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

Iowa News

Privatizing Medicaid rife with problems
Privatizing Medicaid in Iowa is an attempt to fix what isn’t really broken. Compared to other states, Iowa’s Medicaid program has been operating quite effectively. The state-run program provides health insurance coverage to more than 560,000 Iowans in need with low administrative costs and little fraud. The cost per capita is lower than the national average and lower than most other states. But Gov. Terry Branstad earlier this year announced his plan to turn over administration of Medicaid to private managed-care companies. Iowans, it appears, are not on board with the change. (Dubuque Telegraph Herald)

Knoxville hospital offers nearly $7.3 million in community benefit
Knoxville Hospital & Clinics provided nearly $7.3 million in community benefits last year, according to a recently completed assessment by the Iowa Hospital Association. That amount, based on 2014 figures, includes more than $645,000 in uncompensated care such as charity care, bad debt and unpaid costs of Medicaid. (Knoxville Journal Express)

Ames named healthiest city in the U.S.
Ames has been named the healthiest city in the United States, based on a ranking of overall health in the nation’s metropolitan areas by 24/7 Wall St., a partner with USA Today. “Very exciting news,” said city spokeswoman Susan Gwiasda. “We’re delighted to see that and to see the recognition for all of our efforts toward becoming a healthier community being recognized nationwide.” The ranking took many health factors into account, including food insecurity, obesity, health insurance and smoking. (Ames Tribune)

National News

Across much of the U.S., a serious shortage of psychiatrists
It is an irony that troubles health care providers and policymakers nationwide: Even as public awareness of mental illness increases, a shortage of psychiatrists worsens. In vast swaths of America, patients face lengthy drives to reach the nearest psychiatrist, if they can even find one willing to see them. Some states are promoting wider use of long-distance telepsychiatry to fill the gaps in care. In Texas, which faces a severe shortage, lawmakers recently voted to pay the student loans of psychiatrists willing to work in underserved areas. A bill in Congress would forgive student loans for child psychiatrists. (Associated Press/ABC13)

Rising costs, changing payments driving hospital mergers
In the ever-changing world of health care, at least this remains constant: Hospitals want to get bigger. The ongoing merger talks between Beth Israel Deaconess Medical Center of Boston and Lahey Health of Burlington are just the latest example of the bigger-is-better strategy health care executives are pursuing. Like their rivals at Partners HealthCare, Tufts Medical Center, and elsewhere, executives at these two health systems believe building a larger health system is the best way to compete for patients across Eastern Massachusetts, according to people with knowledge of the talks. (Boston Globe)

U.S. moves to protect women, transgender people in health care
The government moved Thursday to strengthen protections against discrimination for women, transgender people, the disabled and others who receive care throughout the health-care system, including those who buy insurance under the Affordable Care Act and providers that receive federal funding. The ACA already bars discrimination based on sex and other factors, but the long-delayed proposed regulation issued Thursday explains how the protections will be applied to insurers and health-care providers, such as hospitals and doctors who receive Medicare and Medicaid payments, and it clarifies the standards federal officials would use in implementing the law. (Washington Post)

What the NLRB joint staffing decision means for health care
Last week, the National Labor Relations Board (NLRB) ruled that contract workers are jointly-employed by both their temporary staffing agencies and the organizations for which they are working; this means both organizations can be held responsible for labor violations committed by contractors. The ruling will also make it easier for contract workers and other temporary employees to unionize. “This decision has broad implications, as it appears to upend decades of settled law defining who the employer is under the National Labor Relations Act,” Randy Johnson, a senior vice president at the U.S. Chamber of Commerce, told The Hill. (Healthcare Dive)

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

Iowa News

Health care providers in Wellmark program see more than $17 million in savings
Eight Iowa health systems participating in a shared savings model of care with Wellmark Blue Cross and Blue Shield collectively saved more than $17 million in health costs in 2014, Wellmark announced this morning. Under the Accountable Care Organization (ACO) model, health care systems are rewarded by insurers for improving quality of care and effectively managing costs. The health care providers assume responsibility for managing a population of patients, both those who are healthy and those who are in need of care. (Des Moines Business Record)

Pella Regional Health Center provides nearly $9.5 million in community benefit
Pella Regional Health Center provided nearly $9.5 million in community benefits last year, according to a recently completed assessment by the Iowa Hospital Association. That amount, based on 2014 figures, includes more than $1 million in uncompensated care such as charity, bad debt and unpaid costs of Medicaid. The Iowa Hospital Association also figured in programs such as health screenings, support groups, community education, health professions education, community clinical services, and other subsidies. (KNIA/KRLS)

Survival training coming to UnityPoint Health-St. Luke’s in October
UnityPoint Health – St. Luke’s and the ALICE Training Institute have teamed up to bring ALICE Instructor Training to St. Luke’s on Thursday, October 1 and Friday, October 2. This two-day instructor course is designed to teach proactive survival strategies for violent intruder or active shooter incidents. The goal of the ALICE program is to provide individuals with survival-enhancing options for those critical moments in the gap between when a violent situation begins and when law enforcement arrives on scene. (KTIV)

Britt hospital celebrates big bequest
Today was a triumphant day for Hancock County Health System as the foundation donated over $34,000 back to the hospital and clinics. Hancock County Health System Foundation President Deanna Kelly describes the board’s emotion. This donation was made possible by the generosity of many volunteers and a year plus of fundraising efforts. Kelly tells about some of those fundraisers. (KIOW)

Waukee player kicking for kids at Blank
Waukee fans have even more reason to cheer on their team this season. Every time the football goes through the uprights, more money will be donated to the children and families at Blank Children’s Hospital. The Warrior Bomb Squad is a fundraiser started and organized by junior placekicker Skyler Crew. He is asking people to donate a dollar amount per point he scores, or make a one-time donation. (KCCI)

National News

Hospital cuts readmissions in half with help from college students
When I was working as an RN, I had a unit director who used to say, “There’s three sides to every story—her side, his side, and what really happened, which is usually someplace in the middle.” She applied that concept to mediating employee squabbles, but the idea relates to patients, too. It could be said there are three sides to every admission (and readmission)—what’s observed in the inpatient setting, what the patient says, and what’s really going on in the patient’s home. (HealthLeaders Media)

White House takes aim at Medicare and Medicaid billing errors
White House budget director Shaun Donovan called for a “more aggressive strategy” to thwart improper government payments to doctors, hospitals and insurance companies in a previously undisclosed letter to Health and Human Services Secretary Sylvia Mathews Burwell earlier this year. Government health care programs covering millions of Americans waste billions of tax dollars every year through these improper payments, Donovan said in the Feb. 26, 2015 letter. (Iowa Public Radio)

Medicaid drives historic coverage gains in Colorado
Colorado’s uninsured rate has plummeted from a recent high of 15.8 percent four years ago to 6.7 percent this year, and the success of the Affordable Care Act in Colorado is almost entirely the result of Medicaid expansion, according to a much anticipated survey from the Colorado Health Institute. The survey found that nearly one in three of the state’s 5.3 million residents now get insurance through Medicaid or other public health insurance programs. (Health News Colorado/Kaiser Health News)

Even with health insurance, many Michiganders struggle to afford care
Many Michigan residents are going without medical care – despite having health insurance – because of rising deductibles and co-pays. Out-of-pocket health care costs have risen much faster than wages, as employers have shifted more costs to workers and individuals have opted for high-deductible plans, according to a report by the Center for Healthcare Research & Transformation at the University of Michigan. Twenty percent of Michigan residents who had insurance reported they delayed medical care in 2013 because of costs, the researchers found. (MLive)

Ohio Supreme Court hears case about medical records and patient rights
If the Ohio Supreme Court upholds a decision that exempted some of a patient’s medical records from his daughters’ request, hospitals could hide critical details about the care of those who are harmed or die there, say the plaintiffs of a case heard this morning. The Ohio Hospital Association argues that the definition of medical records sought by the plaintiff is overly broad, contrary to state law and “untenable for Ohio’s health care providers.” (Columbus Dispatch)

Watchdog: 900,000 veterans have pending healthcare requests
Nearly 900,000 military veterans have officially pending applications for health care from the Department of Veterans Affairs, the department’s inspector general said Wednesday, but “serious” problems with enrollment data make it impossible to determine how many veterans were actively seeking VA health care. About one-third of the 867,000 veterans with pending applications are likely deceased, the report says, adding that “data limitations” prevent investigators from determining how many now-deceased veterans applied for health care benefits or when. (Associated Press/U.S. News & World Report)

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

Iowa News

Chairwoman of hawk-i: Is Iowa’s Medicaid privatization legal?
The chairwoman of a state program that provides health insurance to children of poor families is questioning whether Iowa has acted legally with efforts to privatize management of the system. At issue is a $111.3 million annual program known as hawk-i that provides health insurance for more than 37,000 children from low-income families in Iowa. The program’s management will shift to private companies as part of Gov. Terry Branstad’s effort to privatize oversight of the state’s annual $4.2 billion Medicaid budget. (Des Moines Register)

UI Children’s Hospital construction price rises with upgrades
The 507,000 square feet of new construction, plus 56,250 square feet of renovated space, originally was budgeted to cost $292 million, to be paid through bonds, patient revenue and gifts. Safety updates, clinical upgrades, patient environment enhancements and construction considerations have pushed that total upward of $360 million. Construction is on track to finish in fall 2016, with occupancy slated for that winter. The extra $68 million to pay for it will come from hospital revenue bond proceeds and gifts — not taxpayers. (Cedar Rapids Gazette)

Business conditions weaken again in Iowa, Midwest
Business conditions in Iowa and eight other Midwestern states weakened again in July, according to a monthly survey by Creighton University’s Economic Forecasting Group. The August Business Conditions Index, which ranges between 0 and 100, declined to 49.6 from July’s 50.6, slipping below growth neutral. Ernie Goss, director of Creighton’s Institute for Economic Inquiry, said the index is pointing to weak, and potentially negative growth through the fourth quarter of 2015. (Cedar Rapids Gazette)

Iowa cities rank in top 20 safest-driving cities
A study just released by Allstate Insurance shows that Cedar Rapids and Des Moines have the fewest vehicle collisions in a ranking of America’s 200 largest cities. Cedar Rapids is listed as the seventh safest-driving city, improving from its 2014 ranking at 11th place. Des Moines is listed as the 19th safest-driving city, falling from its 2014 spot as the 13th safest city. (KCCI)

National News

Fewer Americans skipping medical care for cost reasons
During the first three months of the year, just 1 in 20 Americans said they did not get medical care they needed because they could not afford it, according to the U.S. Centers for Disease Control and Prevention. The findings, from the federal National Health Interview Survey, show that 4.4 percent of people interviewed from January through March said they had skipped medical care in the previous year because of its cost — the lowest percentage in 16 years. The percent skipping care for cost reasons had reached nearly 7 percent in 2009 and 2010 and has been shrinking since then. (Washington Post)

How a new program could attract more rural health workers
The Indiana Statewide Rural Health Network is launching a new program to help rural hospital’s fill critical needs for allied health workers. A recent survey with the groups 30 participating hospitals found that nearly a third of them are having difficulty filing positions that require licensed and properly trained allied health workers—like ultrasound techs and lab technicians. Don Kelso, IRHA executive director, says that it was only anecdotally that they decided to survey the hospitals about job vacancies and were surprised to see so many positions that needed to be filled. (Indiana Public Media)

Lawmakers: New Jersey needs more psych beds
In New Jersey, when patients arrive in a hospital emergency department in a mental health crisis, chances are awfully good they will be there for several days — and sometimes weeks — waiting for a short-term psychiatric bed. In South Jersey, the shortage is so bad that the CEOs of five competing health systems have organized a collaborative to study the issue. This year, legislators held three roundtable discussions with health care providers in each part of the state to ask about the problem. (Cherry Hill Courier-Post)

Texas strives to lure mental health providers to rural counties
Of the 254 counties in Texas, 185 have no psychiatrist, according to Travis Singleton, who tracks physician shortages for Merritt Hawkins, a Texas-based consulting firm. “That’s almost 3.2 million [people],” he says. The shortage goes beyond Texas. In the past year, Singleton’s firm has been asked to recruit more psychiatrists nationwide than ever before. “While we knew the demand was high, I don’t think anyone expected it to that extent,” he says. (Iowa Public Radio)

Virginia jail death highlights importance of addressing nation’s mental health crisis
Jamycheal Mitchell was arrested in April for allegedly stealing $5 in groceries from a 7-Eleven, including a Zebra Cake, Mountain Dew, and a Snickers bar, according to The Guardian. His family told the news site that he suffered from bipolar disorder and schizophrenia, and had refused to eat and take his medication. He was supposed to be moved to a state-run mental health facility, but the transfer got stuck in government red tape and he remained in jail, the report notes. (NewsOne)

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

Iowa News

Branstad defends Medicaid bid process
Gov. Terry Branstad is downplaying controversies experienced by four companies selected to manage Iowa’s $4.2 billion Medicaid program, and he says he’s hopeful disputes over the bidding process won’t delay the implementation of their oversight of health care for 560,000 poor and disabled persons. The four winning bidders – Amerigroup, UnitedHealthcare, WellCare and AmeriHealth – have each faced serious charges of fraud or mismanagement in other states with some forced to pay hundreds of millions of dollars in fines, a Des Moines Register investigation has found. (Des Moines Register)

Lucas County hospital affiliates with UnityPoint Health – Des Moines
The board of trustees of Lucas County Health Center announced Friday it has approved a new affiliation with UnityPoint Health – Des Moines, a senior affiliate of UnityPoint Health. The agreement, effective Sept. 1, provides hospital management and consultation services and also includes the necessary affiliation services for the health center to maintain its status as a rural Critical Access Hospital. (Des Moines Business Record)

Senator Grassley says Medicare reimbursement tilt leads to less psychiatrists
Last week’s rampage that saw a mentally-ill Virginia man fatally shoot two former co-workers on live TV is raising new calls for increased funding to identify and treat such people before they become killers. Iowa Senator Chuck Grassley says we can spend more money on mental health care but it doesn’t do any good if there aren’t professionals in place to deliver the help. “We have a dearth of psychologists and psychiatrists,” Grassley says. (Radio Iowa)

Age is just a number for this Ottumwa paramedic
We’ve all heard the saying, “Choose a job you love and you’ll never have to work a day in your life.” Easier said than done and seems to happen to a fortunate few, but Steve West is one of those folks who have done just that. As an ORMIC for Ottumwa Regional Health Center, Steve (at 74 years old) may also be one of the oldest active paramedics in Iowa and in the United States. “As long as I can contribute to the team and help, I will be here,” Steve says. “I like to be busy! The hospital has been good to me and good to this community.” (Ottumwa Courier)

National News

CMS delays two-midnight rule enforcement to January 2016
The Centers for Medicare & Medicaid services on Wednesday said it would delay enforcement of the controversial two-midnight rule until the beginning of 2016, a change from the September 30 extension laid out in the sustainable growth rate replacement legislation passed by Congress in July. According to CMS, newly established quality improvement organizations will begin conducting reviews of short-stay inpatient claims on Jan. 1, 2016, a job that was previously conducted by Medicare Administrative Contractors. (Healthcare Finance News)

Data transparency: What the numbers don’t tell us about quality health care
We urge transparency in patient safety information and discuss the need for “evidence based medicine” incessantly. But what is full disclosure and is it healthy? Every type of company has truckloads of data, be it market data, polling data or public opinion data. Health care also has millions of data bytes that can reflect everything from volume and financial metrics to outcomes, including survival and complications. Reports can be written to pull pieces out here and there, but the challenge comes from putting individual data points together to tell any kind of meaningful story. (U.S. News & World Report)

Brigham and Women’s to cut 100 jobs as costs rise faster than revenues
Brigham and Women’s Hospital plans to cut 100 positions to save $10 million as costs rise faster than revenues, hospital officials said Monday. The cuts, taking effect over several months, will include both layoffs and leaving vacant positions unfilled. They will apply to all jobs that do not deal in direct patient care. No doctors, nurses, or other staff who work directly with patients will be laid off, hospital officials said. The Brigham also has frozen hiring for non-patient care positions. (Boston Globe)

Texas to reimburse for school-based telehealth services
Starting September 1, 2015, the Texas Medicaid program will reimburse physicians for providing school-based telemedicine visits for children enrolled in primary or secondary schools. The new telemedicine program was authorized by Texas House Bill (HB) 1878, which was signed into law on June 16, 2015. The provisions of HB 1878 are based on a pilot program conducted in 2014 by Children’s Health System of Texas in 27 schools in North Texas. The 2014 pilot was funded through the state’s Medicaid 1115 waiver to allow school nurses to connect with physicians from Children’s Health Pediatric Group clinics through a video consultation. (Open Minds)

Mercy Health, Premier partner to advance population health
Mercy Health, Ohio’s largest health system, has expanded its relationship with healthcare improvement company Premier. The action follows savings of more than $117 million attributed to supply chain, business intelligence and performance improvement solutions. This week, Premier announced the two will focus on advancing Mercy’s population health management, with an eye toward improving care for chronically-ill patients. (Healthcare Dive)

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

Iowa News

How does privatizing Medicaid save Iowa money?
I am concerned about the privatization of Medicaid Services in Iowa in general, and in particular the hiring of out-of-state companies to manage the mental health benefit program. I was even more concerned when the Register published that all three of the companies contracted have records of fraud or mishandling claims. I was also taken aback by the information that the previous management company received nearly 10 percent of the total Medicaid budget for managing. (Des Moines Register)

The heroin epidemic: ‘Worse than a sickness’
Heroin’s new hold into Cedar Rapids slipped in quietly, according to one emergency department doctor. UnityPoint Health-St. Luke’s Hospital’s emergency department already has treated more heroin overdoses during the first half of this year than in all of 2014 — 20 from January to June 2015 compared with 19 in 2014. It treated only nine in 2010. (Cedar Rapids Gazette)

Some schools working with parents to address mental illness
When a student’s mental health care requires more than a typical school counselor can provide, where do schools turn? In the Pleasant Valley Community School District in Eastern Iowa, they turn to a professional counselor contracted to work with students in need. “It’s a great partnership,” Pleasant Valley Assistant Superintendent Brian Strusz said. “It’s a win-win for everybody.” (Cedar Rapids Gazette)

A decline in dentists
Iowa’s dental work force looks very different from it did 18 years ago — with far more women practicing and the average age of working dentists steadily climbing. That’s according to new data in several issue briefs out by the University of Iowa’s Public Policy Center. The briefs laid out dentist-workforce supply trends in Iowa from 1997 to 2013 to help the UI’s College of Dentistry and Dental Clinics better anticipate potential shortages and focus retention and recruitment efforts. (Cedar Rapids Gazette)

National News

As health care shifts to homes, need for home health aides grows
Baby boomers, as they grow older and more infirm, will need more people like Antwannette Hill – home health aides, and personal care aides – jobs that overlap, with the latter often doing more housekeeping. The U.S. Bureau of Labor Statistics says both categories will be among the fastest growing in the next seven years, adding just over a million jobs. Aging baby boomers are driving the demand for more health services, but how that care is delivered is not just about demographics. It’s also about who can do it more cheaply, said labor economist Paul Harrington, director of Drexel University’s Center for Labor Markets and Policy. (Philadelphia Inquirer)

A new way to think about conflicts of interest in medicine
Does the source of funding affect study findings? The question is at the heart of a longstanding debate about financial conflicts of interest in medicine and what to do about them. That debate was recently reinvigorated by a three-part series of articles on the subject in The New England Journal of Medicine. But other potential sources of conflicts of interest in medicine have not been as closely examined. (New York Times)

Precision medicine, linked to DNA, still too often misses
Back in January, when President Obama proposed a precision medicine initiative with a goal of “matching a cancer cure to our genetic code,” John Moore could have been its poster child. His main tumors were shrinking, and his cancer seemed to have stopped spreading because of a drug matched to the cancer’s DNA, just as Obama described. This summer, however, after a year’s reprieve, Moore, 54, feels sick every day. The cancer — advanced melanoma like former president Jimmy Carter’s — has spread to his lungs, and he talks about “dying in a couple of months.” (Boston Globe)

Organ donation awareness increases after IndyCar driver Justin Wilson’s death
The Indiana Donor Network said they’re seeing increased attention in the wake of IndyCar driver Justin Wilson’s death. This week we learned Wilson was an organ donor and saved six lives. Still Thursday, flowers remained outside Gate 1 at the Indianapolis Motor Speedway, along with memorials and mementos for fallen IndyCar driver Justin Wilson. But Wilson’s legacy lives on through organ donation. (Fox 59)

FDA warns tobacco makers about label language
The Food and Drug Administration issued warnings to the makers of Natural American Spirit, Winston and Nat Sherman cigarettes, saying that the brands could not be marketed as “additive-free” or “natural.” In three separate letters made public on Thursday, the F.D.A. told the manufacturers of the brands that they did not have the agency’s approval to claim that their products were free of certain harmful substances, or that they posed less risk to consumers than other tobacco products. (New York Times)