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

Iowa News

GOP House budget would trim hospitals’ funding
In the House, the health and human services budget released this week by House Republicans would punish Iowa hospitals that have some of the lowest Medicare and Medicaid reimbursement rates in the nation. Proposals currently would cost Iowa hospitals about $13.5 million a year, equal to a roughly 2 percent per year cut in Medicaid payments. Hospitals are an integral partner in providing care to all Iowans. Republican House members should treat them with more respect. (Des Moines Register)

Marengo Memorial Hospital provides more than just quality health care
Marengo Memorial Hospital employs 171 persons that live in and around Iowa County infusing $9,900,175 to the economy annually, according to the latest study by the Iowa Hospital Association. In addition, hospital employees alone spend an estimated $2,933,279 on retail sales and sales tax in the area annually. “We take pride in our role as both healthcare provider and significant employer in our service area as both are critical,” stated Barry Goettsch, hospital CEO. (Your Weekly Paper)

Scott County wrestles with uncertain state funding
Prospects of cutting $1.1 million to $2.4 million in mental health funding prompted a dire discussion among the Scott County Board of Supervisors Tuesday. Two bills aimed at reforming mental health and developmental disabilities services statewide in the Iowa Legislature have created an air of uncertainty for counties across Iowa. “No one has talked about how they’re going to fund it,” said Lori Elam, director of Scott County Community Services. “They want to add services, but they already don’t provide enough funding.” (Quad-City Times)

Oelwein looks to buy out local hospital
Since 2003, Oelwein Mercy has closed its obstetrics program, lost its RCI radiologist, dissolved its local board and late last year removed its surgical operating room. According to Wayne Saur, Fayette County, Attorney, this makes Mercy the only hospital in Iowa without an operating room. “It’s 90 days it’s $8 million non-negotiable. So do you want it or not? That’s where we are at,” Saur explained before he and other city leaders met with several hundred community members on Tuesday. The group held a forum to talk about what’s happening at the hospital and answer questions about possibly purchasing the building. (KCRG)

Going at it like blue blazes
Muscatine is ready for its close-up — not on the silver screen, though, but rather from some Blue Zones. A team of visitors will take a close look at the city to help determine whether Muscatine will get a $2.5 million grant from the Blue Zones health initiative. And with Muscatine’s proven track record, it should be a shoo-in that the city will be in the running, say its supporters. (Muscatine Journal)

National News

Hospital group to take charity tax exemptions fight to Illinois Legislature
Barring a last-minute deal with the Quinn administration over the tax-exempt status of nonprofit hospitals, a powerful hospital lobbying group has lined up a prominent downstate Democrat to propose legislation to expand what counts as charity. State Senate Majority Leader James Clayborne Jr., D- East St. Louis, has agreed to sponsor the Illinois Hospital Association’s proposal, which would overrule a two-year-old Illinois Supreme Court decision that tightened the requirements for nonprofit institutions to be exempt from property taxes. (Chicago Business)

Most voters believe health care mandate is unconstitutional
Nearly two years after President Obama signed landmark health care package into law, three-quarters of registered voters believe the law’s requirement that every American carry health insurance is unconstitutional, according to a new survey. A USA Today/Gallup poll taken earlier this month and released Monday found that a majority of voters—those surveyed in battleground states and nationwide generally—agreed in their dislike of the Affordable Care Act. Voters in battleground states are more likely to want it repealed, the poll showed. (Seattle Times)

7 accused of $375M Medicare, Medicaid fraud
Years after Jacques Roy started filing paperwork that would have made his practice the busiest Medicare provider in the U.S., authorities say they’ve found most of his work was a lie. They accused Roy on Tuesday of “selling his signature” to collect Medicare and Medicaid payments for work that was never done or wasn’t necessary. Others charged in the scheme are accused of fraudulently signing up patients or offering them cash, free groceries or food stamps to give their names and a number used to bill Medicare. Roy, 41, a doctor who owned Medistat Group Associates in DeSoto, Texas, faces up to 100 years in prison if he’s convicted of several counts of health care fraud and conspiracy to commit health care fraud.  (Associated Press/National Public Radio)

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

Iowa News

Iowa’s health ranking improves in national survey
Iowa is moving up in its health ranking, but Cedar Rapids is losing ground, according to the latest Gallup-Healthways Well-Being Index. According to the report, released today, Iowa improved from 19th in 2010 to 16th in 2011, while Cedar Rapids dropped from seventh to 50th among the 190 metropolitan areas rated. “That doesn’t mean it’s bad news, necessarily, for Cedar Rapids,” said Healthways spokesman Bruce Middlebrooks. Middlebrooks said even one-tenth of a percentage point can move a city several places. (Cedar Rapids Gazette)

National News

Why doctors die differently
Doctors don’t want to die any more than anyone else does. But they usually have talked about the limits of modern medicine with their families. They want to make sure that, when the time comes, no heroic measures are taken.  Why such a large gap between the decisions of doctors and patients? The case of CPR is instructive. A study by Susan Diem and others of how CPR is portrayed on TV found that it was successful in 75 percent of the cases and that 67 percent of the TV patients went home. In reality, a 2010 study of more than 95,000 cases of CPR found that only 8 percent of patients survived for more than one month. Of these, only about 3 percent could lead a mostly normal life. (Wall Street Journal)

Tax deal reduces funds for Massachusetts hospitals
The recent payroll tax cut package passed by Congress - heralded as a bipartisan nod to working families - has Massachusetts hospitals reeling over a little-noted section that will cost them tens of millions of dollars. Tucked into the legislation are cuts to the rates paid to hospitals to care for the elderly and poor, as well as a provision slicing a new preventive care fund by about a third. The cuts amount to at least $62 million over 10 years in Massachusetts and possibly significantly more, and they come on top of other reductions that have administrators feeling they have been pushed to the edge. (Boston Globe)

At-risk patients gain attention from health insurers
No one is especially envious of this group of 1 percenters: the heaviest users of health care. One percent of patients account for more than 25 percent of health care spending among the privately insured, according to a new study. Their medical bills average nearly $100,000 a year for multiple hospital stays, doctors’ visits, trips to emergency rooms and prescription drugs. And they are not always the end-of-lifers. They are people who suffer from chronic and increasingly common diseases like diabetes and high blood pressure. As the new federal health care law aims to expand care and control costs, the people in the medical 1 percent are getting more attention from the nation’s health insurers. (New York Times)

Grassley jumps into federal probe over Minnesota Medicaid
U.S. Senator Charles Grassley, (R) Iowa, wants answers from the state agency that runs Minnesota’s Medicaid program. Senator Grassley rifled off a letter to the head of the Medicaid Program in Minnesota demanding answers about how 4-billion dollars in taxpayers’ money is spent and audited. Senator Grassley wants to know if there are independent audits, why the four HMOs in charge of the Minnesota program have such big financial reserves and what the rules and regulations are in this state to make sure Minnesotans are getting what they paid for. (KSTP)

More Americans seek dental treatment at the ER
More Americans are turning to the emergency room for routine dental problems — a choice that often costs 10 times more than preventive care and offers far fewer treatment options than a dentist’s office, according to an analysis of government data and dental research. Most of those emergency visits involve trouble such as toothaches that could have been avoided with regular checkups but went untreated, in many cases because of a shortage of dentists, particularly those willing to treat Medicaid patients, the analysis said. (Associated Press/Washington Post)

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

Iowa News

Trinity helps FD prosper
The excellence of Trinity Regional Medical Center is a good example of something so important a part of our immediate environment that it is easy to take for granted. Having a first-rate medical center close at hand is essential to the quality of life of every Fort Dodger. Trinity has become a major regional referral center for specialty care. That benefits not only those who call Fort Dodge or Webster County home, but also many others who live in the nearby counties. (Fort Dodge Messenger)

Reforming mental health
Rick Shults is aware that the lofty goals for the Iowa mental health services redesign will not come without time and effort. But the administrator of mental health and disability services for the Department of Human Services believes that they will be achievable, in time. “It’s not going to be magical,” Shults said. “It’s going to be extremely hard work. …Tomorrow we have what we have, but we need to be on a journey.” (Clinton Herald)

Peers give hope to mental health patients
Phyllis Taylor resisted her son’s demand that she go to the emergency room for psychiatric help after she threatened to kill herself last August. Taylor, 83, was despondent over her husband’s entry into a nursing home’s dementia unit and her own move to a small apartment in a town where she knew hardly anyone. She feared that if she went to the local emergency room, she would be carted off to another city and locked up in an unfamiliar place. That happens often in Iowa, where few small-town hospitals have inpatient psychiatric units — or even psychiatrists. Her son took her to Winneshiek Medical Center anyway, and Taylor found unusual support there from a woman who’d walked in her shoes. (Des Moines Register)

Sounding the alarm
“We have seen an increase in patients who don’t have health insurance or have very high deductible insurance,” said Kim Lammers, compliance officer at Jennie Edmundson Hospital in Council Bluffs. “For our patients who don’t have health insurance, that equates to $10 million that we aren’t able to collect. We don’t turn away anyone, though.” As far as the city goes, Finance Director Art Hill said that in the last fiscal year roughly $1.152 million was collected from ambulance users, leaving $850,000 to be paid by taxpayers. “If we collected the full amount on every bill we charge for this service, it would probably pay for the cost of operating this service,” Hill said. (Council Bluffs Daily Nonpareil)

New service at West Burlington hospital all about support
A new service that helps aid patients during a serious illness has started at Great River Medical Center. GRMC recently implemented palliative care, and it’s a program that aims to relieve suffering in people with serious illnesses, such as cancer, lung disease or kidney failure. Amy Crowner, community liaison at Great River Hospice, said the service can be combined with curative treatments and therapies. Lori DeVeau, who suffers from kidney failure and diabetes, said the palliative care program makes sure her needs are met. (Burlington Hawkeye)

National News

Health care history: How the patchwork coverage came to be
Most of us get health insurance through our jobs, a system puzzling to the rest of the industrial world, where the government levies taxes and offers health coverage to all as a basic right of modern society. But for many Americans, their way feels alien — the heavy hand of government reaching into our business as some bureaucrat tells doctors and patients what to do. (Los Angeles Times)

Nation’s governors get collegial over health care
Meeting with fellow state leaders at the National Governors Association here Sunday, Wisconsin Governor Scott Walker said his state can’t justify the health care reform’s added costs to his rapidly rising Medicaid budget when 90 percent of Wisconsin residents already have insurance. But Democratic Gov. Pat Quinn of neighboring Illinois said he could see the lives of people in his state improving roughly 18 months after the law began to take effect. The law has allowed tens of thousands of parents to keep their children on their insurance plans until they are 26, and protected thousands more children from being denied coverage due to earlier health problems.  (Minneapolis Star-Tribune)

Many states take a wait-and-see approach on new insurance exchanges
States are lagging in the creation of health insurance exchanges, the supermarkets where millions of consumers are supposed to buy subsidized private coverage under President Obama’s health care overhaul. Many states are waiting for a Supreme Court decision or even the November election results, to see whether central elements of the new law might be overturned or repealed. But that will be too late to start work. (New York Times)

Medicaid cuts rile doctors
A plan by Washington state’s Medicaid agency to stop paying for certain emergency-room visits is prompting pushback from hospitals and doctors, who say they will be stuck with bills for vital care they often are legally required to provide. The new cuts, set for April 1, focus on about 500 diagnoses including common infections, mild burns, strains and bruises. If an enrollee comes to an emergency room and is diagnosed with one of these conditions, the Washington Medicaid program won’t pay the hospital and doctors. (Wall Street Journal)

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Medicaid is Iowa’s health care program for our poorest citizens.  Despite what you hear about the strength of our state economy, the sobering fact is that the Medicaid rolls in Iowa continue to grow every year. There are now roughly 400,000 Iowans on Medicaid; that’s more than 13 percent of the state’s population.  Nearly 240,000 of these people are children.  Approximately half of all births in Iowa are now covered through the Medicaid program.

There is also a growing number of poor, elderly folks who are dually-eligible for both Medicare and Medicaid. They represent mostly the chronically ill people who are most reliant on Iowa’s health care system.  More about them later.

And at the end of the day, who stands in the breach to make sure that our friends and family have access to quality health care through the Medicaid program?  It’s Iowa’s community hospitals and their dedicated health care professionals.  Their care is provided all day, every day, regardless of the fact that Iowa’s Medicaid payment rates – like our Medicare payment rate – are among the lowest in the nation.

Yet, we are faced with budget proposals that cut hospital and physician payments under Medicaid.  That’s right.  Despite one of the lowest unemployment rates in the nation; despite the state’s mandatory reserve funds being full; and despite state revenues running ahead of projections, both the governor’s budget proposal and the budget approved by a House committee cut Medicaid payments to Iowa’s health care providers.

At issue is Medicaid’s desire to end what are called “crossover claims” for those dually-eligible Medicare and Medicaid beneficiaries.  Essentially, when a person is covered by both Medicare and Medicaid, Medicare pays the main portion of the bill and Medicaid covers the patient’s co-pays and deductibles.  Medicaid believes that payment for services shouldn’t exceed the normal overall payment – which, of course, would be lower than that Medicare base payment the hospital already received.

The net effect is that Medicaid would no longer pay co-pays and deductibles for these patients.

This plan would save the state $5.4 million in hospital payments and $3.8 million in physician payments.  But when the loss of federal matching funds is included, the total cost to hospitals would be $13.5 million and the costs to physicians – most of whom are employed by hospitals – would be an additional $9.5 million!

For hospitals, this represents about a 2 percent Medicaid payment cut.  It’s also worth mentioning that, just last year, the Legislature reduced Medicaid payments for emergency room services.

The impact of this policy change would be more than a financial hit on health care providers.  It would affect patients, too.  As a CFO from one of the state’s smaller hospitals recently pointed out, “This does not include the impact of Medicare patients who will suddenly be confronted by bills for co-pays and deductibles.  These patients may simply opt out of the health care system because they can no longer afford it.  Or they may delay care until they are very ill, increasing utilization of costly emergency and inpatient services.  This approach to cutting the Medicaid budget appears to be very short-sighted.”

Simply put, this is a bad idea. Besides creating an inefficient way to lower state health care commitments when it’s not fiscally necessary, cutting Medicaid spending is a poor financial strategy for the state.  Medicaid is a shared state/federal program, meaning state dollars are matched by federal dollars.  Actually, Iowa receives about a dollar and a half for each state Medicaid dollar, so it’s more than a match; it’s an investment that, if cuts are made, more than doubles the loss of revenue.  It just doesn’t make fiscal sense.

This is why IHA and hospital advocates from all over the state are telling state legislators that cutting health care is the wrong way to balance Iowa’s budget.  We hope more Iowans will join hospitals in sending this message.

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

Iowa News

Squeezing health care costs
When Dr. Tom Evans began promoting “lean” techniques to Iowa hospitals in 2006, some administrators might have thought he was talking about a new weight-loss plan. Since then, hospitals’ use of lean techniques has advanced from a handful of early adopters to a mainstream quality improvement tool. According to a statewide survey conducted in 2011, more than 70 percent of Iowa’s 118 hospitals said they were using lean techniques, up from 50 percent in 2008. And if they’re anything like Greater Des Moines’ two major hospital systems, Iowa hospitals are likely saving millions of dollars a year by employing lean practices. (Des Moines Business Record)

UI to recognize Spencer nurse anesthetist
Eric Anderson, of Spencer, Certified Registered Nurse Anesthetist (CRNA), will be honored on Saturday, Feb. 25, during graduation ceremonies for the University of Iowa Anesthesia Nursing Class of 2012 as the CRNA Teacher of the Year. Each year the university honors one certified registered nurse anesthetist and one physician for providing an outstanding training experience for students. (Spencer Daily Reporter)

Study underway to shed light on common childhood conditions
Researchers are looking into how what’s around us affects our health, from before we’re born to the time we’re adults. And, people in Polk County will play an important role. The main part of an historic national children’s health study gets underway later this year. Doctors say the results could shed light on what causes conditions like asthma, heart disease, diabetes and even autism. Iowa Health-Des Moines physician Dr. Rizwan Shah says researchers are now looking into how the environment and genes both play a role in a child’s health and development. She says, “This is the largest long term study.” (WHO-TV)

National News

Maryland advances ‘enterprising’ plan to eliminate health disparities
In many ways, Maryland is a high-performing state in terms of health care and well-being. It claims within its borders a number of world-class hospitals and medical schools. Still, Maryland continues to struggle with health disparities among its racial and ethnic minority communities. In January, Lt. Governor Anthony G. Brown announced a series of steps designed to begin to address these differences in care, quality and outcomes — especially within the state’s hardest hit areas. The plan is anchored by an economic development concept — the creation of geographically based health enterprise zones. (Kaiser Health News)

A shift from nursing homes to managed care at home
The rapid expansion of this new type of care comes at a time when health care experts argue that for many aged patients, the nursing home model is no longer financially viable or medically justified. In the newer model, a team of doctors, social workers, physical and occupational therapists and other specialists provides managed care for individual patients at home, at adult day-care centers and in visits to specialists. Studies suggest that it can be less expensive than traditional nursing homes while providing better medical outcomes. (New York Times)

Feds give Minnesota $26M to develop insurance exchange
The federal government has awarded Minnesota a $26 million grant to help fund the creation of the state insurance exchange — a key part of the federal health care law. An estimated one million Minnesota consumers and small businesses are expected to use the online marketplace to evaluate and purchase health plans within a couple of years. Minnesota is one of 10 states to receive federal money in this latest round of grant, It’s a substantial award — until now, the federal government has awarded Minnesota two grants totaling a little more than $5 million. (Minnesota Public Radio)

Per person cost of federal high-risk medical plan doubles
Medical costs for enrollees in the health-care law’s high-risk insurance pools are expected to more than double initial predictions, the Obama administration said Thursday in a report on the new program. The health-care law set aside $5 billion for a Pre-Existing Condition Insurance Plan, meant to provide health insurance to those who had been declined coverage by private carriers. Since its launch last summer, nearly 50,000 Americans have enrolled in the program. (Washington Post)

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