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

Iowa News

Hospitals across Iowa facing nursing shortages
Hospitals across the state are scrambling to fill nursing positions, with hundreds of openings in the Des Moines area alone. “Just seeing what nurses do, it’s miraculous,” said Deb Moyer, chief nurse executive at Unity Point Health in Des Moines. What is not miraculous is just how few of them there are in the state. Unity Point in Des Moines currently has around 170 nursing positions open, St. Luke’s Hospital in Cedar Rapids has 71, Broadlawns has 15 vacancies and Boone County Hospital has eight. Nurses say they need the profession to grow quickly the shortage will not be over any time soon. (WHO)

Limits on medical malpractice lawsuits passes Iowa Senate
Legislation aimed at limiting medical malpractice lawsuits won approval in the Senate Monday after a heated debate over the rights of patients hurt by negligent health care against the need to help Iowa attract more physicians. The bill includes provisions governing doctor-patient communications after adverse medical incidents; capping limits on non-economic damages, such as pain and suffering, at $250,000; requiring a “certificate of merit” to screen out frivolous litigation and establishing standards for expert witnesses. The bill’s supporters include the Iowa Hospital Association, Iowa Health Care Association, Iowa Medical Society and other medical organizations. (Des Moines Register)

Des Moines Register to help Iowans follow health care debate
Health care is personal. Health care is also big business. With so much at stake it’s no wonder Congress can find little common ground on health care policy. Actions at the state and federal levels in coming months could affect the quality and cost of health care available for years to come. And across the country, hospitals could struggle financially depending on what Congress ultimately decides. The Des Moines Register’s health care reporter, Tony Leys, will spend much of his time in coming months reporting on how federal health law changes will affect Iowans. (Des Moines Register)

National News

Already in peril, rural hospitals unsure on health care bill
Rural hospitals have long struggled, with patients who are older, suffer from chronic illnesses and face few insurance options, if they’re insured at all. Most rural hospitals have a higher-than-normal percentage of Medicaid patients; expected cuts to the federal program for low-income residents will affect facilities everywhere, but experts and administrators are particularly worried about rural areas. And for many rural health care workers, the GOP’s new plan isn’t calming nerves. When rural hospitals are forced to close, the effects reverberate, a 2016 Kaiser Family Foundation study shows. (Associated Press/ABC News)

As ACA repeal vote nears, Kansas debates on expanding Medicaid
Kansas lawmakers know they are late to the Medicaid expansion party, but they appear determined to show up anyway. “I feel like now is as good a time as any,” says Anthony Hensley, the leader of the Democratic minority in the state Senate. Congress’ bill replacing the Affordable Care Act (ACA) would not immediately close the expansion window for states that have not acted, says Tom Bell, president of the Kansas Hospital Association. An estimated 300,000 Kansans would qualify for coverage under expansion, though only about half that number are expected to initially enroll. (KCUR)

GOP’s Medicaid cuts could affect thousands in SC
South Carolina’s must vulnerable citizens could lose access to health care if massive Medicaid cuts proposed by congressional Republicans become law. The American Health Care Act – President Donald Trump and the GOP House leadership’s plan to replace and repeal President Barack Obama’s signature health care law – would make big changes to Medicaid, the federal health care program for the poor. “This is all about the federal government wanting to save a bunch of money and shifting the risk to the states, and South Carolina is one of the states that can least afford it,” said Sue Berkowitz, director of the S.C. Appleseed Legal Justice Center. (Columbia State)

Trump to Capitol in last-ditch lobbying for health care bill
President Donald Trump is rallying support for the Republican health care overhaul by taking his case directly to GOP lawmakers at the Capitol, two days before the House plans a climactic vote that poses an important early test for his presidency. Top House Republicans unveiled revisions to their bill in hopes of nailing down support. Trump’s closed-door meeting with House Republicans was coming as party leaders released 43 pages worth of changes to a bill whose prospects remain dicey. Their proposals were largely aimed at addressing dissent that their measure would leave many older people with higher costs. (Associated Press/ABC News)

CMS delays expansion of bundled payment programs
The Centers for Medicare & Medicaid Services (CMS) has delayed the expansion of a major bundled payment pilot, Comprehensive Care for Joint Replacement, and the implementation of its bundled payment initiatives for cardiac care from July 1 to October 1, 2017, according to an interim final rule. It also delayed several other payment programs. The Trump administration’s move to delay mandatory initiatives raises questions about the future of government initiatives to usher health care out of fee-for-service operations and into a new age of value-based payment. Hospitals likely will feel varying degrees of the impact of the implementation delay. (Modern Healthcare)

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

Iowa News

Health group: Up to 250,000 Iowans at risk under GOP bill
The Iowa Hospital Association (IHA) estimates a Republican-backed plan to replace the Affordable Care Act could leave up to 250,000 Iowans without health insurance, and others speculate the change could destabilize the entire Medicaid system that serves poor and disabled people. Kirk Norris, president and CEO of IHA, said the bill would cause people to lose preventive care coverage, increasing emergency room visits and leading to more costs for hospitals. (Associated Press/Iowa City Press-Citizen)

Privatized Medicaid a disaster
Before state Medicaid was privatized in the fall of 2015, most of the services Hannah Soyer of Iowa City received were managed through the Department of Human Services (DHS), as was the case of other 600,000 disabled or poor Iowans. But the majority of those who had been managed by DHS are now managed by one of the three private managed care organizations. Soyer and others with disabilities have experienced several problems since then. Quality health care for people with disabilities can be hard to find when making sure these services are funded is a headache. It is time that the state Legislature recognize what privatized Medicaid in Iowa has become: a disaster. (Daily Iowan)

Despite crowd’s hostility, Ernst gratified by town hall in Cedar Rapids
US Senator Joni Ernst welcomed input from a highly partisan, overflow crowd Friday at a town-hall meeting. If nothing else, the Iowa Republican said, the gathering demonstrated that “Iowans understand how politics works” and how to engage elected officials. And the crowd let her know that it doesn’t think much of the proposed replacement to the Affordable Care Act, the president’s “skinny budget” or much of anything they see coming out of the Trump administration and Congress. (Cedar Rapids Gazette)

National News

AHA moves lobbying effort to stop ACA repeal to Senate
Feeling unheard in the House, the American Hospital Association (AHA) is turning to the Senate to stop the American Health Care Act from becoming law. AHA met and shared its concerns with House leadership about provisions of the law it feels will result in millions of people losing coverage, which could ultimately harm the financial stability of many hospitals when their uncompensated care costs soar. “We cannot support the bill in its present form,” Rick Pollack, AHA CEO, said at a news conference Friday. “It doesn’t appear as if they are making any major changes at this point that would accommodate the concerns that we have,” Pollack said. (Modern Healthcare)

Illinois experts say Republican health care plan could cost state $40 billion
Illinois stands to lose an estimated $40 billion in federal money over the next decade under the Republican health care proposal being considered in Congress. The figure comes as state House Democrats sought to put a price tag on the potential impact of the plan on health care programs for the poor. Americans would lose coverage by 2026 under the Republican plan, David Gross, senior vice president of government relations for the Illinois Health and Hospital Association, told lawmakers. “This is at a time when the state is not well positioned to absorb the costs,” Gross said. (Chicago Tribune)

Rural Wisconsin takes hit in GOP health plan after backing Donald Trump
No congressional district in Wisconsin delivered a bigger victory margin for Donald Trump last fall (20 points) than the rural northern one represented by Republican Sean Duffy. But by one key measure, no district in Wisconsin would lose more health care aid under the GOP plan to replace Obamacare. Wisconsin is part of a national pattern in which the Obamacare enrollees who appear to be hit the hardest by the Republican plan fit the demographic and geographic profile of Trump’s political base which disproportionately live in rural areas. (Milwaukee Journal-Sentinel)

On Medicaid money, GOP has win-or-lose proposition for states
States’ policies differ about who or what to cover in Medicaid and those decisions have led to historical variances in how much federal money they receive. House Republicans’ effort to shrink federal Medicaid spending would lock in the differences in a way that favors those already spending high amounts per enrollee. GOP leaders want to give states a set amount of money each year based on a formula known as per-capita caps. But caps would shift costs and financial risks to the states and could force them to cut benefits or eligibility to manage their budgets. (Kaiser Health News)

New Baltimore wellness center works to reduce stigma of mental illness
Patients who receive mental health counseling at the new Simon Life and Wellness Center in Baltimore lie on white leather sofas with faux suede and fur pillows. It’s not the typical decor, but the staff at Simon Life and Wellness in the Charles North neighborhood wants clients, many of them low-income, to see it as a cool and welcoming place. Simon Life and Wellness offers an art therapy room, music therapy and yoga classes. Owner Christopher A. Simon hopes to diminish the stigma that’s often attached to mental illness and draw more people from some of Baltimore’s most troubled neighborhoods into much-needed treatment. (Baltimore Sun)

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

Iowa News

Mercy doctor says state mental health system is ‘broken’
Dr. Alan Whitters is the Medical Director of Behavioral Health at Mercy Medical Center in Cedar Rapids. Dr. Whitters believes Iowa is in the midst of a mental health epidemic. One of the main issues is Iowa doesn’t have enough beds to treat the population. With few places to turn, those seeking treatment often end up in hospital emergency departments. The Treatment Advocacy Center says a minimum of 50 beds per 100,000 people is necessary to provide, “minimally adequate treatment for individuals with severe mental illness” but Iowa only had two beds per 100-thousand last year. (KCRG)

Profit-seeking Medicaid insurers vs. Iowans
Iowa has been victimized by Governor Terry Branstad’s Medicaid privatization for nearly a year. Handing over a $4 billion government health insurance program to profit-seeking companies did not make sense in theory, and in practice, it has been a nightmare for health providers and low-income Iowans. The private insurers are in the business of making as much money as possible. Iowans have suffered under the failed Medicaid experiment. Administration of the health insurance program for more than 500,000 Iowans should be returned to the state, which is not in the business of pleasing shareholders. (Des Moines Register)

Disabled Iowans say Medicaid firms are cutting in-home help
Nearly 7,400 Iowans with disabilities who use Medicaid’s Consumer Directed Attendant Care program (CDAC) which pays members of the community to provide everyday assistance that lets recipients continue living in their homes instead of nursing homes. The Long-Term Care Ombudsman’s Office recently reported that reduced hours in the CDAC program are one of the top complaints about managed care. Charles Palmer, director of the Department of Human Services, said he’s also aware of complaints that managed care companies have been limiting service hours for disabled Iowans. (Des Moines Register)

UnityPoint acquisition of CIH could come in late April
UnityPoint Health-Waterloo will become the owner of Central Iowa Healthcare (CIH) if Federal Bankruptcy Judge Anita Shodeen approves an asset purchase agreement between the two. Attorneys for CIH and UnityPoint Health said they can work out the details and submit the agreement to Shodeen for her review. If Shodeen’s decision is favorable, the closing could come as soon as the end of April. Those were key results which came out of a hearing Thursday afternoon in U.S Bankruptcy Court for the Southern District of Iowa in Des Moines. (Marshalltown Times-Republican)

National News

Kansas lawmakers working to reverse Medicaid cuts
Last summer, Governor Sam Brownback ordered more than $56 million in cuts to KanCare, the state’s privatized Medicaid program. On Thursday, the Senate took a first step by passing a bill that would reverse a $47 million reduction in reimbursements paid to hospitals and others providing care to those enrolled in KanCare. The effort to reverse the cuts is more complicated in the House, where some members are backing a bill that in addition to raising the health management organization fee would increase a state assessment on hospitals known as the “provider tax.” The Kansas Hospital Association is strongly opposed to the House bill. (KCUR)

Washington State Hospital Association: AHCA is ill-considered
Washington hospitals have adjusted to the Affordable Care Act and are experiencing fewer visits to emergency rooms for non-emergency care and charity care has declined. Chris Bandoli, the Washington State Hospital Association’s (WSHA) senior vice president for government affairs, said, “You can’t just throw 750,000 Washingtonians off health care coverage and expect it to be OK.” WSHA came out against the American Health Care Act (AHCA) and reiterated that opposition after the Congressional Budget Office issued its analysis. (Spokane Spokesman-Review)

Connecticut health care industry blasts ‘Trumpcare’ plan
Area hospitals and health care organizations have given their opening reviews of the proposed American Health Care Act – and they aren’t good. Particularly troubling, health care providers said, are the changes in Medicaid.  “Medicaid expansion resulted in more than 200,000 Connecticut residents gaining coverage,” said Michele Sharp, spokesperson at the Connecticut Hospital Association. “But if funding is lost, there is an open question regarding how those people would receive coverage.” “We are also concerned for providers,” she said. (Westfair Communications)

Americans not sold on cost and coverage claims in GOP’s health bill
A majority of the public is skeptical the Republican health plan would be an improvement over the Affordable Care Act, with widespread concerns that insurance costs would increase while people lost coverage, according to a poll released Wednesday. The Kaiser Family Foundation poll found that 48 percent of the public thought the GOP plan would decrease the number of people who have health insurance. Another 30 percent expected the insured rate would stay the same and 18 percent thought the number of covered people would increase.  (Kaiser Health News)

Republicans split, conservatives angry as health care overhaul inches ahead
Deeply divided Republicans squeezed their US health care overhaul through a key House panel on Thursday despite defections by three conservatives who consider it too similar to the Obamacare law it is intended to replace. Trump’s first major legislative initiative still faces an uphill battle in the full House and later the Senate despite ongoing efforts by the White House and Republican leaders to satisfy conservative opponents. The Budget Committee vote was 19 to 17. Republicans, who control Congress and the White House, could not afford to lose more than three from their ranks on the committee for it to pass. (Reuters)

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

Iowa News

Medicaid firms spending less on care for Iowa’s poor, disabled
The three private firms running Iowa’s Medicaid program have found ways to trim spending on care for the poor or disabled Iowans they cover, a new report suggests. But all three continue to lose tens of millions of dollars on the controversial project. The companies’ per-member monthly spending on health care for adults fell by as much as 28 percent from the three months ending in September 2016 to the three months ending in December 2016, the new report shows. Governor Terry Branstad’s office touted the new report as representing “unprecedented transparency” in how the giant health-care program is run. (Des Moines Register)

Iowa Medicaid insurers pay more in claims than they get from the state
For the third consecutive quarter, the three private insurers managing the state’s Medicaid program paid out more in claims than they were paid by the state, causing the insurers to see losses between 11 percent and 27 percent, according to Department of Human Services data out Wednesday morning. The quarterly report helps shed additional light on the insurance companies’ financial losses reported earlier in March in Iowa Insurance Division filings. Governor Terry Branstad said Wednesday that the private insurers have plenty of experience administering Medicaid programs in other states and anticipate start-up costs. (Cedar Rapids Gazette)

Iowa lawmakers brace for tough budget choices
Iowa’s downward revenue projection slide has created major ripples in state budgets as Governor Terry Branstad and GOP legislators look to backfill an immediate $131 million gap with reserves and begin to fashion spending plans for the next two fiscal years shaken by this week’s taxing developments. Budget-makers also project Iowa’s Medicaid program will need $42 million in the coming fiscal year, along with other funding needs that are putting a crunch on the budget even before Republicans have fashioned their fiscal 2018 spending targets. (Sioux City Journal)

National News

Minnesota health care groups don’t back GOP replacement bill
The primary groups representing Minnesota doctors and hospitals say they oppose the plan to repeal and replace the federal Affordable Care Act (ACA), citing the potential for thousands of state residents to lose coverage. The plan would be a problem for Minnesota because the state has seen a dramatic reduction in the rate of uninsured residents under ACA, according to the Minnesota Hospital Association. The group stressed how the current law helped drive the rate of Minnesotans lacking coverage to a historic low of 4 percent which has helped hospitals by reducing uncompensated care costs. (Minneapolis Star Tribune)

GOP health bill worries rural Oregon
Oregon’s decision to expand eligibility for Medicaid in 2014 led to increased enrollment in the Oregon Health Plan, the state’s Medicaid program. And the trend of expanded coverage is across rural Oregon. Uncertainty has plagued many citizens throughout the beginning of the new administration and the insurance plan is no different. The irony is many of the poor, rural districts that voted for President Donald Trump — who supports the new health care legislation — stand to lose the most from the plan. The result is an increased amount of debt for the hospital because patients won’t be able to afford insurance coverage, let alone their bills. (Coos Bay World)

Obamacare repeal could hurt rural areas — a key Trump constituency
Republicans from rural states increasingly are worried that their party’s plan to replace the Affordable Care Act would inflict damage on vulnerable communities, especially the poor and middle-aged in isolated areas whose votes helped catapult Donald Trump into the White House. The concerns are a byproduct of this week’s nonpartisan Congressional Budget Office analysis of the GOP replacement, which highlighted multiple ways that the health care plan falls far short of Trump’s campaign promise to keep Medicaid intact and to create a system that provides “insurance for everybody.’’ (Boston Globe)

Obamacare pushed nonprofit hospitals to do good beyond their walls. Now what?
Requiring a “community health needs assessment” was part of a broader package of rules included in the Affordable Care Act (ACA) to ensure that nonprofit hospitals justify the tax exemption they receive. “There’s no question ACA required us to bump up our game,” said Joan Quinlan, its vice president for community health at Massachusetts General Hospital. If people lose coverage, it could stifle efforts to promote more substantial community benefit. That scenario would increase the amount of free care nonprofit hospitals provide, creating new budget pressures that could lead them to tamp down on efforts to promote community health work. (Kaiser Health News)

GOP leaders acknowledge health bill changes, may delay vote
Their health care overhaul imperiled from all sides, top House Republicans acknowledged Wednesday they would make changes to the legislation in hopes of nailing down votes and pushing the party’s showpiece legislation through the chamber soon. House Speaker Paul Ryan declined to commit to bringing the measure to the House floor next week, a fresh indication of uncertainty. Republican leaders have repeatedly said that was their schedule, but opposition mushroomed after a congressional report concluded this week that the measure would strip 24 million people of coverage in a decade. (Associated Press/ABC News)

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

Iowa News

GOP health plan would hit Iowa especially hard
After seven years, US House Republicans have finally unveiled their plan to repeal and replace the Affordable Care Act. It immediately went over like a lead balloon with pretty much everyone, including doctors, hospitals, insurers and advocacy groups. Iowa, currently a largely red state with many older residents and a governor who expanded Medicaid, will feel disproportionate pain. There are the tens of thousands of Iowans who will eventually lose Medicaid coverage. Governor Terry Branstad used the expansion offered under Obamacare to extend coverage to low-income Iowans and eventually help fund his Medicaid privatization mess. All that could fall apart. (Des Moines Register)

Iowa Faces $131M Shortfall for Current Budget
Iowa is taking in less revenue than expected and must address a new shortfall of about $131 million to its current budget, financial analysts announced Tuesday in releasing data that could spell deep cuts for the next spending year. The news from the three-member Revenue Estimating Conference means Iowa will need to plug a deficit to the budget year that went into effect last summer and ends June 30. The governor’s office and at least one key Republican quickly endorsed tapping into cash reserves instead of cuts to state government — as long as the money was repaid. (Associated Press/U.S. News & World Report)

Mercy Auxiliary honors volunteers, makes donations
Mercy Auxiliary’s members gathered Friday to celebrate their achievements over the last year. Auxiliary President Marilou Finn announced Friday that over the past year, 218 area residents have served as active volunteers for the Auxiliary, logging a total of 31,199 hours of work – a number that hasn’t gone unnoticed by the community. Finn also announced the group raised $76,057.73 throughout the year. Additionally, a total of $10,000 in scholarships was given to the Mercy Healthcare Foundation and a $63,000 donation was announced to fund emergency room vein finders at Mercy Medical Center-Clinton. (Clinton Herald)

National News

Louisiana Hospital Association: ‘deeply concerned’ about AHCA
Paul Salles, president and CEO of the Louisiana Hospital Association, released a joint statement with Jennifer McMahon, executive director of the Metropolitan Hospital Council of New Orleans, regarding the American Health Care Act (AHCA) — the GOP’s answer to repealing and replacing the Affordable Care Act (ACA). The letter states that patients and the caregivers who serve them across Louisiana are depending on Congress to make continued coverage a priority and both organizations are deeply concerned about several provisions in the AHCA. Under ACA, there have been significant investments in the health care of Louisiana residents that must be protected. (Acadiana Business)

How the House GOP bill would affect Missouri hospitals
More than 200,000 Missourians have gained insurance since the Affordable Care Act took effect. It’s not clear yet how many Missourians would lose insurance under the GOP bill but with more Missourians uninsured, hospital officials fear they would have to provide more uncompensated care. The Missouri Hospital Association estimates that the Republican plan could cost the state’s hospitals $5.5 billion over the next decade. “Hospitals could be paying for a significant portion of the new law, at the same time as uncompensated care costs explode and Medicaid comes a less reliable source of care for the poor,” said Dave Dillon, a spokesman for the association. (Springfield News-Leader)

GOP replacement plan could send hospital costs soaring again
The US hospital industry is irate about provisions in the Republican plan to repeal and replace Obamacare that would freeze spending on expanded Medicaid coverage for 10 million people in 31 states in 2020 followed by sharply reduce federal assistance to Medicaid. As spending on Medicaid plummets, hospitals and other medical providers will incur steep losses to provide emergency treatment and services to those least able to pay for them. Medicaid payments to hospitals and other providers amounted to 90 percent of the costs of patient care in 2013, according to estimates by the American Hospital Association. (Fiscal Times)

GOP senators suggest changes for health care bill offered by House
A day after a harsh judgment by the Congressional Budget Office on the House plan to repeal the Affordable Care Act, nervous Senate Republicans on Tuesday suggested changes to the bill. They told Trump administration officials that they wanted to see lower insurance costs for poorer, older Americans and an increase in funding for states with high populations of hard-to-insure people. They said those changes would greatly improve the chances of Senate approval even though they might further alienate conservatives. (New York Times)

North Carolina legislation backs reimbursements for telemedicine use
Telemedicine has grown in demand in recent years, particularly aimed at individuals who live in rural and suburban areas and/or who have difficulty getting to an urban hospital campus. A requirement that insurers provide standard coverage and reimbursements for telemedicine and other digital services was introduced in a bipartisan House bill last week in North Carolina. The legislation would prohibit insurers from treating telemedicine differently solely because it is not provided as in-person delivery of service or consultations. (Winston-Salem Journal)