Midwest Healthcare News Dec 1, 2015

Midwest Healthcare News

  • Kansas Pushes 2016 Enrollment Effort

    Outreach Program Includes Working With Social Agencies

    Dec 1, 2015 By Bryan Thompson


    Since enrollment opened Nov. 1 for 2016 health insurance in the federal marketplace, an effort called Cover Kansas has branched out across the state to help Kansans find a plan that best suits their needs.

    At a recent outreach event at the Dodge City Public Library, most of the chairs in the public meeting room were full as people waited for the consultations with marketplace navigators.

  • Bonus To Primary Care Physicians Ending Soon

    Concern it May Impact Access to Care

    Dec 1, 2015 By Michelle Andrews


    Many primary care practitioners will be a little poorer next year because of the expiration of a health law program that has been paying them a 10% bonus for caring for Medicare patients. Some say the loss may trickle down to the patients, who could have a harder time finding a doctor or have to wait longer for appointments. But others say the program has had little impact on their practices, if they were aware of it at all.

    The incentive program began in 2011 and was designed to address disparities in Medicare reimbursements between primary care physicians and specialists. It distributed $664 million in bonuses in 2012, the most recent year that figures are available, to roughly 170,000 primary care practitioners, awarding each an average of $3,938, according to a 2014 report by the Medicare Payment Advisory Commission.

  • In-Hospital Complications Stay The Same

    Leveled Off in 2014 After Years of Drops

    Dec 1, 2015 By Jordan Rau


    The rate of avoidable complications affecting patients in hospitals leveled off in 2014 after three years of declines, according to a federal report released Tuesday.

    Hospitals have averted many types of injuries where clear preventive steps have been identified, but they still struggle to avert complications with broader causes and less clear-cut solutions, government and hospital officials said.

  • Premiums On Illinois Exchange Up Sharply

    Blues Charging Nearly 18 Percent More

    Nov 17, 2015 By Ameet Sachdev


    Linda Sabor says Obamacare was a godsend. As the health care law enters its third year, her faith is starting to waver.

    Last month, her insurance company gave the 59-year-old Palatine resident some bad news. Blue Cross and Blue Shield of Illinois canceled the health plan that she and her husband have had the past two years. The company offered a plan for next year that has a similar network and benefits that would cost $1,142.24 a month, $325 more than their current monthly premium.

  • Brownback's Budget Shortchanges Children, Group Alleges

    Says Moves to Fill Budget Gap Hit Many Health Programs

    Nov 17, 2015 By Jim McLean


    A nonprofit advocacy group that frequently tangles with Gov. Sam Brownback on policy issues is charging that his latest plan to avert a budget shortfall will shortchange some of the state’s poorest and most vulnerable children.

    Shannon Cotsoradis, CEO of Kansas Action for Children, said the Brownback administration’s plan to sweep $9 million from a fund earmarked for early childhood programs will reduce their funding by about $1.3 million over the next 18 months.

  • When There's A Medical Error, It's Hazy Who Pays

    Fearing Litigation, Hospitals Are Often Elusive

    Nov 17, 2015 By Shefali Luthra


    When Charles Thompson checked into the hospital one July morning in 2011, he expected a standard colonoscopy.

    He never anticipated how wrong things would go.

    Partway through, the doctor emerged and said there were complications, remembered Ann, Charles’ wife. Charles’ colon may have been punctured. He needed emergency surgery to repair it.

  • Kansas Will Shift Medicaid Infusion Into General Fund

    Brownback's Plan Draws Criticism From Democrats

    Nov 10, 2015 By Andy Marso


    A budget deal in Washington, D.C., is helping Kansas balance its own books temporarily with an infusion of Medicaid cash.

    But a Democratic senator says the savings should be used to provide home and community-based services to Kansans with disabilities.

  • Mental Health Services Stumped By Language Issues

    Many Patients Require Bilingual Providers

    Nov 10, 2015 By Tim Henderson


    The U.S. is grappling with a severe shortage of mental health professionals. But the situation is particularly dire for some minority communities, where barriers of language and culture can make it hard to seek and get help.

    Most good mental health care requires subtle, intimate conversation with patients. But too often, mental health experts say, professionals lack the language skills needed to serve those who struggle with English.

  • More Hospital Systems Selling Insurance To Patients

    They Can Price Such Coverage Competitively

    Nov 10, 2015 By Julie Appleby


    In addition to treating what ails you, a number of healthcare systems aim to sell you a health insurance plan to pay for it. With some of the most competitively priced policies on the marketplaces, “provider-led” plans can be popular with consumers. But analysts say it remains to be seen how many will succeed long term as insurers.

    It’s not surprising that health systems might get into the insurance business. Doing so funnels more patients to a health system’s hospitals and doctors. And it makes sense that combining clinical and claims data under one roof could lead to better coordinated, more cost-efficient patient care.

  • Departure Of Two Kansas Plans From Exchange Raises Concerns

    Experts Fear Large Numbers Won't Reenroll

    Nov 3, 2015 By Jim McLean


    Groups working to boost health insurance enrollment in Kansas are concerned their efforts could be undermined by the last-minute departure of one of the state’s largest insurers.

    Coventry Health Care of Kansas Inc. and Coventry Health & Life Insurance Co. — both subsidiaries of Aetna — abruptly decided to stop offering policies to Kansas consumers in the federal marketplace. The decision, made two weeks before the start of the open enrollment period, surprised state insurance regulators.

  • UnitedHealth Will Expand Bundled Cancer Payments

    Initial Pilot Cut Costs by More Than a Third

    Nov 3, 2015 By Julie Appleby


    UnitedHealthcare said last week it will expand its high-profile test of whether bundled payments for chemotherapy can help slow rising cancer treatment costs, part of a growing effort by insurers to find new ways to pay for care.

    Results from United’s initial pilot test – reported last year – were puzzling: The overall cost of cancer care for patients in the study dropped by 34%, even as spending on chemotherapy drugs spiked significantly.

  • Average 2016 Exchange Premiums Drop In Indiana, Ohio

    But They Rise in Many Other States

    Nov 3, 2015 By Mary Agnes Carey and Jordan Rau


    Premiums will increase an average of 7.5% for the second-lowest-cost silver insurance plan to be offered next year in the 37 states where the federal government operates health marketplaces, according to an analysis by the Department of Health and Human Services.

  • Telemedicine Poised For Big Breakthrough

    But State Regulations Still Challenge Its Expansion

    Oct 27, 2015 By Michael Ollove


    Telemedicine has been praised as a cost-effective way to link doctors and patients, enabling physicians to monitor their medical conditions and consult with specialists in a way that overcomes time and distance.

    But despite a half-century of technological advances, the ready availability of interactive devices, and the full-throated encouragement of the Obama administration, advocates say telemedicine has failed to reach its full potential, due largely to policies in some states that make it difficult to practice, and pay for, such care.

  • Feds May Make It Easier To Sue Nursing Homes For Neglect

    Arbitration Clause in Minnesota Case Culled Award

    Oct 27, 2015 By Ina Jaffe


    As Dean Cole’s dementia worsened, he began wandering at night. He’d even forgotten how to drink water. His wife, Virginia, could no longer manage him at home. So after much agonizing, his family checked him into a Minnesota nursing home.

    “Within a little over two weeks he’d lost 20 pounds and went into a coma,” says Mark Kosieradzki, who was the Cole family’s attorney. Dean Cole was rushed to the hospital, says Kosieradzki, “and what was discovered was that he’d become totally dehydrated. They did get his fluid level up, but he was never, ever able to recover from it and died within the month.”

  • Kansas GOP Now Clashing Over Medicaid Expansion

    Brownback Getting Pressured by His Own Caucus to Relent

    Oct 27, 2015 By Jim McLean


    Kansas Senate Vice President Jeff King is taking issue with Gov. Sam Brownback’s reasons for opposing Medicaid expansion.

    Melika Willoughby, Brownback’s deputy communications director, outlined those reasons in an Oct. 6 email to supporters. Referring to expansion as a “masquerading component of Obamacare,” Willoughby said the governor believes it would be “morally reprehensible” for the state to provide health coverage to low-income Kansans “who choose not to work” before providing support services to all of the disabled Kansans now on waiting lists.

  • HHS Makes Enrollment Estimates For 2016

    Says 10 Million Will be Covered by End of Next Year

    Oct 20, 2015 By Mary Agnes Carey


    Department of Health and Human Services officials last week predicted that about an additional 1 million Americans would sign up for coverage under the federal health law next year and acknowledged that prospective enrollees are worried about the cost of health insurance, even with the law’s financial help.

  • A State's Major Overhaul Of Medicaid

    North Carolina Wants to Keep Costs in Check

    Oct 20, 2015 By Michael Tomsic


    North Carolina is in the process of overhauling its Medicaid program. The governor and state lawmakers are using a mixture of healthcare models to put the major players — doctors, hospitals and insurers — all on the hook to keep rising costs in check.

    For many of the Republicans who control the state legislature, the reason for the change is simple: budget predictability.

  • Two Insurers Pull Out Of Kansas Exchange

    Aetna Affiliates Leave Just Weeks Before Open Enrollment

    Oct 20, 2015 By Jim McLean


    A major provider of health insurance in Kansas is pulling out of the Affordable Care Act marketplace.

    Two companies under the Aetna corporate umbrella — Coventry Health & Life Insurance Co. and Coventry Health Care of Kansas Inc. — are withdrawing from the marketplace just two weeks before the Nov. 1 start of the next open enrollment period.

  • Express Scripts Won't Take Role In Lowering Price of New Cholesterol Drugs

    Instead, Will Aggressively Monitor Their Distribution

    Oct 13, 2015 By Julie Appleby


    The nation’s largest pharmacy benefit manager said last week it’s not going to try to bring down costs by forcing the makers of two pricey new cholesterol drugs to compete against each other, as it successfully did this year with expensive hepatitis C treatments.

    Instead, St. Louis-based Express Scripts said it will control spending by aggressively managing which patients get the injectable medications. The firm also said it won some discounts from the treatments’ estimated $14,000 annual list price.

  • Hospitals Tackle Urban Poverty

    Cleveland Clinic Plays Significant Role

    Oct 13, 2015 By Michael Ollove


    As a child, Bishop Douglas Miles heard the warnings about vans trolling East Baltimore streets, snatching up young African-Americans for medical experiments at nearby Johns Hopkins Hospital.

    Whether there was any truth behind those stories—Hopkins has always denied them—hardly mattered. The mythology lived on and, combined with the hospital’s very real development decisions, contributed to a persistent view of Hopkins as an imperious, menacing presence amid the largely poor and African-American neighborhoods surrounding it.

  • KanCare Administrators Held Fundraiser For Lawmakers

    Raises concerns among minority Democrats

    Oct 13, 2015 By Andy Marso


    One of the three companies that administer KanCare, Kansas' Medicaid managed care program, co-hosted a fundraiser last week for Republican members of the Senate Public Health and Welfare Committee, opening a new chapter in the state’s move to privatized Medicaid.

    The three managed care organizations the state contracted with in 2012 receive nearly all their revenue in Kansas from state and federal tax dollars.

  • ICD-10 Creates A Cascade Of New Codes

    But Many Cover Unlikely, Even Bizarre Incidents

    Oct 6, 2015 By Barbara Feder-Ostrov


    If you’re struck by an orca, sucked into a jet engine, or having relationship problems with your in-laws, fear not: Your doctor now has a medical diagnosis code for that.

    Today U.S. doctors, hospitals and health insurers must start using the ICD-10, a vast new set of alphanumeric codes for describing diseases and injuries in unprecedented detail.

  • Value-Based Purchasing Doesn't Improve Quality

    GAO Says Program Has Done Little to Make a Difference

    Oct 6, 2015 By Jordan Rau


    Medicare’s quality incentive program for hospitals, which provides bonuses and penalties based on performance, has not led to demonstrated improvements in its first three years, according to a federal report released last Thursday.

  • Some States Pushing For Medicaid Work Requirement

    Arizona's Plan Drastically Different From Indiana's

    Oct 6, 2015 By Michael Ollove


    If Arizona gets its way, its able-bodied, low-income adults will face the toughest requirements in the country to receive healthcare coverage through Medicaid.

    Most of those Medicaid recipients, and new applicants, would have to have a job, be looking for one or be in job training to qualify for the joint federal-state program for the poor. They would have to contribute their own money to health savings accounts, which they could tap into only if they met work requirements or engaged in certain types of healthy behavior, such as completing wellness physical exams or participating in smoking cessation classes. And most recipients would be limited to just five years of coverage as adults.

  • Kansas Providers Pressured By Lack Of Medicaid Expansion

    At Least One Hospital Slated to Close as a Result

    Sep 29, 2015 By Jim McLean


    Kansas’ “failure” to expand Medicaid is putting healthcare providers in jeopardy, the head of the state’s largest health system said Wednesday.

    Jeff Korsmo, CEO of Wichita-based Via Christi Health, issued a statement calling on Gov. Sam Brownback and Republican legislative leaders to drop their opposition to expanding KanCare, the state’s privatized Medicaid program.

  • HHS Will Push For Greater Enrollment Numbers In 2016

    Agency Will Launch Aggressive Marketing Campaign

    Sep 29, 2015 By Mary Agnes Carey


    The health law’s upcoming enrollment period may be its toughest yet, with federal officials promising a vigorous outreach campaign to enroll millions of eligible yet hard-to-reach Americans who have yet to sign up for health insurance.

    “Those who are still uninsured are going to be a bigger challenge,” Department of Health and Human Services Secretary Sylvia Mathews Burwell said Tuesday in remarks to the Howard University College of Medicine.

  • Prescribing Statins To Elderly Raises Concerns

    Little Research Has Been Performed About Their Impact

    Sep 29, 2015 By Lisa Gillespie


    Many doctors are choosing a better-safe-than-sorry approach to heading off heart trouble in very elderly patients.

    Inexpensive statin drugs are given to millions of people to reduce cholesterol, even many who do not show signs of heart disease. But a recent study has found that seniors with no history of heart trouble are now nearly four times more likely – from 9 percent to 34 percent – to get those drugs than they were in 1999.

  • Male Anesthesiologists Earn Far More Than Female Colleagues

    Study Says Variety of Factors in Play

    Sep 22, 2015 By Shefali Luthra


    In anesthesiology, it pays – literally – to be a man.

    At least, that’s what’s suggested by a study examining this specialty’s demographics and salaries in 2007 and again in 2013. The study, by the RAND Corp., a nonpartisan research institute, was published Thursday in the journal Anesthesiology.

  • Co-Op Health Plans Are Struggling

    Closures In Iowa And Nebraska

    Sep 22, 2015 By Michael Ollove


    Consumer-run health insurance cooperatives, created under the Affordable Care Act to stimulate competition and lower prices for health insurance, faltered almost from the start.

    In just the last two months, health insurance cooperatives in Louisiana and Nevada announced they were going belly up at the end of the year. They followed another, operating in Nebraska and Iowa, which had been ordered by a state court to liquidate.

  • Obesity Rates Inch Up In Kansas And Missouri

    Nearly A Third Of The Residents Fit Description

    Sep 22, 2015 By Bryan Thompson


    Almost one in every three adults in Kansas and Missouri is not just overweight but obese, according to a new report from the Trust for America’s Health and the Robert Wood Johnson Foundation.

    "The State of Obesity: Better Policies for a Healthier America" notes that obesity rates nationwide have stabilized, but at a level that’s much too high.

  • Hospital-Owned Physician Groups Means More Internal Referrals

    Stanford Study Suggests This Drives Up Costs

    Sep 15, 2015 By Phil Galewitz


    Why did hospitals binge-buy doctor practices in recent years?

    To improve care coordination, lower costs and upgrade patient experiences, say hospitals. To raise costs, gain pricing power and steer patient referrals, say skeptics.

  • Educating Doctors About Patient Costs

    More Medical Schools Are Examining Prices of Care

    Sep 15, 2015 By Rebecca Plevin


    Time for a pop quiz: When it comes to healthcare, what’s the difference between cost, charge and payment?

    “Does anyone want to take a stab at it?” Sara-Megumi Naylor asked a group of first-year residents at the David Geffen School of Medicine at UCLA.

  • A Push For More Informational Death Certificates

    Iowa Among Few States With Sophisticated Filing System

    Sep 15, 2015 By Michael Ollove


    Robert Anderson may know more about death than anybody else in the United States.

    Anderson is chief of mortality statistics for the Centers for Disease Control and Prevention. Information about death flows into his suburban Maryland office from all over the country, detailing not only how many Americans have died—2,596,993 in 2013—but the causes of those deaths. Researchers use the information to learn what kills Americans, and public officials use it to craft policies to improve health and safety.

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