Midwest Healthcare News Dec 20, 2014

Midwest Healthcare News

  • Mixed Bag For State Mental Health Funding

    Much of it Tied To Medicaid Expansion

    Dec 16, 2014 By Michael Ollove


    Fewer states increased their spending on mental health programs this year compared to last year, when a spate of horrific shootings by assailants with histories of mental illness prompted a greater focus on the shortcomings of the country’s mental health system.

    Some states slashed their mental health budgets significantly this year. At the same time, however, a number of states adopted mental health measures in 2014 that won plaudits from behavioral health advocates.

  • Will Non-Profit Co-Ops Shake Up Health Insurance Exchanges?

    Their Low Premiums Are Attracting Growing Number of Enrollees

    Dec 16, 2014 By Phil Galewitz


    When Anna Duleep went shopping recently for 2015 health coverage on the Connecticut insurance exchange, she was pleasantly surprised to find a less expensive plan.

    To get the savings, the substitute math teacher had to change from for-profit giant Anthem Blue Cross and Blue Shield to a fledgling carrier she’d never heard of. Still, Duleep, 37, liked saving $10 on her monthly premium of about $400 and knowing that her new plan, HealthyCT, is a nonprofit governed by consumers. She also liked that all her doctors participate. “I just figured, ‘why not change?’” she said.

  • Missouri Lawmakers Move To Block ACA

    Proposal to Gut Subsidy Floated

    Dec 16, 2014 By Jordan Shapiro, St. Louis Post-Dispatch


    It’s been nearly five years since President Barack Obama’s healthcare overhaul was passed by Congress, but it remains a target of conservative state lawmakers intent on blocking the law.

    In Missouri, the most recent attempt was introduced last week by Republican Senator-elect Bob Onder, M.D., a physician from St. Charles. Onder’s bill would suspend a health insurance company’s license to sell policies in Missouri if it accepts federal subsidies for policies sold through the federally run marketplace.

  • Plan To Improve Kansas City's Healthiness Approved

    Will Provide More Green Space, Better Food Options

    Dec 9, 2014 By Jim Mclean


    A multimillion-dollar plan to transform Kansas City, Kan.'s downtown into a national model is one step closer to reality.

    The Unified Government Board of Commissioners last week unanimously approved a new master development plan designed to help improve the health of Kansas City and other Wyandotte County residents by providing a state-of-the-art community center, more green space in which to exercise and access to healthy foods at a 30,000- to 35,000-square-foot urban grocery store.

  • The ACA Is Creating A Federal Contracting Boom

    Defense Companies Among Those Cashing In

    Dec 9, 2014 By Jay Hancock


    Two years ago General Dynamics, one of the biggest federal contractors, reported a quarterly loss of $2 billion. An “eye-watering” result, one analyst called it.

    Diminishing wars and plunging defense spending had slashed the weapons maker’s revenue and left some subsidiaries worth far less than it had paid for them. But the company was already pushing in a new direction.

  • States Taking Steps Toward Cutting Medicaid Super-utilizers

    Missouri, Wisconsin, Ohio among the leaders

    Dec 9, 2014 By Michael Ollove


    In health policy circles, they are called “super-utilizers,” but the name isn’t meant to connote any special powers. Just the opposite.

    They are people whose complex medical problems make them disproportionately heavy users of expensive health care services, particularly emergency room treatment and in-patient hospitalizations. The cost of treating them is huge: Just 5% of Medicaid’s 68 million beneficiaries account for 60% of the overall spending on the program.

  • More Than 230,000 New Enrollees Reported

    Big Improvement Over First Week of 2013 Enrollment

    Dec 2, 2014 By Mary Agnes Carey


    Federal officials said today that during the first week of open enrollment for the health law’s online marketplaces, 462,125 people selected health plans, with just over half of those return customers.

  • Minnesota Using Health Disparities To Drive Other Policy Changes

    Wage And Environmental Issues Tied to Medical Quality of Life For State's Residents

    Dec 2, 2014 By Michael Ollove


    For years, proposals to raise the minimum wage in Minnesota bogged down over economic concerns: Would a raise impel businesses to leave the state? Would it decrease employment? Would it touch off inflation?

    The supporters’ main argument, that raising the minimum wage would put more money into the pockets of low-wage workers and their families, fell short.

  • Kansas Safety Net Organizations Seeking Federal Money To Open Clinics

    At Least Six Have Applied For HHS Funding

    Dec 2, 2014 By Bryan Thompson


    Even with the Affordable Care Act, millions of Americans still lack health insurance. For them, safety net clinics are a lifeline. These clinics provide primary care for anyone, regardless of their ability to pay. Today there are federally funded clinics in 21 Kansas counties, but there soon could be more.

    At least six organizations in Kansas are asking the U.S. Department of Health and Human Services for grants to open new clinics. GraceMed, in Wichita, is asking for $650,000 for a new clinic on the south side of the city. Chief Executive Officer David Sanford said that region of the state’s largest city is underserved.

  • Public Health Funding Cuts Strains Ebola Preparedness

    Fiscal Reality Clashes With Quarantine Orders

    Nov 18, 2014 By Christine Vestal


    Dwindling resources may make it difficult for public health departments across the country to carry out intensive airport screenings, patient monitoring, public education and other preparations for a potential Ebola outbreak in the U.S.

    Since 2008, diminishing federal funding for public health preparedness has meant the loss of 51,000 state and local public health jobs – more than one in five, according to a new survey by the Association of State and Territorial Health Officials.

  • Two KC-Area Firms Won't Have To Provide Contraceptive Coverage

    Companies Received Exemption Under Hobby Lobby Ruling

    Nov 18, 2014 By Dan Margoiles


    Two Kansas City-area companies that challenged the Affordable Care Act’s so-called contraception mandate won’t be required to cover birth control as part of their employees’ health care plans.

    Citing the U.S. Supreme Court’s Hobby Lobby decision, Senior U.S. District Judge Ortrie Smith on Wednesday barred federal officials from enforcing the requirement against Randy Reed Automotive Inc. and Sioux Chief Manufacturing Co.

  • New Enrollment Period Starts With Few Glitches

    9 Million Expected to Sign Up; Bad Weather in Midwest an Issue

    Nov 18, 2014 By Anna Gorman and Phil Galewitz


    A Los Angeles furniture store worker who had never had health insurance enrolled in a plan for $75 a month that will cover both him and his son.

    An unemployed accountant in Charlotte, N.C., who tried and failed to sign up last year found coverage for $11.75 a month.

  • Private Investment In Public Health Initiatives Taking Root

    Investors Get Paid A Return if Initiatives Succeed

    Nov 4, 2014 By Michael Ollove


    South Carolina is turning to an unusual source to finance a new program intended to reduce the state’s high rate of premature births: private investors.

    If the program succeeds in slicing that rate among Medicaid beneficiaries and reduces state spending as a result, South Carolina will repay the principal plus a healthy, yet-to-be determined rate of return. If the program doesn’t meet expectations, the state will owe the investors less or even nothing at all.

  • Home Care Workers Are Struggling To Get More Pay

    Organizing Has Been Sporadic At Best

    Nov 4, 2014 By Sarah Jane Tribble


    Holly Dawson believes her job is a calling.

    She is one of about 2 million home care workers in the country. The jobs come with long hours and low pay.

    Each workday, Dawson drives through the Cleveland suburbs to help people take their medicines, bathe and do the dishes. She also takes time to lend a sympathetic ear.

  • Obama Administration Plans To Close Hospitalization Loophole

    Large Group Plans Will Be Mandated to Provide Inpatient Coverage

    Nov 4, 2014 By Jay Hancock


    Moving to close what many see as a major loophole in Affordable Care Act rules, the Obama administration will ban large-employer medical plans from qualifying under the law if they don’t offer hospitalization coverage.

    The administration intends to disallow plans that “fail to provide substantial coverage for in-patient hospitalization services or for physician services,” the Treasury Department said in a notice Tuesday morning. It will issue final regulations banning such insurance next year, it said.

  • Family Physicians Getting More Aggressive On Economics

    Want More Pay, More Incentives For Young Doctors to Enter Specialty

    Oct 28, 2014 By Lisa Gillespie


    Family medicine doctors are joining forces to win a bigger role in healthcare – and be paid for it.

    Eight family-physician-related groups, including the American Academy of Family Physicians, have formed Family Medicine for America’s Health, a coalition to sweeten the public perception of what they do and advance their interests through state and federal policies.

  • Few Taking Advantage of KanCare's Expanded Dental Coverage

    Less Than 10% of Adults Utilized Benefits

    Oct 28, 2014 By Andy Marso


    About 6% of eligible adults took advantage of new dental coverage offered under KanCare in the first year of the managed care Medicaid program.

    The switch to managed care Medicaid administered by three private companies extended basic dental cleanings to more than 130,000 adults age 19 to 64.

  • After Elections, More Medicaid Expansion Likely

    Some Midwest States May Join The Fray

    Oct 28, 2014 By Christine Vestal


    Less than a year after low-income Arkansans started receiving health coverage under the Affordable Care Act’s controversial Medicaid expansion, the state is declaring its so-called “private option” experiment a success.

    Hospitals saw fewer uninsured patients, state coffers were spared millions in health care costs and private insurers reported record-low premium hikes. Most important, Arkansas’ uninsured rate fell from 23% to 12%, the sharpest drop in the country.

  • KanCare Program For Developmentally Disabled Stirs Controversy

    Families Unhappy About Changes In Funding

    Oct 21, 2014 By Dave Ranney


    Parents of adult children with developmental disabilities say state officials are breaking a provision in deliberations that led to legislators last year agreeing to include Medicaid-funded home- and community-based services for the developmentally disabled in the state’s KanCare program.

    “I have one thing I want to say to the (Kansas) Department for Aging and Disability Services: ‘Liar, liar, pants on fire,’” said Susan Jarsulic, whose 35-year-old daughter, Jayne, has severe physical and developmental disabilities.

  • In Missouri, A Geographical Split On The ACA

    Rural Areas Are Leery of Law; Cities Embrace It

    Oct 21, 2014 By Jordan Shapiro and Walter Moskop, St. Louis Post-Dispatch


    Jasmin Maurer was among nearly 150,000 Missourians who signed up for insurance during the first open enrollment under President Barack Obama’s healthcare overhaul.

    She hadn’t been insured since she graduated from college in 2008 and her mother lost her job — along with her employer-sponsored coverage. Now Maurer had insurance for about six months, and it’s completely changed how she thinks about her health.

  • Reference Pricing Taking Hold

    More Insurers Capping What They Will Pay For Surgeries

    Oct 21, 2014 By Michelle Andrews


    Aiming to contain healthcare costs, a growing number of employers and insurers are adopting a strategy that limits how much they’ll pay for certain medical services such as knee replacements, lab tests and complex imaging. A recent study found that savings from such moves may be modest, however, and some experts question whether “reference pricing,” as it’s called, is good for consumers.

    The California Public Employees’ Retirement System (CalPERS), which administers the health insurance benefits for 1.4 million state workers, retirees and their families, has one of the more established reference pricing systems.

  • Medicaid Coverage Being Boosted In Many States

    Tied to Improving Fiscal Outlook

    Oct 14, 2014 By Phil Galewitz


    With an improving fiscal climate, many states are increasing benefits for Medicaid recipients and paying their providers more.

    The trend is continuing into fiscal year 2015 for those who rely on Medicaid, the state and federal health insurance program for the poor, according to a survey of 50 state Medicaid programs released Tuesday by the Kaiser Family Foundation and the National Association of Medicaid Directors.

  • Will Medicaid Expansion Stick In Ohio?

    Kascich's Back-Door Plan Requires Reauthorization -- And Political Support

    Oct 14, 2014 By Sarah Jane Tribble


    A battle is brewing in Ohio.

    University Hospitals Chief Executive Officer Tom Zenty warned a Cleveland audience that the state’s Medicaid expansion may not be permanent. “In July of next year, if there is no intervention, Medicaid expansion in the state of Ohio disappears,” Zenty said, during a recent panel discussion.

  • Kansas Gubernatorial Candidate Says He Would Revamp Parts Of Medicaid

    Would no Longer Contract With Private Companies to Serve Special Needs Patients

    Oct 14, 2014 By Jim Mclean


    Democratic gubernatorial candidate Paul Davis says if elected he will reverse Gov. Sam Brownback’s controversial decision to put the private companies managing the state’s Medicaid program in charge of delivering support services to Kansans with developmental disabilities.

    Brownback, a conservative Republican seeking a second term, privatized the state’s $3 billion Medicaid program in 2013 and renamed it KanCare to achieve two – and some say conflicting – goals of improving care and reducing costs.

  • New Questions About Drug Prices

    Cost of Hepatitis C Drug Renews Debate on America's Approach

    Oct 7, 2014 By Michael Ollove


    The new hepatitis C drug Sovaldi promises a cure rate of well over 90% compared to 45% (at best) for older drugs. But when Sovaldi went on the market earlier this year for as much as $84,000 for a single course of treatment, critics blasted the cost as “exorbitant” and “gouging.”

    It is estimated that between 3.2 million and 5.2 million Americans have hepatitis C, an infectious illness that can eventually compromise the liver.

  • More Than 2,600 Hospitals Will Be Fined For Readmissions

    Medicare Increasing Penalties

    Oct 7, 2014 By Jordan Rau


    Medicare is fining a record number of hospitals – 2,610 – for having too many patients return within a month for additional treatments, federal records released Wednesday show. Even though the nation’s readmission rate is dropping, Medicare’s average fines will be higher, with 39 hospitals receiving the largest penalty allowed, including the nation’s oldest hospital, Pennsylvania Hospital in Philadelphia.

    The federal government’s penalties, which begin their third year this month, are intended to jolt hospitals to pay attention to what happens to their patients after they leave. Around the country, many hospitals are replacing perfunctory discharge plans—such as giving patients paper instructions—with more active efforts, such as ensuring that outside doctors monitor their recoveries and giving supplies of medication to patients who may not be able to afford them. Others are still struggling to meet the new expectations. Before the program, some hospitals resisted such efforts because they weren’t paid for the services, and, in fact, benefited financially when a patient returned.

  • Kansas University Medical Center Gets $10 Million Obesity Grant

    Will Monitor Rural Patients In Four Midwestern States

    Oct 7, 2014 By Bryan Thompson


    The University of Kansas Medical Center will receive $10 million in federal funding to compare the effectiveness of obesity treatment models in rural communities.

    The money is from the Patient-Centered Outcomes Research Institute, which was created through the Affordable Care Act. Professor Christie Befort's study will track approximately 1,400 patients in rural Kansas, Nebraska, Iowa and Wisconsin.

  • Illinois May Install Cameras In Nursing Homes

    Practice is Controversial in Other States

    Sep 30, 2014 By Jenni Bergal


    Over the years, Illinois Attorney General Lisa Madigan has consistently heard “horror stories” about the abuse or neglect of nursing home residents. Now she is trying to bring such cruelty out of the shadows and into clear view.

    Madigan’s office is drafting legislation, likely to be introduced in 2015, which would allow Illinois nursing home residents and their families to place cameras in their rooms to help protect them.

  • Hospitals To Save Nearly $6 Billion In Uncompensated Care Costs

    ACA Credited With Dramatic Reduction

    Sep 30, 2014 By Mary Agnes Carey


    Hospitals are projected to save $5.7 billion this year as previously uninsured patients gain coverage through the 2010 healthcare law, the Department of Health and Human Services said last week.

    States that have expanded their Medicaid programs will see about 74% of those savings, an HHS report said. While 27 states and Washington, D.C. have expanded the federal-state insurance program for the poor to date, the survey was done when 25 states and D.C. had done so.

  • Gap in ACA Hospital Benefits Stirs Debate

    Some Say it Was Intentional; Others Believe it Was an Error

    Sep 30, 2014 By Jay Hancock


    Lance Schnider is confident Obamacare regulators knew exactly what they were doing when they created an online calculator that gives a green light to new employer coverage without hospital benefits.

    “There’s not a glitch in this system,” said Shnider, president of Voluntary Benefits Agency, an Ohio firm working with some 100 employers to implement such plans. “This is the way the calculator was designed.”

  • Why Do Surgical Rates Differ?

    Studies Show Huge Variations in Utilization by Region

    Sep 23, 2014 By Michael Ollove


    Several years ago, a California study showed that a half-dozen elective surgeries were being performed far more often in Humboldt County than they were in the rest of the state. The procedures included hip and knee replacements, hysterectomies and carotid endarterectomies, a surgery to remove plaque buildup in the carotid arteries.

    Geographical variation in the delivery of healthcare can harm patients and increase costs. That is especially true when it comes to surgery, which is usually more expensive and riskier than less invasive treatments. Medicaid makes up a huge portion of state budgets, so the issue of healthcare variation is a pressing one for states looking to hold down costs.

  • Few States Have Actual Price Transparency For Consumers

    Rates Insurers Pay Providers Mostly Kept From Public

    Sep 23, 2014 By Julie Appleby


    When Anthem Blue Cross Blue Shield became embroiled in a contract dispute with Exeter Hospital in N.H. in 2010, its negotiators came to the table armed with a new weapon: public data showing the hospital was one of the most expensive in the state for some services.

    Local media covering the dispute also spotlighted the hospital’s higher costs, using public data from a state website.

  • Iowa, South Dakota Least Successful ACA States?

    Wellmark's Refusal to Enter Exchange Depresses Enrollment

    Sep 23, 2014 By Pauline Bartilone


    Here’s a health law pop quiz: Which two states have the least successful Obamacare health insurance exchanges?

    You may guess a state in the Deep South where political opposition to the law is fierce. Or maybe Missouri? It passed a state law saying consumer advisors funded by the Affordable Care Act aren’t allowed to advise consumers.


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