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

Iowa News

Mercy doctor says state mental health system is ‘broken’
Dr. Alan Whitters is the Medical Director of Behavioral Health at Mercy Medical Center in Cedar Rapids. Dr. Whitters believes Iowa is in the midst of a mental health epidemic. One of the main issues is Iowa doesn’t have enough beds to treat the population. With few places to turn, those seeking treatment often end up in hospital emergency departments. The Treatment Advocacy Center says a minimum of 50 beds per 100,000 people is necessary to provide, “minimally adequate treatment for individuals with severe mental illness” but Iowa only had two beds per 100-thousand last year. (KCRG)

Profit-seeking Medicaid insurers vs. Iowans
Iowa has been victimized by Governor Terry Branstad’s Medicaid privatization for nearly a year. Handing over a $4 billion government health insurance program to profit-seeking companies did not make sense in theory, and in practice, it has been a nightmare for health providers and low-income Iowans. The private insurers are in the business of making as much money as possible. Iowans have suffered under the failed Medicaid experiment. Administration of the health insurance program for more than 500,000 Iowans should be returned to the state, which is not in the business of pleasing shareholders. (Des Moines Register)

Disabled Iowans say Medicaid firms are cutting in-home help
Nearly 7,400 Iowans with disabilities who use Medicaid’s Consumer Directed Attendant Care program (CDAC) which pays members of the community to provide everyday assistance that lets recipients continue living in their homes instead of nursing homes. The Long-Term Care Ombudsman’s Office recently reported that reduced hours in the CDAC program are one of the top complaints about managed care. Charles Palmer, director of the Department of Human Services, said he’s also aware of complaints that managed care companies have been limiting service hours for disabled Iowans. (Des Moines Register)

UnityPoint acquisition of CIH could come in late April
UnityPoint Health-Waterloo will become the owner of Central Iowa Healthcare (CIH) if Federal Bankruptcy Judge Anita Shodeen approves an asset purchase agreement between the two. Attorneys for CIH and UnityPoint Health said they can work out the details and submit the agreement to Shodeen for her review. If Shodeen’s decision is favorable, the closing could come as soon as the end of April. Those were key results which came out of a hearing Thursday afternoon in U.S Bankruptcy Court for the Southern District of Iowa in Des Moines. (Marshalltown Times-Republican)

National News

Kansas lawmakers working to reverse Medicaid cuts
Last summer, Governor Sam Brownback ordered more than $56 million in cuts to KanCare, the state’s privatized Medicaid program. On Thursday, the Senate took a first step by passing a bill that would reverse a $47 million reduction in reimbursements paid to hospitals and others providing care to those enrolled in KanCare. The effort to reverse the cuts is more complicated in the House, where some members are backing a bill that in addition to raising the health management organization fee would increase a state assessment on hospitals known as the “provider tax.” The Kansas Hospital Association is strongly opposed to the House bill. (KCUR)

Washington State Hospital Association: AHCA is ill-considered
Washington hospitals have adjusted to the Affordable Care Act and are experiencing fewer visits to emergency rooms for non-emergency care and charity care has declined. Chris Bandoli, the Washington State Hospital Association’s (WSHA) senior vice president for government affairs, said, “You can’t just throw 750,000 Washingtonians off health care coverage and expect it to be OK.” WSHA came out against the American Health Care Act (AHCA) and reiterated that opposition after the Congressional Budget Office issued its analysis. (Spokane Spokesman-Review)

Connecticut health care industry blasts ‘Trumpcare’ plan
Area hospitals and health care organizations have given their opening reviews of the proposed American Health Care Act – and they aren’t good. Particularly troubling, health care providers said, are the changes in Medicaid.  “Medicaid expansion resulted in more than 200,000 Connecticut residents gaining coverage,” said Michele Sharp, spokesperson at the Connecticut Hospital Association. “But if funding is lost, there is an open question regarding how those people would receive coverage.” “We are also concerned for providers,” she said. (Westfair Communications)

Americans not sold on cost and coverage claims in GOP’s health bill
A majority of the public is skeptical the Republican health plan would be an improvement over the Affordable Care Act, with widespread concerns that insurance costs would increase while people lost coverage, according to a poll released Wednesday. The Kaiser Family Foundation poll found that 48 percent of the public thought the GOP plan would decrease the number of people who have health insurance. Another 30 percent expected the insured rate would stay the same and 18 percent thought the number of covered people would increase.  (Kaiser Health News)

Republicans split, conservatives angry as health care overhaul inches ahead
Deeply divided Republicans squeezed their US health care overhaul through a key House panel on Thursday despite defections by three conservatives who consider it too similar to the Obamacare law it is intended to replace. Trump’s first major legislative initiative still faces an uphill battle in the full House and later the Senate despite ongoing efforts by the White House and Republican leaders to satisfy conservative opponents. The Budget Committee vote was 19 to 17. Republicans, who control Congress and the White House, could not afford to lose more than three from their ranks on the committee for it to pass. (Reuters)

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

Iowa News

Medicaid firms spending less on care for Iowa’s poor, disabled
The three private firms running Iowa’s Medicaid program have found ways to trim spending on care for the poor or disabled Iowans they cover, a new report suggests. But all three continue to lose tens of millions of dollars on the controversial project. The companies’ per-member monthly spending on health care for adults fell by as much as 28 percent from the three months ending in September 2016 to the three months ending in December 2016, the new report shows. Governor Terry Branstad’s office touted the new report as representing “unprecedented transparency” in how the giant health-care program is run. (Des Moines Register)

Iowa Medicaid insurers pay more in claims than they get from the state
For the third consecutive quarter, the three private insurers managing the state’s Medicaid program paid out more in claims than they were paid by the state, causing the insurers to see losses between 11 percent and 27 percent, according to Department of Human Services data out Wednesday morning. The quarterly report helps shed additional light on the insurance companies’ financial losses reported earlier in March in Iowa Insurance Division filings. Governor Terry Branstad said Wednesday that the private insurers have plenty of experience administering Medicaid programs in other states and anticipate start-up costs. (Cedar Rapids Gazette)

Iowa lawmakers brace for tough budget choices
Iowa’s downward revenue projection slide has created major ripples in state budgets as Governor Terry Branstad and GOP legislators look to backfill an immediate $131 million gap with reserves and begin to fashion spending plans for the next two fiscal years shaken by this week’s taxing developments. Budget-makers also project Iowa’s Medicaid program will need $42 million in the coming fiscal year, along with other funding needs that are putting a crunch on the budget even before Republicans have fashioned their fiscal 2018 spending targets. (Sioux City Journal)

National News

Minnesota health care groups don’t back GOP replacement bill
The primary groups representing Minnesota doctors and hospitals say they oppose the plan to repeal and replace the federal Affordable Care Act (ACA), citing the potential for thousands of state residents to lose coverage. The plan would be a problem for Minnesota because the state has seen a dramatic reduction in the rate of uninsured residents under ACA, according to the Minnesota Hospital Association. The group stressed how the current law helped drive the rate of Minnesotans lacking coverage to a historic low of 4 percent which has helped hospitals by reducing uncompensated care costs. (Minneapolis Star Tribune)

GOP health bill worries rural Oregon
Oregon’s decision to expand eligibility for Medicaid in 2014 led to increased enrollment in the Oregon Health Plan, the state’s Medicaid program. And the trend of expanded coverage is across rural Oregon. Uncertainty has plagued many citizens throughout the beginning of the new administration and the insurance plan is no different. The irony is many of the poor, rural districts that voted for President Donald Trump — who supports the new health care legislation — stand to lose the most from the plan. The result is an increased amount of debt for the hospital because patients won’t be able to afford insurance coverage, let alone their bills. (Coos Bay World)

Obamacare repeal could hurt rural areas — a key Trump constituency
Republicans from rural states increasingly are worried that their party’s plan to replace the Affordable Care Act would inflict damage on vulnerable communities, especially the poor and middle-aged in isolated areas whose votes helped catapult Donald Trump into the White House. The concerns are a byproduct of this week’s nonpartisan Congressional Budget Office analysis of the GOP replacement, which highlighted multiple ways that the health care plan falls far short of Trump’s campaign promise to keep Medicaid intact and to create a system that provides “insurance for everybody.’’ (Boston Globe)

Obamacare pushed nonprofit hospitals to do good beyond their walls. Now what?
Requiring a “community health needs assessment” was part of a broader package of rules included in the Affordable Care Act (ACA) to ensure that nonprofit hospitals justify the tax exemption they receive. “There’s no question ACA required us to bump up our game,” said Joan Quinlan, its vice president for community health at Massachusetts General Hospital. If people lose coverage, it could stifle efforts to promote more substantial community benefit. That scenario would increase the amount of free care nonprofit hospitals provide, creating new budget pressures that could lead them to tamp down on efforts to promote community health work. (Kaiser Health News)

GOP leaders acknowledge health bill changes, may delay vote
Their health care overhaul imperiled from all sides, top House Republicans acknowledged Wednesday they would make changes to the legislation in hopes of nailing down votes and pushing the party’s showpiece legislation through the chamber soon. House Speaker Paul Ryan declined to commit to bringing the measure to the House floor next week, a fresh indication of uncertainty. Republican leaders have repeatedly said that was their schedule, but opposition mushroomed after a congressional report concluded this week that the measure would strip 24 million people of coverage in a decade. (Associated Press/ABC News)

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

Iowa News

GOP health plan would hit Iowa especially hard
After seven years, US House Republicans have finally unveiled their plan to repeal and replace the Affordable Care Act. It immediately went over like a lead balloon with pretty much everyone, including doctors, hospitals, insurers and advocacy groups. Iowa, currently a largely red state with many older residents and a governor who expanded Medicaid, will feel disproportionate pain. There are the tens of thousands of Iowans who will eventually lose Medicaid coverage. Governor Terry Branstad used the expansion offered under Obamacare to extend coverage to low-income Iowans and eventually help fund his Medicaid privatization mess. All that could fall apart. (Des Moines Register)

Iowa Faces $131M Shortfall for Current Budget
Iowa is taking in less revenue than expected and must address a new shortfall of about $131 million to its current budget, financial analysts announced Tuesday in releasing data that could spell deep cuts for the next spending year. The news from the three-member Revenue Estimating Conference means Iowa will need to plug a deficit to the budget year that went into effect last summer and ends June 30. The governor’s office and at least one key Republican quickly endorsed tapping into cash reserves instead of cuts to state government — as long as the money was repaid. (Associated Press/U.S. News & World Report)

Mercy Auxiliary honors volunteers, makes donations
Mercy Auxiliary’s members gathered Friday to celebrate their achievements over the last year. Auxiliary President Marilou Finn announced Friday that over the past year, 218 area residents have served as active volunteers for the Auxiliary, logging a total of 31,199 hours of work – a number that hasn’t gone unnoticed by the community. Finn also announced the group raised $76,057.73 throughout the year. Additionally, a total of $10,000 in scholarships was given to the Mercy Healthcare Foundation and a $63,000 donation was announced to fund emergency room vein finders at Mercy Medical Center-Clinton. (Clinton Herald)

National News

Louisiana Hospital Association: ‘deeply concerned’ about AHCA
Paul Salles, president and CEO of the Louisiana Hospital Association, released a joint statement with Jennifer McMahon, executive director of the Metropolitan Hospital Council of New Orleans, regarding the American Health Care Act (AHCA) — the GOP’s answer to repealing and replacing the Affordable Care Act (ACA). The letter states that patients and the caregivers who serve them across Louisiana are depending on Congress to make continued coverage a priority and both organizations are deeply concerned about several provisions in the AHCA. Under ACA, there have been significant investments in the health care of Louisiana residents that must be protected. (Acadiana Business)

How the House GOP bill would affect Missouri hospitals
More than 200,000 Missourians have gained insurance since the Affordable Care Act took effect. It’s not clear yet how many Missourians would lose insurance under the GOP bill but with more Missourians uninsured, hospital officials fear they would have to provide more uncompensated care. The Missouri Hospital Association estimates that the Republican plan could cost the state’s hospitals $5.5 billion over the next decade. “Hospitals could be paying for a significant portion of the new law, at the same time as uncompensated care costs explode and Medicaid comes a less reliable source of care for the poor,” said Dave Dillon, a spokesman for the association. (Springfield News-Leader)

GOP replacement plan could send hospital costs soaring again
The US hospital industry is irate about provisions in the Republican plan to repeal and replace Obamacare that would freeze spending on expanded Medicaid coverage for 10 million people in 31 states in 2020 followed by sharply reduce federal assistance to Medicaid. As spending on Medicaid plummets, hospitals and other medical providers will incur steep losses to provide emergency treatment and services to those least able to pay for them. Medicaid payments to hospitals and other providers amounted to 90 percent of the costs of patient care in 2013, according to estimates by the American Hospital Association. (Fiscal Times)

GOP senators suggest changes for health care bill offered by House
A day after a harsh judgment by the Congressional Budget Office on the House plan to repeal the Affordable Care Act, nervous Senate Republicans on Tuesday suggested changes to the bill. They told Trump administration officials that they wanted to see lower insurance costs for poorer, older Americans and an increase in funding for states with high populations of hard-to-insure people. They said those changes would greatly improve the chances of Senate approval even though they might further alienate conservatives. (New York Times)

North Carolina legislation backs reimbursements for telemedicine use
Telemedicine has grown in demand in recent years, particularly aimed at individuals who live in rural and suburban areas and/or who have difficulty getting to an urban hospital campus. A requirement that insurers provide standard coverage and reimbursements for telemedicine and other digital services was introduced in a bipartisan House bill last week in North Carolina. The legislation would prohibit insurers from treating telemedicine differently solely because it is not provided as in-person delivery of service or consultations. (Winston-Salem Journal)

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

Iowa News

Bluffs health care officials watching evolution of GOP bill’s proposals
Local health care officials are watching development of the Republican health care plan carefully. The American Health Care Act was introduced Monday and has passed in two committees of the U.S. House of Representatives. The bill is expected to reach the House floor by the end of the month. “The biggest concern I have right now with the proposed legislation is the impact on Medicaid expansion and the federal government funding their share of the Medicaid program in the future,” said Steve Baumert, president and CEO at Methodist Jennie Edmundson Hospital. “You’re going to impact children, the aged and the disabled,” he said. (Council Bluffs Daily Nonpareil)

Hy-Vee Mainstreet, St. Luke’s team up to create prescription delivery program
Most medications have easy-to-follow directions, but others, which are more complex, can trip up patients who are fatigued and stressed from a hospital stay. To prevent medication errors – a major contributor to hospital readmissions – UnityPoint Health-St. Luke’s and Hy-Vee Mainstreet have teamed up to deliver discharge medications to patients at the bedside at no additional cost, called the Meds to Bed program. “We’re offering them a service that makes it easier to get their medication before they’re being discharged,” said Alejandro DeAnda, Hy-Vee Mainstreet pharmacy manager. (Sioux City Journal)

National News

CBO: 24 million more without health insurance under GOP plan
The Republican plan to replace the Affordable Care Act would leave 24 million more Americans without health insurance by 2026 than under current law, according to an analysis Monday from the Congressional Budget Office (CBO). The CBO report found that 14 million more people would be without health insurance by 2018. Following a two-year spike, the plan would also lower average premiums after 2020 relative to President Barack Obama’s health care law. But premiums would be expected to go down for younger people, while being raised for older Americans. (NBC News)

Virginia hospital group concerned about AHCA replacement
The Virginia Hospital & Healthcare Association (VHHA) has expressed concern about the American Health Care Act (AHCA) in letters it sent to Virginia’s representatives in Congress. In the letters, VHHA’s president and CEO Sean Connaughton applauded the fact that the proposed replacement does not change Medicaid to a block-granting system, but expressed concerns about the proposed per capita cap, which would lock Virginia in at what it paid per Medicaid enrollee in 2016. “This inequity, with far-reaching ramifications for Virginia’s health systems and their patients, must be addressed before any final legislation is adopted,” he states. (Richmond Times-Dispatch)

Medicaid expansion helped New Jersey save millions in charity care
New Jersey has saved hundreds of millions of dollars on hospital support since the federal Affordable Care Act (ACA) took full effect in 2014. “Governor Christie made the right decision for our state to expand Medicaid to more individuals, and it has had a real impact,” according to Betsy Ryan, president of the New Jersey Hospital Association. “It’s a simple, but alarming, formula: Fewer patients with insurance + less money to pay for charity care = a fiscal crisis for New Jersey’s health care community,” Ryan wrote, regarding the increase in uninsured patients that would occur if ACA is repealed. (New Jersey Spotlight)

GOP ‘health’ bill cruelly aims at mentally ill
In their rush to dismantle the Affordable Care Act (ACA), congressional Republicans are engaging in a sleight-of-hand at the expense of people who are among the least able to fend for themselves, the severely mentally ill. In December, Republicans were patting themselves on the back for approving what they called major mental health care legislation, the 21st Century Cures Act, a measure to increase funding for mental health care and ensure more treatment for severely mentally ill people. But the American Health Care Act would eliminate much of the Medicaid coverage guaranteed under ACA for mental health care and addiction services. (Sacramento Bee)

Health policy expert is confirmed as Medicare and Medicaid administrator
The Senate yesterday confirmed Seema Verma, a health policy expert from Indiana, to lead efforts by the Trump administration to transform Medicaid and upend the Affordable Care Act. By a vote of 55 to 43, the Senate approved the nomination of Verma to be the administrator of the Centers for Medicare & Medicaid Services. Verma was an architect of Indiana’s Medicaid program, widely seen as a model by conservatives, and she worked closely with Vice President Mike Pence when he was the state’s governor. (New York Times)

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

Iowa News

As state funding wanes, local stakeholders left to address mental health needs
As mental health and substance abuse funding shifts in Iowa, the problem is neither trivial nor is it going away. Spurred by the July 2015 closures of state-run mental health institutes in Mount Pleasant and Clarinda, communities across Iowa have been left to shoulder the brunt of services to the mentally ill, who often battle substance abuse addictions. Mount Pleasant’s institute was the only state-run facility in Iowa providing dual-diagnosis inpatient care to people battling addiction and mental illness. Now that the facility is closed, hospitals have been left scrambling to pick up the pieces. (Burlington Hawk Eye)

Iowa bill to keep volunteers secret faces criticism
Iowa would make the names of public volunteers confidential under a fast-moving bill that critics warn could protect criminals who are found working for government and public institutions. The bill applies to governments and public institutions, including publicly owned hospitals. It is a product of the lobbying efforts of the Iowa Hospital Association, which contends that public disclosure has a possible “chilling effect” on volunteer efforts. The move is in response to an Iowa Public Information Board ruling last year that forced Crawford County Memorial Hospital to release a list of its driver volunteers. (Des Moines Register)

Iowa facing more budget woes?
Governor Terry Branstad and legislative budget-makers may have to confront options this week for balancing the state’s fiscal 2017 ledger that could include dipping into reserves as a temporary stopgap if projected growth in tax collections is downgraded again. The state Revenue Estimating Conference — which already has lowered this fiscal year’s tax receipt estimates in October and again in December — is slated to convene Tuesday to decide whether its 4.7 percent growth projection for total net state tax receipts through June 30 is too optimistic. (Cedar Rapids Gazette)

National News

Rural hospitals in Georgia struggling to survive
Last year, Irwin County Hospital in Georgia was about $2.5 million in the red, hospital officials said. Irwin County Hospital recently topped a state list of rural hospitals in need of financial help and is one of dozens in Georgia trying to stay afloat. According to the NC Rural Health Research Program, six rural hospitals in Georgia have closed since 2010. The Affordable Care Act was supposed to help by insuring more people, but Georgia and 18 other states did not expand Medicaid, which would have covered more low-income residents. Nationwide, 80 hospitals have closed and almost half of all rural hospitals are currently losing money. (WABE)

Rural Oregon doctors, hospitals fear Republican plan
Some pushback on the Republican health care plan is coming from rural Oregon, which could be hit hard by the plan. The massive expansion of the Medicaid program under the Affordable Care Act (ACA) gave rural hospitals a badly needed infusion of new paying customers. The Oregon Association of Hospitals and Health Systems said “rural hospitals’ financial picture has improved since the full implementation of the ACA, but their situation still remains largely precarious.” Fourteen Oregon hospitals posted negative operating margins in 2015, compared with 23 in 2013. (The Oregonian)

Texas rural health care faces funding crisis
A new report warns that rural hospitals in Texas could be hit hardest under a Congressional plan to repeal and replace the Affordable Care Act. It found that proposed funding cuts to the Medicaid program, which already is operating at a minimal level in Texas, could force many rural hospitals to close, leaving hundreds of thousands of people without reasonable access to health care. David Pearson, director of the Texas Organization of Rural and Community Hospitals, which produced the study, said a new round of funding cuts could devastate the state’s already challenged rural health care system. (Public News Service)

New plan could cost 230,000 in Tennessee their insurance
Tennessee hospitals are warning that the Republican health care reform plan adopted by a pair of key House committees could jeopardize health care benefits for 230,000 Tennesseans enrolled under Obamacare health exchange plans. Tennessee Hospital Association President Greg Becker said the current GOP proposal to repeal and replace the Affordable Care Act “jeopardizes the continuation of access insurance for many Tennesseans, which could further drive up the costs of uncompensated care.” Becker said Tennessee hospitals already provide nearly $2 billion in uncompensated services to uninsured persons every year. (Columbia Daily Herald)

By law, hospitals now must tell Medicare patients when care is ‘observation’ only
Under a new federal law, hospitals across the country must now alert Medicare patients when they are getting observation care and why they were not admitted — even if they stay in the hospital a few nights. The notice is — as of last Wednesday — one of the conditions hospitals must meet in order to get paid for treating Medicare beneficiaries, who typically account for about 42 percent of hospital patients. Doctors and hospital representatives still have questions about how to fill out the new observation care form, including why the patient has not been admitted. (Kaiser Health News)

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