by Scott McIntyre on Monday, May 14, 2012
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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 16th 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.
by Scott McIntyre on Friday, May 11, 2012
New data from the federal government has reaffirmed that Iowa’s hospitals are among the most cost efficient in the nation. The new Medicare figures show wide variance among hospitals around the country, even within the same city. In Los Angeles, for example, the average patient admitted to Temple Community Hospital cost Medicare $24,104 during the stay and in the month afterward, 34 percent above the national median. Meanwhile, about a mile and a half away at Saint Vincent Medical Center, the cost was $17,628, or 5 percent below the median.
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 9th 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.
by admin on Tuesday, May 8, 2012
Members of Spencer's "Blue Crew" celebrate the city's selection. (Spencer Daily Reporter)
Cedar Falls, Mason City, Spencer and Waterloo have been selected as the first Blue Zones Project demonstration site communities in Iowa. The selected communities will receive assistance from national experts to develop and implement a blueprint for making permanent environmental, social and policy changes that transition people into healthier behaviors that can lead to longer, happier lives.
Hospital CEOs in the selected communities praised the efforts of citizens and said health care providers will continue to support Blue Zones.
“Allen has been planning its own Blue Zone initiative since January,” said Tom Tibbitts, CEO of Allen Health System in Waterloo. “We’ve also been enthusiastic advisors since last October to the people who worked so hard to win the bids. Having both Cedar Falls and Waterloo as Blue Zones sites gives us tremendous opportunity to help our associates and two of our largest communities, at work and at home.”
“The Blue Zones project is a great opportunity to showcase how the two communities can work together to make improvements in the health and well-being of Cedar Valley residents,” stated Jack Dusenbery, CEO of Wheaton Franciscan Healthcare-Iowa, which includes Sartori Memorial Hospital in Cedar Falls and Covenant Medical Center in Waterloo. “We look forward to learning more about Blue Zones, further developing community partnerships and ultimately achieving the goal of Iowa becoming a model for the nation as the healthiest state.”
“We are beyond excited that Mason City was named a demonstration site for the Blue Zones project,” said Rod Schlader, interim CEO at Mercy Medical Center-North Iowa. “Hospitals around the state need to become leaders in this effort. Mercy-North Iowa looks forward to working side-by-side with its community partners to make our city a healthier and happier place for residents.”
Mason City residents supported Blue Zones during a walk last December. (Mason City Globe Gazette)
“We are excited to be a part of the community-wide, grassroots effort to make the Spencer area a healthier place to live and work,” said Spencer Hospital CEO Bill Bumgarner. “The enthusiasm is contagious and the commitment demonstrated by numerous hard-working community members will ensure success for our Blue Zones efforts.”
The Blue Zones Project is based on Blue Zones principles developed by author and explorer Dan Buettner and is the centerpiece of the Healthiest State Initiative to make Iowa the healthiest state by 2016 as measured by the Gallup-Healthways Well-Being Index. Blue Zones employs evidence-based ways to help people live longer, better lives by taking a systematic, environmental approach to well-being, which focuses on optimizing policy, social networks and the built environments where people spend their time.
The progress of the demonstration site communities will also be measured using the Gallup-Healthways Well-Being Index, the first-ever daily assessment of U.S. residents’ health and well-being.
“Recent Gallup-Healthways Well-Being Index findings reveal that despite a modest increase in overall well-being from 2010 to 2011, there is significant opportunity in Iowa for improvement in several key areas, including healthy behaviors and work environments,” said Healthways President and CEO, Ben R. Leedle, Jr. “Selection as Blue Zones Project demonstration sites will equip Cedar Falls, Mason City, Spencer and Waterloo residents with tools to directly address each community’s specific areas of opportunity and achieve greater well-being, which should ultimately lead to lower health-related costs, increased productivity and higher economic viability.”
In the first application round last November, 84 communities indicated an interest in becoming Blue Zones Project demonstration sites. Of these 84 communities, 58 were asked to submit a comprehensive application. On January 4, 54 communities submitted their applications to continue their journey to become a demonstration site. The selection of 11 finalist communities was announced on February 10, followed by Blue Zones Project team site visits to each of the finalist communities in February and March.
Six additional Iowa communities with populations above 10,000 will be selected as demonstration sites in the next year, for a total of 10 sites. These communities will share their learnings with other communities in Iowa that are employing Blue Zones principles.
by admin on Friday, May 4, 2012
The “100 Great Iowa Nurses” program annually recognizes the state’s outstanding nurses whose courage, competence and commitment to patients and the nursing profession stand out above all others. The 100 Great Iowa Nurses for 2012 will be honored during a May 6 celebration at Veterans Memorial Convention Complex in Des Moines. It’s also a great way to kick off National Nurses Week.
Nurses selected for this honor represent many sectors of health care, including hospitals, long-term care facilities, schools, public health and medical offices. More than 80 of the 100 honorees for this year are nurses at Iowa hospitals or health systems. You can learn more about some of the hospital nurses receiving the honor using the links below. In addition, IHA will continue to provide profiles of individual Great Iowa Nurses throughout the year.
Mary Greeley Medical Center, Ames
Mary Greeley Medical Center, Ames
St. Anthony Regional Hospital, Carroll
Mahaska Health Partnership, Oskaloosa
Mercy Medical Center-Centerville
University of Iowa Hospitals and Clinics, Iowa City
Mercy Medical Center-Cedar Rapids
Mercy Medical Center-North Iowa, Mason City
Mahaska Health Partnership, Oskaloosa
Knoxville Hospital and Clinics
Buena Vista Regional Medical Center, Storm Lake
Genesis Health System, Davenport
Mercy Medical Center-Sioux City
St. Luke’s Health System, Sioux City
Jefferson County Health Center, Fairfield
by Kirk Norris on Tuesday, May 1, 2012
In the discourse of representative government, good politics often takes precedence over the prerogative of good public policy. Good public policy works in the interests of all involved, is vetted, discussed openly and supported by majorities of elected representatives and ultimately stands the test of time. Good politics is often the lubricant that’s applied in hurried, end-stage negotiations to resolve larger and more routine business like passing a state’s annual budget. That’s the context for the politics articulated in the Des Moines Register’s April 28 front-page story and subsequent editorial on Cedar Rapids ophthalmologist Dr. Lee Birchansky.
The public policy questions at hand is two-fold, whether one believes: 1) that Certificate of Need (CON) improves health care in Iowa and 2) it is good public policy to grant political exemptions to an administrative process created by the Legislature (and in this specific decision affecting one individual, a decision upheld by Iowa’s Supreme Court).
IHA’s position is that the CON process is good public policy and the Legislature should not grant political exemptions to this process. CON is good public policy because it has standards that, with the Legislature’s oversight, have evolved with the health care market. CON requires collaboration between hospitals and physicians at the community level on the necessity of creating new services, discourages unnecessary capital expenditures and therefore supports delivery of high quality care in Iowa.
Illustrations of health care markets without strong CON statutes can be found along Iowa’s border in Wisconsin, Minnesota, South Dakota and Nebraska. In Minnesota, a health care facility moratorium law is routinely skirted legislatively with lots of money thrown around in the process. In Wisconsin, Nebraska and South Dakota, health care providers exercise individual prerogative at the peril of a relatively finite number of health care consumers. More than one specialty hospital and/or ambulatory surgical center has opened in these markets only to be sold off to the highest bidder. In the absence of strong statutes to stop the “cherry picking” and profiteering that CON restrains in the establishment of health care services, Congress in 2010 stepped forward to place a ban on further construction of specialty hospitals.
This debate isn’t about a perceived “injustice”, “the money”, a constituent “problem” or a “slanted process,” nor is it about “saving taxpayer money.” This also isn’t an example of the proverbial David taking on the financial Goliath of hospitals. The IHA political action committee takes no corporate contributions and is funded by Iowans who support their community hospitals in all their endeavors, some political, most not. In fact, more than 800 Iowans voluntarily contributed to the IHA political action committee last year.
This is a story about giving an ambulatory surgery center that remains operational without the legal approval of the five-member, governor-appointed citizen board charged with making such decisions. The net effect of granting this political exemption is not just to legalize the operation of one practitioner’s surgery center, but rather to create an economic franchise for one Iowan that could be legally sold to any surgeon performing any type of service, not just ophthalmology. In effect, the Legislature would be allowing an end run of the process they publicly declare as “working,” which quite simply is not in the best interests of all Iowans.
If the General Assembly believes a more thorough discussion regarding the overall merits of CON is warranted, that is its legislative prerogative. In fact, the Legislature has conducted several interim evaluations regarding CON over the past 15 years and has always concluded the process serves the public interests.
But end-running the process by inserting an amendment into a budget bill is simply wrong-headed. Iowans expect and demand more from our elected officials.
