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

Iowa News

Branstad rejects ‘catastrophic’ comments about Medicaid managed care
The Des Moines Register has obtained new documents showing the for-profit companies running Iowa’s Medicaid program are complaining about “drastic” losses. One company’s manager describes the process as a “catastrophic experience,” according to the newspaper. Governor Terry Branstad is downplaying the report. “I’m confident that it’s going to work out,” Branstad says. Branstad’s current state budget plan is based on more than $100 million worth of savings from switching to privately-managed care for Medicaid patients. (Radio Iowa)

Genetic Testing helps Siouxland hospital offer improved pain management
Every person reacts to medicine differently. And, because of that, medical professionals in one Siouxland hospital are taking a look at pain management from a different angle. Lakes Regional Healthcare in Spirit Lake is using genetic testing before surgery to treat their patients more effectively. It’s not a new concept, but it is new to smaller, rural hospitals. Genetic testing before surgery is available at Lakes Regional through an outreach program of Avera McKennan in Sioux Falls. The process helps the professionals here find out how pain meds will affect their patients. (Siouxland Matters)

University of Iowa nursing college gets $5.25 million from former dean
Long before former University of Iowa (UI) College of Nursing Dean Rita Ann Frantz died, she and her husband wrote into their will a UI donation supporting an endowed chair. As their funds grew over the years — through monthly contributions and wise investments — the couple discussed supporting a College of Nursing professorship as well. But it wasn’t until after Frantz died at age 68 on September 7 that her husband realized they had enough to support the professorship, two scholarships and two endowed chairs. (Cedar Rapids Gazette)

As Iowa records first flu death of season, residents urged to get vaccinated
Iowa’s first flu-related death of the season should spur residents to be vaccinated, the Iowa Department of Public Health warned Monday. The victim was described as an elderly woman from central Iowa. Her name and hometown were not released. The flu season has been relatively mild so far, but that could change quickly. Even relatively healthy young people can be felled by flu complications, such as pneumonia or bacterial infections. (Iowa City Press-Citizen)

National News

Montana may be model for Medicaid work requirement
Montana State Senator Ed Buttrey is a no-nonsense businessman from Great Falls. Like a lot of Republicans, he’s not a fan of the Affordable Care Act, nor its expansion of Medicaid. Buttrey wrote a Medicaid expansion bill for Montana that linked the health coverage to a job training program. He wanted everyone getting benefits to have to meet with a labor specialist who would help them figure out how to get a job or to get a better paying job. But so far, federal officials said states can’t make participation in a work program mandatory for Medicaid recipients. Montana, instead, had to make its job training component voluntary. (Kaiser Health News)

California hopes $3 billion experiment will improve health of neediest
California has approved plans in 18 counties intended to reduce unnecessary emergency room visits and hospital stays among these groups. The effort, known as “whole person care,” is part of an agreement between California and the federal government. It gives the state flexibility to try to improve the efficiency and quality of care in the state’s Medicaid program — known as Medi-Cal — which provides health coverage to low-income people. The projects are designed to blend physical care, mental health care and social services for the participants, who are among the neediest and costliest in the state. (Kaiser Health News)

In Texas, students help provide health care for refugees
Each Wednesday at St. Francis Episcopal Church on the north side of San Antonio, dozens of refugees from all over the world come for free care at the Refugee Health Clinic. Students and faculty at the University of Texas Health Science Center in San Antonio have teamed up to operate one of the only student-run refugee clinics in the country. In the past six years, more refugees have resettled in Texas than in any other state. That was before the State of Texas pulled out of the refugee resettlement program in September, citing concerns over terrorism. (Iowa Public Radio)

How hospitals are trying to improve the patient experience
At Lenox Hill Hospital in New York City, the facility’s maternity ward provides perks for new parents, such as champagne with chocolate-covered strawberries to celebrate the birth of the baby. Improving the patient experience helps promote healing and makes good business sense, says Joe Leggio, director of patient and customer experience at Lenox Hill. “It is important for every organization that serves the public to give the customer their best possible service,” says Nancy Foster, vice president for quality and patient safety policy at the American Hospital Association. (U.S. News & World Report)

Education partnerships could produce better prepared health care employees
There is a disconnect between the needs of health care organizations and the skills delivered by educational institutions that leaves many entry-level health care jobs unfilled, according to a new report from The Advisory Board Company. Health care organizations are having trouble filling many non-clinical, entry-level positions because there are either too few candidates or available candidates don’t have the desired skills, according to the report. Partnering with educators to better prepare students for roles in health care could give them opportunities for middle class incomes. (Healthcare Dive)

Obamacare enrollment is beating last year’s early pace
Despite the Affordable Care Act’s rising prices, decreased insurer participation and a vigorous political threat to its survival, consumer enrollment for 2017 is outpacing last year’s, according to new federal data and reports from state officials around the country. Americans’ anxiety about how a new Republican-controlled Congress and President-elect Donald Trump will repeal and replace the health law is helping fuel early enrollment gains in the online marketplaces that sell individual coverage, state exchange officials and health consultants said. (Kaiser Health News)

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

Iowa News

Loebsack calls on CMS to rescind Iowa’s Medicaid waiver
Congressman Dave Loebsack (D-IA) today called on the Centers for Medicare & Medicaid Services (CMS), the federal agency responsible for granting the State of Iowa the waiver to privatize its Medicaid program, to rescind the waiver. A report published today by the Des Moines Register shows that payment shortages have created a ‘catastrophic experience’ for the program’s private managers. This new report comes on top of continued complaints from patients about access to services and providers about delayed reimbursements. (KWQC)

Iowa Medicaid payment shortages are ‘catastrophic,’ private managers tell state
The for-profit companies running Iowa’s Medicaid program have been complaining to state administrators that the controversial project is “drastically underfunded” and that the situation has been a “catastrophic experience,” newly released documents show. One managed care executive wrote that Iowa’s recent offer to give the companies an extra $127.7 million in state and federal money this budget year “is not acceptable.” He added that without major changes, the privately run Medicaid program could be unsustainable. None of the three companies has agreed to accept the state’s revised rate offer. (Des Moines Register)

Agency projects $14.5 million Medicaid shortfall
An Iowa Legislative Services Agency report released Wednesday estimates Iowa’s Medicaid program needs a $14.5 million budget boost still this fiscal year. And for the next budget year that begins July 1, the shortfall would grow to $109 million, the agency forecasts. However, Governor Terry Branstad expressed confidence that any losses in the state’s program — along with concerns from the three private insurers handling Iowa’s managed care — could be ironed out. The governor said he would not offer additional higher rates for the insurers. (Cedar Rapids Gazette)

State to expand mental health regions?
Diane Buss, coordinator of disability services, Monday morning described to the Appanoose County Board of Supervisors what she sees as a disturbing development if the state gets what it wants with its mental health and disability services regions. The state is divided up into 14 approved mental health and disability services regions, according to a map on the Iowa Department of Human Services website. Appanoose, Davis, Wapello and Mahaska counties are in the South Central Behavioral Health region. Buss said the state is going to move toward larger regions of at least 200,000 in population. She said the four-county region Appanoose County is in has about a 78,000 population. (Daily Iowegian)

National News

Missouri one of eight states participating in mental health treatment expansion pilot program
Missouri will be one of eight states participating in a pilot program expanding access to mental health services in community health clinics. It’s the next step in the Excellence in Mental Health Act. Minnesota, New York, New Jersey, Nevada, Oklahoma, Oregon and Pennsylvania are the other seven states chosen Wednesday by the Department of Health and Human Services. Vikki Wachino, deputy administrator of the Centers for Medicare & Medicaid Services, said the demonstration program will allow state to have more access for behavioral health services for Medicaid and Children’s Health Insurance Program recipients. (St. Louis Post-Dispatch)

Staff vacancies down but still a concern at state psychiatric hospitals
State officials say conditions for staff and patients at Kansas’ two state-run psychiatric hospitals are improving but still need work. Representatives from the Kansas Department for Aging and Disability Services, Osawatomie State Hospital, Larned State Hospital and the Kansas Organization of State Employees spoke to a legislative committee overseeing the hospitals. The committee made six recommendations for the Legislature to consider during the 2017 session, including requirements for private contractors bidding to operate Osawatomie State Hospital and support for programs addressing staff shortages at both hospitals for Kansans with severe mental health issues. (Kansas Health Institute)

North Carolina mayor fights to save a small-town hospital: ‘It’s life or death’
He was born in Pungo District Hospital in the sleepy town of Belhaven, N.C. Decades later, as mayor of Belhaven, he counted on the hospital to provide not just health care, but scores of jobs. In his rural stretch of coastal North Carolina — beautiful but isolated, with a painfully high poverty rate — he saw Pungo as the “heartbeat” of the community. That is, until the hospital was shut down on July 1, 2014, less than three years after a much larger health system had purchased it. Ever since, O’Neal has fought to revive the hospital. His last chance may come Wednesday as Belhaven residents go to court to try to block its demolition. (STAT)

Medicaid expansion delivers ED care more quickly, study says
Researchers determined that Medicaid expansion provides patients with greater choice in hospitals and reduced average travel time to emergency departments (EDs), according to a study published Tuesday by Annals of Internal Medicine. Hospitals in states that expanded Medicaid say a 47.1 percent drop in uninsured ED visits in the 12 months following expansion and Medicaid visits increased 125.7 percent. The results could translate into improved outcomes for patients. (Healthcare Dive)

Latest hospital injury penalties include crackdown on antibiotic resistant germs
The federal government has cut payments to 769 hospitals with high rates of patient injuries, for the first time counting the spread of antibiotic-resistant germs in assessing penalties. The punishments come in the third year of Medicare penalties for hospitals with patients most frequently suffering from potentially avoidable complications, including various types of infections, blood clots, bed sores and falls. This year the government also examined the prevalence of two types of bacteria resistant to drugs. The reductions apply not only to patient stays but also will reduce the amount of money hospitals get to teach medical residents and care for low-income people. (Kaiser Health News)

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

Iowa News

Mental health in Iowa is fragmented and costly
When mental health issues become visible, it often happens explosively and tragically. This is when, like a volcano erupting, mental health explodes across the headlines, only to eventually be replaced by some other disaster or scandal. But, as health care providers well know, the problem not only doesn’t go away, it’s getting worse. Unlike volcanoes, poor mental health and the dangers that can accompany it can be controlled. In Iowa, more than 120,000 people live with serious mental health issues and 80,000 Iowa youths cope with severe emotional disorders. Yet Iowa has fewer psychiatric beds and mental health professionals than nearly every state in the nation. (Des Moines Register)

Waterloo UnityPoint aims to buy bankrupt Marshalltown hospital
Central Iowa Healthcare in Marshalltown filed for bankruptcy Tuesday. The health care system asked the court to approve a plan to sell its assets to UnityPoint Health-Waterloo. “Our decision today reflects our enduring commitment to the Marshalltown community to provide access to quality health care services close to home,” Central Iowa Health Care acting Chief Executive Officer Dawnett Willis said in a statement. “It should be business as usual for the staff and providers at CIH throughout the bankruptcy process.” (Waterloo-Cedar Falls Courier)

National News

Connecticut hospitals and clinics fear cuts in Medicaid under Trump
As the future of Obamacare hangs in the balance, the chief medical officer for Hartford Healthcare says that scaling back the Medicaid part of the law would mean a loss of “tens of millions of dollars” in revenue and would result in staff reductions and scaling back of services. “The Affordable Care Act expanded coverage to a significant number of individuals; this expansion was funded in part through cuts to Medicare payments to hospitals,” the Connecticut Hospital Association said in a statement. “If the law is repealed and the cuts remain in place, Connecticut hospitals’ fiscal stability and sustainability, as well as patient access to care, will be compromised.” (Hartford Courant)

Tennessee health system rolls out statewide virtual clinic
Anyone living in Tennessee can visit a Saint Thomas Health walk-in clinic without leaving their home. Saint Thomas Health On Demand, as of Friday, is an around-the-clock virtual clinic that people can use by smartphone, tablet or computer to get a diagnosis and treatment for many common issues, such as urinary tract infections, pink eye, sinus problems or colds. Saint Thomas Health has 92 physician locations and nine hospitals in 30 counties, but the new platform gives Tennesseans living in the other two-thirds of the state an opportunity to get treatment where they are. (Tennessean)

Florida senators working on new Medicaid ‘framework’ that could expand coverage
The Florida Senate is starting to consider a new Medicaid system it could put into place if Congress gave the state a block grant and freedom to run the program with limited federal involvement, Senate President Joe Negron said Tuesday. It’s a change Negron, R-Stuart, said he hopes could expand health coverage to more than half a million Floridians caught in the “coverage gap” — people who make too much money to qualify for Medicaid but not enough to afford health insurance of their own. (Tampa Bay Times)

Doctor shortage in poor, rural areas needs to be addressed
Doctor’s appointments may soon be hard to come by. According to a new study, the United States will be short up to 90,000 doctors by 2025. This shortage will hit rural and poor urban areas hardest – largely because the vast majority of newly minted doctors don’t end up practicing in these locales. Medical schools must change this state of affairs – by pushing their graduates to practice in the communities that most desperately need them. Rural areas in particular suffer from a dearth of doctors. (Sacramento Bee)

Millions more Americans can afford a doctor’s visit under Obamacare, study shows
The Affordable Care Act’s historic expansion of health insurance coverage has brought medical care within reach of millions of Americans who previously couldn’t afford it, new research shows. The share of adults who skipped medical care because of costs dropped by nearly one-fifth between 2013 and 2015, according to a report from the Commonwealth Fund. The gains were even more dramatic in the states that have most expanded coverage through the federal health care law, often called Obamacare. (Los Angeles Times)

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

Iowa News

Mary Greeley reaches 2,000 robot-assisted surgeries
When a patient was rolled into an operating room at Mary Greeley Medical Center Friday morning for a double hernia surgery, he was tended to by a normal team handling an operation: a surgeon, anesthesiologist, a few nurses and a robot. It may seem futuristic, but robotic surgery assistants have already been embraced by surgeons at Mary Greeley. Eleven staff surgeons are trained to use them and the hospital completed its 2,000th robot-assisted surgery earlier this week after purchasing its first machine six years ago, spokesman Steve Sullivan said. (Ames Tribune)

Grinnell Regional Emergency Department renovations get boost
The Grinnell Mutual Group Foundation has made a pledge of $50,000 to help renovate the emergency department at Grinnell Regional Medical Center (GRMC). The pledge brings GRMC’s fundraising efforts for a new emergency room almost to completion. Only about $60,000 is left to raise of the $2 million needed to begin the project. Renovations are tentatively set to begin in the spring of 2017. “We are ecstatic to receive this support from Grinnell Mutual Group Foundation,” says Todd Linden, GRMC president and CEO. (Tama News-Herald/Toledo Chronicle)

AbbeHealth and UnityPoint Health – Cedar Rapids Finalize Affiliation Agreement
It’s official – starting January 1, 2017, AbbeHealth will be an affiliate of UnityPoint Health – Cedar Rapids. The two entities met Monday to finalize and sign the affiliation agreement. This agreement makes AbbeHealth an affiliate of UnityPoint Health – Cedar Rapids and allows it to continue as a community based provider of behavioral health care and aging services. All programs, services and care will continue to be offered to clients of AbbeHealth regardless of where individuals receive medical health care services currently or in the future. (UnityPoint Health-Cedar Rapids)

National News

Kansas Medicaid application backlog climbs again
The Medicaid application backlog in Kansas is on its way back up, threatening months of progress on a coverage problem that has vexed health care providers across the state. For more than a year, providers that rely on Kansas Medicaid, or KanCare, have been stung by delayed payments as they wait months for eligibility determinations that by federal rule are supposed to take no more than 45 days. A report commissioned by the Kansas Hospital Association, Kansas Medical Society and Kansas Association for the Medically Underserved found the cost burden for the backlog shifting to areas like Adult Protective Services. (Kansas Health Institute)

Renewed Tennessee Medicaid waiver will limit uncompensated-care funds
The Obama administration and Tennessee officials have broken their impasse over the future of federal funding that subsidizes uncompensated care provided by the state’s hospitals. The funding pool is part of a larger waiver that allows the state to continue its Medicaid managed care model, known as TennCare. Tennessee hospitals are nervous about how the allocations will change. It’s “a whole new ballgame with a new distribution system of funding for hospitals,” said Craig Becker, CEO of the Tennessee Hospital Association. (Modern Healthcare)

Health IT effective, but not widely used for behavioral health
The use of health IT to advance behavioral health, in part by integrating it with general medical care is lagging. Greater use would not only facilitate care coordination, but could fulfill the goals of the Medicare Access and CHIP Reauthorization Act and other value-based care initiatives, a survey of more than 8,000 commercial health plan products shows. Behavioral health providers, in particular specialty addiction treatment organizations, often lack resources and infrastructure to implement health IT which could improve care. (HealthLeaders Media)

Inova launches investment fund to find personalized medicine innovators
Inova Health System, the giant nonprofit hospital network serving Northern Virginia, is creating a new start-up incubator and investment program focusing on “personalized” medicine innovations. “We want to create an environment that makes health sciences a new destination, a new economic engine for the region,” said Peter Jobse, who was named managing partner of the new venture. The incubator aims to focus on innovations that can better predict and prevent disease. Rather than concentrate on drug development, the program will look to develop medical devices and analytical platforms. (Washington Post)

Price transparency is nice, just don’t expect it to cut health costs
This lack of price transparency in health care has been cited as one of the reasons we spend too much on it. It’s easy to overpay and health care prices vary tremendously. However, more than half of the states have passed laws that either establish websites with health care prices or require plans, doctors and hospitals to disclose them to patients. But improved transparency isn’t working as well as hoped, according to a study published this year in The Journal of the American Medical Association. Price transparency may be part of the answer, but it isn’t the entire answer. (New York Times)

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

Iowa News

Robust oversight of Medicaid is needed
The state’s second quarterly oversight meeting of Medicaid modernization showed the need: Iowa lawmakers must work to provide more robust oversight of the system. Three out-of-state, private providers manage the public health care system, which delivers essential services to more than 600,000 state residents and absorbs more than $5 billion taxpayer dollars. Effective and cost-efficient management must be a bipartisan priority. It’s both a moral and economic imperative. All Iowans benefit from a system that delivers quality service at the lowest cost. But such a system cannot and will not manifest on its own. (Cedar Rapids Gazette)

How repealing Obamacare will affect Iowans
Beginning the day after the election, President-elect Donald Trump and key members of Congress began calling for a “full repeal and replacement” of the Affordable Care Act as one of the highest priorities for the new administration. This talk is already morphing to “repeal now and transition over a two-three year period.” While the specific policies associated with “repeal and replace or transition” have not been fully articulated, certain options have been contained in previous “replace” bills. These include eliminating the health insurance exchanges and the Medicaid expansion — both of which would have significant implications for Iowa. (Des Moines Register)

Hospital Foundation awards grants to local projects
Recently, the Grundy County Memorial Hospital Foundation awarded a Community Health Need grant to three projects in the area. Two of the grants were awarded to the senior citizen exercise programs sponsored by the Northeast Area Agency on Aging.  The third grant was awarded to Grundy County Public Health to purchase demonstration dolls for the Child Passenger Safety program. Community Health Need grants are a way for the Grundy County Memorial Hospital Foundation to help non-profit organizations, schools and health-promoting groups to positively impact health needs in their communities. (Grundy Register)

National News

Minnesota hospitals face uncertain prognosis with ACA up in the air
In 2010, when federal lawmakers passed the Affordable Care Act (ACA), Minnesota health systems provided $226 million in charity care to patients who couldn’t cover all of their treatment costs. By the time Minnesota fully expanded its Medicaid insurance program as part of health law in 2014, annual charity care expenses dropped to just $164 million. “The industry is totally uncertain at this point,” said Lawrence Massa, chief executive of the Minnesota Hospital Association. “Everybody is just kind of sitting back — it’s hard to make big decisions now about committing resources beyond 2017, not knowing what’s going to happen.” (Star Tribune)

Kansas delays KanCare changes amid federal uncertainty
Governor Sam Brownback’s administration has requested a one-year extension of the current KanCare program while delaying a proposal for an updated version of the Medicaid managed care system. KanCare began in 2013 and is scheduled to expire at the end of 2017. State officials had planned to make changes to the current contracts and then apply for a long-term extension of KanCare with the federal Centers for Medicare & Medicaid Services at the beginning of 2017. But Lieutenant Governor Jeff Colyer said that the state had renewed the current contracts and would not request updated bids until late next year. (Kansas Health Institute)

Virginia governor leaves Medicaid expansion funds out of his budget revisions
Faced with a budget shortfall now estimated at $1.26 billion, Governor Terry McAuliffe and General Assembly Republicans are bickering instead over whether the governor proposed to expand Medicaid in the budget he presented legislators on Friday. McAuliffe did not include $2.4 billion in federal funds that Virginia could use to expand the health care program under the Affordable Care Act. Citing “a great deal of uncertainty” over the future of the law, the governor told legislators he chose “the fiscally prudent path” by leaving enhanced federal Medicaid funds out of the budget. (Richmond Times-Dispatch)

Slow repayment of  Medicaid funds irks behavioral health care providers
When state officials announced in 2013 that 15 behavioral health providers might have committed Medicaid fraud, they cut off future Medicaid payments to those organizations and froze more than $11 million in reimbursements for treatment services already rendered. Now cleared of criminal wrongdoing, the providers want the Medicaid funds they are owed. But all is not going smoothly, according to an email exchange in September between a state official and an executive with OptumHealth New Mexico, which has been holding the money and is supposed to distribute it at the direction of state officials. (Santa Fe New Mexican)

MACRA implementation key issue for next Congress
Members of the next Congress – from both sides of the aisle – will be watching to see whether the Medicare Access and CHIP Reauthorization Act (MACRA) is being properly implemented over the next few years, congressional staff members said Thursday. “Making sure MACRA is a success is important; we all held hands and jumped on that one,” a Republican congressional aide said. “There are plenty of places within MACRA that the committees will have to be engaged in.” (HealthLeaders Media)

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