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

Iowa News

Change of date for move-in and opening of UI Stead Family Children’s Hospital
The new University of Iowa Stead Family Children’s Hospital is postponing its original December 10 move-in until late January or early February 2017. In evaluating the progress to date, officials determined that they are close, but not quite ready, to move patients and staff into the new facility. The safety and comfort of patients, their families and hospital employees are the top priorities. Officials believe a late January or early February move-in and opening will provide the safest environment and smoothest transition for everyone involved. (Iowa Now)

Eastern Iowa hospitals giving and receiving
Giving trees, angel trees, poinsettias, love lights, sock lines and ornaments. All are ways Corridor hospitals are raising spirits and funds through the holiday season. “No one wants to be in the hospital over the holidays,” said Mary Klinger, president of the UnityPoint Health-St. Luke’s Foundation in Cedar Rapids. The various initiatives in Cedar Rapids and Iowa City help foster the spirit of giving. “We see so many less-fortunate people that don’t really have a lot of things, and they have a need,” she said. “The spirit of giving is impactful for the patients … so we want to be able to make their holiday special, too.” (Cedar Rapids Gazette)

BVRMC celebrates Kelly’s Leadership in health care
Michele Kelly, executive director of quality at Buena Vista Regional Medical Center (BVRMC), has been voted to serve as the position of president elect for the Iowa Organization of Nurse Leaders (IONL) board for 2017. Through IONL, Michele will represent and support nurse leaders in Iowa to shape the future of health care delivery, education and health policy. BVRMC celebrates Michele Kelly’s leadership in health care to foster the future of nurse leaders. (Storm Lake Times)

UIHC patients give thanks for hearing this season
The University of Iowa Hospitals and Clinics (UIHC) is working to bring that hearing back to those who’ve lost it. UIHC leads research for this innovative hybrid cochlear implant technology. “It’s a device for people who are actually having trouble hearing nose,” Otolaryngology Head and Neck Surgery Department Chair Dr. Bruce Gantz said. Doctors at UIHC put in the first cochlear implant back in 1979. Ever since, the hospital dedicated time and research to improving them. The Food and Drug Administration approved the hybrid implant only three years ago. (KCRG)

Hampton nurse killed in weekend accident was a ‘bright, shining star’
Griselda “Gris” Tello of Hampton, a 22-year-old nurse at Mercy Medical Center-North Iowa who died in a motor vehicle accident Friday, is being remembered for her bright smile and her desire to help others. “Her smile just lit up the room and made patients feel at ease,” said Linda Latham, director of critical care and nursing administrative services at Mercy. Tello was killed Friday evening on U.S. Highway 65 between Mason City and Rockwell when an oncoming pickup truck allegedly crossed the centerline and hit Tello’s car. (Mason City Globe Gazette)

National News

Mental health care still relatively difficult to access in New Hampshire
A survey from the National Alliance on Mental Illness (NAMI) shows that for people with insurance, mental healthcare is still tougher to access than other kinds of care. There are a variety of reasons for that according to Ken Norton, executive director of NAMI New Hampshire. New Hampshire has had pretty severe workforce development issues. “A recent report indicated in the community mental health system alone that there were 200 vacancies, and that becomes a compounding effect, certainly,” said Norton. There’s certainly a psychiatric shortage, but also prescribers, nurse practitioners, nurses, psychiatric nurses, social workers, therapists. (New Hampshire Public Radio)

Thousands on Medicaid, MinnesotaCare to switch plans as Medica drops contract
More than 300,000 Minnesotans on public health programs could have to switch to a new plan next year after insurer Medica couldn’t agree on a new contract with the state of Minnesota. The move is fallout from last year, when Minnesota for the first time issued contracts to manage Medicaid and MinnesotaCare plans based on competitive bidding. This is the second major upheaval in just over a year in Minnesota’s public plans. Now that Medica’s out, the roughly 310,000 Minnesotans with Medica-managed Medicaid or MinnesotaCare plans will be moved to new plans by May 1. (Twin Cities Pioneer Press)

Vermont’s health care regulator hopeful state’s plan stays
Vermont’s top health care regulator said Wednesday he was hopeful any changes to the federal health care system under president-elect Donald Trump’s administration would recognize that the state’s effort to pay doctors to keep people healthy is a better business model than paying them for the procedures they perform. In September, Vermont and federal officials agreed that the state could begin implementing a system in which payments could go to providers to keep patients healthy, including Medicare and Medicaid recipients and residents with private insurance. It replaces the traditional fee-for-service that pays providers for the procedures they perform. (Associated Press/San Francisco Gate)

AHA congratulates Trump, proffers wish list
The American Hospital Association (AHA) this week urged President-elect Donald Trump to avoid “abrupt changes” to the Affordable Care Act that could destabilize the health care sector. The plea from AHA President and CEO Rick Pollack came near the end of a four-page wish list the hospital lobby sent this week to the president-elect, who has vowed to repeal Obamacare on his first day in office. Pollack’s letter highlighted five areas of concern for hospitals: reducing the regulatory burden; enhancing affordability and value; continuing to promote quality and patient safety; ensuring access to care and coverage and continuing to advance health care system transformation and innovation. (HealthLeaders Media)

Telemedicine may work as well as in-person visits for depression
Treating depression with video conference calls may offer symptom improvement similar to in-person visits, a recent US study suggests. “Based on results of this study and prior research, telemedicine is a highly relevant option to address the needs of rural patients or those living in remote locations, while providing patient satisfaction and quality of life similar to that provided by in-person treatment delivered at clinics,” said lead study author Dr. Leonard Egede, a researcher at the at the Medical University of South Carolina and the Ralph H. Johnson VA Medical Center in Charleston. The findings add to existing evidence suggesting telemedicine can work as well as in-person visits. (Reuters/Fox News)

GOP may delay Obamacare replacement for years
Congressional Republicans are setting up their own, self-imposed deadline to make good on their vow to replace the Affordable Care Act. With buy-in from Donald Trump’s transition team, GOP leaders on both sides of the Capitol are coalescing around a plan to vote to repeal the law in early 2017 — but delay the effective date for that repeal for as long as three years. They’re crossing their fingers that the delay will help them get their own house in order, as well as pressure a handful of Senate Democrats — who would likely be needed to pass replacement legislation — to come onboard before the clock runs out and 20 million Americans lose their health insurance. (Politico)

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

Iowa News

Medicaid management firms continue to lose millions
The three for-profit companies managing Iowa’s Medicaid program continue to lose tens of millions of dollars on the project, a report released Wednesday shows. The companies, Amerigroup, AmeriHealth Caritas and UnitedHealthcare, reported losses ranging from 18 percent to 25 percent for the three months ending in September. The firms took over management of Iowa’s $4 billion Medicaid program last year in a controversial shift ordered by Governor Terry Branstad. The governor continued to tout the project in a news release accompanying the quarterly report from his Department of Human Services. (Des Moines Register)

More urgent care centers open in Eastern Iowa
In a world where people love getting things instantly, it seems the health care field is trying to fill that need. The American Academy of Urgent Care Medicine says that is one of the reasons driving the growth in urgent care centers across the nation. Eastern Iowa is not immune to this growth. On Wednesday, Unity Point Allen Hospital opened an urgent care center in Cedar Falls. Unity Point – Finley will open an urgent care clinic in Dubuque next week. Unity Point – Finley Hospital President David Brandon says goal is to give more people an alternative to going to the emergency room, if they don’t really need to. (KCRG)

United Way of Central Iowa receives largest grant to train workers in health care skills
The 100-year-old United Way of Central Iowa has received its largest grant, $2.2 million from the U.S. Department of Labor to train 380 Central Iowans in health care skills. The four-year grant will double the capacity of Central Iowa Works to serve individuals with barriers to education and employment. United Way’s award was part of $111 million in America’s Promise grants made to 23 regional workforce partnerships. The projects connect more than 21,000 Americans to education and fields that need more workers. (Des Moines Business Record)

Iowa Obamacare sign-ups run a bit higher this fall
President-elect Donald Trump’s pledge to repeal Obamacare has not dampened Iowa applications for subsidized health insurance. Slightly more Iowans are signing up for such coverage this fall than did at this point last year. Federal officials said Wednesday that 12,099 Iowans had signed up for new or renewed policies via the Affordable Care Act exchange since the annual enrollment period opened November 1. That’s compared to 11,811 during the first four weeks of November 2015. (Des Moines Register)

National News

Rhode Island gets $129M to ‘reinvent’ Medicaid
The state of Rhode Island will receive federal funding up to $129.7 million to update how it operates its Medicaid program and to bolster its health care workforce training, Governor Gina Raimondo announced Monday. The state has framed the effort as “Reinventing Medicaid 2.0,” its second stage in transforming the health care program. Rhode Island’s focus on Medicaid improvement comes just as the incoming Republican administration plans to up-end the Affordable Care Act, so the overhaul will therefore have to proceed amid some uncertainty. (Healthcare Dive)

California State University students lead outdoor exercise in low-income areas
California State University students are instructing a free exercise program offered at parks in various California counties. The program, 3WINS Fitness, helps people get moving — and meet the federally recommended exercise requirements — without having to pay for expensive fitness club memberships Free park-based programs like 3WINS help increase physical activity among low-income residents and can prevent or lessen the impact of chronic diseases, according to Deborah Cohen, senior scientist at the RAND Corporation who conducted an evaluation of the program in 2015. (Kaiser Health News)

AHA says new laws under Trump administration could help struggling hospitals
Could bundled payments be the key to keeping struggling hospitals healthy? The American Hospital Association (AHA) seems to think so and it’s planning on lobbying for several legislative changes including loosening anti-kickback laws to allow financial agreements between hospitals and other healthcare providers. The organization suggests that adopting bundled payments for individual episodes of treatment could encourage hospitals to contain growth and concentrate resources on services that improve quality and lower costs. (Modern Healthcare)

Only about 1 in 4 wants Trump to repeal health law
A new poll has found that only about one in four Americans wants President-elect Donald Trump to entirely repeal his predecessor’s health care law that extended coverage to millions. The post-election survey released Thursday by the nonpartisan Kaiser Family Foundation also found hints of a pragmatic shift among some Republican foes of “Obamacare.” While 52 percent of Republicans say they want the law completely repealed, that is down from 69 percent just last month, before the election. And more Republicans now say they want the law “scaled back.” (Associated Press/Washington Post)

From drug research to cancer moonshot, Congress preps massive health care bill
With Republicans just weeks away from possibly repealing the Affordable Care Act, President Obama’s signature domestic policy program, it may seem like an odd time to look for bipartisan unity on legislation related to health care. Nevertheless, Congress appears to be ready to pass a major bill funding medical research and overhauling the approval process for new drugs and medical devices. The 21st Century Cures Act, which spans 25 separate sections touching on subjects as diverse as drug research and foster care, runs to nearly 1,000 pages. (Fiscal Times)

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

Iowa News

Mental health report does not paint rosy picture, as governor claims
Mental Health America recently issued its State of Mental Health Care in America report, based on data from 2014. The governor’s office widely distributed a press release, stating that Iowa’s overall ranking had moved from 13th to 7th in the nation with respect to a combination of 15 measures. The premise is that states with higher rankings have lower prevalence rates and higher rates of access. However, the report is based on data obtained between 2011 and 2014 and, therefore, does not take into account Iowa’s transition to a privatized managed care system. How will Iowa rate once 2016 data is taken into account? (Des Moines Register)

DMACC and Iowa Wesleyan University enter innovative nursing partnership
Des Moines Area Community College (DMACC) and Iowa Wesleyan University signed an innovative agreement resulting in the first-ever bachelors of science in nursing (BSN) completion program in the state of Iowa. This partnership enhances health care across Iowa and advanced health care education. As a result of this agreement, DMACC nursing graduates will be able to complete their BSN degrees in one year online, allowing them to stay in central Iowa and work. Also, there are financial aid opportunities through the Iowa Tuition Grant program. (DMACC)

Trump tags consultant who helped Iowa privatize Medicaid
A national consultant who helped the state of Iowa make the controversial shift to private Medicaid management is Donald Trump’s choice to run the federal government’s giant health insurance programs. Seema Verma leads an Indianapolis consulting firm that works with state governments on health care programs. Trump announced Monday that he would nominate her to lead the Centers for Medicare & Medicaid Services. Iowa’s Department of Human Services has twice hired Verma’s firm, SVC Inc., to help the state redesign its Medicaid program. (Des Moines Register)

Meet the nuns bringing prayers, smiles to Mercy patients
Nuns started working at Mercy Medical Center back in 1893, but they haven’t walked the halls there for 25 years until now. Sister Rose Hellen works as a patient care tech on the oncology floor at Mercy Medical Center. She is one of four nuns from a congregation in Kenya who traveled all the way to Des Moines to work at the bedside of some of the sickest Iowans. “When we are caring for the sick, we are fulfilled and we feel happy,” Hellen said. Nuns have been a part of Mercy since they started the hospital more than 120 years ago, but this is the first time in 25 years they are serving patients at the hospital. (KCCI)

National News

After decades of rivalry, Charlotte hospitals partner to help the poor
Chief executives of Charlotte’s two competing health systems – Carolinas HealthCare System and Novant Health – have launched a first-of-its-kind partnership that appears to signal a new era after decades of sometimes bitter rivalry. The hospital CEOs have met several times to talk about ways their systems can collaborate to improve access to health care for under-served communities in Charlotte. They invited leaders from more than 40 businesses, religious and educational institutions, local government agencies and nonprofits to meet Monday night to discuss ways to improve the health of Charlotte’s communities. (Charlotte Observer)

GE, Children’s Hospital form medical software venture
Boston Children’s Hospital is teaming up with General Electric Co. (GE) to produce software that will help doctors more accurately interpret brain scans of young patients. Under a deal set to be announced Monday, Children’s and Boston-based GE’s health care division will develop the system over the next 18 months, then market it to hospitals around the world. The effort is part of GE’s Health Cloud, which is launching this week and is expected, over the next three to five years, to house hundreds of different “apps” that doctors can use to sort through medical data. (Boston Globe)

Legislation to improve mental health care for millions faces congressional vote
Efforts to strengthen the country’s tattered mental health system, and help millions of Americans suffering from mental illness, are getting a big boost this week, thanks to a massive health care package moving through Congress. Key provisions from a mental health bill approved last summer by the House of Representatives have been folded into the $6.3 billion 21st Century Cures Act, which aims to speed up drug development and increase medical research. The legislation also aims to make mental health a national priority and coordinate how mental health care is delivered. (Kaiser Health News)

CMS’ star ratings for hospitals linked to social, economic factors
The Centers for Medicare & Medicaid Services (CMS’) hospital quality star ratings have been strongly criticized by industry stakeholders and Congress as unfairly tarnishing the reputations of hospitals in low-income communities. A new study reinforces the concerns, concluding that a hospital’s rating is heavily influenced by its location’s socio-economic conditions. Hospitals with relatively low star ratings from the CMS were located in cities with high “stress” levels, according to the study, published Monday in JAMA. The stress levels of cities were determined using an analysis that measured socio-economic conditions like unemployment and poverty rates in 150 cities across the country. (Modern Healthcare)

Paul Ryan’s plan to change Medicare looks a lot like Obamacare
President-elect Donald Trump and House Speaker Paul Ryan agree that repealing the Affordable Care Act (ACA) and replacing it with some other health insurance system is a top priority. But they disagree on whether overhauling Medicare should be part of that plan. Medicare is the government-run health system for people aged 65 and older and the disabled. Trump said little about Medicare during his campaign, other than to promise that he wouldn’t cut it. Ryan, on the other hand, has Medicare in his sights. The irony of the Ryan Medicare plan is that it would turn the government program into something that looks very much like the structure created for insurance plans sold under the ACA. (NPR)

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Iowa News

Psych hospital firm to forego next state meeting
It will be at least another six months before a Tennessee company that has been trying to build a psychiatric hospital in the Iowa Quad-Cities will go before a state board for approval. Jim Shaheen, president of Strategic Behavioral Health LLC, of Memphis, confirmed Monday that the company will not seek the approval of Iowa’s State Health Facilities Council at the panel’s February meeting. Strategic has been trying for more than a year to build a 72-bed psychiatric hospital in the Quad-Cities. The company has failed to get a certificate of need from the state, a requirement before new health care facilities can be built. (Quad-City Times)

GRMC announces plans for unique partnership with UnityPoint and University of Iowa
Grinnell Regional Medical Center (GRMC), UnityPoint Health Des Moines and University of Iowa (UI) Health Care have begun exclusive negotiations about forming a new relationship. While details of the proposed relationship remain to be determined, the vision for Grinnell is clear. The goal is to bring the best of UnityPoint Health Des Moines and UI Health Care to Grinnell to enhance the care that is offered to the Grinnell community. Examples include enhancing specialty services, telemedicine, research, and educational opportunities, as well as introducing insurance products and direct-to-employer programs. (Tama News Herald-Toledo Chronicle)

UI receives $45 Million to support Iowa Neuroscience Institute
The Roy J. Carver Charitable Trust has committed a transformational $45 million grant to the University of Iowa that will allow for the creation of a comprehensive and cross-disciplinary neuroscience center within the University of Iowa (UI) Roy J. and Lucille A. Carver College of Medicine. The new Iowa Neuroscience Institute will conduct research to find the causes of, and preventions, treatments and cures for, the many diseases that affect the brain and nervous system. This gift from the Carver Charitable Trust also is the largest in the UI’s For Iowa. Forever More. fundraising campaign, which started in 2008 and continues through December 2016. (University of Iowa Foundation)

Mercy donates AED’s to area schools, organizations 
Mercy Medical Center, Cedar Rapids, is donating Automated External Defibrillators (AEDs) to 12 area schools, churches and community organizations in December. The AEDs will be placed in readily-accessible locations at the schools and organizations, to be used in case of an emergency. The AED donation program at Mercy is designed to equip local non-profits demonstrating financial need with the life-saving devices.  The non-profits must also exhibit a need for AED coverage for their facility and participate in an application process. (Corridor Business Journal)

National News

What happens in New Jersey if Trump kills Medicaid expansion?
If President-elect Donald Trump and the Republican Congress carry out their promise to repeal the Affordable Care Act, the loss of federal Medicaid funding could mean a loss of health coverage for more than 500,000 New Jersey residents. Hospitals already accepted reduced reimbursement for Medicare as part of the grand bargain that led to enactment of the health care law. They did so expecting to see fewer uninsured patients, as Medicaid covered more people. If funding to expand Medicaid is cut, they will take a double financial hit, said Neil Eicher, a vice president of the New Jersey Hospital Association. (Newark Star-Ledger)

Alabama Medicaid change to managed care postponed till October
Alabama Governor Robert Bentley says Medicaid’s shift to managed care will be pushed back from July to October amid uncertainty about funding and what changes the Trump administration might bring to Medicaid. The governor said he is committed to moving forward with the switch to managed care, but said there are a few unknowns, including funding for next fiscal year and if the Trump administration will give states block grants allowing more flexibility to write the rules for their programs. Alabama since 2013 has been working on a plan to shift some of the state’s 1 million Medicaid patients to managed care. (Associated Press/AL.com)

North Carolina legislators face full agenda with public health, Medicaid updates
Two joint legislative oversight committees on health care in North Carolina will receive this week an update on how the state’s Medicaid program is performing, along with progress reports on two high-profile behavioral health initiatives. The morning session covering Health and Human Services will focus on how the state is doing in diverting individuals having a behavioral health crisis from a hospital emergency department to other care settings. The afternoon session will review a waiver request with an end goal of Medicaid oversight being placed in the hands of three statewide managed care organizations. (Winston-Salem Journal)

Rural health care access at risk
Health care remains an issue of debate across the country. However, when it comes to rural health care, the issue is complicated further by geography and a lack of providers, resulting in a loss of competition and ultimately costly burdens being placed on patients. There are a number of medical issues that affect rural communities at a greater rate than their urban counterparts. The majority of those living in rural regions receive their health care coverage through private payers or public programs like Medicaid, with many using a combination of both to bridge the gaps in care. Yet rural communities are now faced with a push by insurance companies to limit prescription drug coverage. (The Hill)

Tom Price tapped as HHS head
President-elect Donald Trump has selected Georgia Representative Tom Price, a leading critic of President Barack Obama’s sweeping health care law, to head the Department of Health and Human Services (HHS). A key Senate Democrat immediately criticized the choice. If confirmed by the Senate, Price would play a central role in Republican efforts to repeal and replace the current health care law. Trump has pledged to move quickly on overhauling the landmark measure, but has been vague about what he hopes to see in a replacement bill. Also, Seema Verma was picked to become administrator of the Centers for Medicare & Medicaid Services. (Associated Press/U.S. News & World Report)

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

Iowa News

New UnityPoint building serves patients where they live
UnityPoint-Pinnacle Prairie, UnityPoint Health’s latest move — and part of a trend in the health care industry — will bring health care to people where they live. It’s 90,000 square feet, or 30,000 per floor over three floors. The building was scheduled to open in December and a grand opening celebration is anticipated for January. “There’s a number of specialty offices and urgent care, primary care,” UnityPoint CEO Pam Delagardelle said. “It’s all clinic based and ancillary based, but it’s not hospital-based services. It’s really a health and wellness campus. We’re really set up to deliver care to keep people healthy.” (Waterloo-Cedar Falls Courier)

Obstetric unit to come to Marengo hospital
A unanimous vote was collected after hearing the Marengo Memorial Hospital’s (MMH) presentation before the State Health Facilities Council on Tuesday October 11, to propose converting two medical/surgical beds to add a two-bed obstetrics unit. The application included a written analysis that would help provide obstetric services for women with low risk pregnancies in and around the surrounding communities of Marengo. The formal letter for approval was received last week. According to MMH, the closest location for delivery is approximately 32 miles from Marengo, requiring women to travel more than 60 miles roundtrip for their numerous prenatal visits and to deliver their babies. (Iowa City Press-Citizen)

Sioux City hospitals delivered $42M in benefits
The two hospital systems based in Sioux City contributed a total of $41.6 million in community benefits in 2015, according to a new report. UnityPoint Health – St. Luke’s provided nearly $15.6 million in benefits and Mercy Medical Center—Sioux City provided another $26 million in benefits in Siouxland, according to a recently completed assessment of those programs and services by the Iowa Hospital Association. Mercy provided $6.2 million in uncompensated care and St. Luke’s provided $4.5 million in uncompensated care. (Sioux City Journal)

GOP’s state trifecta has its own challenges
It’s a Republican reunion, 20 years in the making. In 2017 and 2018, at the least, the Iowa Capitol will be ruled by Republicans. After the November 8 elections, the GOP took control of the state government trifecta — majorities in the Iowa House and Iowa Senate and a Republican in the governor’s office. Republicans who were on the legislative front lines 20 years ago say there is much professional joy in being able to advance a policy agenda without political opposition, but that intraparty challenges remain. “You can get some good things done, but it’s not all roses and sunshine,” said Brent Siegrist, the House majority leader then. (Cedar Rapids Gazette)

National News

Small-town hospital closings leave rural Texans far from medical care
Since 2013, 15 rural hospitals — located in counties with no more than 60,000 residents — have closed across Texas. Rural hospitals face many challenges, including competition for doctors from larger cities and ever-increasing student debt for doctors coming out of medical school. There’s also uncertainty about another round of government reimbursement cuts. If Texas legislators cut Medicaid payments in the upcoming session as they did in 2011, more rural hospitals could fail. At a September 13 hearing of the state’s Senate Committee on Health and Human Services, legislators discussed the future of rural health care. (Fort Worth Star Telegram)

Nevada’s rural residents face fraying safety net
The dearth of hospitals is just one of the issues threatening the well-being of the roughly 300,000 Nevadans who live in small towns and rural communities. A shortage of medical professionals, an increasingly strained emergency care network and escalating costs of health care are threatening to turn them into health care “have-nots” who pay a steep price for their rural lifestyle. Across the nation, residents of rural areas are experiencing health-outcome disparities, including “higher incidence of disease and disability, increased mortality rates, lower life expectancies and higher rates of pain and suffering,” according to the Rural Health Information Hub. (Raleigh News & Observer)

Republican states that expanded Medicaid want it kept
Former Arizona Governor Jan Brewer fought her own Republican party in the state Legislature for months to push through a Medicaid expansion under the Affordable Care Act. Arizona is one of 31 states that expanded Medicaid, many of them run by Democrats. Republicans have blocked expansion in the remaining 19 states. Among the GOP-led states that expanded Medicaid, many officials are strong proponents of the program that has brought insurance to about 9 million low-income Americans who can’t possibly afford to buy it themselves. States that strongly oppose Medicaid expansion, however, continue to do so. (Associated Press/Washington Post)

Managed care plans increasingly taking over Medicaid long-term care
States are increasingly turning to private firms to provide managed long-term supports and services (MLTSS). Their goal is to rein in costs and increase budget predictability. Officials say it enables delivery of more coordinated care and prevents sending people to expensive nursing home settings. But some advocates are claiming that they are seeing care suffer under the model. Until recently most state Medicaid programs have excluded people with disabilities from managed care because of their complex needs. Twenty states now have shifted their MLTSS program to private managed care companies. (Modern Healthcare)

A frenzy of lobbying on 21st Century Cures Act
The 21st Century Cures Act set for a House vote Wednesday is one of the most-lobbied health care bills in recent history, with nearly three lobbyists working for its passage or defeat for every member on Capitol Hill. More than 1,455 lobbyists representing 400 companies, universities and other organizations pushed for or against an earlier House version of a Cures bill this congressional cycle, according to federal disclosure forms compiled by the Center for Responsive Politics. A compromise version was released over the holiday weekend. (Kaiser Health News)

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