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

Iowa News

Ruling overturns state law mandating pharmacy benefits manager pricing oversight
An Iowa law that required pharmacy benefits manager (PBM) companies to provide pricing transparency to their network pharmacies and to disclose their pricing methodology to the Iowa Insurance Division was overturned Wednesday by a federal appeals court. The Pharmaceutical Care Management Association filed suit against the state, seeking a declaration that the statute places restrictions and requirements on PBMs that impermissibly refer to or are connected with the Employment Retirement Income Security Act of 1974 plans. (Des Moines Business Record)

VBCH expands services with UI Health Care Virtual Hospitalist Service
Van Buren County Hospital (VBCH) has partnered with University of Iowa (UI) Health Care to launch the Virtual Hospitalist Service. The service provides access to hospitalists at UI Hospitals and Clinics via a secure telemedicine connection between both hospitals. The program aims to support local providers, enhance inpatient care and keep patients in their local hospital. VBCH providers and nurses collaborate with a UI hospitalist—a physician focused on inpatient care—in Iowa City through secure video conferencing and a shared electronic health record. (The Loop)

HCHS installs sound masking system, promotes healing, enhances satisfaction
In an effort to promote faster healing, enhance patient satisfaction and continued patient privacy, Hancock County Health System (HCHS) has installed a sound masking system in its medical-surgical inpatient unit. The sound masking system introduces a spectrum of noise which gently raises the ambient background sound in order to cover speech and other noises. Comfort is achieved through the quality and range of the sound produced. Installing the sound masking system is just one of many programs HCHS has implemented to increase privacy and enhance patient satisfaction. (Britt News Tribune)

Buena Vista Regional Medical Center ambulances receive grant money
Four Buena Vista Regional Medical Center ambulances have been rewarded with $25,000 grants from the American Heart Association’s Mission: Lifeline, a community-based initiative aimed at improving the system of care for heart attack patients throughout rural Iowa. Ambulances in Albert City, Sioux Rapids and Storm Lake received the funding from the program, which is financed nationally with $6.1 million in funding, including a $4.6 million grant from the Leona M. and Harry B. Helmsley Charitable Trust. (Sioux City Journal)

Doane’s 50 years in health care, a testament to an ever-changing world
Carol Doane has seen a myriad of changes in health care over the 50 years she’s lived and worked in Mitchell County as a health care professional. Doane grew up in the Cresco and Decorah area and has worked at several hospitals, but most recently Mitchell County Regional Health Center (MCRHC) upon her return from their honeymoon. Doane retired the first time in 2005; however, returned to MCRHC after a short break and continues to work as a licensed practical nurse and activity coordinator for the in-patient unit. Doane said the biggest change over all her 50 years has been the ever-changing technology. (Mitchell County Press News)

National News

Kansas lawmakers racing clock to expand Medicaid
It very well might be too late, but some Kansas lawmakers are moving ahead on a plan to expand KanCare, the state’s privatized Medicaid program. The House Health and Human Services Committee voted Thursday to introduce an expansion bill at the request of Representative Susan Concannon. The bill, largely crafted by the Kansas Hospital Association (KHA), would expand KanCare coverage to between 100,000 and 150,000 low-income Kansans. “KHA’s website has a running calculation of the federal dollars that we’ve missed by not expanding,” she said. “It’s at $1.6 billion and adding up as we speak.” (KCUR)

Alabama seeks federal OK to delay switch to managed care
Alabama wants to delay plans to move its Medicaid program to a managed care model with regional care organizations (RCOs) due to financial issues. Last year, the Centers for Medicare & Medicaid Services (CMS) approved an 1115 waiver that provided up to $748 million over five years to move Alabama away from traditional fee-for-service health care delivery. Even with the federal dollars, the state told the CMS it does not have money to help providers switch to RCOs in a notice posted by the agency Monday. (Modern Healthcare)

Pennsylvania to test fixed-rate funding model for rural hospitals
Pennsylvania will be testing a new payment model for rural hospitals designed to improve the health of residents and help the hospitals they depend on stay financially solvent. With $25 million funding from the U.S. Centers for Medicare and Medicaid, the Pennsylvania Rural Health Model will try an innovative payment structure in which hospitals will be paid a fixed amount each month, instead of being reimbursed for services provided. Six Pennsylvania hospitals will be selected in the spring to participate in a pilot project to launch in 2018. Then 24 hospitals will be added in the next three years. (Philadelphia Inquirer)

Sponsor of Georgia’s rural hospital donor law seeks to expand tax credit
The lawmaker who created Georgia’s new tax credit program for rural hospitals wants to boost the incentives for donors. State Representative Geoff Duncan has introduced a House bill that would raise the tax credit from 70 percent to 90 percent for individuals and corporations who donate money to rural hospitals. Five rural hospitals have closed in Georgia since the beginning of 2013, and many more are in financial trouble. Jimmy Lewis of HomeTown Health, an organization of rural hospitals in the state, said that under the current tax credit rate, the donations have not come in as hoped. (Georgia Health News)

House expected to follow Senate’s lead on rush to repeal health law
The House is expected to give final approval on Friday to a measure that would allow Republicans to speedily gut the Affordable Care Act with no threat of a Senate filibuster, a move that would thrust the question of what health law would come next front and center even before President-elect Donald Trump takes office. The House vote would come after the Senate narrowly approved the same measure, a budget blueprint, early Thursday morning. Democrats said the rush to repeal was the height of legislative irresponsibility and would endanger the health of millions. (New York Times)

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

Iowa News

Iowa mother helps mentally ill kids
Tammy Nyden realized when her son was very young that he was mentally ill. And unlike most other people with mental illness, he was violent. As years passed and diagnoses changed, she knew she had to do something to prevent him from spiraling into disaster — and at the same time help other young people suffering from mental illness. With others, Nyden created Parents Creating Change in Iowa, and NAMI Iowa Children’s Mental Health Committee. They formed the NAMI Iowa Casserole Club, an online support group for parents and caregivers of children and adolescents with mental health needs. (Washington Post)

Kim Reynolds on mental health system: “It’s not perfect”
In a sit-down interview with Local 5 following the governor’s final Condition of the State on Tuesday, Lieutenant Governor Kim Reynolds talked about one of the big issues facing the Legislature this session: dealing with the struggling mental health system. Reynolds admitted that with two mental health hospitals closing in Iowa, there are people left without nearby facilities and work still needs to be done. Reynolds did not say if a proposal or a bill was in the works this session to continue reforming the mental health system. (We Are Iowa)

Bipartisan mental health coalition hopes to tackle funding disparities
An informal group of Republican and Democratic lawmakers met at the Capitol Wednesday to begin seeking solutions for mental health funding inequities across the state. At the top of the group’s agenda is addressing disparities in the way counties use property taxes to support mental health services in their region. But lawmakers who attended Wednesday’s meeting said they hoped to discuss other mental health funding issues across the state, including a workforce shortage for mental health professionals and a shortage of beds at mental health facilities. (Des Moines Register)

‘Access center’ jail diversion campus takes shape
Officials are inching closer to developing a new center that would provide comprehensive assistance to people experiencing behavioral or substance-related health crises. Plans for what officials are calling an access center — which would be an all-in-one site that would include a sobering center, short-term mental health crisis observation beds and a year-round low-barrier homeless shelter — have been in the works for months as part of a push by local governments and nonprofits to change the way Johnson County approaches policing. (Iowa City Press-Citizen)

DHS director: Iowa Medicaid insurers paid ‘fair’ and ‘appropriate’ rates
The state believes it’s paying the three private insurers now caring for its Medicaid population “fair,” “appropriate” and “actuarially sound” rates despite documents that show the managed care organizations (MCOs) describing the program as “drastically underfunded.” In early December, two of the tree MCOs reported hundreds of millions of dollars in losses. What’s more, correspondence between the MCO leaders and Iowa Department of Human Services (DHS) officials reveal that the insurers have been lobbying for increased rates since the start of the transition. (Cedar Rapids Gazette)

National News

Planned mental health hospital in Illinois ‘long overdue’
A new facility planned in New Lenox, Illinois could help provide mental health services to area residents, as well as help alleviate pressure on Will County programs dealing with mental health and drug addiction issues. Silver Cross Hospital plans to partner with a national firm to build a $22 million behavioral health hospital to help address the need for such services in Will County. “This is going to be a vast improvement for mental health services in Will County,” Silver Cross Hospital President and Chief Executive Officer Paul Pawlak said. (Chicago Tribune)

Repeal of health law will affect those treating mental illness in Ohio
More than 220,000 people in Ohio may be unable to afford care for mental illness or drug addiction if congressional Republicans scrap the 2010 health care law without passing a substitute measure, a new report says. Ohio Governor John Kasich expressed his concerns Wednesday about simply gutting the Medicaid expansion that he embraced and fought to institute in Ohio. “It’s really allowed people the ability to treat people who might not have been treated,” including the “destructive cycle” of mental illness and drug addiction, Kasich told hundreds of people at the Ohio Behavioral Health Conference at the Hyatt Regency Downtown. (Columbus Dispatch)

Rural hospitals brace for damage from health law repeal
The health care law expanded Medicaid to tens of thousands of previously uninsured patients, providing new revenue streams for rural hospitals, which often serve a poorer, sicker patient population. Rural hospitals have long operated on the edge. In the past six years, more than 70 such facilities have closed, citing financial duress. Almost 700 more have been deemed at risk of following the same path. “All these rural hospitals are operating on thin margins. The removal of any income source or coverage, or expansion of bad debt, is going to create significant financial hardship,” said Alan Morgan, CEO of the National Rural Health Association. (Kaiser Health News)

Senate takes majors step toward repealing health care law
Senate Republicans took their first major step toward repealing the Affordable Care Act on Thursday, approving a budget blueprint that would allow them to gut the health care law without the threat of a Democratic filibuster. The vote was 51 to 48. During the roll call, Democrats staged a highly unusual protest on the Senate floor to express their dismay and anger at the prospect that millions of Americans could lose health insurance coverage. The approval of the budget blueprint, coming even before President-elect Donald Trump is inaugurated, shows the speed with which Republican leaders are moving to fulfill their promise to repeal the law. (New York Times)

Could changing the way doctors are paid help narrow health disparities?
A Harvard Medical School study suggests that changing the way doctors are paid could narrow some of the health disparities between poorer and wealthier patients. The study suggests that one solution may lie in the way health care providers are compensated by insurers and that the way payments are structured has the potential to improve the health of those who need care the most. That is a promising sign as other health insurers, Medicare and Medicaid continue to the move to accountable care models, which tie payments to budgets and quality scores. (Boston Globe)

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

Iowa News

Majority unhappy with Medicaid modernization
When it comes to Governor Terry Branstad’s Medicaid modernization, “catastrophic experience” is a term usually associated with recipients, providers and political opponents. Add for-profit corporations to the list of the aggrieved, according to documents obtained by the Des Moines Register, and the assessment is “drastically underfunded.” Medicaid recipients claim to have had difficulties seeing their physicians and obtaining prescriptions, while care providers have complained about delayed, insufficient or rejected payments. (Waterloo-Cedar Falls Courier)

Obamacare marketplace attracts 52,237 Iowans, despite controversy
Obamacare’s days may be numbered, but an increasing number of Iowans are signing up for its coverage. Federal officials reported Tuesday that 52,237 Iowans had enrolled in private insurance plans since Novermber 1 via the online marketplace, That’s 5 percent more than enrolled over a similar period a year earlier. A total of nearly 55,000 moderate-income Iowans bought private insurance policies for 2016 on the Obamacare marketplace. More than 145,000 other Iowans enrolled in the state’s expanded Medicaid program, which was changed to cover more poor adults under the Affordable Care Act. (Des Moines Register)

Increase in local flu cases forces area hospitals to enact voluntary visit limitation policy
Due to increasing influenza cases reported across the Quad-Cities region, officials from Genesis Medical Center are asking visitors to its facilities to voluntarily limit their visits if they believe they are sick. Unity Point-Trinity officials are also asking the public to limit visits. With the number of patients testing positive for seasonal flu at Genesis emergency departments on the upswing, the decision was made to enact the voluntary visit limitation policy, according to the Genesis release. (WQAD)

National News

Georgians overwhelmingly support Medicaid expansion
A majority of Georgians support expanding Medicaid, a new poll by The Atlanta Journal-Constitution shows. Seventy-five percent of people surveyed said they support growing the health program for the poor. Georgia is one of 19 states that have not expanded Medicaid under the Affordable Care Act. Governor Nathan Deal and conservative lawmakers have long opposed the expansion, saying the state can’t afford to grow an already too expensive and unwieldy program. Expanding Medicaid would extend health coverage to an estimated 600,000 Georgians. (Atlanta Georgia News)

Virginia looking for Medicaid savings, but fearing cuts from repeal of health law
Virginia could lose more than $314 million from its general fund budget if the new Congress and president repeal the Affordable Care Act, according to estimates by the state’s Medicaid director. The potential revenue losses loom as Virginia is preparing to expand its Medicaid managed care program to some of the sickest people and most expensive to treat in the $8.1 billion program, which is financed equally by state and federal funds. The state’s Department of Medical Assistance Services is expanding its managed care programs to carry out reforms it promised to a legislative commission three years. (Richmond Times-Dispatch)

Obamacare boosted community health centers’ reach. Now what?
Obamacare’s implementation positively changed the patient population and quality of care they receive at many of the nation’s more than 1,400 federally-backed community health centers, according to two studies published today in Health Affairs. The research offers evidence that in states that embraced the health law, community health centers — which play a key role in providing health care to low-income people, often in medically underserved areas — further extended their reach. (Kaiser Health News)

Muted response from health lobby as Affordable Care Act faces repeal
The speed of Republican efforts to repeal the Affordable Care Act has stunned health industry lobbyists, leaving representatives of insurance companies, hospitals, doctors and pharmaceutical makers in disarray and struggling for a response to a legislative quick strike that would upend much of the American health care system. Health care professionals are not totally silent, but industries that were integral to the creation of the Affordable Care Act in 2010 are keeping their voices down as Republicans rush to dismantle it. (New York Times)

Millennials give providers one shot to gain their business
Providers keen to attract millennial patients should make sure to impress them the first time around or risk losing them to another provider, according to a recent study. Millennials are paying close attention to office appearance, cost, customer service and the quality of products used during a visit, according to a recent survey conducted by the Health Industry Distributors Association. Providers are watching the millennial generation, which is known in the industry for opting for the convenience and immediacy of retail and urgent care, rather than the traditional appointment-based primary-care relationship. (Modern Healthcare)

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

Iowa News

Poverty’s impact on a child’s mental health
Growing up in poverty exposes children to greater levels of stress, which can lead to psychological problems later in life, a new study suggests. Researchers at Cornell University reported that kids who grow up poor are more likely to have reduced short-term spatial memory. The study also reported that such kids seem to be more prone to antisocial and aggressive behavior, such as bullying. Of course, the findings don’t mean that all children growing up in poverty will have these problems, only that the risk is higher, the researchers said. (Quad-City Times)

Iowa lawmakers begin session amid GOP vows of major change
Republican leaders on Monday kicked off the new session of the Iowa Legislature with a promise to make major changes to the workings of state government, though the party with new majorities in both chambers remained mum about specific details on plans to cut taxes, restrict abortion and limit the ability of public workers to bargain for health insurance. Republicans did not specify how they would achieve any tax cuts despite a roughly $110 million budget shortfall in the state’s $7.3 billion budget. (Associated Press/Quad-City Times)

Branstad to tout smaller, smarter government
In 1999, Iowans thought they heard Governor Terry Branstad’s final Condition of the State address. Now, 18 years later, as the longest-serving governor in U.S. history, it appears Tuesday’s address to a joint convention of the 87th Iowa General Assembly will mark his farewell message as the state’s chief executive with expectations he will become U.S. ambassador to China in the coming months. “The theme of my speech is going to be smaller, smarter government,” Branstad said in a recent interview. (Quad-City Times)

National News

Patients waiting in emergency rooms for New Hampshire to fix mental health system
Emergency departments are often the doorstep to New Hampshire Hospital, the state’s psychiatric hospital in Concord. But on any given day there’s an average of 28 people with acute mental health symptoms waiting to get in. And that number has been climbing, says Suellen Griffin, the president of West Central Behavioral Health. But if patients have a severe mental illness they could wait days or even weeks before getting a hospital bed in New Hampshire. Families and mental health professionals are looking to the Republican-controlled statehouse for a solution. (New Hampshire Public Radio)

Nonprofit providing for health care in rural West Virginia counties
A Hurricane nonprofit is using nearly $1 million in government and private funds to finance a rotating loan fund for health care in 26 rural West Virginia counties. The Center for Rural Health Development Inc.’s West Virginia Rural Health Infrastructure Loan Fund project is designed to strengthen the health care industry in nearly half of the state’s counties. Sharon Lansdale, the center’s president and CEO, said the organization differs from many others throughout the nation because it partners with public and private health care providers. (Charleston Gazette-Mail)

Missourians brace for loss of health insurance as Congress moves to dismantle Obamacare
As Republicans begin the process of repealing the Affordable Care Act (ACA), some consumers in Missouri are bracing for life without health insurance coverage. “We’ve made some pretty significant gains,” said Ryan Barker, vice president of health policy for the Missouri Foundation for Health. “Missourians stand a lot to lose with the ACA if it would get repealed.” In Missouri, nearly 250,000 consumers have picked a health plan on for 2017 coverage. A majority of them receive financial help to afford the coverage. (St. Louis Post-Dispatch)

GOP governors fight uphill battle to save Medicaid expansion
An effort by Republican governors in Medicaid expansion states to show the expansion is worth keeping is unlikely to influence congressional Republicans in their drive to repeal the Affordable Care Act and its expansion of coverage to low-income adults. Medicaid expansion advocates hope the governors’ lobbying will cause congressional Republicans to think twice before wiping out the coverage extension that has brought billions of federal dollars into their states. Congressional Republicans seem determined to roll back Medicaid expansion, arguing it’s unaffordable for both the federal government and the states. (Modern Healthcare)

Republicans scramble to ease concerns about Obamacare replacement
Republican leaders on Capitol Hill are scrambling to ease growing concerns among GOP lawmakers about rushing to repeal the federal health-care law before plans for a replacement take firmer shape, addressing complications to the effort to deliver on one of the party’s signature campaign promises. In the Senate, where Republicans are using a budget package to move swiftly ahead with repeal, leaders are looking at ways to adjust their plans to address the skittishness that GOP senators have voiced in recent days. (Washington Post)

Dwight Dial

As he sits in the kitchen of his Lake City farm home, Dwight Dial is surrounded by items that remind him of his loved ones: a barometer his mother passed down to him from Swedish ancestors, photos on the fridge of children and grandchildren, embroidered wall hangings completed by his beloved wife, Jane. It’s a comfortable room in a sprawling farmhouse, but at the moment, it’s quiet. The only sound in the house is Dwight’s voice as he remembers three people he lost within three years.

His father, Gerald, was a tail gunner in a B-17 bomber during World War II in the European theater. He flew 36 missions and was featured in a book written about the “Flying Fortress.” Gerald rarely discussed his experiences with his family, who only came to realize the dangers he had faced when they read the book. “We told each other we’re lucky to be here!” recalls Dwight.

After the war, Gerald returned to the farm and married Alice Ann. Together, they raised seven children and tended the land. When he was 85, a lifetime of smoking resulted in a diagnosis of chronic obstructive pulmonary disease (COPD) and emphysema. In 2009, he began to utilize Community Hospice at Stewart Memorial Community Hospital (SMCH) in Lake City. Hospice is a special kind of care that brings terminally ill patients and their families comfort, support and compassion in a manner that respects and cherishes the dignity and uniqueness of each individual. When cure is no longer possible, hospice can provide highly skilled care to patients and their families in the familiar surroundings of their own home or residence, including nursing homes.

Dwight recalls, “The nurses would come to the house to take care of him. My parents were very private, but I think my folks shared more of their personal lives with them than they did with their children.” He was impressed with the level of care his father received at the hands of the hospice team. “At one point, my father decided to stop going to see his doctor for checkups. The nurses communicated with his physician who then made a housecall. Together they decided to let mom continue to take care of Dad in their home with the help of the hospice nurses. When he passed on December 6, 2013, his last words to mom were ‘I’m glad you kept me at home.’”

In May 2011, Dwight and Jane were visiting their son in Alabama who was preparing for his third tour of duty in Iraq. They were playing with their grandson when Jane suddenly said to Dwight, “Something’s not right inside.” When the couple returned home Jane made an appointment with her primary care provider Nancy Flink, certified physician assistant. Tests revealed that Jane had ovarian cancer. Dr. Marc Miller performed surgery in June and Jane, a long-time Nutrition Services Director at SMCH, began chemotherapy at the hospital that felt like home.

On August 28, 2013 the couple celebrated their anniversary with dinner, margaritas and laughter. Dwight recalls that it was their last meal together. A few days later, Jane was taken to Des Moines to receive care from her oncologist where she stayed until October. When she was able to return to her home, she opted to do the next round of chemotherapy at the Lake City hospital, entering the hospice program at the same time. “Everyone at the hospital worked to make sure Jane was comfortable. The maintenance crew brought a hospital bed, then went and got a new mattress for it, while Bethany Morrow made sure Jane had new sheets and anything else she needed. Friends came to sing Christmas carols for us and later hung Valentine’s cards all over the walls,” says Dwight.

The hospice team helped with bathing Jane and medications. They trained Dwight on how to care for her ileostomy and how to give her nutrients through a port after she was unable to digest food. Dwight pauses for a long moment, “Jane passed away on December 26, 2013, 20 days after her father-in-law. She didn’t want to go before Dad and she didn’t want to go on Christmas day. That morning she said to me, ‘I made it.’” Softly, Dwight continues, “I told her it was okay for her to go, and she went.”

A few months passed and Dwight continued to farm. In June 2014, his mother, Alice Ann was diagnosed with breast cancer. Dr. Miller performed a mastectomy, but the disease had spread into her lymph nodes. “My mother was very strong. She went home and convalesced for a few weeks on her own and then began a series of 29 radiation treatments. After she completed 20, I took her to California to see her sister. When we returned she completed the last nine.”

Before Thanksgiving that year, Alice Ann acquired an infection and was hospitalized for 100 days. Dwight decided to take her home to his house where he could care for her. “The wound nurse showed me how to clean and pack her wound. The hospice nurses were also there to help care for Mom.” Throughout 2015, Alice Ann was in and out of the hospital but on December 5 she returned to the hospital for the final time. She told Dwight, “As soon as I’m well enough, I’m going to go to Shady Oaks.”

She reached that goal on December 9. “The hospice team was involved in mom’s care at the hospital and the nursing home,” says Dwight. “The communication, care and support flow so well from the SMCH hospice team. They bent over backwards to make the process as easy as possible for the family.” Alice Ann passed away on December 31, 2015.

Dwight is grateful for the care shown to Gerald, Alice Ann and Jane, “Hospice gave my loved ones the ability to live out their last days in dignity and love, surrounded by people who truly cared. They became our family during those very critical days. The sincerity this staff has is unquestionable. For the compassion they have for those that are leaving us and for the caregivers, I cannot thank them enough.”