Iowa News

New health care payment system links costs, patients’ outcomes
In January, Trinity Regional Health Center in f Fort Dodge founded an accountable care organization, under which hospitals, doctors and other health care providers are paid partly on how well their patients fare. That’s a switch from the traditional system, which pays most medical providers by how many surgeries, high-tech scans and other services they perform, regardless of whether patients get better. The changes will mainly happen behind the scenes, but proponents say they could bring major improvements in the quality of care and could help hold the line on medical costs. (Des Moines Register)

Medicare payment board merits repeal
By 2035, Medicare is expected to account for nearly 7 percent of our nation’s gross domestic product. In Iowa alone, Medicare spending grew by an average of about 7 percent a year between 1991 and 2009. In a misguided effort to address this problem, the 2010 health care reform laws created a board of 15 advisers given the task of laying down cuts in Medicare spending. The first problem is that these 15 members aren’t elected officials, but appointed bureaucrats. Though they are empowered to make binding decisions about Medicare finances and even to override decisions by Congress, they are accountable essentially to no one. (Des Moines Register)

Stroke rehab helps one eastern Iowan walk again
Thanks to rehabilitation at Covenant Medical Center in Waterloo, Scott Clements is now a miracle man to his wife. “There wasn’t too much motion in his leg at all. And he said he was gonna walk out of here,” said Edna Williams, a therapist assistant. Williams says attitude is everything and Scott is a pleasure to work with. “The attitude is the most important. If they feel that they can’t and they won’t, they won’t. I was so pleased with him and he’s the kind of person you really enjoy working with because anything I asked him to do he would do,” said Williams. (KWWL)

Iowa Cancer Consortium hopes to reach out to rural cancer patients, survivors
Medical professionals, healthcare providers, cancer survivors and more gathered at Ottumwa Regional Health Center’s McCreery Cancer Center for the Southeast Iowa Cancer Forum held by the Iowa Cancer Consortium Thursday. Iowa Cancer Consortium is a non-profit organization that works to collaborate with medical groups across Iowa to lower cancer rates in the state. (KTVO)

National News

Celebrities make pitch for NTSB-like patient safety panel
Actor Dennis Quaid has joined with patient safety and aviation experts to call for an agency akin to the politically insulated, independent National Transportation Safety Board to investigate cases of medical harm and report de-identified findings to physicians, hospitals and the public. “We do not have bad people, we have bad systems,” Quaid said in an article he co-wrote in the most recent issue of the Journal of Patient Safety. (American Medical News)

Tax-exempt reporting too burdensome, nonprofit hospitals say
The Internal Revenue Service guidance, particularly the Schedule H amendment, on reporting for tax-exempt organizations is too burdensome and overly prescriptive, the national collaborative for nonprofit healthcare organizations VHA testified at yesterday’s House Ways and Means Committee Oversight Subcommittee hearing. Among other nonprofit issues, Ways and Means looked at reporting requirements for tax-exempt hospitals. VHA urged Congress not to go beyond the original intent and to work with charitable hospitals to reduce governmental burden. (Fierce Healthcare)

‘Uninsurable’ patients could lose coverage if the health care law is overturned
Under President Obama’s healthcare law, cancer patient Kathy Watson and nearly 62,000 other “uninsurable” patients are getting coverage through a little-known program for people who have been turned away by insurance companies because of pre-existing medical conditions, the Pre-Existing Condition Insurance Plan. Watson’s case illustrates the potential impact of tying everything in the far-reaching legislation to the fate of one provision, the unprecedented requirement that most Americans carry health insurance. State officials who administer the federal pre-existing condition plan in 27 states are trying to make fallback arrangements in case the law is invalidated and coverage suddenly terminates. (Washington Post)

Embattled hospital debt collector taps politicians for defense
Accretive Health has enlisted a veritable who’s who in health policy to come up with “national standards for how hospitals and other providers interact with patients regarding their financial obligations.” The group includes some well-connected heavy-hitters, including former Bush administration Health and Human Services Secretary Mike Leavitt and Medicare chief Mark McClellan, former Senate GOP leader Bill Frist. There some prominent Democrats too, including former Clinton Administration HHS Secretary Donna Shalala and former Senate Democratic leader Tom Daschle. (National Public Radio)

Cataloging wounds of war to help heal them
Each wounded or killed soldier was listed in a small but meticulous computer entry by Colonel Michael Wirt, a doctor intent on documenting how soldiers were wounded or sickened, how they were treated and how they fared. For those seeking to understand war and how best to survive it, the doctor on his own initiative created an evidence-based tool and a possible model. But there are concerns that the potential lessons from such data could be lost, because no one has yet brought the information together and made it fully cohere. (New York Times)

Iowa News

First responders simulate terrorist attack at Carver-Hawkeye Arena
About 100 feet from the entrance, human volunteers went through decontamination, which in this drill involved being drenched with water from an Iowa City fire truck. The volunteers were then triaged by emergency medical technicians before being transported to the University of Iowa Hospitals and Clinics and the Veterans Affairs Health Care System. UI spokesman Tom Moore said the training was “extremely valuable.” (Iowa City Press-Citizen)

Mobile health clinic stops at homeless shelters
Des Moines University students gain real-world experience in many ways. They can travel overseas to learn about international medicine, or experience different backgrounds and cultures right in our own neck of the woods. The Homeless Outreach Club allows them to do just that, taking them to out-of-the-way homeless camps as well as shelters to provide medical care. Two Sundays a month, students drive the school’s mobile health clinic — a flashy green Winnebago — to local shelters. Any patient is welcome, although many are homeless or have been at some point in their lives. (Des Moines Register)

Depression common for farm people
Agriculture is one of the most stressful occupations. Farmers are subjected to stressful conditions that affect their success or failure, such as the uncertain weather, fluctuations in market prices and input costs, disease outbreaks, machinery breakdowns and government policies that regulate agriculture.  Farmers have little control over these “make or break” factors. Many of these factors have a financial effect that can threaten the ability to hang onto the land and resources needed to farm.  (Iowa Farmer Today)

National News

Joplin hospitals share lessons on disaster planning
Hospitals in Missouri coped well with natural disasters last year after a blizzard and floods in January 2011, but they were not as prepared for the overwhelming patient surge from the EF-5 tornado that wiped out Joplin in May, according to a Missouri Hospital Association report. As one of the deadliest tornados in American history, the tornado caused 161 fatalities and approximately 1,371 injuries. (Fierce Healthcare)

Health IT gap between large, small hospitals widens
The federal government’s incentive programs for the adoption of electronic health records (EHRs) is widening the digital divide between large and small providers. In fact, the 15 percent gap in EHR adoption between small and large hospitals seen in 2010 has grown to nearly 22 percent in 2011, according to an online study in Health Affairs. The report is the first nationally representative survey of hospital EHR system adoption since the federal incentive programs began. It examined EHR adoption among U.S. hospitals, using data from the American Hospital Association annual survey of health information technology. (InformationWeek)

Health care costs top $20K per family
The national annual cost of medical care for a typical family of four with PPO coverage has edged up over $20,000 for the first time, according to the actuarial and consulting firm, Milliman. The 2012 Milliman Medical Index estimates the annual cost at $20,728. That’s a record $1,335 increase in the total cost of care compared with 2011, and the first time the cost has notched above the $20K mark since Milliman started reporting on these costs twelve years ago. (HealthLeaders News)

Insurers to lose $1 trillion if health law struck down
Nearly one-tenth of the insurance industry’s total revenue through 2020 is at stake in the Supreme Court’s decision on healthcare reform, a new study by Bloomberg Government says. That figure equals about $1 trillion, or about one-half percent of the projected U.S. gross domestic product over eight years, the report said. The $1 trillion in new revenue would come from the law’s expansion of Medicaid and from subsidies to individuals purchasing insurance. Though most of the money would eventually flow to healthcare providers, insurers would keep an average of $22 billion per year for profit and administrative costs, the study said. (The Hill)

Hospital hit by phone scam
MedCentral/Mansfield Hospital was targeted by a telephone scam that tied up its switchboard for more than a week. The switchboard was receiving several hundred calls an hour from people who presented themselves as bill collectors but would not identify the company they represented. Cindy Jakubick, corporate director of public relations and marketing at MedCentral Health System, said hospital officials contacted Mansfield police and the Ohio Attorney General’s office. (Mansfield News-Journal)

Iowa News

Creston hospital rebuilds after tornado
“We had 80 to 90 percent of roof damage and of that 80 to 90 percent probably 30% of that was gone totally,” says hospital CEO Monte Neitzel. With the roof gone, the water did just as much damage.  Two wings of the 25-bed facility had to be gutted. Six beds are in use now, but every day the hospital gets closer to returning to normal. “Within the next two to three weeks, we’ll be getting into the emergency, second floor and then we’ll get into the Medical Art Plaza for our clinics for the permanent home because right now they’re all in temporary locations,” said Neitzel. The damage to Greater Regional Medical Center is estimated at $8-10 million. (WHO-TV)

ACO deal raises health care hopes
A new partnership between Wellmark Blue Cross and Blue Shield and the Iowa Health System holds promise of controlling costs with a higher quality of care — all while leaving medical decisions in the hands of patients and medical professionals. We think setups like Wellmark-Iowa’s Accountable Care Organization could play a role in solving the complicated problem of spiraling health care costs. (Cedar Rapids Gazette)

Eastern Iowa mother says AirCare helped save son’s life
Late in the afternoon on January 30, Trevor Abernathy, 22, fell off a ladder and became impaled on a piece of rebar sticking out of the ground. The six foot metal rod went through his head and into his brain. “I had my buddy cut it off,” Abernathy said of his recollection of the incident. “That was it.”  A University of Iowa AirCare helicopter was called to the scene and transported Abernathy to the University of Iowa Hospitals and Clinics where he underwent emergency surgery to remove the rod from his head. (Cedar Rapids Gazette)

National News

Massachusetts governor pushes health care cost controls
Governor Deval Patrick said Tuesday he is confident that health care cost increases can be slowed to no more than the annual growth of the Massachusetts economy without harming the hospitals and doctors that make up the state’s dominant industry. Patrick did not explicitly put his support behind either of the two cost-containment bills being debated in the Legislature. However, he said he probably would not support anything that allows health spending to continue to grow more quickly than the gross state product, a measure of economic activity. (Boston Globe)

Illinois governor may order start of health insurance exchange
Michael Gelder, the governor’s adviser, said the Legislature’s workload on Medicaid and pension reform makes it unlikely lawmakers will be able to pass legislation authorizing an insurance exchange during the current session, which is scheduled to end later this month. Looming federal deadlines leave the governor with two choices: calling the Legislature back into special session or issuing an executive order, Gelder said. (Evansville Courier & Press)

Americans show support for compensating organ donors
If compensation took the form of credits for health care needs, about 60 percent of Americans would support it. Tax credits and tuition reimbursement were viewed favorably by 46 percent and 42 percent, respectively. Cash for organs was seen as OK by 41 percent of respondents. Among people who said some form of compensation was acceptable, 72 percent said it should come from health insurers, followed by private charities at 62 percent and the federal government at 44 percent. (National Public Radio)

43 percent of California nursing grads can’t find work
A survey last fall of nearly 1,500 California newly licensed registered nurses found 43 percent did not have a nursing job 18 months after graduating, according to the California Institute for Nursing and Health Care. According to the nurses who were not working, 92 percent said they were told they did not have enough experience, 54 percent told no jobs were available and 42 percent told a bachelor’s degree was preferred or required. (San Jose Mercury News)

Poor hospital billing controls lead to $1M Medicare overpayments
Medicare overpaid Barnes-Jewish Hospital in St. Louis and Indiana University Health in Indianapolis more than a million dollars combined because the two healthcare organizations didn’t have adequate controls to prevent billing errors, according to recent audits by the Office of Inspector General. (Fierce Healthcare)

Iowa News

Winneshiek County officials wrestle with mental health reorginization
Last week the Iowa Legislature approved a reorganization of mental health and developmental disability programs in the state.  Now county officials will have to figure out what the new legislation means for their county. On Monday Winneshiek County supervisors got a report from Winneshiek County CPC Coordinator Jan Heikes.  She told supervisors the new system, which will create regional groups to handle mental health and developmental disability programs, will take two years to fully go into operation. (Decorah News)

East Iowa clinics example of new model for health care
Experts say a proliferation of hospital-affiliated primary care and urgent care clinics is part of the future wave of health care. The clinics help provide the access, continuity and integration of care that are hallmarks of health care reform, while at the same time promoting “brand” loyalty to the hospitals, said Scott McIntyre, communications director for the Iowa Hospital Association. (Cedar Rapids Gazette)

Trinity Muscatine celebrates expansion at groundbreaking ceremony
The $18.5 million expansion includes the emergency department, operating area, laboratory and radiology departments. The project addressed concerns about space and technology in the facility. The ER was built in 1979 to handle about 3,500 patients. In 2011, about 15,000 patients were treated in the same space. That number is expected to continually go up. Patients will notice shorter wait times in the ER and more privacy with their own rooms. (WQAD)

Jefferson hospital receives USDA support for improvements
Agriculture Under Secretary for Rural Development Dallas Tonsager has announced that Greene County Medical Center in Jefferson will receive $20 million in loans through the Community Facilities program to expand and renovate a 75-year-old medical facility and create a state-of-the-art medical campus. The Under Secretary made the announcement during a visit to the area. (United States Department of Agriculture)

National News

Readmissions linked to beds, income more than quality
Supply and demand have more to do with readmission rates over illness severity and care quality, according to new research presented at the American Heart Association’s Quality of Care & Outcomes Research Scientific Sessions. Differences in regional hospitals for heart failure, in fact, have more to do with the number of hospital beds (availability of care) and income levels (socioeconomics), rather than hospital performance, the American Heart Association reported. (Fierce Healthcare)

Third of hospital emergency room visits not necessary
More than a third of the people who go to hospital emergency rooms in New Jersey are there for non-emergency conditions that could be treated in a doctor’s office or clinic, according to a new report from the New Jersey Hospital Association. Overall, the number of emergency room visits statewide is escalating, up 27 percent in a 10-year period ending in 2010, the report showed. And nationally, more than $400 million is spent on avoidable emergency department visits. (Bergen Record)

Berwick on MA health care reform: More pain, more gain
Dr. Donald Berwick, the widely admired former chief of Medicare and one of the nation’s leading health policy mavens, has just weighed in on the competing proposals for cost-cutting reform in Massachusetts. He argues in favor of aiming for more ambitious cost-cutting targets: The House’s tougher goal rather than the Senate’s less ambitious one, or even the still-tougher target put forth by business and religious groups. (WBUR)

Aging population leads MN nurses back to school
Population estimates indicate that the number of Minnesotans age 65 and older will rise 40 percent in the next 10 years. Students are looking beyond two-year-nursing programs to learn more about physical therapy, treatment management and psychological care while pursuing a bachelor’s degree. Nurse educators say two-year degree programs are not enough to keep up with the increasing demands on the profession, and more nursing students are pursuing four-year programs. (Minnesota Public Radio)

Workers at 8 Twin Cities hospitals take strike vote
Nursing assistants, food service workers and support staff at eight Twin Cities hospitals are voting this week on whether to authorize a two- to five-day strike. The vote, which will continue through Tuesday, was called by the Service Employees International Union Healthcare Minnesota, which represents some 3,500 employees who have been in contract talks with the hospitals since January. (Minneapolis Star Tribune)

Marin Koka, PharmD

Why did you choose this as your career? I have always been interested in pharmacotherapy and how it affects the ways our bodies function.  I was initially exposed to the profession approximately 15 years ago when my wife and I were both serving in the military.  At that time, she worked as a pharmacy technician and I was training to work as a physical therapy assistant.  When we were done with our military service, I decided to go back to school and, ever since, pharmacy has become a “family thing.”

What are the challenges and rewards you experience in your work? I primarily work in critical care and telemetry floors.  Patient care in these areas can be extremely demanding in various aspects, and each treatment plan has its own set of unique challenges and obstacles.  One of the greatest feelings I experience is seeing that same patient who, a few days ago we were literally struggling to keep alive, get better, move out to another step-down floor or go home.  This is the best reward that I can get.  It is also great when you get to see the training you receive on a daily basis and the hard work you put into the care you provide for your patients pay off.  Also, being able to participate in various committees and having the opportunity to work alongside other healthcare professionals to improve on a broad range of policies and processes to better provide the best quality of care is definitely very rewarding for my career.

What are your plans for the future? Continuing to become more involved in the areas where I currently practice as well as be able to gain more knowledge in nutrition support, cardiology and infectious diseases areas.

How has the hospital supported your career? Iowa Health-Des Moines has supported my career by giving me the opportunity to practice in those areas that I am more interested in, providing me with the opportunity to participate in various hospital groups and by continuously providing support for my training and education.

More about Marin Koka:

Education: Drake University (Doctor of Pharmacy)

Years with hospital: 9

Iowa News

St. Luke’s seeks $3.1 million in tax credits for clinic
St. Luke’s Regional Medical Center in Sioux City is seeking $3.1 million in state tax credits to build a medical clinic in Morningside, city documents show. The $26.7 million clinic is planned on 17 acres at Sunnybrook Drive and Sergeant Road. The City Council on Monday is scheduled to vote on submitting an application for the Iowa Economic Development Authority targeted jobs withhold tax credit program on behalf of the hospital. (Sioux City Journal)

Still the best and brightest
As the son of two doctors, Azeemuddin Ahmed had a pretty good idea when he graduated from Pleasant Valley High School in 1992 that he would be a doctor, too. And that’s how it worked out, with one slight variation. Ahmed decided emergency medicine was a better fit for him, and he completed a residency in that field at Michigan State University after completing his undergraduate work at Augustana and medical school at the University of Iowa. Ahmed is now vice chairman and a clinical associate professor in the emergency medicine department at the University of Iowa and serves as medical director of the university’s AirCare program (Quad-City Times)

Will construction boom find a shortage of workers?
Iowa City and Cedar Rapids face an impending construction boom that could close in on $2 billion over the next three years, a building explosion that has some leaders concerned the record-level work could overwhelm the state’s builders and workforce. The concerns come even as the aftermath of the recession continues to punish the commercial construction industry. The downturn has driven skilled workers into other fields, say experts, who are unsure whether the loss of workers is permanent or temporary. (Des Moines Register)

National News

As U.S. argues over health care, nations embrace global coverage
Even as Americans debate whether President Obama’s healthcare law and its promise of guaranteed health coverage should be scrapped, many far less affluent nations are moving in the opposite direction to provide medical insurance to all citizens. Today, the U.S. is alone among the world’s richest nations in not providing healthcare coverage to all citizens. Many countries are still struggling to improve the quality of their medical care. And making healthcare affordable remains a challenge for most countries, as it does for the U.S., where about 15 percent of the population lacks coverage. (Seattle Times)

Nurse practitioners look to fill gap with expected spike in demand for health services
President Obama’s health-care law is expected to expand health insurance to 32 million Americans over the next decade. Health policy experts anticipate that the wave of new insurance subscribers will lead to a spike in demand for medical services. That has a battle heating up over who will provide that care. Nurse practitioners are rolling out a campaign this week to explain what, exactly, nurse practitioners do — and why patients should trust them with their medical needs. (Washington Post)

Health care jobs fuel revival in Pittsburgh
While most of the nation is still trying to claw its way out of the deep economic crater left by the recession, this onetime steel capital is already out—thanks largely to the relentless growth in healthcare jobs. Partly because of the outsized ambitions of the University of Pittsburgh Medical Center, the health care industry has replaced manufacturing as the region’s powerhouse. About 1 in 5 private-sector employees in the Pittsburgh area today works at a hospital, a doctor’s office or in some other health services business. (Los Angeles Times)

Retail health clinics grow in popularity
CVS’ Minute Clinic concept has about 600 sites nationwide and registers about 11 million patient visits annually. This growth comes after only having a handful of clinics in 2005, said Angela Patterson, regional director of operations for CVS’ Minute Clinics in California, Nevada, Arizona and Texas. The company, which has six locations in the valley, is also looking to add 100 clinics per year for the next four years. Walgreens has 350 of its Take Care clinics around the country, 13 locally, and Walmart has 140 nationwide. (Las Vegas Review-Journal)

Is it time to update your social media policy?
Number one, of course, is to explicitly spell out that social media users must respect patient privacy at all times–not only on the organization’s social media sites but also on personal accounts. “Physicians have an obligation to prevent unauthorized access to, or use of, patient and personal data and to assure that ‘de-identified’ data cannot be linked back to the user or patient,” the Federation of State Medical Boards said in its guidelines. (Fierce Health Care)

This group of employees from Grundy County Memorial Hospital was one of 10 teams fielded by the hospital for the Live Healthy Iowa 100-Day Challenge.

The Live Healthy Iowa 100-Day Wellness Challenge, which ended on May 1, was a rousing statewide success and Iowa hospitals have led the way.  About 5,800 employees representing more than 50 hospitals have been participating on hospital-sponsored teams in all parts of the state.  IHA joined the fray as well with a pair of staff teams.

Hospitals are also competing in the challenge’s “Corporate Cup.”  While no hospitals were in the lead at last check, many were in the upper tier of the standings.  Corporate Cup winners will ultimately be determined by a combination of the percentage of participants from each business’s work force and the percentage of participants who complete the program.

IHA sweetened the Live Healthy Iowa and Corporate Cup pot with a $500 prize to be awarded to the top-finishing hospitals’ foundations in each of IHA’s seven districts.  Early returns indicated that the competition was heated across the board.

All told, about 33,700 Iowans signed on for the 100-Day Challenge, meaning hospitals were responsible for about 17 percent of total participation.  This is a great example of health care providers who put on their workout shoes so they could add “walking the walk” to “talking the talk.”

Indeed, talking about wellness is sometimes a major occupation of those in health care.  If it were set to music, it would likely be a monotonous tune that had worn out its welcome and certainly could not be danced to.  One might say, as Emperor Joseph II supposedly once told Mozart about one of his operas, that “there are simply too many notes.”

But efforts like Live Healthy Iowa and the Blue Zones Project offer a distinctly refreshing melody, with a populous beat that doesn’t require world-class athleticism or a fanatical fitness mentality to join in and enjoy.  What they are doing is offering a simple yet robust program that is not only unintimidating, but actually inviting.

What most people are discovering is that they are already practicing some level of wellness in their daily lives.  They desire to go further, but with a friendly nudge, as opposed to the coercive push they have at least perceived – if not actually received – from past efforts.  Live Healthy Iowa and Blue Zones offer that nudge, helping people who are well-meaning and well-intended find the purpose, camaraderie and motivation to move the needle a few degrees toward greater wellness.

Appropriately enough, it all began with the record-breaking “Start Somewhere Walk” just last fall, a literal step in the right direction that signaled a beginning, a commitment – a few degrees.  Fittingly, many hospitals hosted these walks and hundreds of hospital employees took part.  Then many hospitals led their communities into Blue Zones and continue to do so, whether they are still in the formal “model community” competition or not – a few more degrees.

The Gallup-Healthways Well-Being Index puts Iowa 16^th in the nation, up three notches from about a year ago.  This is evidence that those few degrees are nudging an entire state in the right direction – from good, to great, to best in the nation.

It’s because of a wellness movement that does not beat people over the head, but provides a beat that matches our own internal drummer while inviting every participant to take it up a notch.  It’s gotten a lot of wallflowers onto the dance floor – thousands, in fact.

That should be music to every health care provider’s ear.

Iowa News

Cedar Rapids hospital reports more babies treated for drug withdrawal
Growth in prescription drug abuse is also impacting the littlest members of society. “I’ve definitely seen more babies that have been born dependent on methadone,” said Denise Sorensen, a social worker with St. Luke’s Hospital in Cedar Rapids. Methadone is a legal prescription pain killer used to treat withdrawal from illegal drugs, most often heroin. It’s also the drug frequently used to wean infants off their mother’s prescription addiction. “You can hear a very screechy cry the baby may have tremors.”  (KCRG)

New hospital stroke alert helping eastern Iowans
When it comes to diagnosing and treating a stroke, time lost is brain loss. From the radiology department to the emergency room, staff at Covenant Medical Center in Waterloo are ready if a stroke call comes in. “Within 45 minutes of the arrival time to the report time, the ER physician can make a diagnosis and determine what method of treatment he wants to use,” said Luanne Blasberg, Covenant CT Supervisor. (KWWL)

Renovation of emergency, surgery areas planned at Mitchell County hospital
A $2.29 million remodeling project at Mitchell County Regional Health Center is now under way. The emergency and surgery departments will receive the lion’s share of the renovation. The new surgery area will feature four same-day recovery areas separated by walls and sliding glass doors. A family waiting area near the surgery suite will be constructed as part of the plan. (Mason City Globe Gazette)

St. Luke’s kicks of a new wellness campaign
Getting fit and healthy have been in the news lately and to help, Saint Luke’s Regional Medical Center in Sioux City is kicking off a new wellness program. StairWELL is a new campaign that encourages employees and the general public to take the stairs instead of the elevator. St. Luke’s received a grant from the Siouxland Community Health Center so they could put up posters and vinyl artwork to make the stairwells more appealing. (KTIV)

Police learn to deal with mentally disabled people
For law enforcement officers, dealing with unruly suspects is risky enough, but when the person suffers from a mental disorder, it can be downright dangerous. “Even if they have a disability, they can still be threatening, and they can still be hurtful to other people. And it’s that officer’s primary job, to maintain the safety of the environment he’s in. He is the person that is called to handle the situation,” said Cyndee Davis, staff psychologist at the Iowa Law Enforcement Academy. (KCCI)

National News

Suspicious Medicare bills found at 2,600 U.S. pharmacies
More than 2,600 U.S. drug stores, or 4 percent of all retail pharmacies, may have suspicious or excessive billing to Medicare, government investigators said. Some pharmacies dispensed unusually high percentages of painkillers and other controlled substances or expensive brand- name drugs, according to a report today from the inspector general for the Health and Human Services Department. (Bloomberg)

Reform pushes patient satisfaction, hospital quality efforts
With hospitals bracing themselves for changes under the Patient Protection and Affordable Care Act, they are primarily focusing on the patient experience, one of the care measures under value-based purchasing, according to a new study by Healthcare Research & Analytics. With patient satisfaction determining 30 percent of Medicare incentive payments and improved clinical outcomes deciding 70 percent starting in October, hospitals are prioritizing efforts that monitor and drive quality and patient satisfaction, according to study respondents. (Fierce Healthcare)

Doctors trained to take on health care transformation at new leadership institute
Good physicians are tireless caregivers and patient advocates focused on delivering high-quality care in primary care offices, emergency departments, operating rooms and other settings. However, medical schools don’t train doctors to lead teams, manage departments or understand complex financial plans. Yet, increasingly, clinicians are being asked to take on key leadership and management roles and develop policy as Maine transforms the way health care is delivered and paid for. (Bangor Daily News)

Tips to keep patients engaged with Facebook pages
People will usually become a fan of your page because they are aware of your brand or because they see a friend “liked” your page. But once they’ve liked you, how do you keep those fans? Being on Facebook is not just about how many “likes” you can build up. If you’re not listening to those folks and interacting with them, then it’s pointless to even have a page. On top of that, if you’re not giving them a reason to continue paying attention to your page, then you’re going to lose them. It’s very easy to “unlike” a page. (Hospital Impact)

Is this patient privacy crusader doing more harm than good?
If the electronic health records industry has a nemesis, it’s Deborah Peel, the founder of Patient Privacy Rights. At a time when doctors and hospitals are digitizing their paper medical records as mandated by the government, Peel, a psychiatrist, has been the most vocal agitator against loss of patient privacy. (Forbes)

Every Iowa hospital included in the data came in below the national median and the level of variance was not nearly as wide in Iowa, where the average Medicare cost ranged from 16 percent to 2 percent below the national median.  Iowa hospitals, on average, cost Medicare $16,427, or about 9 percent below median.  This ranked Iowa as the 9^th most efficient state in the nation.

The efficiency of hospitals has become more important in recent years, particularly with regard to Medicare, which is looking for ways to rein in costs.  Some researchers believe as much as one-third of Medicare’s $551 billion in health care spending – and the nation’s $2.6 trillion – is wasted on excessive care.  In Medicare, that waste occurs, for example, when patients use multiple physicians, including many specialists, and at the end of life when they spend days and even weeks in hospital and intensive care units instead of hospice care.

More and more, Medicare is implementing a payment model that recognizes and rewards value, like that seen in Iowa.  IHA supports value-based payment, as it ensures patients receive appropriate care in the appropriate settings while also reducing overall cost.  If high-cost hospitals were able to reduce their spending to Iowa’s level, or even just the current national median, billions of dollars could be saved.

The new Medicare data is adjusted for certain factors that some believed were a problem in earlier analyses, such as the fact that certain hospitals receive greater Medicare reimbursements to offset higher wages, the large numbers of low-income patients they treat and the number of medical residents they train.

Medicare also took into account the differing mixes of patients hospitals treat, allowing for academic medical centers that handle more complex cases to be compared to small rural community hospitals.  This was done to quell complaints from large urban hospitals, particularly in New York City, which claimed that the unadjusted figures unfairly punished them for treating sicker and poorer patients.  Despite the adjustments, an analysis by Kaiser Health News showed Medicare paid 5 percent or more above the national median to care for patients from 657 hospitals, about one in every five.  The cost for caring for Medicare patients at 1,150 other hospitals — or one out of every three — was at least 5 percent below the national median, according to the analysis.

But the changes worked out well for the New York hospitals.  In the Manhattan region, which other studies showed to be among the most expensive, the average cost was $17,039, about 5 percent less than the national median.  California and Texas are a different story; more than half of the 50 most expensive hospitals are in those two states.  Those 28 hospitals spent an average of $23,143 per patient, or about 29 percent above the national median.

Iowa News

Legislature adjourns for 2012
What was expected in January to be a short, orderly legislative session focusing on four key priorities finally ended on Wednesday, weeks behind schedule and with the single biggest issue left undone. When the final gavels fell in the House and Senate, legislators could boast of a balanced budget, a solid start on education reform and a vast redesign of the state’s mental health care delivery system. (Des Moines Register)

Denison hospital achieves electronic health record goal
Almost two and one half years of research and planning has helped Crawford County Memorial Hospital achieve a major information technology goal resulting in an official reward by the U.S. Department of Health and Human Services (HHS). CCMH was recently notified it has attested to Stage 1 of Meaningful Use under the Health Information Technology for Economic and Clinic Health (HITECH) Act developed by HHS. (Denison Bulletin-Review)

Mercy sponsors ‘We Can Program’ for parents and children
Centerville has joined We Can! (Ways to Enhance Child Activity and Nutrition), a science-based National Institutes of Health movement that teaches parents, caregivers, kids and communities ways to eat healthier, increase physical activity and limit screen time to help children maintain a healthy weight. Sponsored by Mercy Medical Center, the We Can! Parent/Child program will begin on May 19 at the Rathbun Lake Area YMCA. (Centerville Daily Iowegian)

Officials work to stem synthetic drug use
Herbal incense, potpourri and bath salts may sound like harmless Mother’s Day gifts, but these items are fueling the latest drug craze throughout the country, synthetic drugs. These synthetic cannabinoids and cathinones have been reported in 2⁄3 of Iowa’s 99 counties, including Clinton County. “These drugs scare me more than anything else,” Mary O’Donnelly, RN Director at Mercy Medical Center, said. “The symptoms are so severe, we can’t even begin to interact with the individuals. They are so paranoid, they don’t even trust their family. These effects go on for days.” (Clinton Herald)

Help reduce stigma of mental illness
As part of the United Way of North Central Iowa’s commitment to the three building blocks of a good life, Education, Income and Health, one of our goals is to help educate the communities we serve on mental wellness and to help reduce the stigma of mental illness. (Mason City Globe Gazette)

National News

Medicare spotlights hospitals with especially costly patients
The new data appear to reaffirm decades of studies showing that patients in some regions of the country are bigger users of health care services than other places. Patients treated at most or all hospitals in Las Vegas, Fort Lauderdale, Newark, Miami, Los Angeles and Orange County, Calif., tended to cost more than the national median, which is $17,988. Patients treated at most or all hospitals in Anchorage, Des Moines, Honolulu, Minneapolis and Portland, Ore., tended to cost Medicare less. (Kaiser Health News)

Why nurses need more authority
One of the best ways to alleviate the coming shortage of primary care physicians is to expand the scope of practice for advanced practice registered nurses (APRNs), well-trained registered nurses with specialized qualifications who can make diagnoses, order tests and referrals, and write prescriptions. APRNs could provide a variety of services that primary care physicians now provide. (The Atlantic)

Non-profit US hospitals to do more with less, says Moodys
Nonprofit hospitals in the United States face a future of rising costs and dwindling funds as the healthcare reform is implemented and the Congress battles over the budget, according to a Moody’s Investors Services report released on Wednesday. Moody’s has a negative outlook for the sector and expects rating downgrades for nonprofit hospitals to outpace upgrades this year. Standard & Poor’s Ratings Services has a stable outlook on the sector, but expects operating pressures to worsen over time. (Reuters)

Big data and public health: Reducing unwarranted services
Hospital organizations are sitting on large volume data sets, typically in the petabyte scale for each hospital. These are composed of individual patient electronic information that has the potential to root out these systemic inefficiencies in their healthcare services. Sorting through this data, however, presents a substantial challenge. (Government Health IT)

Hospitals turn up the heat on outpatient centers
Officials of outpatient centers say they provide personal care in a less stressful environment than hospitals and the procedures are less costly. It has become increasingly common for women to have breast reduction surgery at an outpatient surgery center. Hospital leaders insist there are questions about the ethics of some of the outpatient programs and their reliability. “We are at risk of blurring the line between commercial businesspeople and medically ethical doctors,” says Terry Myckatyn, MD, director of breast and cosmetic plastic surgery at the Washington University School of Medicine in St. Louis. (HealthLeaders Media)

Hospital food so fresh even the healthy come to dine
Twice a week, local seniors in Warrenton, Virginia, flock to a hip new dinner spot called the Bistro on the Hill for good food, a great view, and musical accompaniment by a retired piano player from a nearby Nordstrom’s. Only “The Bistro” is no stand-alone restaurant. It’s the cafeteria of Fauquier Hospital, one of a new group of “patient-centered” health facilities focused on meeting more than just people’s medical needs. (National Public Radio)