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

Iowa News

Branstad’s Medicaid dog-whistle
Governor Terry Branstad’s Medicaid privatization looks to be collapsing under its own weight. Yet, Iowa’s governor can only skewer the messenger. Branstad lashed out Monday at editorial writers and critical lawmakers. Huge savings are being realized after three private companies usurped control, Branstad said. “Fraud and abuse” is down, he pledged. Yet, unsurprisingly, Branstad failed to cite a single figure to support his claims. Nor could he. More than 500,000 Iowans and hundreds of service providers are experiencing the real-world effects of Branstad’s rush-job. (Quad-City Times)

Keokuk County Medical Clinic opens its doors
The Keokuk County Medical Clinic, an affiliate of Keokuk County Health Center (KCHC), began seeing family care patients upstairs in the new clinic last week. They will continue to work on renovations and updates to the space. Matt Ives, KCHC CEO, feels that expanding upstairs will lead to more health care options after the current renovations are completed and the clinic is settled in. Ives reiterates that primary care for the community comes first, but other options are possible with the new space. (Sigourney News Review)

Better care, better efficiency at Spencer Hospital
During a meeting this week, the Spencer Hospital Board of Trustees focused on increasing quality of care and reducing costs. Jim Potvin, regional director for Avera Medical Group, updated the board on how the Accountable Care Organization (ACO) demonstration has effected the clinics. “This essentially is a three-year demonstration project and essentially what it’s doing is giving us an opportunity to use a type of alternative reimbursement model that folks anticipate will be more widely used in the future,” Hospital President Bill Bumgarner said. (Spencer Daily Reporter)

Iowa City native helms a documentary about former NFL player with ALS
Iowa City native and Hollywood film producer Mary Rohlich hasn’t been in Iowa City since 2004. She’s fixing that this week when she comes to town for a screening of her critically lauded documentary “Gleason,” which follows former NFL player Steve Gleason as he and his family come to grips with his diagnosis of ALS. It will also serve as a fundraiser for the University of Iowa Hospitals and Clinics — a portion of all proceeds will go to treatment and research of ALS. (Iowa City Press Citizen)

Volunteers can make a big difference
Public-spirited people who make time in their lives to support worthy causes help make any town a better place to live. In that regard, the large and dedicated cadre of volunteers at UnityPoint Health – Trinity Regional Medical Center is an especially noteworthy example. Trinity celebrates the efforts of these praise-worthy individuals with an annual Volunteer Recognition Event. That important tribute took place Tuesday at Fort Frenzy. The roughly 75 volunteers honored had each helped make visits to the hospital complex easier for patients. (Fort Dodge Messenger)

National News

Controversial parts of Kentucky Medicaid plan remain
Governor Matt Bevin’s administration unveiled its long-awaited plan to reshape the state’s Medicaid program Wednesday, and while it restores some benefits Bevin proposed be cut two months ago, it retains the most controversial components of the governor’s approach to overhauling the federal-state health plan for low-income and disabled Kentuckians. Taking aim at the Medicaid expansion launched by his predecessor, Bevin said he wants to create a different program that includes more cost-sharing by consumers and brings the state’s soaring costs of Medicaid under control. (Courier Journal)

Texas owes the Medicaid program $57.8 million, report says
Texas received nearly $58 million from the federal Medicaid program for health services that did not qualify for reimbursement — and it may be asked to return part of the money. Payments made to six facilities were calculated in a way that did not meet federal and state requirements, according to an audit released by the Department of Health and Human Services. The Centers for Medicare & Medicaid Services said it will be reviewing the report and working with the Texas Health and Human Services Commission to come up with a solution. (Dallas Morning News)

How artificial intelligence could help diagnose mental disorders
People convey meaning by what they say as well as how they say it: Tone, word choice and the length of a phrase are all crucial cues to understanding what’s going on in someone’s mind. When a psychiatrist or psychologist examines a person, they listen for these signals to get a sense of their wellbeing, drawing on past experience to guide their judgment. Researchers are now applying that same approach, with the help of machine learning, to diagnose people with mental disorders. (Atlantic)

The life-changing magic of choosing the right hospital
There’s an exceedingly simple way to get better health care: Choose a better hospital. A recent study shows that many patients have done so, driving up the market shares of higher-quality hospitals. “Our results fit with the view that hospitals’ reputations spread through social networks of patients and doctors influencing the decision over where to seek care,” Adam Sacarny, one of the study’s authors, said. Rather than clinical quality, which is hard to perceive, patients may be more directly attuned to how satisfied they, or their friends and family, are with care. (New York Times)

Study looks at policy options to contain high prescription drug costs
According to a study published recently in the Journal of the American Medical Association (JAMA), the most realistic short-term strategies to address high U.S. prescription drug prices include enforcing more stringent requirements for the award and extension of exclusivity rights; enhancing competition by ensuring timely generic drug availability; providing greater opportunities for meaningful price negotiation by governmental payers; generating more evidence about comparative cost-effectiveness of therapeutic alternatives and more effectively educating patients, prescribers, payers and policy makers about these choices. (JAMA)

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

Iowa News

Branstad argues managed care reduces fraud; figures show Medicaid fraud already rare
Governor Terry Branstad this week again defended the state’s decision to move its $5 billion Medicaid program over to a managed care system, saying the transition is saving Iowa “significant” money by rooting out fraud that previously went undetected. “Historically actual Medicaid fraud is very rare in Iowa,” said Scott McIntyre, spokesman for the Iowa Hospital Association. The association has been a vocal opponent to Medicaid managed care and does not have any indication that it prevents fraud or discovers fraud better than other Medicaid systems. (Cedar Rapids Gazette)

Iowa Medicaid program in trouble
As predicted by other states’ bad experiences, Governor Terry Branstad’s decision to privatize Iowa’s Medicaid program has run into serious problems. Not only are two of the three health insurance companies reporting significant losses for the first four months of operations, but providers of medical care are reporting late or insufficient reimbursements, denials of care for patients, more and costly paperwork and other expenses. Patients report being denied medical services they got when the state ran the program. (Burlington Hawk Eye)

Emergency room renovation a go
As part of a grant/loan funded by the U.S. government, the emergency room at Grinnell Regional Medical Center is getting a much needed face lift and renovation. United States Department of Agriculture Rural Development Under Secretary Lisa Mensah was at the hospital for a tour of the current emergency room facility last week. “We are proud to serve the needs of rural residents and businesses here in Iowa and across the country to ensure rural America continues to thrive and drive the economy,” Mensah said. (Des Moines Register)

Pekin Hospital, UnityPoint Health enter negotiations
Pekin Hospital announced Tuesday its intent to negotiate an agreement to affiliate with UnityPoint Health-Peoria. Any agreement reached with Progressive Health Systems, which includes Pekin Hospital and ProHealth Medical Group, Inc., would make Pekin an affiliate of UnityPoint Health-Peoria. Negotiations will start immediately with an agreement expected to be finalized this year. Pekin Hospital CEO Bob Haley and President and CEO of UnityPoint Health-Peoria Debbie Simon both said the agreement would not result in the sale of the hospital or a merger. (East Peoria Times-Courier)

On With Life commences therapy grounds project
On With Life, a brain injury rehabilitation center in Ankeny, held a groundbreaking ceremony this week for its new therapeutic grounds. On With Life has developed a vision for the transformation of 1.5 acres of its campus to include multiple outdoor therapy areas including a music zen garden, putting green, amphitheater, basketball court, butterfly garden and an all-inclusive playground. The project is a partnership with Iowa State University’s Advanced Garden Composition students and a group of master gardeners and volunteers. (Des Moines Business Record)

National News

Donation program for rural hospitals in Georgia opens door for consulting firms
State health officials say 48 rural hospitals are eligible to receive donations from individuals and corporations under a new Georgia program that will give tax credits to donors. At the same time, new attention has been focused on the creation of consulting services that aim to help rural hospitals market themselves and apply for the funds. The Georgia Hospital Association, through its subsidiary Georgia Hospital Health Services, is working to help hospitals take advantage of the new funds. (Georgia Health News)

Louisiana hospital workers struggle with flood recovery
The waters are receding in flood-stricken Louisiana, but for many residents there the nightmare has just begun. Louisiana Hospital Association President and CEO Paul Salles says hospital services could face months of disruption as thousands of stressed-out employees struggle to put their lives back together. So far, at least 106,000 people have registered for federal disaster aid, including many who work at hospitals in the afflicted areas. The impact to the hospitals primarily is to their staff. (HealthLeaders Media)

Alabama lottery bill won’t make it on November ballot
The Alabama House of Representatives yesterday blocked a committee meeting that was necessary for Governor Robert Bentley’s lottery proposal to get on the ballot in the November 8 general election. Bentley proposed the lottery as a long-term solution to the state’s persistent problems in funding key services, especially Medicaid. About one million Alabamians depend on Medicaid. If lawmakers still approve a proposed constitutional amendment to allow a lottery during the special session, a special election would be required to place it on the ballot for voters. (AL.Com)

Health care staffing gaps push salaries up for most medical professionals
The U.S. health care industry is feeling the staffing pinch with a growing and aging population, which requires more care and has greater access to it. According to career hub Health eCareers and data from the U.S. Bureau of Labor Statistics, 475,000 new health care jobs were created in 2015 to handle this growth — although there’s still a shortage of key positions, making it a job-seeker’s market. Health eCareers’ annual Healthcare Salary Guide, based on a survey involving nearly 20,000 health care professionals, found that 87 percent are making more or the same as a year ago. (Healthcare Finance)

Baby boomers, drugs pushing up federal health care spending
The aging population and higher per-person health spending driven by high prescription drug costs will contribute to increased federal spending over the next decade, according to an economic outlook update from the Congressional Budget Office. The update predicts this year will mark the first increase in the budget shortfall since 2009, as the federal budget deficit will rise to 3.2 percent of the gross domestic product from 2.5 percent in 2015. Federal spending for major health care programs are estimated to increase by $55 billion, or 6 percent, in 2016. (Modern Healthcare)

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

Iowa News

Branstad remains clueless about Medicaid woes
Last year, Governor Terry Branstad’s spokesman told the Des Moines Register the governor believed Obamacare “is unaffordable, unsustainable and creates too much uncertainty for Iowans. The implementation of this law has been flawed from the very beginning.” Oh, the irony. Iowans currently are mired in the disaster of the Medicaid privatization plan Branstad foisted upon the state this spring. Less than five months after its implementation, numerous providers report not having been paid for health services. (Des Moines Register)

Branstad: Some companies “not following” Medicaid privatization rules
Governor Terry Branstad confirmed on Monday that the for-profit companies now managing Iowa’s multi-billion dollar Medicaid program did not follow the rules in the first two months of operation. But the governor also says the state issued no warnings or fees, in spite of complaints of late payments to health care providers and delayed care to patients. Lawmakers told the Associated Press they were not informed of the plan to have a grace period before the companies would be fined for violations. (Iowa Public Radio)

Government should not rely on private insurers
Aetna announced last week that it was reducing participation in health insurance exchanges created by the Affordable Care Act. It will sell plans in only four states next year, including Iowa, down from 15 this year. This follows similar market exits from UnitedHealth Group and Humana. This is yet another reminder of why government should not rely on private companies to deliver health insurance to Americans. History has repeatedly shown this is a costly, dangerous and unsustainable idea. Yet politicians refuse to listen to history. (Des Moines Register)

Donations allow police department to obtain medical supplies
The Cedar Rapids Police Department responds to thousands of medical calls each year. Now, thanks to a donation made possible by the trauma medical director at Mercy Medical Center, as well as a separate donation from the hospital itself, officers will be better equipped to respond to those calls. The donation will allow the police department to purchase 30 Emergency Medical Services shears, 30 personal hemorrhage control kits and 260 Combat Application tourniquets. (Cedar Rapids Gazette)

National News

Parents of disabled urge Connecticut governor to scrap privatizing group homes
Parents of intellectually disabled adults expected to be transferred from state-run group homes to private care reacted Tuesday with a mix of anger and appeals for compassion. About three dozen parents, unionized caregivers and their clients argued at SEIU 1199 headquarters in Hartford that the planned privatization of 40 state-run homes would weaken care and shatter the bonds formed between workers and clients. Critics of the private, nonprofit group homes for the developmentally disabled say they receive insufficient state funding to provide comparable care. (CT Mirror)

New York hospitals in critical condition as deficit looms
New York City’s public hospitals are in critical condition with rising costs and plummeting revenue. There’s no dispute about that diagnosis. The problem is with Mayor Bill de Blasio’s proposed cure, according to health policy makers, hospital administrators and budget watchdogs. As NYC Health and Hospitals President Ram Raju describes it, the largest U.S. municipal-health care provider is an ailing system of 11 hospitals that’s losing revenue because of increased competition from non-profit hospitals for Medicaid patients and drastic cuts in federal and state aid for indigents. (Bloomberg Politics)

As the number of freestanding ERs grows, so does scrutiny
Freestanding emergency rooms (ERs) have sprouted in recent years across the suburban landscape, taking root in affluent neighborhoods and directly challenging nearby medical clinics and hospitals. Five years ago there were a couple dozen stand-alone emergency centers in Texas, and now there are more than 200. Colorado, Ohio and other states also have seen steady growth. As these centers offer another choice for people tired of deflating wait times at hospital emergency rooms, their escalating numbers are sending ripples across the health-care field. (Associated Press)

Legal business relationships can create headaches for hospitals
Even if they’re not illegal or against any rules, nonprofit hospital leaders’ business relationships can create conflicts of interest that put them in awkward positions, according to The Wall Street Journal (WSJ). The WSJ analyzed Internal Revenue Service data and found that of more than 2,300 nonprofit providers, nearly half employed an officer or trustee with business ties to the hospital, whether personally or through a relative. That’s nearly seven times the rate of relationships for nonprofit organizations in general. (Fierce Healthcare)

If it can happen to ESPN, it can happen to health care
The disruptive force of the internet economy is undermining ESPN’s leadership position and the right strategic response is far from clear, even for this iconic brand. For hospitals and health systems, the shift in a long-standing business model and the resulting strategic dilemma should sound very familiar. Like ESPN, many legacy health systems have strong brands, market presence and quality but high fixed costs and prices. As with cable TV, this business model is proving unsustainable in the long term. Government, commercial insurers and employers are pushing back on health care costs. (Hospitals & Health Networks)

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

Iowa News

Iowa’s fighting Medicaid fraud, but at what cost?
Governor Terry Branstad on Monday brushed off like an annoying mosquito questions about health care providers going out of business or having to borrow money because the state’s Medicaid program isn’t paying them on time. the Iowa Hospital Association reported earlier this month that 30 percent of claims, or 1.5 million, had been denied, suspended or rejected since April 1. More than 400 Medicaid providers also reported via a survey taken by Iowa lawmakers. Nearly half said they would be forced to reduce services. (Des Moines Register)

Branstad says ‘significant fraud’ being stopped by Medicaid managed care
Governor Terry Branstad said the reports aren’t ready yet, but his decision to have the state pay three private companies to manage care for Iowa’s 560,000 Medicaid patients is saving the state “significant” money. “Replacing the unmanaged care we had before is stopping significant fraud and abuse that had occurred previously in our state,” Branstad said during his weekly news conference. Under the old system, Branstad said it wasn’t easy to detect Medicaid fraud among Iowa doctors, hospitals and other health care providers. (Radio Iowa)

Medicaid managers report millions in Iowa losses
Two of the three private companies managing Iowa’s Medicaid program say they’ve lost tens of millions of dollars so far, new reports filed with the state show. AmeriHealth Caritas reported last week that it ran a $42.6 million deficit on its Iowa operations in the first six months of 2016. Amerigroup reported it lost $66.7 million. UnitedHealthcare did not break out its Iowa results in its report. “That’s been the scenario in other states,” said state Senator Joe Bolkcom, an Iowa City Democrat who is a fierce critic of the shift to private Medicaid management. (Des Moines Register)

IPERS fund, facing $5 billion shortfall, misses investment goal
Iowa’s largest public employee pension fund has reported an investment return of 2.15 percent for the past state fiscal year, falling short of a key investment target and likely increasing long-term unfunded liabilities that already exceed $5 billion. The Iowa Public Employees’ Retirement System (IPERS), which has 325,000 members, had a market value of $28.27 billion for the 12 months that ended June 30, state officials said Monday. Nationally, many public pension funds face huge shortfalls that have created worries among state and local government policy analysts. (Des Moines Register)

National News

Georgia officials say rural health network faces “bleak” future
Georgia health officials painted a dire picture of the state’s rural hospital network for state lawmakers Monday, with more cuts predicted as the Affordable Care Act (ACA) continues to roll out. About 40 percent of the state’s hospitals lost money in 2014, according to the Georgia Hospital Association’s most recent figures. Georgia is one of 19 states that hasn’t expanded the federal health care program for the poor as called for under the ACA. Georgia has the fourth-highest uninsured rate, according to the Kasier Family Foundation, at around 1.5 million people. (WABE)

Colorado clinic provides free health care through CU medical students
The DAWN — Dedicated to Aurora’s Wellness and Needs — Clinic was formed in March 2015 by a group of medical students and community members at the Dayton Street Opportunity Center in Aurora, Colorado. The clinic is run by inter-disciplinary students from the Colorado University (CU) Anschutz Medical Campus. The University Hospital provides labs and imaging for patients. “We’re trying to mitigate visits to the emergency room, which is costly for uninsured people,” said Joseph Johnson, medical director of the clinic. (Denver Post)

Uncompensated care at hospitals drops under Medicaid expansion
In states that have expanded Medicaid to cover more low-income adults, the health care reform initiative is achieving a primary goal: cutting uncompensated-care costs at hospitals. Medicaid expansion has reduced uncompensated care in states that have taken advantage of the program and represents a missed opportunity for the 19 states that have shunned Medicaid expansion, a recent study suggests. It estimates that in states where Medicaid has been expanded, uncompensated care costs have decreased from 4.1 percentage points to 3.1 percentage points of operating costs. (HealthLeaders Media)

Anthem Blue Cross rolls out Spanish-speaking telehealth feature
Doctors and patients are increasingly using telehealth to deal with nonemergency conditions, post-discharge care and prescriptions. But being able to discuss health concerns in the language one’s comfortable with is key to improving care and the patient experience. Anthem Blue Cross is now offering California enrollees the option of telehealth visits in Spanish using Cuidado Médico on LiveHealth Online. The program lets members connect securely with a board-certified Spanish-speaking doctor from anywhere via a smartphone or tablet. (Healthcare Dive)

Elderly patients in the hospital need to keep moving
At the University of Alabama at Birmingham (UAB) Hospital-Highlands’ 26-bed geriatric unit, known as the Acute Care for Elders (ACE) unit, patients are encouraged to start moving as soon as they arrive. The unit is one of a few hundred around the U.S. that is attempting to provide better and more tailored care to geriatric patients. ACE units are based on the idea that if the unique needs of seniors are met, they will have better outcomes and their care will be less costly. (Kaiser Health News)

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

Iowa News

Branstad’s legacy: Killing health care jobs
For someone who talks big about job creation, Governor Terry Branstad is doing a stellar job of jeopardizing the solvency of some Iowa employers. Four months after implementation of his plan to privatize Medicaid administration, the carnage is in full swing. Stories of small employers not being paid by managed care companies are being reported across the state. According to a recent survey, nearly half of providers indicated they will or are planning to reduce services, and more than 60 percent say privatization has reduced the quality of services they can provide. (Des Moines Register)

DHS waives sanctions at start of Iowa’s new Medicaid system
The state agency overseeing Iowa’s transition to a privatized Medicaid program waived any possible sanctions against three insurance companies during the first two months of the new system. The Iowa Department of Human Services (DHS) issued no written warnings or corrective action plans in April and May to the insurance companies that now run the state’s Medicaid program. The decision to delay sanctions wasn’t shared outside the agency and was a surprise to health advocates and lawmakers monitoring Medicaid. (Associated Press/Daily Progress)

Lawmakers hold Medicaid managed care forum
A crowd of about 25 Clinton-area residents gathered at the Canticle on Friday evening to discuss the struggles of privatized Medicaid. Representative Mary Wolfe (D-Clinton), Senator Rita Hart (D-Wheatland) and Iowa Democratic House Leader Mark Smith conducted the event, which featured the testaments of Medicaid customers and health care providers alike. Many on hand recounted personal stories of mishandled and over-complicated interactions between Medicaid and health care facilities since the transition to privatization. (Clinton Herald)

Iowa unemployment rate nudges up to 4.1 percent
Iowa’s seasonally adjusted unemployment rate increased slightly to 4.1 percent in July from 4 percent in June, Iowa Workforce Development (IWD) said in a release. The state’s jobless rate was 3.6 percent one year ago. The U.S. unemployment rate remained at 4.9 percent in July. “Iowa’s economy revealed both strength and weakness in July,” IWD Director Beth Townsend said in the release. Iowa businesses still showed enough confidence to expand payrolls this month. Hiring in health care and professional and business services was particularly strong.” (Des Moines Business Record)

National News

Minnesota hospitals see decline in charity care costs
As health insurance coverage has expanded under the federal health law, hospitals in Minnesota have seen a significant decline in costs to cover free and discounted care. Some of the savings is being swallowed by patients with big deductibles who aren’t paying their medical bills. But it’s also starting to create room in budgets as hospitals are being pushed to develop more community programs that could ultimately drive down the need for costly care. Less money for charity care could free up funds for new community benefit strategies, said Anderson of the Minnesota Hospital Association. (Star Tribune)

University of Maryland teams with hospital to provide dental care for low-income adults
The University of Maryland School of Dentistry and the hospital have opened the Monocacy Health Partners Dental Clinic in a unique arrangement that school officials hope will serve as a model for providing dental care to low-income adults, who often still lack coverage. The dental school operates other clinics, but Monocacy Health Partners is the first that’s affiliated with a hospital, an arrangement that officials hope will draw patients away from the emergency room and help better integrate dental care with health care. (Washington Post)

Changes to health care industry have rural hospitals on edge
To the small towns they serve, rural hospitals are more than just medical centers. They are economic engines, gateways to mental health care and social services, anchor institutions that provide recession-resistant jobs to small communities. But squeezed by mounting regulations and declining reimbursements, many rural hospital administrators say they are struggling to stay afloat. “It’s tough times for rural hospitals,” said Alan Morgan, CEO of the National Rural Health Association. (Deseret News)

The outpatient imperative: Putting heads in beds
To thrive in today’s health care marketplace, hospital and health system leaders need to think beyond putting “heads in beds.” For some, fulfilling the goal of providing patients with the right care at the right place at the right time means becoming virtually omnipresent in the daily lives of consumers and potential consumers. Expansion of ambulatory and outpatient care networks makes sense for several reasons, including the desire to improve patient access, strengthen patient-provider relationships and increase revenue. (HealthLeaders Media)

Doctors, hospitals prepare for difficult talks surrounding medical mistakes
Hospitals have traditionally been reticent to disclose to patients or their family members the specifics of how a medical procedure didn’t go as planned for fear of malpractice lawsuits. In recent years, though, many are beginning to consider a change and are revamping their policies to be more open. The federal Agency for Healthcare Research and Quality released in May an online toolkit designed to expand the use of the agency’s “Communication and Optimal Resolution” process, which establishes guidelines for adopting more transparency in communicating adverse events. (USA Today)

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