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

Iowa News

Medicare supplement letters allegedly misled Iowa seniors
Two out-of-state companies could face fines for misleading Iowa seniors about their Medicare options, regulators said Monday. The Iowa Insurance Division has filed administrative charges against the two companies, the Robert Stillwell Agency, based in Pennsylvania, and Senior Direct, based in Texas. The administrative charges could lead to fines or suspension of the companies’ permits to market in Iowa. “Because Medicare supplement insurance is an important tool for managing health care costs, it is critical that Iowans are given accurate information as they make decisions,” division spokesman Chance McElhaney said. (Des Moines Register)

AbbeHealth becomes affiliate of UnityPoint Health-Cedar Rapids
After years of an informal partnership, AbbeHealth and UnityPoint Health-Cedar Rapids have made it official. The two Cedar Rapids health care organizations have signed an affiliation agreement that officials say will allow them to provide more coordinated medical, behavioral health and aging services. AbbeHealth, a regional non-profit organization that provides mental health and aging services to more than 17,000 people each year, will continue to provide community-based services. AbbeHealth will be an affiliate of UnityPoint Health — Cedar Rapids starting January 1. (Cedar Rapids Gazette)

Like rest of country, Dubuque exhibits symptoms of growing nursing shortage
At Sunnycrest Manor in Dubuque, Administrator Cristine Kirsch worries about her staffing numbers. The nursing department is looking to fill about three nurse and eight nursing assistant positions. The care facility’s workforce shortage stresses current staff members, she said. While some positions naturally turn over, the time it takes to fill them is increasing, Kirsch said. It’s a problem shared by health care organizations throughout the region. The US Census Bureau projects that by 2050, the number of people age 65 and older will double to 84 million. (Dubuque Telegraph Herald)

‘Riding the roller coaster’ of the NICU
Andrea and Todd Brommelkamp were completely caught off guard when their son was born at just 25 weeks on July 13 — 15 weeks shy of their October 23 due date. Since then, Thomas has been in the neonatal intensive care unit (NICU) at UnityPoint Health — St. Luke’s Hospital, battling the challenges of a premature birth. According to the Centers for Disease Control and Prevention, preterm birth is the biggest contributor to infant death. The final weeks of gestation are crucial in growth and development, and a premature birth can lead to long-term intellectual disabilities, cerebral palsy, respiratory problems, visual problems, hearing loss and feeding and digestive issues. (Cedar Rapids Gazette)

National News

Mental health, substance abuse could be driving up ED use
Almost half of the increasing emergency department (ED) use in New Jersey hospitals is being driven by patients with mental health and substance use disorder needs, according to a report by the New Jersey Hospital Association (NJHA). The report looks at the contradiction in which more people than ever are covered by health insurance, yet more people continue to use hospital EDs for treatment. The problem is a lack of access to appropriate resources for mental health and substance abuse treatment, despite strides in coverage, particularly through Medicaid expansion, said NJHA president Betsy Ryan. (Healthcare Dive)

Putting telemedicine behind bars
Dr. Vinh Pham treats dozens of patients from New York City’s Rikers Island jail complex with hepatitis C and other infectious diseases. He knows their frustration with the process of accessing specialist care—and its quality. Pham and his colleagues came up with a solution. Earlier this year, they introduced telemedicine to Rikers Island, which has some 55,000 inmates come through its doors annually. Since the initiative began in May, 52 inmate patients have had virtual checkups and information visits with Bellevue’s infectious disease, gastroenterology and urology specialists. (Modern Healthcare)

Allina nurses settlement could embolden hospitals
The recently concluded Allina Health nursing strike could be the start of a change in hospital labor relations nationwide. Allina took a hard line saying there would be no deal unless the nurses accepted give-backs on health benefits. “It had national implications,” said Roger King, a labor attorney at the Washington D.C.-based HR Policy Association. For a large, unionized employer like Allina to take a firm stance, King said, “I think probably emboldens other health care organizations around the country to consider the same approach.” (Minnesota Public Radio)

Why hospitals are taking a page from the retail industry
Why would patients get an X-ray at a hospital when the clinic down the road is charging one fifth of the price? Patients are increasingly asking that question, and PwC released a report recently showing how hospitals are responding: with price cuts, simplified billing and even money back guarantees. Amid rising competition from standalone imaging and surgery centers, many hospitals are working harder to market their services and get accurate price estimates to patients. (STAT)

Doctors cut costs by getting to know their patients
The health care landscape is changing. In the past six years, we’ve seen the rise of Accountable Care Organizations (ACOs), now numbering more than 800, where doctors or hospitals work together to streamline care. For physicians that means they now get some compensation through contracts that reward improving health and controlling costs, as opposed to simply making money for every service provided regardless of the outcome or expense. There are now an estimated 28 million Americans enrolled in these ACOs, and that means their care looks radically different than even just a few years ago. (Marketplace)

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

Iowa News

Branstad’s unproven Medicaid claims piling up
Iowa’s governor is making cheerful claims about the benefits of his unpopular Medicaid privatization without providing evidence to back them up. On July 25, Governor Terry Branstad’s office announced the release of “new data” showing Iowans “have more choice, access and accountability” under the new system. That doesn’t jibe with scores of complaints from Iowans since the governor handed over administration of the health insurance program to for-profit insurers on April 1. Iowans do not know what is being saved, gained or improved by the privatized Medicaid model Branstad foisted on this state. (Des Moines Register)

Local agencies continue to battle with Medicaid transition
Health care providers in Jasper County are trying to get up to speed on both billing procedures and receiving payments from the state’s three managed care organizations — but it hasn’t been easy. Integrated Treatment Services, Progress Industries and Capstone Behavioral Healthcare are among the agencies battling with procedures and delayed payments as Iowa continues its transition to managed care. While there has been some progress in terms of locating technical or paperwork-bottleneck glitches that can be remedied, payments for services are still flowing through at a rate that makes it difficult for providers to meet expenses and pay its own bills. (Newton Daily News)

More than half of Iowans unfamiliar with virtual health care services
Virtual care is a growing trend in health care, but few Iowans know about it, according to a University of Iowa Health Care survey conducted this year. The survey of 528 Iowans from both urban and rural areas found that 54 percent of respondents were unfamiliar with the concept of care delivered via computer or smartphone. Patrick Brophy, a physician and associate professor of pediatrics at the University of Iowa, said virtual health care makes it easier and more convenient for any Iowan to visit a doctor. (Sioux City Journal)

UI student groups back mental health fee
Student leaders have responded to concerns over insufficient mental-health resources on campus by proposing a $12.50 fee to fund mental-health initiatives. The student-counseling staff ratio for the University of Iowa (UI) Counseling Service is the second lowest in the Big Ten, said UI Student Government President Rachel Zuckerman. This creates long waiting times for students seeking mental-health resources, she said. To solve this problem, UI student government and the UI graduate and professional student government put forth the idea of raising this fee from the initially requested $10. (University of Iowa Daily Iowan)

National News

States levy taxes on hospitals to cover Medicaid expansion costs
States are beginning to turn to hospitals to cover the cost of Medicaid expansion once the federal match begins to drop next year. Starting next year, eight of the 32 states that have expanded Medicaid planned to use provider taxes or fees to fund all or part of the states’ share of costs, the report said. The Arkansas Hospital Association does not support a raise in taxes to support a program that has already been determined to pay for itself. Elsewhere, hospital associations say they’re willing to pick up the tab since they understand expansion would not have had happened otherwise. (Modern Healthcare)

Three state hospital associations form safety pact
Hospital associations in Michigan, Illinois, and Wisconsin have created a joint Hospital Improvement Innovation Network (HIIN) to reduce readmissions and hospital-acquired conditions, and improve patient safety. More than 330 hospitals and health systems in Michigan, Illinois, and Wisconsin are expected to participate in the Great Lakes Partners for Patients, according to a joint media release issued by the pact. The partnership builds on the quality improvement work of the Michigan Hospital Association, Illinois Hospital Association, and Wisconsin Hospital Association through the federal Partnership for Patients Hospital Engagement Networks 1.0 and 2.0. (HealthLeaders Media)

Washington state takes lead on police mental health training
Legislators in Washington state broke new ground in 2015 when they passed a bill requiring all law enforcement officers to be trained for encounters with people in mental health crises. The bill requires that eight hours of crisis intervention team training be included in the basic curriculum for all Washington officers by 2017, and a two-hour refresher course incorporated into annual training. Law enforcement experts nationwide hail the mental health training as useful, given how frequently officers deal with people in crisis since states began moving away from institutionalizations in the 1960s. (Kansas Health Institute)

Rural hospitals outperformed urban in value, readmissions, HAC programs
When it comes to thwarting hospital-acquired infections and scoring better in government value-based purchasing programs, rural hospitals outperformed their urban counterparts and saw fewer penalties in 2015, shows a report released Wednesday by the US Department of Health and Human Services. In drilling down further into data from the Hospital-Acquired Conditions (HAC) Reduction program, rural hospitals did better overall than urban facilities, as well as in the specific categories of efficiency and patient experience, the report showed. (Healthcare Finance)

Can mental illness be prevented in the womb?
Every day in the United States, millions of expectant mothers take a prenatal vitamin on the advice of their doctor. The counsel typically comes with physical health in mind: folic acid to help avoid fetal spinal cord problems; iodine to spur healthy brain development; calcium to be bound like molecular Legos into diminutive baby bones. But what about a child’s future mental health? Yet much as pediatricians administer childhood vaccines to guard against future infections, some psychiatrists now are thinking about how to shift their treatment-centric discipline toward one that also deals in early prevention. (NPR)

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

Iowa News

Researchers battle cancer with immune system
Using new techniques that tap into the defense mechanisms of the immune system, doctors are able to decloak — or weaken — cancers, in hopes of purging them altogether. “One of the really exciting areas that we are working on is the use of the immune system to treat cancer,” said George Weiner, the director of the University of Iowa Holden Comprehensive Cancer Center. For many years, one of Weiner’s focuses at the center has been using the immune system to treat cancer. (University of Iowa Daily Iowan)

With overdoses on the rise, police consider Narcan
First responders in Des Moines said they have seen 20 percent more overdoses this year than last year. Now, Des Moines police are considering carrying the lifesaving anti-overdose drug Narcan. Narcan reverses the effects of opioids and can save someone’s life in a matter of seconds. Paramedics have carried it for years, but now police say maybe it’s time they do too. Des Moines paramedic Tony Sposeto said he responds to anywhere from 5 to 20 overdose calls a week. Des Moines paramedics have already used the lifesaving drug 160 times this year. (KCCI)

Mercy makes improvements to joint replacement program
Mercy Medical Center-Des Moines’ Joint Replacement Program was recently highlighted in Becker’s Hospital Review as one of 10 hospitals taking their total joint replacement programs to the next level. Mercy has worked throughout the past year on improving its program to better serve patients, the health system said in a release. Mercy’s orthopedic team developed a new approach to offer patients a coordinated, one-stop shop for joint replacement that includes working as a comprehensive team. (Des Moines Business Record)

What is a mammogram?
One woman is diagnosed with breast cancer every three minutes in the US according to the Susan G. Komen Foundation, but health professionals say getting mammograms can help with early detection. “The best protection and the best way to cure breast cancer is to find it early and the only way to do that is by having an annual mammogram,” says Kim Anderson, registered nurse at Mercy Medical North Iowa Regional Breast Center. Mercy Medical Center averages around 170 to 175 breast cancer patients a year and at least 25 percent of them are under the age of 50. (KIMT)

National News

Montana hospitals see good, bad from Medicaid expansion
The first six months of Medicaid expansion in Montana brought more use of hospital services by the 50,000 people enrolled in the program and medical facilities have seen lower costs due to patients’ inability to pay, according to a report released Tuesday by the Montana Hospital Association (MHA). The report compares to the first six months of 2015 from nine Montana hospitals and 22 Critical Access Hospitals, MHA states. And it warns it is too brief a period for conclusions on hospital about Medicaid expansion. (Great Falls Tribune)

Florida eyes Medicaid managed care extension
The Florida Agency for Health Care Administration will start holding public meetings Tuesday as it moves forward with seeking federal approval of a three-year extension of the state’s Medicaid managed-care program.The current federal approval for the program is scheduled to expire June 30, and the proposal seeks an extension through June 30, 2020. State lawmakers in 2011 passed a controversial plan to require most Medicaid beneficiaries statewide to enroll in managed care plans. (Health News Florida)

Yarmuth to Bevin: Kentucky Medicaid plan ‘will fail’
US Representative John Yarmuth on Tuesday called on Kentucky Governor Matt Bevin to withdraw his proposal to reshape Kentucky’s Medicaid program and reconsider his request for a waiver from the federal government to enact the changes. Speaking at a press conference at the Capitol, Yarmuth, a Louisville Democrat, said it’s clear that the US Health and Human Services Department will reject the plan because the agency recently rejected similar changes proposed by other states. Bevin has proposed curtailing the state’s Medicaid program because he says the expansion under the federal Affordable Care Act is not sustainable. (Courier-Journal)

ER wait times, length of stay far longer for psychiatric patients
Psychiatric patients wait disproportionately longer in emergency departments (EDs) before receiving treatment and experience longer stays compared to other patients, according to reports released Monday by the American College of Emergency Physicians. The three separate studies examined how emergency rooms care for patients with psychiatric conditions compared to other patients by looking at ER wait times and length of stay. About 52 percent of surveyed emergency physicians said they have experienced cutbacks to mental health resources in the last year in the communities they serve. Yet, the need for psychiatric services hasn’t diminished. (Modern Healthcare)

Health care attorneys call cybersecurity a growing concern
Attorneys are highly concerned about the threat of IT breaches at hospitals and health care systems, but also fear that little is being done to address the situation. That’s the result of a survey undertaken by Bloomberg Law and the American Health Lawyers Association. According to the survey, 97 percent of respondents believe they will experience an increased involvement in cases involving cybersecurity; 57 percent said it will be a significant increase. There have been several high-profile ransomware attacks on hospitals this year and the Ponemon Institute believes such attacks are occurring against US hospitals almost monthly. (Fierce Healthcare)

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

Iowa News

Area students visit Lakes Regional Healthcare
Some Iowa Great Lakes Area students closed their textbooks and left the classroom last week to learn about innovations in health care. Area high school students, Spirit Lake’s fifth- and sixth-grade science classes, Okoboji Middle School’s “Medical Detectives” and automation and robotics classes took a field trip to Lakes Regional Healthcare on October 12. The hospital showcased its new Mako robot and Lucas CPR machine during the event. Jennifer Gustafson, vice president of marketing and retail services at Lakes Regional Healthcare hopes the day inspired students to consider health care as a possible career in the future. (Dickinson County News)

ISU’s Carriquiry named to National Academy of Medicine
An Iowa State University Distinguished Professor of statistics, whose work has advanced the understanding of nutrition and dietary assessment, has been elected to the National Academy of Medicine (NAM). Alicia Carriquiry is one of two Iowa State faculty among the 70 new members and nine international members the academy announced on Monday. During her 26-year career, Carriquiry has developed statistical methods to better measure food consumption, specifically, nutrient intake. Her work has also focused on mental health issues, which includes leading an ongoing effort by NAM to evaluate Veterans Affairs mental health services. (Iowa State University)

‘Cares for Kids’ donations support BVRMC First Embrace Obstetrics
Donations to the “Cares for Kids” program at Buena Vista Regional Medical Center (BVRMC) have recently been used to purchase a CuddleCot for the First Embrace Obstetrics. The CuddleCot and a Moses Basket are used together when a newborn passes away so the family will have additional time with their child. (Storm Lake Pilot Tribune)

National News

Arkansas Medicaid program adds 7,000 to rolls
More than 7,000 people completed enrollment in Arkansas’ expanded Medicaid program in September, bringing the total to more than 324,000, according to figures released Monday. Those covered under the program as of Sept. 30 included 301,009 who had enrolled in the so-called private option, which uses Medicaid funds to buy coverage for low-income Arkansans in private plans offered on the state’s health insurance exchange. The federal government has been paying the full cost of coverage under expanded Medicaid since 2014, but Arkansas will be responsible for a portion of the cost starting next year. (Arkansas Online)

Transitional care program aims to ease pressures at Kansas State Hospital
Nine months after Osawatomie State Hospital (OSH) lost its federal payments, all rooms are back online following renovations and the state is looking at partnerships to address some of its long-term struggles.The state hospital — one of two in Kansas for patients with severe mental health issues — has shown progress on several problems that led to the loss of Medicare payments. The trade-off, however, is that hospital emergency rooms in eastern Kansas have sometimes had to hold patients deemed a danger to themselves or others for days while waiting for a bed to open at OSH. (Kansas Health Institute)

Hospitals struggle to address terrifying and long-lasting ‘ICU delirium’
Doctors and nurses across the country are now pushing an ambitious campaign to change practices in intensive care units (ICUs) to reduce cases of “ICU delirium” — a sudden and intense confusion that can include hallucinations, delusions and paranoia. Anywhere from a third to more than 80 percent of ICU patients suffer from delirium during their hospital stay. “This is a massive, massive public health problem,” said Dr. Wes Ely, a pulmonologist and professor of medicine and critical care at Vanderbilt University Medical Center in Nashville, Tennessee, who was among the first to recognize the scope of the problem. (STAT)

More adults receiving recommended outpatient care
The quality of outpatient care for US adults improved in the areas of recommended medical treatment, counseling and cancer screening between 2002 and 2013, according to a study published online today by JAMA Internal Medicine. The authors used 46 indicators from the Medical Expenditure Panel Survey to examine changes in the quality of adult outpatient care in the areas of recommended care, inappropriate care and patient experience. The proportion of participants avoiding inappropriate medical treatment and antibiotic use declined over the decade, while the proportion highly rating their care experience improved. (JAMA Internal Medicine)

In final Cancer Moonshot report, Biden lays out progress and obstacles
Vice President Joe Biden delivered his final report Monday on the “Cancer Moonshoot,” reiterating how the US is at an “inflection point” in the fight against cancer. He cited reasons to be hopeful, even as he acknowledged challenges ahead in the drive to achieve a decade of progress on fighting cancer in five years. Monday’s report laid out a strategy to do so, organized into five strategic goals: catalyzing scientific breakthroughs, maximizing the power of data, bringing new therapies to patients more rapidly, improving prevention and diagnosis and enhancing access and care for patients. (Modern Healthcare)

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

Iowa News

Teaching the business of medicine
It was 8 am on Saturday and about 25 University of Iowa (UI) medical students sat in a classroom listening to Greg Stewart, a professor at the UI Tippie College of Business, lecture about human resources strategy. During the four-hour session, Stewart talked about staffing, compensation and competitive strategy. It wasn’t the first time this group of medical students got together to learn about business principles — but it certainly isn’t part of their normal curriculum, either. They’re participating in a business minor of sorts — a pilot program executed through a partnership between Tippie College of Business and the Carver College of Medicine. (Cedar Rapids Gazette)

Lullaby Lane opens with dedication service
The Lullaby Lane path was completed last month as part of a Leadership North Iowa service project. Nearly two dozen people came to the dedication ceremony at Elmwood Cemetery on Saturday. Attendees who lost a child wrote messages and the names on white balloons and released them in their memory. This year, If they choose, grieving parents have a new way to honor their child. Parents who lost children to miscarriage under 20 weeks will have the option of having their child’s name and date of loss engraved on a paver in a new path called Lullaby Lane. (Mason City Globe Gazette)

National News

Denver hospital will start texting more patients about their health care
Denver Health sent 250,000 appointment reminders and 2,000 well child check reminders to patients via text message over the past three years. Patients who got texts made it to their appointments 73 percent of the time, compared to a 66 percent attendance rate for those who didn’t, the historic safety-net hospital and community health care provider said. Now, a federal grant will allow Denver Health to expand its texting capabilities and tie those messages directly into patients’ electronic health records. (Denver Post)

A growing number of patient, family councils help guide hospital operations
If doctors are trained to listen closely to patients to arrive at correct medical diagnoses, shouldn’t hospital administrators listen to patients when designing clinical buildings, creating nursing policies and making discharge plans that affect patient care? A growing number of hospitals in Michigan are doing just that by creating patient and family advisory councils. “We have made great strides with hospitals across the state to get them to commit to this journey,” said Brittany Bogan, vice president of patient safety and quality at the Michigan Health and Hospital Association and its Keystonequality center. (Crain’s Detroit Business)

Scarcity of mental health care means patients – especially kids – land in ER
Research abstracts presented Monday by the American College of Emergency Physicians offers insights into how frequently patients with mental health issues land in the emergency room — often because opportunities to intervene earlier are missed. Compared with patients who have physical illnesses, the researchers found that people with mental health conditions rely more on the emergency department, and are more likely to be admitted when they show up. They tend to stay longer, too. Children and older patients appear particularly affected. (Kaiser Health News)

Hard time or hospital treatment? Mental illness and the criminal justice system
When patients are ill or afraid enough to be potentially assaultive, the earliest decision as to whether they belong in jail or in the hospital may shape the course of the next many years of their lives. It’s now well understood that the closing of state hospitals in the 1970s and 1980s led to the containment of mentally ill people in correctional facilities. Today our jails and state prisons contain an estimated 356,000 inmates with serious mental illness, while only about 35,000 people with serious mental illness are being treated in state hospitals. (New England Journal of Medicine)

Final MACRA rule expands exemptions, flexibility
Nearly a third of physicians could be exempt from Medicare’s new Merit-based Incentive Payment System under a final rule the Centers for Medicare & Medicaid Services (CMS) issued Friday for implementing the Medicare Access and CHIP Reauthorization Act (MACRA). CMS also signaled it would broaden the opportunities for physicians to participate in alternative models that make them eligible for bigger rate increases and bonuses. MACRA replaces the old and flawed sustainable growth-rate formula for physician pay with a new method meant to shift physicians away from the fee-for-service model and onto a value-based payment system. (Modern Healthcare)