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gear380As Apple Watches makes their way onto the wrists of millions in the coming weeks, the company has demonstrated once again that success and sustainability are a direct result of innovation and modernization.  Proof lies in the fact that, like cellular phones, time keeping and personal health tracking isn’t new, but Apple has again re-imagined an old concept to develop something that feels brand new and drives consumers to line up around the block to get their hands on it.

But believe it or not, there is still a sector of our society that lags in innovation, a place where quality and speed are not incentivized and teamwork is more of a concept than reality.  That would be government.

For the most recent example, one need look no further than the request for proposals (RFP) released by the governor’s office that proposes to privatize the state’s Medicaid program.  On first glance, it would seem that privatization could indeed bring about efficiency and better outcomes.  Unfortunately, innovative products and services are only as good as the engineer’s vision and the blueprints used to build them.  And if the RFP serves as a metaphorical blueprint for Medicaid managed care, it’s anything but modern or innovative despite almost humorously being dubbed the “Medicaid Modernization Initiative.”

There’s no doubt that the Medicaid program wants for efficiency, but the companies being asked to find it must design their products using a flawed blueprint that appears to have been simply pulled off a shelf from 25 years ago and dusted off.  Imagine if Apple was preparing to release the Apple Pocketwatch or the new iRotary Phone – how well would that go over?

As Coca-Cola discovered with its “New Coke” re-branding flop in the 1980s, putting a new name on an old idea doesn’t produce anything but new consequences and consumer skepticism.  In this case, Medicaid “modernization” puts hospital payments and beneficiary access to services at risk.

So where do we go from here?  Well, Steve Jobs once said, “Innovation distinguishes between a leader and a follower.”  The state of Iowa needs to determine whether it intends to lead or follow on this initiative.  Will it go the route of New Coke or can the state muster the courage to innovate?

IHA is pushing the state toward the latter, but with a proposal anchored to a jalopy of an idea, it will take significant muscle from hospital advocates to move things in the right direction.  By following hospitals’ lead in innovation, the state itself can lead by example.  Under those conditions, just like Apple Watch hopefuls, Iowa’s hospitals, Medicaid beneficiaries and the uninsured hopefuls, just might consider lining up days in advance to get signed up.



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

Iowa News:

Iowa View: Understanding Medicaid underscores why the expansion is important for Iowa
The Iowa Legislature is heading down the stretch toward a historic opportunity to greatly improve the well-being of Iowans by providing comprehensive insurance to 150,000 citizens who now lack coverage. In pursuing this goal, policymakers should be aware of the following facts concerning Iowa’s Medicaid program. (Des Moines Register)

Le Mars hospital to roll out capital campaign
Last week the Floyd Valley Hospital (FVH) Board of Trustees voted to hold a capital campaign to raise $2.6 million of the proposed $24 million cost of the project. (LeMars Sentinal)

GRMC responds, recovers from tornado with community support
Greater Regional Medical Center was two weeks away from an open house to unveil a newly renovated wing of the facility, when it was struck by an EF-2 tornado. (Creston News-Advertiser)

Our View: Health plan poor alternative to Medicaid
Gov. Terry Branstad is correct about many of his specific criticism of Medicaid. We agree with his call for developing a health care system that pays doctors more for the quality of service and healthy outcomes rather than strictly in terms of the quantity of services provided. And we’re especially interested in helping the governor succeed in his goal of making Iowa into the healthiest state of the nation.  (Iowa City Press-Citizen)

Family Medical Center to merge with Mahaska Health Partnership
Mahaska Health Partnership is pleased to announce that they have entered a contractual agreement to merge with Family Medical Center, a private medical practice on the MHP campus, effective July 1, 2013. (Oskaloosa News)

National News:

Obama Sees Insurers; Health Law Is Subject
President Obama met with insurance industry executives at the White House on Friday to coordinate the introduction this fall of the insurance marketplaces at the heart of the national health care law, and to discuss so-called rate shock if the industry sharply raises premiums. (The New York Times)

Sebelius: Exchanges will be ready on time, no need for backup plan
The Health and Human Services Department will meet its central ObamaCare deadline and does not need a backup plan for delays, HHS Secretary Kathleen Sebelius said Friday. (The Hill HealthWatch)

Five Ways The President’s Budget Would Change Medicare
President Barack Obama’s fiscal 2014 budget includes a variety of what he says are “manageable” changes for Medicare’s 54 million beneficiaries as well as for the hospitals, nursing homes and other health care providers that serve them. (Kaiser Health News)

Medicaid backers will add safeguards to bill
Supporters of a proposal to expand Medicaid in Nebraska said they’re willing to include cost safeguards within the bill, including a mandatory review of the program if its expenses were to skyrocket and a possible requirement that the state withdraw if the federal government fails to fund it as promised. (Fremont Tribune)

Health care providers want faster changes in payments
Health care providers are pushing the federal government to scrap the payment plan for medical services, preferring instead one payment for a patient’s entire care instead of separate fees for each item. (USA Today)


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

Iowa News

Democrats say Iowa Senate will OK Medicaid expansion on Monday
The Iowa Senate is expected to approve a plan Monday to provide Medicaid health insurance to thousands of additional low-income Iowans, despite opposition from Republican Gov. Terry Branstad.

Genesis goes on the road for heart health
Beginning in April, the Genesis Heart Institute is partnering with HealthFair to provide affordable screenings in an effort to prevent heart disease and stroke. (Quad City Times)

Iowa’s Medicaid money runs out in June without supplemental funds
State funding for Medicaid is slated to run out in early June, putting additional pressure on state lawmakers to resolve an ongoing impasse over language dealing with public funding of abortions that has stalled work on the health and human services budget piece this session, officials said Thursday. (Waterloo-Cedar Falls Courier)

Mercy One helicopter program gains international interest
Des Moines’ helicopter emergency medical service (EMS) program, Mercy One, is gaining an international reputation for showing other countries how it’s done. (Des Moines Business Record)

Mercy CEO, staff members celebrate facility’s success with safety
At Mercy Medical Center, we recognize the first week in March as one of the most important weeks of the year: Patient Safety Awareness Week, sponsored by the National Patient Safety Foundation. (Clinton Herald)

Composting option coming for University of Iowa Hospitals cafeteria diners
The University of Iowa Hospitals and Clinics will start next week offering food composting for visitors at six dining rooms at the 14-acre health care campus. (The Gazette)

U.S. News

Medicaid expansion is still a big pill for Missouri GOP
Missouri’s Republican legislative leaders used their last few hours before spring break to make it known they are not on board with raising the state’s miserly income qualifications for Medicaid. (Kansas City Star)

House Passes Money Bill and Budget Blueprint
The House gave final approval on Thursday to legislation to keep government financed through September, and it also passed a Republican blueprint that enshrined the party’s vision of a balanced budget that would substantially shrink spending, privatize Medicare and rewrite the tax code to make it simpler. (New York Times)

AHIP: Hospital Inpatient Pricing Up Sharply
Prices for inpatient hospital care rose 8.2% between 2008 and 2010, with wide price and cost growth fluctuations recorded across states and localities over the timeframe, according to a study by America’s Health Insurance Plans. (HealthLeaders Media)

Will Americans ever love Obamacare?
All through the Obama years, backers of the Affordable Care Act have lifted their spirits with a consistent refrain: Just you wait. (Politico)

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

Iowa News

Anti-tobacco Advocates Say Graphic Images, Other Measures Influence Smokers to Quit
Plans for graphic warning labels on cigarette packs have gone up in smoke. The Food and Drug Administration decided not to challenge a judge’s ruling that the labels violated free speech under the first amendment. Instead, the FDA will go back to the drawing board. (KCRG)

Federal budget cuts creep into Iowa
Not much fallout from the across-the-board federal budget cuts has started to trickle into Iowa yet, a spot check by The Des Moines Register shows. (Des Moines Register)

IHC Awarded Grant to Engage Physicians about Medical Tests
The ABIM Foundation has awarded funding to 21 state medical societies, specialty societies and regional health collaboratives to help physicians and patients engage in conversations aimed at reducing unnecessary tests and procedures. Support for the grant program comes from the Robert Wood Johnson Foundation (RWJF). (ABIM Foundation)


U.S. News

Rankings compare population health by county
The Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute today released their latest annual health rankings for U.S. counties based on 25 factors that influence health, including health behaviors, social-economic factors and access to care. (AHA NewsNow)

When States Reject Medicaid Expansion, Providers, Businesses Will Pay
States that reject Medicaid expansion under the Affordable Care Act will subject the hospitals and employers within their borders to a considerable financial hit, separate analyses show. (HealthLeaders Media)

CMS innovation center claims big drop in elective preterm births
Use of hospital intensive-care units for newborns appears to be dropping as a result of a federal push to reduce preterm births, according to early evidence cited by federal officials. (Modern Healthcare)

Report: CVS Caremark demands workers disclose weight, health info
Employees at one of the nation’s largest drugstore chains must disclose personal health information — including their weight — or pay a $600-a-year fine, according to a published report. (Los Angeles Times)


The Kaiser Family Foundation has released a report showing that Iowa is one of only a handful of states (eight to be exact) that would see reduction in costs in the Medicaid program should the Legislature and governor agree to expand the program per the recommendations of the federal Affordable Care Act.

IHA supports such an effort as doing so would have a positive impact on Iowa’s businesses, state budget, Medicaid beneficiaries and hospitals.

Some of Iowa’s elected officials remain skeptical of the program, fearing that the federal government will not keep its end the bargain to provide funding for the expanded population in a phased down approach that would require Iowa to kick in 10 percent of the cost after the third year.  The federal government would pay 100 percent of the cost for the first three years of the program.

However, the Kaiser report indicates that Iowa would save about $30 million annually on the Medicaid program should the program expand.  The report shows that the discontinuation of the current IowaCare program (set to expire next year) would allow those beneficiaries to transition to the Medicaid program as well as transfer the costs associated with the program (40 percent currently paid by Polk and Iowa county taxpayers and 60 percent by the federal government).

In addition to the 70,000 Iowans who could transition from IowaCare to Medicaid, the report estimates another 60,000 or more Iowans who don’t qualify for Medicaid today (and are likely uninsured) would qualify for Medicaid under an expanded program.  This represents a wide swath of Iowa’s poor children, parents of children, people with serious disabilities and elderly people who would receive health benefits from an expanded Medicaid program.

Click here to read the full Kaiser report

Click here to read IHA’s Policy Brief on Medicaid Expansion.