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Today’s NewsStand (October 31, 2011)

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

Iowa News

Iowa hospitals earn tax-exempt status
In a country with a stagnating economy, it’s tempting to toss out simplistic solutions that rarely account for all the policy considerations at play let alone consider the implications for an industry that has a $6 billion impact on Iowa’s economy and provides nearly 70,000 jobs. The important thing to know is that Iowa’s hospitals believe in and live up to being accountable to the communities they serve. (Des Moines Register)

Competition ramping up as both Cedar Rapids hospitals ready cancer centers
Two new technology systems at Cedar Rapids hospitals offer promise to help women in the fight against breast cancer, but one came about with a fight of its own. Mercy Medical Center this week began using low-dose molecular breast imaging with the LumaGem MBI system, a tool used to detect breast cancer early, particularly for women with dense breast tissue. Meanwhile, the state Health Facilities Council approved St. Luke’s Hospital’s certificate of need for a new Intraoperative Radiation Therapy system, marking St. Luke’s first foray into radiation treatment. (Eastern Iowa Health)

Area companies receive wellness awards
Winegard Co. and Great River Health Systems have received a Gold Well Workplace Award from The Wellness Council of America for its employee wellness programs. The award recognizes organizations that have embraced the responsibility for maximizing the health and well-being of their employees. “This is a designation and putting our name out there on the WELCOA website as being a representative of a well workplace,” said Jamie Dengler, Great River Medical Center health and fitness coordinator. “Our hope is to get more companies in Burlington and Des Moines County energized to be well workplaces.” (Burlington Hawkeye)

Fido’s getting tested next to grandma in St. Luke’s lab
Many people aren’t aware, but that blood taken from your dog to test for heartworms? Unless your veterinarian has a lab in his or her clinic, there’s a good chance it’s sent to St. Luke’s Regional Medical Center for analysis. The lab at St. Luke’s processes animal samples, analyzing them for diseases specific to animals. But when checking a blood sample for kidney or liver function, virtually the same test is used on the animal sample as a human sample. (Sioux City Journal)

National News

Deficit reduction panel reaches crucial juncture
Congress’ “super committee” on deficit reduction moves into its serious negotiation stage this week, with its members still far from the goal of reducing the deficit by $1.5 trillion over the next decade. Negotiators from both parties emerged from their secret talks in recent days to float a pair of partisan deficit-cutting proposals. Both were swiftly shot down. (Los Angeles Times)

Big insurer fights back in court against regulation of profit margin
A lawsuit challenging Maine’s authority over health insurers’ profit margins is drawing national attention from state regulators worried about the impact on their power to hold down rate increases. The state’s highest court has scheduled oral arguments Nov. 10 on a case brought by a Maine unit of WellPoint – one of the nation’s largest health plans.  Anthem Health Plans of Maine argues that regulators violated state law and the U.S. Constitution when they reduced requested premium increases in each of the past three years, depriving the company of “a fair and reasonable return.” (Kaiser Health News)

Obama tries to speed response to shortages in vital medicines
The order offers drug manufacturers and wholesalers both a helping hand and a gloved fist in efforts to prevent or resolve shortages that have worsened greatly in recent years, endangering thousands of lives. It instructs the F.D.A. to do three things: broaden reporting of potential shortages of certain prescription drugs; speed reviews of applications to begin or alter production of these drugs; and provide more information to the Justice Department about possible instances of collusion or price gouging. (New York Times)

A merger wave hitting health care
If you can’t beat ‘em, join ‘em. Big managed health-care companies are starting to take that idea to heart. These insurers, which try to coordinate patients’ medical providers to keep a lid on costs, are facing the double whammy of market saturation and margin-squeezing health-care reform. Last week, Cigna said it would pay $3.8 billion to buy HealthSpring , giving it a foothold in the senior-citizen and Medicare markets. (Wall Street Journal)

Corporations offer help in trimming the waist
As companies feel the financial burden of the obesity epidemic, some are trying to help their bottom line by helping employees with their waistline. One of the largest such efforts is at the Dow Chemical Company, which has operations in Michigan, Texas, Louisiana and West Virginia — all states with some of the highest obesity rates in the nation. At 6:30 a.m. on a recent Tuesday, maintenance superintendent Jeff Leasher is dripping sweat, coming into his last stretch on a stationary cycle. He’s in one of two on-site gyms at Dow headquarters in Midland, Mich. (National Public Radio)

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A recent Des Moines Register article expounded on publicly reported information to support the obvious conclusion that bringing tax-exempt organizations onto the tax rolls would lower other taxpayers’ proportional tax liability.  It’s important to know that two different standards on tax exemption are involved in an evaluation of this question.  

One is a standard in Iowa law that exempts from property taxation any religious, educational or charitable institution.  The other is a federal regulation that exempts organizations from taxes on revenue if that organization provides community benefits that the government otherwise would have to provide or, at the time of application for tax exemption, don’t exist in the community.   

Each standard involves evaluation by regulators – the Internal Revenue Service for community benefit and the Iowa Department of Revenue for charitable status – and both have had extensive and consistent scrutiny by the courts.  The Register noted that hospitals pay significant sums in property taxes and in addition to that, some make payments in lieu of taxes to support police and fire protection. 

A nurse from Lucas County Health Center teaches a free "anytime CPR" class in Chariton.

Iowa hospitals supported mandatory reporting of community benefits in federal law because of their practice of doing so prior to this mandate.  Iowa hospitals continue to support the community benefit standard for the express reason that an assessment of community need is driven by its demographics and by the needs and priorities identified by community members.  The capacity, opportunity and definition of community benefit is different in a community of 1,500 than one modestly or significantly larger.  It’s certainly different when that institution exists in Des Moines or Chicago or Los Angeles. 

As the Register noted, opinions of policymakers and policy wonks differ on the question of what should be included in the definition of community benefit or whether a flat percentage mandate should be required.  Iowa Senator Charles Grassley supports inclusion of Medicaid payment shortfalls in an analysis of community benefit.  In 2010, Iowa hospitals’ net losses from Medicaid equaled nearly $200 million.  Uncompensated care, that care which was not classified as charity but which otherwise had no identifiable source for payment, equaled $340 million in 2010. 

So, what should be the appropriate ratio for calculating community benefit?  The Register took a very narrow view and used charity care divided by total expenses.  Hospital expenses consist of labor costs, infrastructure costs in delivering patient care as well as expenses unrelated to patient care.  Why not net patient revenues?  Perhaps because it supports a conclusion exactly opposite of the position promoted by the Register.   

Using the analysis of charity care plus Medicaid losses plus uncompensated care, Iowa hospitals provided 11.2 percent of net patient revenues for community benefit.  Using the same inputs and expenses for the denominator as the Register does shows Iowa hospitals allocated 10.2 percent of expenses for free care. 

In a country with a stagnating economy, it’s tempting to toss out simplistic solutions that rarely account for all the policy considerations at play let alone consider the implications for an industry that has a $6 billion impact on Iowa’s economy and provides nearly 70,000 jobs.  The important thing to know is that Iowa’s hospitals believe in and live up to being accountable to the communities they serve.

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Today’s NewsStand (October 28, 2011)

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

Iowa News

Waukon hospital paramedic honored with 2011 Iowa Hospital Hero Award
Livingston has been an EMT with Veterans Memorial Hospital for the past 10 years, but her service to the community began long before that.  While working at Citizens State Bank in Waukon, she became very active in the local Chamber of Commerce, even serving as president at a very young age. She then tirelessly gave of her time and talent to the local Chamber in many roles, even donating her time to automate the chamber office. Each year, Livingston coordinates a special “Reality 101” program for all graduating high school seniors in the hospital’s service area, giving them a real life scenario of what life will be like as they learn to balance their own budgets on a fixed income. (Waukon Standard)

Officials seek help in garnering support for wellness project
Burlington-area residents have backed the Blue Zones Project for more than a month, but officials at Great River Health Systems want more support. Ten communities that demonstrate the greatest passion, interest and ability to generate interest will receive assistance from national experts to develop and implement wellness programs. Local support is an important selection factor. The support each community gets will be measured by the percentage of residents who pledge participation if their hometown is chosen. On Wednesday, Burlington was ranked 40th out of more than 900 Iowa communities. The rankings are updated daily. (Burlington Hawkeye)

In the zone: Community asked to pledge support for health initiative
More than 9,300 people registered and participated in one of more than 100 walks in Black Hawk County to kick off the application process to become one of the state’s first Blue Zone communities. However, organizers in the Cedar Valley say that isn’t enough. In addition to registering for the walk, which was part of the governor’s Healthiest State initiative, those committed to the cause are also being urged to log onto to pledge their support for the official Blue Zones project. (Waterloo-Cedar Falls Courier)

Clinton urses push plan to better measure blood pressure
Jill Iben and Paula Telford were frustrated. As experienced nurses at Mercy Medical Center in Clinton, both just knew they weren’t getting accurate blood pressure readings from the pregnant women they checked. The discovery came about two years ago. In the intervening 24 months, the blood pressure-reading process has become standardized throughout the Mercy Medical Center system as a direct result of the two nurses’ research and work. Iben and Telford also presented their findings at a professional conference held this past spring in Iowa City. (Quad-City Times)

Cedar Rapids hospital uses new technology to treat cancer
An eastern Iowa hospital will become the first in the state to offer a new type of technology to cancer patients. It’s called intra-operative radiation therapy. Ted Townsend, president and C.E.O. of St. Luke’s Hospital in Cedar Rapids, says the $1.3 million  machine will be ready for use in a few months. “We do expect it to be a draw for patients outside the Cedar Rapids area,” Townsend says. He says a similar machine is now in use at a hospital in Sioux Falls, South Dakota, and people are driving five and six hours to take advantage of the technology. (Radio Iowa)

Le Mars hospital uses interactive technology to enhance care
About a month ago the hospital rolled out eConsult and in November will bring eICU online, both of which utilize two-way interactive video equipment to connect doctors and patients. “It all uses a technology-based system where the patient remains here and through video camera and audio they can either be observed in a bed by specialists or in the case of eConsult they sit on a chair and face the doctor who’s on a screen,” explained Loretta Myers, director of patient care at Floyd Valley Hospital. (Le Mars Daily Sentinel)

National News

Public support of health law drops sharply
Public support of last year’s health care law hit an all-time low in October as many Democratic voters lost confidence that one of President Barack Obama’s major programs will improve their lives, a new poll finds. For the first time, as many people believe the law won’t make the country better off as believe it will. The poll found that 51 percent of the public now dislikes the law and only 34 percent favor it. The scores were the least favorable in the 19 months the Kaiser Family Foundation has been tracking public perceptions. (Kaiser Health News)

Repeal of health law? It won’t be easy
Every Republican presidential candidate has promised to repeal the Obama administration’s health-care overhaul. But despite full-throated criticism, it’s going to be hard for any of them to fulfill that pledge if elected. Standing in the way of that seemingly simple campaign promise—an article of faith among GOP voters—is a welter of practical and political obstacles. They include immovable limits on what elements the Senate can tackle, in the likely event Republicans don’t have a 60-seat majority after the 2012 election, and the party’s need to come up with spending cuts to replace savings promised by “ObamaCare.” (Wall Street Journal)

State spending on Medicaid up sharply
The expiration of federal stimulus funding for Medicaid has dealt a blow to states still struggling to recover from the economic downturn, according to figures released Thursday. To compensate for the loss of extra federal Medicaid dollars this June, states have increased their spending on the program by an average of 29 percent in the current fiscal year. Nearly every state also has turned to tough measures to trim Medicaid costs, such as eliminating benefits, reducing payment rates to doctors and hospitals, and increasing the co-payments they charge the poor and disabled served by the program. (Washington Post)

Medicare Part B premium increase to be less than expected
Monthly premiums for Medicare Part B, which covers doctors’ visits and outpatient procedures, will increase by $3.50, to $99.90, in 2012. Initially, government forecasters had projected a $10.20 premium bump, to $106.60, in seniors’ monthly fees. The White House said in August that premiums would drop 4 percent in Medicare Advantage, the privately run alternative to the traditional program. Premiums for Medicare’s prescription drug program, Part D, also will drop slightly in 2012. (Washington Post)

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Featured Employee: Lori Pietig


Lori Pietig
Radiologic Technologist
St. Anthony Regional Hospital, Carroll

Why did you choose this career? Radiology gave me the opportunity to combine two types of studies that I loved, science and art.  A career in radiology allowed me to explore different avenues in the healthcare world combining anatomy, patient care and technology. This career allows me to work independently and still be part of a team, allowing room for advancement and endless learning opportunities.

What are the challenges and rewards you experience in your work? As a radiologic technologist it is my job to provide the best care possible in a professional manner. Working in the same community where I grew up can be challenging. This places me in situations to care for my family and friends if they become sick or injured. I am directly associated with their care which can be difficult to handle both professionally and emotionally. This same situation can also be very rewarding. A benefit as reported by some of those individuals is that by having me present the overall situation was more pleasant because of the personal comfort I was able to provide. I attempt to approach those situations as a friend who is knowledgeable about my chosen healthcare field. Assuring them that I am here to answer their questions and provide the best care possible.

What are your plans for the future? I look forward to working on my management skills and hope to someday find a position in management or administration within my facility.

How has your hospital supported your career? St. Anthony has been very supportive by offering educational opportunities and helping employees to advance in their chosen field of health care. The hospital has provided study materials and tuition assistance for my education. I have been lucky to be surrounded by management and administration that were willing to take their time to help me complete and excel in my masters program. Their leadership and guidance allowed me to understand different concepts of administration and complete my thesis project successfully. 

More about Lori Pietig:

Education: Master’s degree in health care administration from Bellevue University, bachelor of science degree in medical imaging/radiologic technology from Clarkson College

Years with hospital: 6

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Today’s NewsStand (October 27, 2011)

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

Iowa News

Federal cuts could cost UIHC $5.3M
The University of Iowa Hospitals and Clinics could face a loss of $5.3 million a year in Medicaid reimbursements as part of a federal deficit reduction plan, hospital administrators told the Iowa state Board of Regents on Wednesday. The cut could be made if a 2 percent across-the-board cut is issued by Congress as part of the Budget Control Act of 2011. A Congressional super committee was created this summer and tasked with developing a package of $1.5 trillion in federal spending cuts over the next 10 years. If those cuts are not enacted by the end of the year, a 2 percent cut automatically will be implemented on all federal programs. (Iowa City Press-Citizen)

Hospital helps Fort Dodge kids THRIVE
Trinity Regional Medical Center is helping Fort Dodge school children to achieve better health with its THRIVE program. The Healthy Living Department at TRMC has partnered with Fort Dodge Community Schools to provide activities and curriculum to educate children on healthy lifestyles. “THRIVE is designed to better approach the wellness that this community really needs,” Matt Hanson, youth wellness coordinator, said. “There’s an epidemic of childhood obesity that’s going on across our nation, and so we’re really trying to help kids - and teaching parents, as well - the importance of good nutrition and exercise.” (Fort Dodge Messenger)

Hospitalists, rather than primary doctors, increasingly serve hospital patients
“It ends up being a win-win for both patients and doctors,” said Dr. Tracy Reittinger, medical director of St. Luke’s adult hospitalist program in Cedar Rapids. Heather Schrock, 33, of Urbana, said her daughter, Micheala, 6, has become accustomed to seeing the two pediatric hospitalists while at St. Luke’s for diabetes complications. “They’re great,” Schrock said. “They spend time; they answer any questions we have. They’re very thorough.” More than 30,000 hospitalists practice in about 3,300 hospitals nationwide, according to the Society of Hospital Medicine. (Cedar Rapids Gazette)

Iowa honored for efforts to prevent shaken baby syndrome
Statewide efforts in Iowa to prevent shaken baby syndrome have drawn national recognition. The National Center on Shaken Baby Syndrome on Thursday recognized Iowa as a ‘Purple State’ for statewide efforts to protect vulnerable children in their formative years. The state Department of Public Health, Prevent Child Abuse Iowa, Early Childhood Iowa, Blank Children’s Hospital in Des Moines, St. Luke’s Hospital in Cedar Rapids, University of Iowa Hospitals and Clinics in Iowa City and other partners were honored. (Eastern Iowa Health)

National News

Congressional Democrats offer $3 trillion debt deal
Congressional Democrats are urging the debt-reduction super committee to pursue a far-reaching agreement to slice $3 trillion from the federal budget over the next decade through significant cuts to federal health programs, including Medicare, and as much as $1.3 trillion in new taxes. Savings under the plan would be about equally divided between tax increases and spending cuts, including as much as $500 billion in fresh savings from health programs, such as Medicare and Medicaid. Aides said Baucus also urged his colleagues to approve Obama’s request for as much as $300 billion in fresh measures aimed at stimulating the economy, another idea Republicans have resisted. (Washington Post)

Few doctors, nurses report asking patients about what they expect in their care
While a majority of doctors and nurses think it is important to check in with patients about what they expect to get from their care during a hospitalization, few have the training or awareness needed to ask the right questions, a team led by researchers at Brigham and Women’s Hospital found in a study released today in BMJ Quality & Safety. The use of patient satisfaction surveys as a measure of hospital quality has grown in recent years. And some studies have shown that patients, such as those who suffer heart attacks, may have better health outcomes if they report being happier with the care they have received. (Boston Globe)

Harvard study highlights wide range of Medicaid expansion estimates
In a Health Affairs article released Wednesday, researchers at the Harvard School of Public Health say the expansion of Medicaid under the Affordable Care Act (ACA) could add between 8.5 million and 22.4 million people to the rolls by 2019. It could also drive up annual federal spending on the program by anywhere from $34 billion to $98 billion. Medicaid expansion begins in 2014, when the threshold for eligibility will be raised nationwide to 133 percent of the federal poverty level. Currently, eligibility varies widely among the states once certain federal minimums have been met. (Kaiser Health News)

Spending more doesn’t make us healthier
“We know that our families, our economy and our nation itself will not succeed in the 21st century if we continue to be held down by the weight of rapidly rising health care costs,” President Obama said in 2009. Representative Paul D. Ryan, Republican of Wisconsin, agrees: “There is no serious dispute — on either side of the aisle.” Unfortunately, few people really understand how much we spend on health care, how much we need to spend to provide quality care, and the difference between the two. Do we spend too much? Would cutting costs require rationing, or worse, death panels? (New York Times)

2 hospitals, several medical offices to refuse Medicaid
Two New Hampshire hospitals and several medical offices will stop treating patients on Medicaid in the upcoming weeks, LRG Healthcare officials said.LRG Healthcare, which operates Lakes Regional General Hospital and Franklin Regional Hospital, announced that its facilities would no longer accept new or existing patients on Medicaid by mid-November. Company officials said financial challenges prompted the decision that will affect more than 3,000 patients.  (WMUR)

Top Republicans urge federal health officials to use moratoriums to fight Medicare fraud
Teams of federal prosecutors and health investigators have set up camp in nine fraud hot spots around the country including Miami, Brooklyn, Detroit, Houston and Los Angeles — all obvious places to consider moratoriums. Yet federal health officials inexplicably have not done so, according to Senators Chuck Grassley of Iowa and Orrin Hatch of Utah. The senators sent a letter to federal health officials Tuesday urging them to use moratoriums as a tool to combat an estimated $60 billion a year in Medicare fraud. (Associated Press/Washington Post)

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