those and other Affordable Care Act policies. To reduce costs, the entire spectrum of health care parties, including employers, insurers, brokers and patients, must be involved. “Even if we could cut that cost in half, think of what that would do to the cost of health care,” said Brown. (Corridor Business Journal)

Hansen Family Hospital creates $19 million impact on local economy
Hansen Family Hospital generates 409 jobs that add $15,703,138 to Hardin County’s economy, according to the latest study by the Iowa Hospital Association (IHA). The IHA study examined the jobs, income, retail sales and sales tax produced by hospitals and the rest of the state’s health care sector. “This annual study illustrates the impact our hospital makes in our Hardin County community beyond the medical services we provide,” said Cherelle Montanye, CEO of Hansen Family Hospital. (Hansen Family Hospital)

National News

In Chicago, triage for mentally ill before jail
One of the nation’s most crowded jails may get relief later this year with the opening of a 24-hour triage center in Chicago where police can take people experiencing psychiatric or substance-abuse crises. The goal is to ease pressure on the county jail, where officials have long complained that about a fifth of the detainees are locked up because of mental health problems. (ABC News)

Demand growing for mental health treatment in Maryland county
Issued once every three years by the Healthy Anne Arundel Coalition, the Community Health Needs Assessment released Wednesday found residential mental health beds to be almost nonexistent in Anne Arundel, though there are 259 residential rehabilitation beds in the county for people with chronic and persistent mental illness. Hospitals in the county are planning to use data from the report to improve mental health services provided to the community. (Baltimore Sun)

Alabama Senate passes budget without Medicaid fix
Plans to reform Alabama’s Medicaid program would end — and the state would lose hundreds of millions of dollars in federal matching funds — under the state budget passed by the Alabama Senate on Thursday. The rising cost of Medicaid has put strain on the General Fund, which pays for most state agencies. Lawmakers in 2013 approved a sweeping plan to switch Medicaid to a managed-care-like model in hopes of slowing the program’s growth. (Anniston Star)

New Jersey towns challenging hospitals’ tax-free status
A dozen municipalities across the state are challenging the tax-exempt status of non-profit hospitals in their communities, sparked by Morristown winning a $15.5 million settlement against a hospital last year. A spokeswoman for the New Jersey Hospital Association said she is aware that municipalities have filed tax appeals against another five hospitals. (NJ.com)

Change to hospital regulation again looms in Connecticut – but direction unclear
Health care is changing in Connecticut: Once-independent hospitals are joining larger health systems. Physicians are joining hospitals or larger practices. And some observers worry about what that means for people’s access to care. Amid all that, lawmakers are revisiting the way the state regulates major changes in health care, but it’s unclear whether any changes would leave the state with more regulation or less. (CT Mirror)

WebMD hints at joining telehealth space
WebMD CEO David Schlanger said during an earnings call on Tuesday the company will “likely” enter the telehealth space through an acquisition or partnership as prices have started to moderate. “We believe that alternative primary care like telehealth will eventually gain a wider adoption, and we think that WebMD is well-positioned to provide access to those services because of the trust in our brands and our distribution,” said Schlanger. (Healthcare Dive)

White House announces ambitious plans to advance precision medicine efforts
President Barack Obama yesterday touted the progress the government has made on precision medicine during a summit, where officials announced a new round of commitments from the private, public, academic and nonprofit sectors aimed to accelerate future efforts. The initiative aims to advance a new era of medicine that focuses on delivering more personalized health care. However, the health care system at large does not consider precision medicine a major priority, with about 59 percent of hospitals and health systems saying it was not a key goal in the next five years. (Fierce Healthcare)

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

Iowa News

Medicaid patients voice concerns over privatization
The group Advocates for Iowa Medicaid packed the capitol rotunda Wednesday afternoon, with the goal of making sure the voices of Iowans on Medicaid and their families are heard during the controversial shift to a privately managed system. There were between 40 and 50 beneficiaries gathered at the capitol to tell their stories. Former governor Chet Culver also attended the rally, and said lawmakers now have to scramble and play catch-up before the new system goes into effect. (KCRG)

Emotional Iowans plead for Medicaid oversight
Dozens of Iowans, many of them speaking through tearful sobs, pleaded, implored and demanded state lawmakers provide additional oversight of the state’s pending shift to private management of the Medicaid program. Lawmakers held a hearing Wednesday at the Capitol on legislation that would add some layers of oversight of the three health-care companies that starting April 1 will manage the vast majority of Iowa Medicaid patients. (Sioux City Journal)

Culver tells Iowans: ‘Be heard’ on Medicaid controversy
Former Iowa Governor Chet Culver says changes in Medicaid health care represent one of the state’s biggest public policy shifts in the past 50 years, and he’s urging Iowans to speak out and being heard. Culver, a Democrat, told about 100 people at an Iowa Capitol rally on Wednesday he has concerns about Republican Governor Terry Branstad’s plan to have private firms assume management of Medicaid for about 560,000 low-income and disabled people. (Des Moines Register)

Initial losses, then profits projected for Medicaid managers
Two of the four companies that originally won contracts to manage Iowa’s Medicaid system projected financial losses for at least the first year of their contracts, but assured investors that profits are on the horizon. That’s in part because the initial per-patient payments locked in by state contracts extend for only 18 months. After that, the companies can use their own estimates to help secure fatter profit margins. (Des Moines Register)

Medicaid oversight: ‘Where’s the teeth?’
Lawmakers who had worked to slow down or derail Iowa’s effort to privatize Medicaid management have a new focus following Tuesday’s federal approval: oversight. And while it appears the effort has more bipartisan support than failed efforts to terminate the privatization plan, criticisms were voiced Wednesday from disability rights advocates who say the new effort is too shallow. (Des Moines Register)

With Iowa Medicaid changes approved, recipients work to make sure they are covered
Just one day after the federal government gave the go ahead for the state of Iowa to move forward with an April 1st rollout of Medicaid privatization, a state Senate subcommittee is taking a look at the possibility of overseeing the program, ensuring it maintains integrity. The packed meeting hosted 20 people testifying about their concerns, saying the transition is happening too fast. Others contend the process could leave many recipients “out to dry” and keeps the money away from those who really need it. (Siouxland Matters)

National News

Rural hospitals in North Carolina scale to fit communities’ needs
Smaller, relatively remote hospitals continue to face numerous challenges: declining, aging populations; dwindling margins; difficulties recruiting providers. In North Carolina, as elsewhere, rural hospitals are pursuing varying strategies that they trust fit the populations they serve today. It’s important to have the right kind of system best suited for a particular region, believes Jeff Spade, executive vice president of the North Carolina Hospital Association’s NC Center for Rural Health Innovation and Performance. (North Carolina Health News)

Missouri group urges state to expand Medicaid for young adults with mental illnesses
Advocates in Jefferson City are lobbying for expanded access to Missouri Medicaid for young adults suffering with mental illness. Members of the National Alliance on Mental Illness are working to establish a waiver that would allow people age 21 to 25 to obtain health care through Medicaid at the first signs of serious mental illness. (Southeast Missourian)

Compromise plan seeks to expand Medicaid in Maine
A coalition of police agencies and medical providers is backing another attempt to expand Medicaid coverage in Maine, this time with a compromise measure tied to the heroin crisis. The coalition includes the Maine Hospital Association, the Maine Sheriffs Association and the Maine Chiefs of Police Association. The proposal would give 70,000 low-income people the option of getting health insurance through a program that uses a combination of Medicaid and private health insurance. (WLBZ)

Bad debt is the pain hospitals can’t heal as patients don’t pay
Hospitals have long struggled to collect bills when patients aren’t covered by insurance – creating delinquent accounts. While millions of people have gained coverage since Obamacare became law in 2010, there’s also been an increase in insurance that comes with high deductibles and cost-sharing. Under those plans, the first few thousand dollars of annual medical expenses come out of patients’ wallets. That’s money that hospitals are unlikely to collect and hospitals are feeling the pressure from those patients. (MSN)

Lowering the barriers to primary care
Though the nation still faces a shortage of primary-care physicians, regulatory and payment roadblocks to delivering that basic service in less expensive ways are finally starting to come down. The key is expanded access to telehealth technologies and shifting more primary care to alternative practice models. These approaches can go a long way toward alleviating the shortage. (Modern Healthcare)

Zika virus: Docs develop first hospital-based rapid test
Amid increasing fears over the spread of the Zika virus, two Texas Medical Center institutions announced they have developed the first hospital-based rapid test for the virus. The test can be applied to urine, spinal fluid, amniotic fluid or blood. It will substantially simplify the testing process, which up to this point could present long delays due to reliance on public health laboratories and the Centers for Disease Control and Prevention. (Fierce Healthcare)

Shortage of addiction counselors further strained by opioid epidemic
As the drug-related death toll rises in the United States, communities are trying to open more treatment beds. But an ongoing labor shortage among drug treatment staff is slowing those efforts. Each year, roughly one of every four substance-abuse clinicians nationally chooses to leave the job, according to recent research. And that’s not just turnover — leaving one job for another in the same field. As an Institute of Medicine report documented in 2006, there’s been a shortage of addiction workers for decades. And the demand is only increasing. (Iowa Public Radio)

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(From time to time, the blog features recipients of the IHA Iowa Hospital Heroes Award. These outstanding hospital employees come from across the state and work at hospitals of every size. They exemplify the courage, caring and community focus that are the hallmarks of the hospital mission in Iowa.)

Michelle-Callahan-Moore-headshot-smallCompassion is a human emotion prompted by the pain of others. More vigorous than empathy, the feeling commonly gives rise to an active desire to alleviate another’s suffering.

Fort Madison Community Hospital (FMCH) Iowa Hospital Hero Michelle Callahan-Moore is the embodiment of compassion. Her job is as a registered nurse on the medical/surgical unit, her vocation is healer, teacher, nurturer and friend. As one coworker put it: “There is no patient who leaves FMCH that doesn’t know her. They all greet her with a smile and a hug and she does them as well. She is the most hugged person I have ever met!”

There are many patients with whom Michelle has gone above and beyond during her 16-year tenure at FMCH. She takes food to patients after they are discharged, runs errands for them, takes them places and basically continues care for them post-discharge. She purchases meals from the cafeteria for family members not wanting to leave their loved ones’ bedside. And on multiple occasions, she has driven patients when they had no other means of getting home. Michelle most recently drove an Amish family to the FMCH emergency room when their child needed an emergent appendectomy. She stayed with them the entire time.

IMG_9336-small“Michelle is such an asset to us on the floor,” her colleagues exclaim. “She is constantly going out of the way for each and every one of her patients and nurses. She is not only a supervisor, she is a teacher and supporter. We have all leaned on her for her guidance and expertise at some point. She kindly points us in the right direction and leads by example.”

Another coworker wrote: “She is a person to idolize and learning from her made me a better nurse. I couldn’t have asked for a better mentor!”

“It is not a surprise to us when a patient mentions her name or tells us a story of something that Michelle has done for them either while they were in the hospital or out in the community. And if you talk to any of the nurses who have ever worked with her, there is nothing but good things that would be reported back. We love Michelle.”

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

Iowa News

Feds OK Medicaid privatization, with another delay
Governor Terry Branstad gained federal approval Tuesday for his controversial plan to turn Medicaid over to private managers, but not until April 1. “Although we understand the state’s preference to move forward on March 1, the April 1 effective date provides additional time for Iowa to complete activities needed to ensure a smooth transition, such as completing contracting with providers and training case managers,” federal administrators wrote to Branstad officials. Senate Democrats released a statement with mixed reaction to the news of the federal approval and continue to call for more legislative oversight of the shift. (Des Moines Register)

Halt devastating Medicaid plan
Concerns of participants, providers and all stakeholders engaged in the Medicaid system make it clear that Iowa’s rush to privatize Medicaid does not fulfill the league’s priority for quality health care. A detailed look at the plan suggests those making key decisions have not done their due diligence in protecting Medicaid’s future. Fears and concerns of Medicaid participants and their families are real and they must be taken seriously. (Des Moines Register)

Senate moves to protect children’s health benefits
Children with speech, language or hearing disorders currently enrolled in Iowa’s Hawk-I health program would continue to receive therapy as medically necessary benefits if the state switches to a privately run Medicaid managed care program, under a bill approved 50-0 by the Iowa Senate on Tuesday. Senate File 2145 requires that the Hawk-I covered speech therapy benefit under Medicaid managed care provide for coverage of both “habilitative and rehabilitative” services for children with speech, language, and hearing disorders, as medically necessary. (Quad City Times)

Hospital CEOs weigh in on challenges ahead
The leaders of the Corridor’s hospitals and health care systems met for a panel discussion at the Corridor Business Journal’s 2016 Health Care Summit, with the intent of digging into some of the biggest health care issues of the day. The conversation did not disappoint. Over the course of an hour, the expert panel analyzed everything from the state’s pending Medicaid transition to “Death with Dignity” laws. (Corridor Business Journal)

National News

Medical doctors and mental health professionals are finally talking
Even when people with severe mental illness do have medical appointments, their doctors rarely communicate with their mental health providers. Experts said the lack of coordination can lead to medication problems, higher health costs and gaps in care. Now, though, providers are beginning to bridge the gap between medical and mental care, forming partnerships aimed at improving patients’ physical and mental health, and reducing costs at the same time. (CNN)

Why better retirement plans could solve the rural physician shortage
It’s one thing to read statistics about how the US shortage of physicians will grow to about 90,000 by 2025. It’s another thing to hear about it from a room full people, whose job it is to deliver health care to the local rural population. This is not an isolated issue; studies show the number one problem for rural health care organizations is physician recruitment and retention. Health care organizations can solve their physician recruitment and retention problems by offering physicians lifetime tax-free pension plans. (Physician’s Money Digest)

Hospital safety blog makes medical errors public
Boston’s Brigham and Women’s Hospital is publicly sharing stories about medical errors made at the hospital in a blog that officials hope will reduce the risk of future mistakes. The “Safety Matters” blog features a monthly article describing a medical error or near miss at the hospital. Written by patient safety and public affairs staffers, the topics are selected based on the opportunity to prevent similar events from occurring. The posts protect patient privacy, but provide a breakdown of what happened and subsequent efforts to prevent a recurrence. (Fierce Healthcare)

How one hospital is beating sepsis and saving lives
Sepsis accounts for one-third to one-half of all deaths that occur in U.S. hospitals, or between 225,000 and 350,000 deaths a year. Dartmouth-Hitchcock Medical Center in New Hampshire collaborated with the Centers for Medicare & Medicaid Services, medical staff and partners in the High Value Healthcare Collaborative reduced the death rate from sepsis by more than 75 percent in less than six months. (STAT)

Population health, patient engagement top health care purchasing plans in 2016
Health care organizations are making big investments in population health and patient engagement platforms as they prepare to move past meaningful use and toward value-based reimbursement, according to “The Big Mega HIT Purchasing Report” released Monday by market research firm peer60. Electronic health records remain core to health care IT, but “Population health and patient engagement are the hottest areas by a wide margin,” wrote peer60 executive vice president Chris Jensen in the report. (Healthcare IT News)

Many hospitals will embrace concierge health care
While concierge health care comes in a variety of service delivery models, there is a retainer-based component to paying the providers. There are many reasons for the growth of concierge medicine such as the preference of many people for expedited access to high-caliber physician talent. The rationale for hospitals to offer concierge medical services parallel those of physicians with the economic benefits near the top of the list. There are potentially enormous benefits to a hospital based on the approach taken to deliver concierge medical services. (Forbes)

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