Midwest Healthcare News Sep 21, 2014

Midwest Healthcare News

  • Nation's Uninsured Numbers Dropped

    Rate Fell 10 Percent in a Year

    Sep 16, 2014 By Jordan Rau


    The federal government’s first survey of the nation’s insured rate since the health care law’s new marketplaces began found a decrease in the number of adults without coverage, particularly among young adults.

    The National Health Interview Survey of people during the first three months of this year found that the number of adults under 65 without health insurance dropped to 18.4% from 20.4% in 2013.

  • Is ACA Clouding State-Level Coverage Mandates?

    Attempts to Sidestep Law May Mislead Consumers

    Sep 16, 2014 By Michelle Andrews


    For decades, states have set rules for health coverage through mandates, laws that require insurers to cover specific types of medical care or services. The health law contains provisions aimed at curbing this piecemeal approach to coverage. States, however, continue to pass new mandates, but with a twist: Now they’re adding language to sidestep the health law, making it tougher than ever for consumers to know whether they’re covered or not.

  • 89 Midwest Hospitals in Telehealth Program

    Avera Health Provides Low Cost Service For Emergency Care

    Sep 16, 2014 By Jim Mclean


    A new nurse was on duty a few weeks ago in the emergency room at the Phillips County Hospital when paramedics arrived with a critically injured patient.

    She immediately pushed the red button on some newly installed equipment. Seconds later, a seasoned ER nurse and board-certified doctor sitting at a bank of monitors 380 miles away in Sioux Falls, S.D., were using a high-definition camera and other diagnostic equipment to monitor the patient, give advice and document everything the on-site nurse was doing to save the patient’s life.

  • 34 States Get $60 Million To Boost ACA Enrollment

    Providers in Iowa, Kansas and Ohio Get Grants

    Sep 9, 2014 By Phil Galewitz


  • Are New Eye Treatments Too Costly?

    Data From Kansas, Missouri Suggests Drug Companies May Be Gaming Medicare

    Sep 9, 2014 By Mike Sherry


    Spritzing perfume is how Judy Johnson realized her eyesight had gone bad.

    At one point, diabetes had worsened her vision so much that the 69-year-old Lansing resident had to squirt out a puff of her favorite scent just to find the opening in the mister.

  • Osteopathy Gaining More Traction With Patients

    Created in Midwest, Its Patient-Centered Approach Dovetails With ACA

    Sep 9, 2014 By Michael Ollove


    Recent reforms in American healthcare weren’t designed with osteopathic medicine in mind. It only seems that way.

    The emphasis on “patient-centered care”—the idea that physicians should follow the wishes and preferences of patients, and treat patients holistically, rather than just treating their symptoms—have been the hallmarks of osteopathic medicine since its founding in the 19th century by a frontier doctor.

  • Antipsychotic Drugs Overused In Midwest Nursing Homes

    Kansas Report Paints Troubling Picture

    Aug 26, 2014 By Mike Shields


    Experts say powerful antipsychotic drugs — sometimes given in combination — are used too much and often inappropriately as “chemical restraints” or sedatives to control the behavior of Kansas nursing home residents suffering from Alzheimer’s or other dementias, and that efforts to curb the practice so far are showing weak results compared with other states.

    “Kansas is pretty far outside the norm, clearly, of what is happening in the rest of the nation,” said Mitzi McFatrich, executive director of Kansas Advocates for Better Care, a Lawrence-based group that champions improved conditions in nursing homes.

  • How ACA Is Being Used In Mid-Term Elections

    GOP Focuses on Impact to Economy

    Aug 26, 2014 By Phil Galewitz


    Beverly Hires, a former nurse running for Congress in South Florida in one of the nation’s rare competitive House races, ticks off her problems with the federal healthcare law: higher premiums, cancelled policies and employers cutting full-time jobs.

    “The Affordable Care Act is not making insurance more affordable,” she said in an interview, citing many of the same criticisms as her five GOP opponents in the Aug. 26 primary, who are vying for the chance to oust first-term Democrat Rep. Patrick Murphy.

  • In Some Specialties, In-Office Surgeries Blur

    Nurse Practitioners Bill For Dermatology Procedures at High Rate

    Aug 26, 2014 By Shefall Luthra


    ne of the hopes embedded in the Affordable Care Act was to expand the role of nurse practitioners and physician assistants in addressing the nation’s shortage of primary care providers. But a new study questions whether that’s actually happening in doctors’ offices.

    Of the more than 4 million procedures office-based nurse practitioners and physician assistants independently billed more than 5,000 times in a year to Medicare – a list including radiological exams, setting casts and injecting anesthetic agents – more than half were for dermatological surgeries.

  • Mental Health Services In Kansas Stretched To Breaking Point

    Budget Cuts, Lack of Insurance Create Crisis

    Aug 19, 2014 By Dave Ranney


    One day last month, Osawatomie State Hospital had 254 patients in its care — almost 50 more than its optimal capacity.

    The overcrowded conditions forced a few dozen patients, all of them coping with a serious mental illness and likely a danger to themselves or others, to be triple-bunked in rooms meant for two.

  • Missouri Remains Opaque On Insurance Rates

    Show Me State Has Yet to Disclose 2015 Premiums

    Aug 19, 2014 By Samantha Liss


    Health insurance carriers all across the country are disclosing what they plan to charge customers for coverage in 2015 — almost everywhere, that is, except Missouri.

    In Connecticut, for example, Anthem Health Plans Inc. submitted its rates to the state’s insurance department in May, requesting an average increase of 12.5%. The state denied the request on July 25. Anthem has until Aug. 31 to submit revised rates.

  • With ACA In Place, Some Hospitals Rethinking Charity Care

    Some Want to Rescind Offers to Those Who Refuse to Get Coverage

    Aug 19, 2014 By Julie Appleby


    As more Americans gain insurance under the federal health law, hospitals are rethinking their charity programs, with some scaling back help for those who could have signed up for coverage but didn’t.

    The move is prompted by concerns that offering free or discounted care to low-income uninsured patients might dissuade them from getting government-subsidized coverage.

  • More Inmates Being Cared For Outside Of Prison

    It Cuts Costs, But Resistance Remains Strong

    Aug 12, 2014 By Christine Vestal


    Providing healthcare to an aging prison population is a large and growing cost for states. Not only do inmates develop debilitating conditions at a younger age than people who are not incarcerated, but caring for them in the harsh environment of prisons is far more expensive than it is on the outside.

    Of the 2.3 million adults in state and federal prisons, about 246,000 are 50 or older, according to the National Institute of Corrections. The U.S. currently spends more than $16 billion annually caring for these aging inmates, and their numbers are projected to grow dramatically in the next 15 years.

  • Growing Number Of Free Clinics Accept Medicaid

    Program Expansion Led to Drop in Patient Volumes

    Aug 12, 2014 By Phil Galewitz


    Without insurance, Pam Milliken relied for years on the free health clinic here to help manage her arthritis, high blood pressure and diabetes. When she needed to have her gallbladder removed, the clinic, located in a former State Farm Insurance building, found her a specialist and hospital willing to do the surgery at no cost.

    This year, Milliken was among the 70% of patients at Wheeling Health Right Center who enrolled in Medicaid after the state expanded the program under the Affordable Care Act.

  • Stance on Medicaid Expansion Would Cost Missouri, Kansas Nearly $10 Billion

    Urban Institute Report Outlines Potential Loses

    Aug 12, 2014 By Jim McLean


    A new study by the Urban Institute says that not expanding Medicaid will cost hospitals in Kansas and Missouri more than $9 billion over a 10-year period.

    The analysis from the nonpartisan research organization pegs the loss to Kansas hospitals at $2.6 billion between 2013 and 2022. Missouri hospitals would forfeit $6.8 billion over the same period.

  • Exchange Court Decision Send Some States Scrambling

    They Want to Solidify Control in Case Ruling on Subsidies Holds Up

    Aug 5, 2014 By Christine Vestal


    As states ready their health insurance exchanges for a second open enrollment season in November, many have more to worry about than the computer glitches that plagued them last year.

    Last month’s federal appeals court ruling that said language in the Affordable Care Act allows only state-run exchanges to give consumers tax credits to help pay for policy premiums is spurring several states to solidify their state-based credentials.

  • GME Funding Report Sets Off Debate

    IOM Recommends More Equitable Distribution of $15 Billion to Train Doctors

    Aug 5, 2014 By Julie Rovner


    A high-level report recommending sweeping changes in how the government distributes $15 billion annually to subsidize the training of doctors has brought out the sharp scalpels of those who would be most immediately affected.

    The reaction also raises questions about the sensitive politics involved in redistributing a large pot of money that now goes disproportionately to teaching hospitals in the Northeast U.S. All of the changes recommended would have to be made by Congress.

  • Earnings Reports Send Mixed Messages About Spending Trends

    They Could be Interpreted as Going in Either Direction

    Aug 5, 2014 By Jay Hancock


    Analysts who fear health spending is accelerating got plenty of evidence in Wall Street's second-quarter results to support their thesis. But so did folks who hope spending is still under control.

    Now everybody's trying to sort out the mixed message.

  • Narrow Networks Are Pinching Some Consumers

    They Wind up With Big Out-Of-Pocket Costs

    Jul 29, 2014 By Julie Appleby


    Nancy Pippenger and Marcia Perez live 2,000 miles apart but have the same complaint: Doctors who treated them last year won’t take their insurance now, even though they haven’t changed insurers.

    “They said, ‘We take the old plan, but not the new one,’” said Perez, an attorney in Palo Alto, Calif.

  • Social Security Trust Fund Strengthening

    But Disability Program is on Brink of Insolvency

    Jul 29, 2014 By Julie Rovner


    Medicare’s Hospital Insurance Trust Fund, which finances about half the health program for seniors and the disabled, won’t run out of money until 2030, the program’s trustees said Monday. That’s four years later than projected last year and 13 years later than projected the year before the passage of the Affordable Care Act.

    Unlike Medicare, however, the part of Social Security that pays for people getting disability benefits is in far more immediate danger. The Disability Insurance Trust Fund is projected to run out of money in 2016, just two years from now, unless Congress intervenes, the trustees said.

  • 10 Million Gained Coverage From ACA

    No Estimates On Those Who Previously Lacked Coverage

    Jul 29, 2014 By Phil Galewitz


    About 10.3 million Americans gained health coverage this year, primarily as a result of the Affordable Care Act, according to a study by the federal government and Harvard University, published Wednesday in the New England Journal of Medicine.

    The estimate of newly insured adults — the largest to date — is the first published in a major medical journal and authored by some federal health researchers.

  • Not Expanding Medicaid Costing Midwest Billions Of Dollars, Tens of Thousands Of Jobs

    Pro-ACA States Enjoy Economic Expansion

    Jul 22, 2014 By Bryan Thompson


    A study released earlier this month by the White House Council of Economic Advisers says the decision not to expand Medicaid is costing Kansas and other Midwest states billions of dollars and tens of thousands of jobs.

  • ACA Will Help Mentally Ill Obtain Jobs

    Wisconsin, Iowa First States to Obtain Medicaid Waivers

    Jul 22, 2014 By Michael Ollove


    By his own admission, for many years Cyrus Napolitano’s mental illness—bipolar disorder—did not make him an ideal employee. Perhaps the worst moment came when he walked into the Brooklyn McDonald’s he was managing to discover some now-forgotten worker infractions.

    “Whatever it was,” he said, “it triggered an explosion where I was screaming at the top of my lungs and beating a path of destruction all the way to the back, knocking everything off shelves and kicking the back door with my boot.”

  • Physicians Chafe Against Continual Recertifications

    They Say Repeating The Arduous Process Doesn't Make Them Better Doctors

    Jul 22, 2014 By Roni Caryn Rabin


    Many specialist physicians are balking at what they say are onerous new rules to get recertified, warning the demands will force some physicians out of practice at a time when the nation faces a shortage.

    Doctors say the new requirements have made maintaining specialty certifications a process that never ends. Younger doctors already retake the arduous certification exam every seven to 10 years to keep their credential, long considered the gold standard of expertise. But physicians of all ages must now complete a complex set of requirements every two to three years, or risk losing their certification.

  • Kansas, Michigan Asked To Fix Medicaid Glitches

    CMS Wants Eligibility Delays Ironed Out

    Jul 15, 2014 By Dave Ranney


    Federal officials have asked six states, including Kansas and Michigan, to submit plans for resolving issues that appear to be delaying the processes to determine Medicaid eligibility, primarily for pregnant women, children and people with disabilities.

    Letters were sent to each state’s Medicaid director on June 27.

  • Few mentally ill can find jobs

    Eight out of 10 are out of work

    Jul 15, 2014 By Jenny Gold


    Employment rates for people with a serious mental illness are dismally low and getting worse, according to a report from the National Alliance on Mental Illness. Just 17.8 percent of people receiving public mental health services were employed in 2012 – down from 23 percent in 2003.

    That’s an unemployment rate of more than 80%.

  • States Retooling Medicaid Long-Term Care Programs

    Focusing On Keeping Patients at Home

    Jul 8, 2014 By Michael Ollove


    Three years after the demise of the long-term care piece of the Affordable Care Act, some states are retooling their Medicaid programs to maximize the number of people who can get care at home and minimize the number who have to become poor to receive help.

    They also are trying to save state dollars. Medicaid is a joint state-federal program, and long-term care for the elderly is putting an ever greater burden on state budgets: Total Medicaid spending for long-term services rose from $113 billion in 2007 to nearly $140 billion in 2012.

  • Supreme Court's Recent Healthcare Labor Ruling In Illinois Casts Doubts Elsewhere

    Could Affect Nine Other States

    Jul 8, 2014 By Jake Grovum


    The U.S. Supreme Court’s recent ruling in a case brought by home healthcare aides in Illinois casts doubt on labor agreements between such workers and state governments in nine other states.

    It also closes off—or at least complicates—one of labor’s clearest paths to reversing a decades-long trend of declining ranks and shrinking clout.

  • Uncertainty On How Supreme Court Will Move On Future Contraception Cases

    Liberals, Conservatives Have Different Interpretations

    Jul 8, 2014 By Julie Rovner


    The U.S. Supreme Court’s opinion last week holding that some for-profit firms do not have to provide women the contraceptive coverage required under the Affordable Care Act if they have religious objections addressed only half of the ongoing legal battle over the birth control mandate.

    But those on both sides of the issue think the court’s majority may have telegraphed which way it could rule when one of those other cases reaches the justices.

  • Many Who Bought Coverage Under ACA Were Previously Uninsured

    Many Had Lacked Coverage For Years, According to Survey

    Jun 24, 2014 By Julie Appleby


    Nearly six in 10 Americans who bought insurance for this year through the health law’s online marketplaces were previously uninsured—most for at least two years, according to a new survey that looks at the experiences of those most affected by the law.

    That finding is higher than some earlier estimates, and counters arguments made by critics of the law that most of those who purchased the new policies were previously insured.

  • 340B Drug Program Coming Under Fire

    Midwest Hospitals Defend Business Practices

    Jun 24, 2014 By Mary Agnes Cary


    A federal program designed to allow certain safety net hospitals and clinics to save money on drug purchases is under fire from critics who say the facilities are using that money to pad profits rather than help patients.

    The 340B drug pricing program lets thousands of hospitals, community health centers and family planning clinics buy outpatient prescription medications from manufacturers at an estimated 25% to 50% discount. Participants can then charge higher rates to insured patients and keep the additional revenue.

  • Ohio's Amish Hit With Measles Outbreak

    Making Group Reconsider Vaccinations

    Jun 24, 2014 By Sarah Jane Tribble


    The Amish countryside in central Ohio looks like it has for a hundred years. There are picturesque pastures with cows and sheep, and big red barns dot the landscape. But something changed here when, on an April afternoon, an Amish woman walked to a communal call box. She called the Knox County Health Department and told a county worker that she and a family next door had the measles.


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