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Today’s NewsStand (March 31, 2011)

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

Iowa News

Lakes Regional Healthcare: The $19.4 million business
A patient and visitors may see the nurse who brings a meal or medicine, but they may not pass by the lab technician analyzing the results of a CT scan — they may miss Jason Harrington, the Lakes Regional Healthcare President for that matter. Because of that, Dickinson County residents may not fully realize the economic impact the Spirit Lake hospital has on the communities it serves. (Dickinson County News)

Hospital creates $10.9 million impact on local economy
“The health services we provide at our hospital, clinics, and senior services are very important to Palo Alto County’s economy. In addition to providing residents with quality and compassionate care, we contribute to the economy in all of our communities as an employer that employs a significant number of area residents,” said Tom Lee, CEO of Palo Alto County Health System in Emmetsburg. (Emmetsburg Reporter-Democrat)

Keokuk hospital faces struggle
“We really are struggling financially,” said Allan Zastrow, CEO. “We are designing what the future of health care is going to be here in Keokuk and at Keokuk Area Hospital.” High unemployment in the county and a large number of uninsured residents are hurting the hospital, he said. (Burlington Hawk Eye)

Marketing of Wright Medical Center contributes to its growth
The tremendous growth of Wright Medical Center (WMC) in Clarion over the past few years can be attributed to a number of factors, including quality employees and high patient satisfaction numbers. But at the heart of it might be the work of the marketing department, helping do their part to make the facility the best it can be. (Wright County Monitor)

U.S. News

Republicans and Democrats begin negotiating possible budget agreement
“We’re all working off the same number now,” Vice President Biden told reporters after meeting with Senate Democratic leaders at the Capitol on Wednesday evening. “Obviously, there’s a difference in the composition of that number — what’s included, what’s not included. It’s going to be a thorough negotiation.” If approved, the deal would be the largest single-year budget cut in U.S. history. (Washington Post)

Virginia AG gives suit 60 percent chance of prevailing
Ken Cuccinelli said he thinks he has a 60 percent chance of prevailing in the dispute of the health care reform law. He also acknowledged that the health care system isn’t perfect and that it is “painful for us … knowing some care exists somewhere that I can’t get because I don’t have enough money.” But he believes that if the Virginia suit is successful, it will preserve the free market in health care, which ultimately will be better for society. (Kaiser Health News)

Health care job postings outnumber seekers
Even with March’s tepid growth in job postings, there were three job listings for every health care technician and practitioner job seeker, with the average salary of $33.51 an hour. Conversely, there were two health care support workers for every online job listing, with pay averaging $12.84 an hour, The Conference Board reports. (HealthLeaders Media)

Warning flags: How safe is your hospital?
There’s an important distinction between great doctoring and great safety. The University of Chicago has a reputation for outstanding cancer care. That’s likely the reason that James Tyree, suffering from stomach cancer and pneumonia, had a relatively good prognosis when he entered the hospital and why his death so shocked his family and friends. But as a wise physician once warned, “Every hospital should have a plaque at its entrance that reads, ‘There are some patients whom we cannot help; there are none whom we cannot harm.’” (Chicago Tribune)

Meaningful use guidelines for social media in health care
Meaningful use says it is not enough to simply have an electronic record. Meaningful use says the EMR’s feature set and how it is put into practice determine the impact it has on care. Today, we can say the same thing about social media in healthcare. With heartfelt thanks to the pioneers who fought the HIPAA and ROI battles, it is no longer enough to simply have a Facebook page or twitter account. There are expectations around engagement, user experience, quality and value which users have come to expect through interactions with other individuals and organizations. (

Number of measles cases in Minn. up to 13
Another measles case has been confirmed in Minnesota, bringing the outbreak total to 13 so far. No deaths have been associated with the outbreak, but eight people have been hospitalized. Cases have ranged in age from four months to 34 years old. Five individuals were too young to receive vaccine, six were of age but were not vaccinated, and two have unknown vaccine status. (Minnesota Public Radio)

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News is surfacing from Washington, D.C. concerning the budget proposal being prepared by the House Budget Committee under the direction of Chairman Paul Ryan (R-WI).  Notably, news reports that the budget proposal is expected to “spare” Social Security, but will place Medicare and Medicaid front and center for an overhaul.

Every year, the Budget Committee puts together a budget resolution, which is largely a blueprint – but sets the tone for the 13 annual appropriations bills Congress is expected to pass.

Of key concern at this juncture is the federal deficit.  Over the past decade the deficit has gone from a $300 billion surplus to now nearing $15 trillion in debt.

According to a committee spokesperson, “Chairman Ryan has committed to put forward a budget that deals with the drivers of the debt.  He has committed to put forward a budget that helps spur job creation and economic growth. He has committed to put forward a budget that helps save the nation’s critical health and retirement security programs.”

What is expected, however, is a proposal that would alter the way in which federal dollars are spent on Medicaid, a state-federal partnership.  Ryan’s budget is likely to propose the federal share of Medicaid be converted into a block grant structure.  This would save money for the federal government by providing set amounts to states each year (adjusted for inflation annually), rather than today’s model which allows for more uncertainty of the costs.  In other words, if a state sees a major increase in its Medicaid volume, the federal share grows along with it with and has no mandated cap.

Under a block grant proposal, regardless of increased patient volume or other factors, states would receive a pre-determined federal share and would be required to manage the population using only those dollars.  Specifics on this option are still being panned out, though the Congressional Budget Office has reported that this provision could save up to $280 billion over 10 years. The proposal in total is still in draft stage and is expected to be unveiled next week.

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Today’s NewsStand (March 30, 2011)

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

Iowa News

Trinity Regional Health System parent to explore new partnership
The parent organization of Trinity Regional Health System and Methodist Health Services Corp. of Peoria, Ill., said Tuesday that they have entered into a nonbinding letter of intent to explore a strategic partnership. If Iowa Health System, which is Trinity’s parent organization, and Methodist are in agreement after completing a process of which the letter of intent is the first step, Methodist will become the eighth senior affiliate hospital of Iowa Health System. (Quad-City Business Journal)

Oskaloosa hospital creates $25.4 million impact
Mahaska Health Partnership (MHP) generates 350 jobs that add $25.4 million to Mahaska County’s economy, according to the latest study by the Iowa Hospital Association.  In addition, MHP employees by themselves spend $5.8 million on retail sales and contribute $349,600 in state sales tax revenue. “We recognize our impact in the community as one of the top five employers,” said MHP CEO Jay Christensen. “As a business leader, we have made a commitment to be good community partners.” (Mahaska Health Partnership)

Big disparity found in health of Iowans
Delaware County in northeast Iowa has the state’s healthiest residents, while those living in Appanoose County are the least healthy. The report by the University of Wisconsin’s Population Health Institute and the Robert Wood Johnson Foundation documents a significant health disparity between some Iowa counties. The state’s most healthy counties are generally clustered in northeast Iowa, while the least healthy are primarily in southern Iowa, historically home to many of the state’s poorest residents. (Des Moines Register)

U.S. News

A primer on health care ‘exchanges’
It seems like a simple idea: Create new marketplaces, called “exchanges,” where consumers can comparison shop for health insurance — sort of like shopping online for a hotel room or airline ticket. But, like almost everything else connected with the health-care overhaul law, state-based insurance exchanges are embroiled in politics. Some Republican governors are threatening to refuse to set up exchanges unless they get more flexibility over Medicaid, the state-federal health program for the poor. Others say they don’t want to implement any part of the federal health-care law. (Washington Post)

High-deductible health plans: When spending less isn’t always good
Redesigning insurance in a way that actually lowers spending and, by the way, promotes good health, is a lot more complicated than merely giving people “more skin in the game,” as conservatives like to put it. A new study by researchers affiliated with the Rand Corporation suggests why. (Kaiser Health News)

Feds to release dialysis clinic data
Federal regulators say they are moving to make once-confidential data about the performance of kidney dialysis clinics more readily available to the public. The move, disclosed in a letter to Sen. Charles Grassley, R-Iowa, follows a ProPublica investigation last year that revealed substandard care and weak oversight in some clinics. (ProPublica)

Tainted IV packs suspected in Alabama hospital deaths
Nine patients died in Alabama hospitals — most in the Birmingham area — after receiving intravenous nutritional supplements contaminated with a lethal bacteria, the state health department said Tuesday.  A total of 19 patients in six hospitals were confirmed to be infected, the Centers for Disease Control found in an investigation called at the state’s request. (Birmingham News)

AMA launches mobile app and challenge
The American Medical Association is making its first foray into the software development world with a free CPT (current procedural terminology) code glossary application. So far, the app includes just 129 codes classified for evaluation and management, for consultations, critical care services, domiciliary, ED, home services, hospital inpatient, hospital observation, inpatient neonatal, newborn care, non face-to-face, nursing facility, preventive medicine, and prolonged services. The AMA wants to go beyond this single app and is offering $2,500  in cash and prizes for ideas to generate “the next great medical app.” (HealthLeaders Media)

Hard times prompt calls for zany Medicaid measures
When New York’s Medicaid director asked the public for money-saving ideas, the most popular suggestion, as measured by the sheer volume of emails, left him a bit red-faced: End payments for routine circumcisions. Though the idea didn’t make the cut for New York’s latest cost-curbing plan, it’s just one example of how interest groups, such as the anti-circumcision group, businesses and other policy proponents are pushing to capitalize on states’ dire Medicaid shortfalls. (National Public Radio)

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With Congress back to work this week, all eyes are on the ongoing federal budget negotiations.  House Republicans are scrambling to find support for their budget proposal as they lack consensus within their own ranks.  News surfaced this week in a Washington Post article indicating that GOP leaders have begun courting moderate Democrats in an effort to get a budget proposal passed by next Friday or face a government shutdown.

On the shutdown, April 8 marks the next budget deadline whereby Congress must act.  Congress has two options: 1) pass a continuing resolution (CR) or 2) pass a budget bill that would fund federal agencies and programs through the remainder of this federal fiscal year, which ends September 30.

The problem with the first option is that there is little support to continue passing CRs.  Operating the government in this way is not an effective use of resources, particularly when the deficit remains top of mind for many lawmakers - and not to mention the government is currently operating under the sixth consecutive CR.  A continuing resolution authorizes the government to continue operating at “current” funding levels.”  This does not allow agencies to change their budgets and keeps current staffing and spending constant.  Imagine a business operating on the same budget every year without opportunity for adjustments — not likely to be a sustainable choice, but for Congress it seems to have been the least politically risky choice in the short-term.

Option two presents additional obstacles as well, because House GOP members, attempting to make good on campaign promises and take steps to reduce the deficit, have indicated their desire to institute significant cuts to the current fiscal year in the budget bill, so a new dynamic is now introduced into the debate.  This does not sit well with the Democratic majority in the Senate and there is little agreement on not only what to cut but by how much.

On the health care front, it appears at this time that Congress is not looking to propose cuts to the Medicare or Medicaid programs as part of these budget negotiations.  However, providers should be aware that in the event of a government shutdown it is likely that during that time Medicare reimbursements and would cease to be paid.

Try your hand at balancing the budget in this New York Times budget puzzle.  What would you do?  How would you reduce the $418 billion shortfall in this year’s budget?

IHA will continue to monitor the budget debate as it moves forward in Washington.

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Congress Picks Back up On ‘Doc Fix’

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The “sustainable growth rate” in the Medicare program is a flawed equation that leads to the proposal huge cuts to physician payments under the program each year.  However, when looking at the price tag, a mere $300 billion over 10 years, it’s easy to see why a permanent solution has been slow to come by.

However, the House Energy and Commerce Committee recently announced a bi-partisan effort to solicit ideas, feedback and proposals from national physician and hospital groups in an effort to permanently fix this flawed provision.  The key word is “permanently” as over the past decade, Congress has elected to only temporarily patch the problem passing a variety short-term fixes to prevent 15, 20, or even 30+ percent cuts to physician Medicare payments.  But like many efforts seeking to do the same - preventative procrastination hasn’t done much to solve the long-term, hugely expensive problem.

Problematically there is little agreement on a solution and the proposals vary greatly, and with so much emphasis on the federal deficit and budget debate in Washington D.C. its unclear what will come next on this issue.  However, the budget debate could present Congress with an opportunity for a fix, as it has become clear that in order to fix the nation’s budget - everything must be on the table.

The letter to stakeholders requests feedback by early April and the committee could hold as early as May. Key recipients include: The American Medical Association, American Academy of Family Physicians, American Hospital Association, Federation of American Hospitals, Medical Group Management Association and many others.

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