Midwest Healthcare News Aug 3, 2015

Midwest Healthcare News

  • Even In Prison, There's No Escaping Co-Pays

    Most States Charge Inmates For Care

    Jul 28, 2015 By Michael Ollove


    Even going to prison doesn’t spare patients from having to pay medical copays.

    In response to the rapidly rising cost of providing healthcare, states are increasingly authorizing the collection of fees from prisoners for medical services they receive while in state prisons or local jails. At least 38 states now do it, according to the Brennan Center for Justice at New York University School of Law and Stateline reporting.

  • HHS Health Center Initiative Falls Flat

    Did Not Come Close to Estimated Savings

    Jul 28, 2015 By Phil Galewitz


    A $57 million experiment to deliver better, more efficient care at federally funded health centers struggled to meet its goals and is unlikely to save money, said a new government report.

    The test to coordinate treatment for high-risk Medicare patients in hundreds of communities was one of many demonstrations run by the Department of Health and Human Services’ innovation center.

  • Missouri Not Likely To Expand Medicaid Eligibility Soon

    Safety Net Hospitals Feeling Pinch

    Jul 28, 2015 By Dan Margoiles


    It’s a sweltering Monday afternoon, and in the emergency room of Truman Medical Centers near downtown Kansas City, Mo., a patient complains of excruciating abdominal pain.

    The attending physician advises her there’s only so much he can do.

  • Kansas Medicaid Backers Must Change Tact To Achieve Expansion

    More Personal Stories Are Needed

    Jul 21, 2015 By Andy Marso


    One of the leading advocates for Medicaid expansion in Kansas says it’s time to change tactics.

    This week Alaska became the 30th state to expand Medicaid under the federal Affordable Care Act. Kansas is one of the remaining states where Republican legislators and governors remain resistant.

  • Medically Complex Kids Are Drain On Medicaid Program

    Providers in Midwest and Elsewhere Device Ways of Alternate Care

    Jul 21, 2015 By Christine Vestal


    Five-year-old Lakota Lockhart talks about Batman nonstop. When his mom, Krystal, can wedge in a word, she describes what life has been like since Lakota was born with a rare central nervous system disorder that causes his breathing to stop every time he falls asleep.

    She says they’re lucky Lakota was born across the street, at Brandon Regional Hospital in Tampa, Fla., or she might never have known about the Chronic Complex Clinic at St. Joseph’s Children’s Hospital.

  • When It Comes To Delivering A Baby, The Price Varies Widely

    Some Hospitals Charge $2,000, Some $12,000

    Jul 21, 2015 By Michelle Andrews


    Which hospital parents pick to deliver their baby can have serious cost consequences, according to a new study.

    Hospital costs for women who had no maternal or obstetric risk factors to complicate childbirth ranged from less than $2,000 to nearly $12,000, the analysis of discharge data found. The wide variation in cost means that for expectant parents, it can pay to shop around.

  • Companies That Run Kansas' Medicaid Program Are Big Donors To Lawmakers

    Amerigroup, Centene lead the pack

    Jul 14, 2015 By Andy Marso


    The three companies that administer KanCare have donated more than $50,000 to the campaigns of current Kansas legislators since the $3 billion Medicaid program began in 2013.

    Amerigroup leads the trio with $27,750 in donations, as of the most recent filings, which include donations through Dec. 31, 2014. Centene Management Corporation, the parent company of Sunflower State Health Plan, gave $17,250 in that time period. United for Health, the political action committee of United HealthCare, came in a distant third with $6,200 in campaign cash. Amerigroup donated to 20 current senators and 37 current House members, Centene gave to five senators and 26 House members, and United HealthCare donated to nine senators and four House members.

  • HHS Proposes Big Changes To Nursing Home Operations

    Wide Ranging Revamp Comes As Population Ages

    Jul 14, 2015 By Susan Jaffe


    After nearly 30 years, the Obama administration wants to modernize the rules nursing homes must follow to qualify for Medicare and Medicaid payments.

    The hundreds of pages of proposed changes cover everything from meal times to use of antipsychotic drugs to staffing. Some are required by the Affordable Care Act and other recent federal laws, as well as the president’s executive order directing agencies to simplify regulations and minimize the costs of compliance.

  • Cellphones In Operating Rooms A Growing Concern

    Their Ability to Distract Becomes a Safety Issue

    Jul 14, 2015 By Shefali Luthra


    Next time you’re on the operating table and you have one last look around as the anesthesiologist approaches, don’t be too sure that that person in scrubs looking at a smartphone is pulling up vital health data. He or she might be texting a friend, or ordering a new carpet.

    Cellphone use is not generally restricted in the operating room, but some experts say the time for rules has come. In interviews, many described co-workers’ texting friends and relatives from the surgical suite. Some spoke of colleagues who hide a phone in a drawer and check it when they think no one is watching.

  • Obama Asks Republicans For Cooperation In Fixing ACA

    Wants Bipartisan Support to Address Lingering Issues

    Jul 7, 2015 By Mary Agnes Carey


    President Barack Obama called on Republicans last week to find a bipartisan way to fix problems in the nation’s health care system rather than continue to fight over the health law.

    “Part of what I’m hoping is with the Supreme Court case now behind us what we can do is … focus on how we can make it even better because it’s not as if we’ve solved all the problems in our health care system,” Obama said in remarks at an elementary school in Nashville, Tenn. “America still spends more on health care than any other advanced nation and our outcomes aren’t particularly better.”

  • Legalization Of Gay Marriage Expected To Boost Ranks Of Insured

    More Couples to Gain Access to Employer Plans

    Jul 7, 2015 By Jay Hancock


    The right to marry in any state won’t be the only gain for gay couples from the recent U.S. Supreme Court ruling. The decision will probably boost health insurance among gay couples as same-sex spouses get access to employer plans, say analysts and benefits consultants.

    How much is unclear, but “it’s going to increase coverage” in a community that has often had trouble getting access to medical services, said Jennifer Kates, a vice president at the Kaiser Family Foundation. (Kaiser Health News is an editorially independent program of the foundation.)

  • States Moving To Cap Costs Of Specialty Drugs

    Rising Prices to Blame; Midwest Yet to Act

    Jul 7, 2015 By Michael Ollove


    As more expensive specialty drugs come on the market to treat some of the most serious chronic diseases, more states are stepping in to cushion the financial pain for patients who need medicine that can cost up to hundreds of thousands of dollars a year.

    At least seven states — Delaware, Louisiana, Maine, Maryland, Montana, New York and Vermont — limit the out-of-pocket payments of patients in private health plans. Montana, for instance, caps the amount that patients pay at $250 per prescription per month. Delaware, Maryland and Louisiana set the monthly limit at $150 and Vermont at $100. Maine sets an annual limit of $3,500 per drug.

  • Kansas Lawmakers Fall Way Short On Public Health Issues

    Medicaid Expansion And Other Key Matters All But Unaddressed in Session

    Jun 23, 2015 By Andy Marso


    When the 2015 legislative session started in January, public health advocates had reason to be optimistic they could reach some of their most ambitious goals.

    The Kansas Hospital Association was ramping up efforts to expand Medicaid coverage to about 100,000 uninsured Kansans, with the political implications of the 2014 election over.

  • Family Caregiver Legislation Moves Forward

    Bill Passed in Indiana; Illinois is Close

    Jun 23, 2015 By Susan Milligan


    Iraq war veteran Doug Mercer had been home in McAlester, Oklahoma, for just four days when he was in a motorcycle accident that left him broken and brain-damaged. His wife Michelle became his caregiver after he left the hospital, but nobody there explained how to transport him safely. A few weeks later, Michelle struggled as she tried to get Doug from the car to his wheelchair, breaking his leg.

    “They’re sending you home, and you’re thinking, ‘What?’ Nobody instructs you, and says, ‘This is what’s coming home with you and how to use it,’” she said.

  • CBO Says ACA Repeal Would Uninsure 19 Million

    Deficit Would Also Rise

    Jun 23, 2015 By Phil Galewitz


    Repealing the federal health law would add an additional 19 million to the ranks of the uninsured in 2016 and increase the federal deficit over the next decade, the Congressional Budget Office said last week.

  • St. Louis Tackles Lack Of Dental Care

    Large New Clinic Opens For Safety Net Patients

    Jun 16, 2015 By Jordan Shapiro


    The city of St. Louis hasn’t had a general dental school in nearly 25 years, and it shows. Too few dentists and lack of access have contributed to a measurable decline in dental health for many of the region’s residents.

    Organizers of a $23 million dental clinic near Lafayette Square, which opened last week, hope to reverse that trend.

  • Most Americans Say Drugs Are Too Expensive

    Significant Numbers Have Foregone Prescriptions Because of Cost

    Jun 16, 2015 By Phil Galewitz


    Nearly three in four Americans say the costs of prescription drugs are “unreasonable” — and most blame drugmakers for those prices, according to a poll released Tuesday.

  • Kansas Pondering Changes In Medical Marijuana Laws

    Mother's Prosecution For Treating Crohn's Disease Raises Eyebrows

    Jun 16, 2015 By Andy Marso


    For years Garden City resident Shona Banda has been self-medicating her Crohn’s disease with cannabis oil and making no secret of it, touting her homemade vaporizer on YouTube and in a self-published book.

    Now Banda could face up to 17 years in prison for doing so, in a case that has medical marijuana advocates enraged and legislators from both parties saying it is past time to re-examine the state’s drug laws.

  • Kansas Health Insurers Seek Big Exchange Rate Increases For 2016

    Claim Hikes Are a Reflection of Accurate Claims Data

    Jun 9, 2015 By Dave Ranney


    Two of the three companies that sell individual-market policies for Kansans on the federally administered health insurance marketplace are proposing significant premium increases for 2016.

    Rate increases proposed by Blue Cross and Blue Shield of Kansas, the state’s largest insurer, range from 35% to 39%. Aetna and Coventry Health Co., which merged in 2013, requested rate increases of 20% to 35%.

  • Health Plans Try To Predict Preventable Readmissions

    They Run Algorithms to Determine The Most At-Risk Patients

    Jun 9, 2015 By Todd Bookman


    John Iovine finally went home in April 2014, after several months in a rehab facility.

    And this point in patients’ recovery — when they’ve been discharged and have to sink or swim on their own — is the stage that everyone in the health system is paying special attention to right now. For too long, too many people like John Iovine would take a dive at this stage and end up back in the hospital again.

    The industry calls these returns to the hospital preventable readmissions, and they are a huge drain on finances, costing Medicare alone $15 billion annually. That’s why Medicare launched an initiative a few years ago that penalizes hospitals that see too many patients readmitted too soon. And in turn, that spurred many hospitals to pay more attention to the problem.

  • Push Is On To Improve Home Care Workers' Wages, Benefits

    But Ohio, Michigan, Wisconsin Trying to Block Implementation

    Jun 9, 2015 By Rebecca Beitsch


    People working in one of the fastest growing professions in America aren’t well paid. Many of them don’t get health or retirement benefits. And federal minimum wage and overtime protections still don’t apply to them.

    Despite the low wages and odd hours, 2 million Americans are home care workers, helping to dress, feed, and bathe the elderly and disabled within their homes. They are in high demand: The U.S. population is aging, and more seniors want to stay in their homes instead of moving to nursing homes.

  • eHealth Hit Hard By State Exchanges

    But Adverse Supreme Court Ruling Could Help Its Business

    Jun 2, 2015 By Phil Galewitz


    The Affordable Care Act was expected to be a boon for eHealth Inc., the nation’s largest online health insurance broker. After all, the law required most Americans to have coverage, provided government assistance to afford it and allowed Internet brokers to sell Obamacare policies.

  • Kansas Hospitals Could Lose Sales Tax Exemption

    Legislature Mulling Ways to Fill in Budget Gaps

    Jun 2, 2015 By Andy Marso


    Kansas hospitals were surprised by a plan that surfaced late last week to solve the state budget crisis by ending a sales tax exemption for some nonprofit organizations.

    The Senate voted down the plan 30-9 after several hours of debate. But with the state facing a budget gap of nearly $800 million and the Legislature looking for $400 million in new taxes, there’s a chance lawmakers could take another look at it.

  • Insurance Rate Hikes In Missouri To Undergo Independent Review

    Consumer Groups to Look At Premium Increases

    Jun 2, 2015 By Jordan Shapiro


    A Missouri consumer advocacy group plans to take on the tedious task of reviewing health insurance rates with the goal of identifying and challenging hefty price hikes.

    Missouri is one of the few states that does not allow its insurance regulators to review and approve health plan prices before they can be sold. As a result, local health advocates are planning for the first time to conduct that review themselves.

  • Kansas Medicaid Expansion May Be Forced To A Vote

    Insurance Fee Bill Could Prove Successful

    May 26, 2015 By Dave Ranney


    A Senate committee last week learned that a bill proposing that the state collect a 3.5% fee on health insurance policies sold to Kansans on the federal government’s online marketplace could be used to force a vote on Medicaid expansion.

    “I want to know if Senate Bill 309 could be a vehicle for Medicaid expansion,” Sen. Laura Kelly, a Topeka Democrat, asked in the final minutes of the Senate Ways and Means Committee hearing.

  • Elder Abuse Likely Endemic In United States

    Cases Underreported; Health Crises Often an Issue

    May 26, 2015 By Rita Beamish


    We know that victims of elder abuse tend to be socially isolated, physically weakened and struggling to maintain their independence. They are reliant on family, friends or caregivers who violate their trust.

    What we don’t know, because elder abuse is underreported, is how big the problem really is.

  • Medicaid Expansion Key To Cutting Uninsured Rates Among Middle-Aged Adults

    Those Without Coverage Dropped Dramatically

    May 26, 2015 By Michelle Andrews


    The health law’s expansion of Medicaid coverage to adults with incomes over the poverty line was key to reducing the uninsured rate among 50- to 64-year-olds from nearly 12% to 8% in 2014, according to a new analysis.

    “Clearly most of the gains in coverage were in Medicaid or non-group coverage,” said study co-author Jane Sung, a senior strategic policy adviser at the AARP Public Policy Institute, which conducted the study with the Urban Institute.

  • Kansas Will Not Protect Subsidies If Burwell Decision Is Adverse

    Political Atmosphere Too Toxic

    May 19, 2015 By Andy Marso


    Some state legislatures are moving to shield residents’ federal health insurance subsidies in advance of a U.S. Supreme Court decision regarding the Affordable Care Act.

    The Kansas Legislature is not among them.

  • Mental Health Respite Centers Can Cut Hospital Costs

    Concept is Just Beginning to Take Hold

    May 19, 2015 By Christine Vestal


    It is a busy Friday afternoon. Staff members check in guests at the front desk. Other employees lead visitors on tours of the upstairs bedrooms, or field calls from people considering future stays. Aromas of garlic and roasted chicken seep out of the kitchen.

    Community Access is not a bed and breakfast, although it feels that way when you walk through its unmarked door off Second Avenue on Manhattan’s Lower East Side. Also known as Parachute NYC, this quiet seven-bedroom facility is one of four publicly funded mental health centers in New York City (located in Manhattan, Brooklyn, Queens and the Bronx) that provide an alternative to hospital stays for people on the verge of a mental health crisis.

  • When It Comes To Hospital Bills, This Company Puts Its Foot Down

    ELAP calculates costs on its own for employer groups

    May 19, 2015 By Jay Hancock


    In the late 1990s you could have taken what hospitals charged to administer inpatient chemotherapy and bought a Ford Escort econobox. Today average chemo charges (not even counting the price of the anti-cancer drugs) are enough to pay for a Lexus GX sport-utility vehicle, government data show.

    Hospital prices have risen nearly three times as much as overall inflation since Ronald Reagan was president. Health payers have tried HMOs, accountable care organizations and other innovations to control them, with little effect.

  • Mental Health Parity Law Is Falling Short

    Few States Enforce Federal Mandate

    May 12, 2015 By Michael Ollove


    Under federal law, insurance plans that cover mental health must offer benefits that are on par with medical and surgical benefits. Twenty-three states also require some level of parity.

    The federal law, approved in 2008, and most of the state ones bar insurers from charging higher copayments and deductibles for mental health services. Insurers must pay for mental health treatment of the same scope and duration as other covered treatments; they can’t require people to get additional authorizations for mental health services; and they must offer an equally extensive selection of mental health providers and approved drugs.

  • Kansas Launches New Physician-Oriented ACO

    Will Involve Only Medical Groups

    May 12, 2015 By Bryan Thompson


    Accountability means taking responsibility for an action or result. Lately, it’s taken on a new connotation in the field of healthcare.

    The Affordable Care Act provides a way for healthcare networks to get bonus payments by providing better care and keeping Medicare patients healthier through accountable care organizations that are about to have a larger presence in Kansas.

  • Cancer Is Spurring A Healthcare Building Boom In Cleveland

    Demographics Driving More Demand For Services

    May 12, 2015 By Sarah Jane Tribble


    It’s difficult to imagine that a seven-story glass building will soon take the place of what’s now a vast hole near the corner of Carnegie Avenue and 105th Street in Cleveland. But Cliff Kazmierczak, who is with Turner Construction and overseeing the transformation, points to the gray sky, tracing a silhouette with his fingertips. In two years, he says, the Cleveland Clinic’s nearly $300 million cancer center is slated to open here.

    “The big thing is to make the patient comfortable with the treatments that they’re going through,” he said of the building’s design. “So lighting, light colors, [and] as much natural light as possible are always very important to cancer patients.”

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