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

Iowa News

Legislator rips up bill to end licensing for social workers, barbers, other professionals
Representative Bobby Kaufmann (R-Wilton) drew applause from dozens of citizens Monday for literally tearing up a bill from Governor Terry Branstad that would have cancelled licensure requirements for social workers, mental health therapists and several other professions. However, Kaufmann said afterward that the Legislature would consider other parts of the bill. Among them is a proposal to ease requirements on proposed health care facilities. Such proposals now need a Certificate of Need to show they wouldn’t duplicate current facilities. (Des Moines Register)

CON law may change hospital’s economic impact
The Iowa Hospital Association has released a study examining the economic impact of hospitals in the state. Locally, the study found that Spencer Hospital employs 543 individuals and generated $40 million for the local economy last year. Spencer Hospital President Bill Bumgarner said the study’s findings demonstrate the hospital’s positive effect on the community. However, Bumgarner expressed some concern as to how proposed legislation may diminish the hospital’s economic impact. Specifically, Bumgarner cited state legislation aimed at altering the Certificate of Need (CON) law which would undermine the viability of hospitals in Iowa by allowing specialty facilities to develop unchecked. (Spencer Daily Reporter)

Too many uninformed about Medicaid privatization
The facts are that Iowa had a very well-run Medicaid program by the state with only a 4 percent overhead, where patients got treated and the health care providers got timely and accurate payment. Governor Terry Branstad almost unilaterally scrapped it in favor of giving it to three out-of-state private health care firms, each of which operate with 15 percent overhead, plus profit. The result has been that Medicaid enrollees have found that getting the care they need has been difficult at best, with many being denied coverage. The health care providers are either not receiving payment or payments are being made in error, causing financial difficulty for many of our doctors and hospitals. (Des Moines Register)

National News

Hospitals, both rural and urban, dread losing ground with health law repeal
Rural hospitals have long struggled to stay open. They have far fewer patients and thin profit margins. Dozens have closed across the country in recent years, mostly in states that didn’t expand Medicaid. Hospitals across the country made a high-stakes trade when they signed on to the Affordable Care Act. They agreed to massive cuts in federal aid that defrayed the cost of caring for the uninsured. In exchange, they would gain tens of millions of newly insured customers. Now that deal is in jeopardy, and many hospital executives anxiously await whatever comes next. The American Hospital Association has warned of “an unprecedented public health crisis” if the law gets hastily scuttled. (Kaiser Health News)

Minnesota hospital partnership helps people with mental illness by providing free bikes
A recent collaboration between the Nice Ride Minnesota bike share program and Hennepin County Medical Center (HCMC) is helping people deal with mental illness by giving them free bike memberships. The program, which starts its second year April 1, is part of a broader shift in mental health treatment to prescribe physical exercise for people with depression, anxiety or other mental illnesses. HCMC is taking it a step further, stationing a cardiologist in its mental health day treatment program to do a more intensive assessment of physical health and cardiovascular-specific treatments. It’s the only mental health program doing so in the country, according to the hospital. (Minneapolis Star Tribune)

Mental illness, untreated behind bars
President Trump has talked quite a bit about cracking down on a nonexistent crime wave. Rarely does he talk about the different kinds of support law enforcement needs or what actually keeps communities safe. So it might have come as a surprise to him when a member of the National Sheriffs’ Association at a White House meeting earlier this month brought up an urgent problem sheriffs’ offices all face — the mental health crisis that has filled jails to bursting with mentally ill people who would be more effectively dealt with through treatment. Mental health problems are rampant in local jails, often because the illness was a primary factor in the offensive conduct. (New York Times)

Trump: ‘Nobody knew that health care could be so complicated’
President Trump said Monday that “nobody knew that health care could be so complicated,” as Republicans have been slow to unite around a replacement plan for Obamacare. “I have to tell you, it’s an unbelievably complex subject,” Trump said after a meeting with conservative governors at the White House. The GOP governors were in town this weekend for their annual conference and met with Trump to talk about a variety of things, but it’s likely the conversation largely focused on health care. Governors have been split on what should be done with Obamacare’s Medicaid expansion, which brought health coverage to many even in deep-red states. (The Hill)

The political time bomb at the heart of Obamacare alternatives: Higher costs for more Americans
Republicans came into office this year promising to rescue Americans from rising healthcare bills by repealing and replacing the Affordable Care Act. But the party’s emerging healthcare proposals would shift even more costs to patients, feeding the very problem GOP politicians complained about under Obamacare. And their solutions could hit not only Americans who have Obamacare health plans, but also tens of millions more who rely on employer coverage or on government health plans such as Medicaid and Medicare. (Los Angeles Times)

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

Iowa News

Certificate of Need, licensing requirements could be cut in Iowa
A broad-ranging piece of legislation introduced last week could make significant changes to the state’s health care system. The 82-page bill put forth by Governor Terry Branstad would weaken the Certificate of Need program for hospitals as well as eliminate licensing requirements for a wide number of professions, from social work to mental health counselors, boards and commissions. Much still is unknown about the bill, but affected groups worry the bill could hurt hospital budgets and negatively impact some providers’ ability to receive insurance reimbursements. (Cedar Rapids Gazette)

Blood supply dangerously low for Iowa’s patients
Due to a dangerously low supply of blood in the area, LifeServe Blood Center opened some of its donation facilities on Sunday. It is the second-time ever that the organization has opened its facilities on a Sunday. The low blood supply for local hospital patients prompted the centers to open an extra day with the hope that more people would donate this weekend. Due to winter weather and a seasonal spike in illness, the blood supply has been low all year. “This is unprecedented for LifeServe Blood Center,” said Stacy Sime, president and CEO of LifeServe Blood Center, in the news release. (Des Moines Register)

National News

Connecticut hospitals say they face hidden, $156M tax hike in Malloy budget
Connecticut hospitals would pay $156 million more in state taxes over the next two years under Governor Dannel P. Malloy’s new budget — an increase Malloy did not report to legislators when presenting his biennial plan on February 8, the Connecticut Hospital Association (CHA) says. But the administration, which has had a rocky history with the industry, says hospitals only would owe more taxes if they are making more money. CHA sent an analysis of the governor’s budget on Friday to hospitals statewide, warning that the net effect of Malloy’s proposals amount to a $116 million annual hit to the industry as a whole starting next fiscal year. (CT Mirror)

Indiana’s claims about its Medicaid experiment don’t all check out
Indiana expanded Medicaid under the Affordable Care Act in 2015, with a few extra conditions that were designed to appeal to the conservative leadership in the state. The federal government approved the experiment, HIP 2.0, which is up for another three-year renewal. But a close reading of the state’s renewal application shows misleading and inaccurate information is being used to justify extending HIP 2.0. This is important because the initial application and expansion happened on the watch of then-Governor, now-Vice President Mike Pence. And Seema Verma, who is now President Trump’s pick to lead the Centers for Medicare and Medicaid Services, helped design it. (Iowa Public Radio)

With Obamacare in jeopardy, California considers going it alone with ‘single-payer’ system
With President Trump now vowing to put forward a replacement for the Affordable Care Act in March, some California politicians and health care advocates are once again promoting the idea of a state-run “single-payer” system that operates like Medicare. Backers say the uncertainty surrounding Trump’s promise to repeal Obamacare presents California with a chance to rethink how healthcare is delivered to its 39 million residents. In a single-payer system, residents would pay into a state agency that essentially functions as an insurance company. The agency would pay doctors and hospitals when people sought treatment. (Los Angeles Times)

Liberal Vermont tests the waters on GOP health care overhaul
Vermont could be at the leading edge of the health reforms envisioned by the Trump administration and a Republican Congress. The state got a broad waiver last October from the federal government to redesign how its health care is delivered and paid for. The statewide experiment aims to test new payment systems, prevent unnecessary treatments, constrain overall growth in the cost of services and drugs and address public health problems such as opioid abuse. The six-year initiative could eventually encompass almost all of its 16 hospitals, 1,933 doctors and 70 percent of its population, including workers insured through their jobs and people covered under Medicare and Medicaid. (Kaiser Health News)

House GOP plans to keep some Medicaid expansion, steer money to states that never bought in
Congressional Republicans have been struggling for months to resolve one of the most vexing problems in their tortuous effort to replace the Affordable Care Act: What to do about the generous federal funding for states that broadened their Medicaid programs under the law, while not shortchanging the 19 states that balked at expansion? Now, as the House begins to hone details of its legislative proposal, a possible compromise has emerged. It would temporarily keep federal dollars flowing to cover almost the entire cost of the roughly 11 million Americans who have gained Medicaid coverage but would block that enhanced funding for any new participants. (Washington Post)

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

Iowa News

Iowans voice concerns as broad gun bill advances
A wide-ranging firearms bill that covers everything from youth handgun use to carrying weapons in the Des Moines Capitol proved contentious as the legislation received its first public hearing Thursday. The bill would pre-empt local ordinances that restrict firearms use at public facilities such as universities and hospitals, among others. A wide range of groups have lined up in opposition, including the Iowa Hospital Association. Jim Atty, CEO of the city-owned Waverly Health Center, said stress and tensions can run high in the emergency department. Fights have broken out, and he said he’s concerned about what could happen if somebody in those situations was to be carrying a gun. (Des Moines Register)

Young: Congress doesn’t have the votes to toss Obamacare
Lawmakers may make substantial changes to Obamacare, but Congress doesn’t possess the political will to fully repeal the controversial health care legislation, U.S. Representative David Young (R-IA) told a fiery crowd of constituents Thursday. “The Affordable Care Act is not going to be repealed outright,” Young said at forum at Living History Farms, “because there’s not the votes and there’s not the support.” Like other Republicans returning to their home districts, Young was greeted with a liberal-leaning crowd angry over the direction of President Donald Trump’s administration, but managed to score some points as he distanced himself from Trump on some issues. (Des Moines Register)

Medicaid poll result disappointing
In regard to the Iowa Poll for private Medicaid, unless one is directly involved with Medicaid privatization, then “not sure,” as was chosen by 54 percent of respondents, may be a reasonable answer to the question “Has Medicaid privatization been a good or bad change?” However, if one is a family member, caregiver or providing services to disabled people, Deb Pape of West Des Moines would expect the answer to the original poll question to have been a much higher percentage of “No, it has not been a good change.” She is the primary legal guardian of an adult autistic son who relies on Medicaid and thinks the first question of the poll should have been “Do you know anyone affected by Medicaid privatization?” (Des Moines Register)

Phase one of dialysis center project complete
Plans for Spencer Hospital’s expanded dialysis services have continued to move forward. Last September, the hospital’s board of trustees approved plans to begin interior demolition of a hospital-owned building. The hospital plans to relocate the Warner Dialysis Center to the location once the project is completed. The interior demolition was completed in November and, as of Thursday, the board approved bid letting for the construction phase of the project. Hospital Vice President of Operations Steve Deutsch explained that the initial floor plan for the facility has been drafted. (Spencer Daily Reporter)

Grammy winner playing music in Cedar Rapids hospital for years
Middays on Friday, music drifts through the UnityPoint St. Luke’s Helen G. Nassif Pavilion. An angelic sound that brings a little cheer to people having to spend part of their day in a hospital lobby. The source isn’t a well-hidden speaker, it’s a well-hidden person, Ron Levine. Ron’s a volunteer who’s been playing in a semi-secret spot for about two years now – some of it spent keeping a secret of his own – Ron is a 1981 Grammy award winning country artist. Ron was diagnosed with multiple sclerosis about 30 years ago and his weekly music sessions at the hospital double as musical therapy. (KCRG)

National News

Why the health care industry isn’t keen on Medicaid reform
President Trump and Republicans have made it clear they want to change Medicaid in a way that reduces spending and gives states more leeway to operate their programs. But that financial blow faces resistance from hospitals and others who rely on Medicaid’s already tight resources. Safety net hospitals, rural facilities and community health centers would be most affected in the industry by the cuts that result from block grants or per capita caps, since they treat more Medicaid patients. Many consumers also haven’t been thrilled about shifting to Medicaid managed care. Iowa is a big case in point, where pretty much everyone is unhappy with the conversion. (Axios)

Protest builds over Pennsylvania Medicaid contracts
Winning a contract to manage part of Pennsylvania’s $12 billion in Medicaid benefits is a big prize. That’s why losing bidders with a long-term presence in the market of 2.3 million participants are not taking lightly the Pennsylvania Department of Human Services’ decision last month to cut them out of all or part of Medicaid management in Pennsylvania. The governor’s office and the Department of Human Services did not respond to requests for comment on the controversy surrounding the Medicaid program known as Health Choices, which carves the state into five zones. (Philadelphia Inquirer)

Kansas House advances Medicaid expansion; final action next
The Kansas House on Wednesday advanced a bill expanding Medicaid to more low-income, non-elderly adults, a proposal that was denied votes and floor debates for four years. Supporters argued the increased access means patients will get primary care, decreasing expensive emergency health care costs and uncompensated care costs that hospitals incur when they treat uninsured patients. Several providers testified before the committee earlier this month and said they were struggling or laying off employees because of uncompensated care costs and cuts to the payments they receive for treating Medicare and Medicaid patients. (Associated Press/Kansas City Star)

Repeal of health law faces obstacles in House, not just Senate
Ever since Republicans got down to the business of repealing the Affordable Care Act, the Senate has been singled out as the likely problem. Any plan that could zoom through the House would hit roadblocks among Senate Republicans, many of whom have resisted a wholesale repeal of the health law without a robust replacement plan. But after weeks of loud protests, boisterous town hall meetings and scores of quieter meetings with health care professionals, patients, caregivers and hospital managers in their districts, it is becoming increasingly likely that a consensus in the House may be just as hard to reach. (New York Times)

Are health insurance marketplaces in a death spiral?
It’s been a rocky few months for the health insurance marketplaces created by the Affordable Care Act. Last week, national insurance giant Humana announced it would stop selling plans on the marketplace. Aetna’s chief executive claimed the marketplaces are in a “death spiral.” Republicans say the marketplaces are Exhibit A that Obamacare is collapsing. So what’s the real story? Are these things really kaput or can they be fixed? Here’s a rundown of where things stand. (Los Angeles Times)

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

Iowa News

Don’t change Iowa’s Certificate of Need health care review system
Iowa has one of the highest quality, lowest cost health care systems in the United States. And at the heart of that system are 118 community hospitals that stand ready, day and night, to serve everyone, regardless of their ability to pay. A significant reason for health care excellence in Iowa has been state management of institutional health care services through the Certificate of Need law. Today, with the uncertainties surrounding the future of the Affordable Care Act, Iowa’s Medicaid program and even Medicare, the constancy of Certificate of Need is more important than ever. (Decorah News)

Iowans unsure about privatized Medicaid
Iowa’s decision to hire private companies to run its Medicaid program has more than twice as many detractors as fans, a new Des Moines Register/Mediacom Iowa Poll shows. However, more than half of Iowans don’t know what to make of the situation, the poll suggests. The controversial shift to private Medicaid management was pushed through last year by Governor Terry Branstad. Thirty-three percent of Iowans say it has been a bad change, and just 13 percent say it has been a good change, the new poll shows. Fifty-four percent of poll participants are unsure. (Des Moines Register)

Iowa’s private Medicaid insurers to lose $450 million in first year
The three private insurers managing the state’s nearly $5 billion Medicaid program expect their one-year losses cumulatively to reach $450 million, they told legislators on Wednesday morning during a joint Senate and House Health and Human Services Appropriations Subcommittee meeting. Pressed by lawmakers to give “ballpark” figures as to what the state can expect to see in end-of-year reports, AmeriHealth Caritas said it anticipates to have lost upward of $200 million; Amerigroup will have lost $150 million and UnitedHealthcare said it expects to have lost around $100 million. (Cedar Rapids Gazette)

National News

What’s the matter with KanCare? Challenges on four fronts
KanCare is a $3 billion program that provides health insurance to more than 425,000 Kansans — complex and bureaucratic by its nature. And lately it seems the privatized Medicaid program has drawn more than its share of complaints from Kansas medical providers, beneficiaries and applicants. Some are the result of a switch in 2013 to management not by the state but instead by three private insurance companies, while others stem from court rulings or policymaker decisions. Complaints generally fall into one of four issues: application backlog, reimbursement problems, expansion rejection and quality of care issues. (KCUR)

Single-payer health care bill introduced in California Senate
Legislation introduced in the California Senate last week would set the state on a path toward the possible creation of a single-payer health care system―a proposal that has failed to gain traction there in the past. A single-payer system would replace private insurance with a government plan that pays for coverage for everyone. Proponents argue that single-payer systems make health care more affordable and efficient, but opponents say they raise taxpayer costs and give government too much power. (HealthLeaders Media)

65,000 providers have been cut from state Medicaid rolls
A provision of the Affordable Care Act (ACA) that requires providers to revalidate or recertify their Medicaid reimbursement eligibility has caused 65,000 providers to be stripped from the federal program, according to a Modern Healthcare analysis. Providers that enrolled in Medicaid before March 25, 2011, had to send in revalidation notices to the Centers for Medicare & Medicaid Services on or before September 25, 2016, or risk being dropped. Some states were successful in receiving revalidation notices, while others are just now evaluating their rolls because of staffing or technical limitations, according to Medicaid agency spokespeople. (Modern Healthcare)

Nation’s mayors hold ‘day of action’ on ACA
Mayors around the country held a “day of action” Wednesday to warn of the risks to their cities if Congress repeals the Affordable Care Act (ACA) without an effective replacement. More than 50 mayors hosted town halls and other events pressing lawmakers to preserve key parts of the law, which has helped reduce the country’s uninsured rate to a record low. Especially vulnerable to losses are what are known as “safety net” hospitals, which serve mostly low-income patients and saw their uncompensated care costs drop significantly under the ACA. According to the trade group America’s Essential Hospitals, those providers could lose more than $40 billion over the next decade if the law is repealed. (Marketplace)

Two tax issues dividing Republicans on Obamacare
Republican lawmakers are objecting to two key elements of their party’s plan to replace Obamacare, creating obstacles in the road to repeal. Conservatives worry a tax credit to assist people with the cost of insurance, which would help people maintain or get coverage, will be too costly and that recipients might abuse the government help. Objections also are being raised against a proposal to open up some employer-sponsored health insurance plans to taxation. Some Republicans worry that proposal is essentially a new version of Obamacare’s much-reviled “Cadillac tax.” (The Hill)

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Iowa’s Certificate of Need (CON) regulations were first enacted in 1977 for the express purpose of providing for the orderly and economical development of health care services, thereby avoiding unnecessary duplication of services, controlling the growth of overall health care costs and ensuring the stability of community hospitals. Since that time, these regulations have been re-examined multiple times and each time the same conclusion was reached: Iowa needs Certificate of Need.

Now the Iowa Legislature is considering a bill that, if enacted, would repeal significant portions of the CON program, putting community-based health care at risk. Here are some of the reasons why Iowa hospitals are supporting CON:

CON ensures access to health care services

  • CON repeal will reduce access by destabilizing local health care systems.
  • Without CON, services that keep hospitals financially healthy will be stripped away by for-profit, out-of-state, investor-owned organizations that selectively perform services simply because those services are likely to create the most income.
  • These niche providers would leave the financial burden on hospitals to provide 24/7/365 emergency care, to provide care for patients with complicated conditions and patients with Medicaid or no insurance.

 CON supports rural communities

  • States without CON have seen hospitals close, especially in rural areas.
  • Rural Iowa is uniquely susceptible to losing essential health care services. CON criteria and safeguards ensure health care systems are financially stable and that health care options exist throughout all of Iowa.
  • In many counties, rural hospitals are among the largest employers, bolstering Iowa’s rural economy, attracting and retaining young professionals and families and bringing high-quality jobs where they are most needed.

CON promotes quality health care services

  • CON criteria ensure new facilities operate with patient volumes that are sufficient to provide high quality services.
  • CON criteria ensure excess capacity does not lower volumes in a manner that compromises patient safety.
  • CON criteria result in consideration of the quality services available in the community.

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