Midwest Healthcare News May 1, 2016
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Midwest Healthcare News

  • Bundled Payments Often Means Free Surgeries For Patients

    Lowe's Among The Companies Making Such Offer

    Apr 26, 2016 By Michael Tomsic

     

    Lowe’s home improvement company, like a growing number of large companies nationwide, offers its employees an eye-catching benefit: certain major surgeries at prestigious hospitals at no cost to the employee.

    How do these firms do it? With “bundled payments,” a way of paying that’s gaining steam across the healthcare industry, and that Medicare is now adopting for hip and knee replacements in 67 metropolitan areas, including New York, Miami and Denver.

  • Supreme Court Deals Blow To Subrogration

    Health Plans Must Now Act Quickly If They Want Settlement Shares

    Apr 26, 2016 By Michelle Andrews

     

    Accidents happen, and if they’re someone else’s fault, you can go to court to try to get compensation for your medical expenses, lost wages, and pain and suffering. If you win, though, the pot of gold you receive may be considerably smaller than you expect: Your health plan may claim some or all of it as reimbursement for money it spent on your medical care.

    It’s completely legal and it happens all the time. But a recent Supreme Court decision gives consumers ammunition to push back.

  • Missouri, Kansas Laggards In Public Health Spending

    They're 50th and 47th Nationwide

    Apr 26, 2016 By Megan Hart

     

    Kansas spends only about $12 per person on public health, making it one of the states putting the least money into preventing chronic and infectious diseases.

    According to a recent report from the Trust for America’s Health, Kansas spent about $36 million in fiscal year 2015 on public health programs for its 2.9 million people, or about $12.40 per person. That ranked the state 47th in per capita spending compared to the other 49 states and the District of Columbia.

  • Missouri Is Only State Not Tracking Prescriptions

    Politics Has Blocked Tool to Curb Drug Abuse

    Apr 19, 2016 By Bram Sable-Smith

     

    At Richard Logan’s pharmacy in Charleston, Mo., prescription opioid painkillers are locked away in a cabinet.

    Missouri law requires pharmacies to keep schedule II controlled substances — drugs like oxycodone and fentanyl with a high addiction potential — locked up at all times.

  • Community Clinics Help Patients With Out-Of-Pocket Costs

    Many Have Insurance, But Lack Funds

    Apr 19, 2016 By Michelle Andrews

     

    Denise Johnson works two jobs, but neither of them offers health insurance to part-timers like her. She signed up for a marketplace plan this year, but for routine medical care, Johnson still goes to the free clinic near her Charlottesville, Va., home.

    The problem is her plan’s deductible of at least $1,000. She can’t recall the precise figure, but it doesn’t really matter. “It’s absolutely high,” said Johnson, 58. “Who can afford that?” She struggles to pay her $28 monthly premium.

  • Kansas Struggles With Medicaid Backlog

    Many Applicants Have Been Waiting For Months

    Apr 19, 2016 By Andy Marso

     

    Representatives of 15 groups that advocate for Kansas Medicaid populations sent a letter to state leaders this week urging them to eliminate a Medicaid application backlog that has left thousands of Kansans awaiting coverage.

    The groups have formed a coalition called the KanCare Advocates Network. They represent children, pregnant women and Kansans who are elderly or disabled.

  • Ohio Struggling With Fentanyl Overdoses

    Up More Than 500 Percent

    Apr 5, 2016 By Christine Vestal

     

    When Ohio tallied what many already knew was an alarming surge in overdose deaths from an opioid known as fentanyl, the state asked the U.S. Centers for Disease Control and Prevention to investigate.

    The rash of fatal overdoses in Ohio — a more than fivefold increase in 2014 — was not an isolated outbreak. Fentanyl is killing more people than heroin in many parts of the country. And the death toll will likely keep growing, said CDC investigators Matt Gladden and John Halpin at the fifth annual Rx Drug Abuse and Heroin Summit here.

  • IRS Knows Who Lacks Insurance -- But Isn't Telling

    Agency Being Urged to Change Policy

    Apr 5, 2016 By Phil Galewitz

     

    Nearly a third of people without health insurance, about 10 million, live in families that received a federal earned income tax credit (EITC) in 2014, according to a new study.

    But the Internal Revenue Service doesn’t tell those tax filers that their low and moderate incomes likely mean their households qualify for Medicaid or subsidies to buy coverage on the insurance exchanges.

  • Kansas Nursing Homes Subject To Crackdown

    Justice Department Spearheads Investigation

    Apr 5, 2016 By Dan Margoiles

     

    Kansas is one of 10 judicial districts nationwide selected to form units to crack down on nursing homes providing “grossly substandard” care, the Justice Department announced last week.

  • Healthcare Mortgages Could Finance Pricey Care For Patients

    But Proposal Raises Ethical Issues

    Mar 29, 2016 By Michelle Andrews

     

    A Massachusetts Institute of Technology economist and Harvard oncologist have a proposal to get highly effective but prohibitively expensive drugs into consumers’ hands: health care installment loans.

    Writing last month in the journal Science Translational Medicine, the authors liken drug loans to mortgages, noting that both can enable consumers to buy big-ticket items requiring a hefty up-front payment that they could not otherwise afford.

  • Kansas authorizes EPO plans

    But such policies won't be subject to Medicaid fee

    Mar 29, 2016 By Andy Marso

     

    Gov. Sam Brownback signed a bill Monday that will allow insurance companies to avoid paying a privilege fee when they sell health plans that cover only in-network care.

    The state already allowed insurers to sell network-only plans if they registered with the Kansas Insurance Department as health maintenance organizations, or HMOs, and paid the fee.

  • Opioid Epidemic Raises Concerns About Expectant Mothers

    More Children Being Born At-Risk For Withdrawal

    Mar 29, 2016 By Christine Vestal

     

    As soon as the home pregnancy test strip turned blue, Susan Bellone packed a few things and headed straight for Boston Medical Center’s emergency room. She’d been using heroin and knew she needed medical help to protect her baby.

    “I felt so guilty. I still do,” said Bellone, a petite, energetic woman. At 32, and six years into her heroin addiction, having a baby was the last thing on her mind. “I was not in the right place to start a family,” she said. “But once it was happening, it was happening, so I couldn’t turn back.”

  • Value-Based Pricing Reaches Part D

    CMS Introduces Various Initiatives to Cut Costs

    Mar 22, 2016 By Julie Appleby

     

    Aetna and Cigna inked deals in early February with drugmaker Novartis that offer the insurers rebates tied to how well a pricey new heart failure drug works to cut hospitalizations and deaths. If the $4,500-a-year drug meets targets, the rebate goes down. Doesn’t work so well? The insurers get a bigger payment.

    In another approach, pharmacy benefit firm Express Scripts this year began paying drugmakers a special negotiated rate for some cancer drugs — to reward the use of the medicines for the specific cancers for which they have the most demonstrated effectiveness.

  • Kansas Gets Federal Money To Combat Opioid Abuse

    Four Centers Receive HHS Grants

    Mar 22, 2016 By Megan Hart

     

    More than $1.4 million in federal grants will help four Kansas health centers enhance their treatment programs for opioid abuse.

    In announcing the grants earlier this month, the U.S. Department of Health and Human Services said abuse of and addiction to opioids, such as heroin and prescription painkillers, “is a serious and increasing public health problem.”

  • End-Of-Life Discussions Expand

    Cleveland Clinic Among Those Providing Training

    Mar 22, 2016 By Phil Galewitz

     

    She didn’t want to spend the rest of her days seeing doctors, the 91-year-old woman confessed to Kevin Newfield, M.D., as he treated a deep wound on her arm.

    “You don’t have to, but you have to tell me what you do want,” Newfield replied.

    “I’m not afraid of dying. I’m afraid of being 106,” she told the surgeon and her daughter, who was in the room with them.

  • Rural Towns Rattled By Hospital Closures

    Other Businesses Often Impacted Hard

    Mar 15, 2016 By Sarah Varney

     

    For years, Sybil Ammons was the director of nursing at Stewart County’s only hospital. Now, she’s the county coroner.

    Since the hospital here closed three years ago, Ammons says more than a dozen local residents were unable to get medical care quickly enough and were either harmed or died because of the delays. “We’ve had a stroke, several heart attacks,” she said, standing along Richland’s main street in this small town about 150 miles south of Atlanta. “We’ve had traumas out on the four-lane.”

  • States Mull Sanctioning Of Heroin Use

    Safe Injection Sites Would Cut Overdoses

    Mar 15, 2016 By Sarah Breitenbach

     

    A bustling economy. Record-low unemployment. A ballooning heroin problem.

    That’s how Mayor Svante Myrick describes Ithaca, N.Y., where he hopes to open the nation’s first safe injection facility — a place where heroin users could shoot their illegal drugs under medical supervision and without fear of arrest.

  • Concealed Guns Will Soon Be A Reality At KU Medical Center

    New Law Allowing Them on College Campuses Affects Hospital

    Mar 15, 2016 By Sam Zeff

     

    July 2017 may seem like a long way away, but when you’re planning to allow guns on college campuses, it might as well be just around the corner.

    How Kansas colleges will comply with the law allowing guns on campus while maintaining security is complicated. But it’s perhaps most complex at the University of Kansas Medical Center and KU Hospital in Kansas City, Kan.

  • Poll Shows Large Majority Of Kansans Want To Expand Medicaid

    But no Action Being Taken by Legislature For Now

    Mar 8, 2016 By Jim McLean

     

    Poll results released Monday by the Kansas Hospital Association show a majority of Kansans continue to favor expanding Medicaid to cover more low-income adults.

    The statewide poll conducted in mid-February found that 62% of Kansas voters supported expanding KanCare, the state’s privatized Medicaid program, to cover approximately 150,000 non-disabled adults earning less than 138% of the federal poverty level, which is $16,242 for an individual and $33,465 for a family of four.

  • States For Pushing For Greater Price Transparency For Drugs

    Michigan Among 11 Advocating Reforms

    Mar 8, 2016 By Michael Ollove

     

    Outraged by exorbitant prices for certain prescription drugs, lawmakers in at least 11 states have introduced legislation that would require pharmaceutical companies to justify their prices by disclosing how much they spend on research, manufacturing and marketing.

    The bills are similar to a provision in President Barack Obama’s proposed 2017 budget.

  • Retail Clinics May Be Driving Up Health Spending

    Study Contradicts Notion They Cut Costs

    Mar 8, 2016 By Chad Terhune

     

    Retail clinics, long seen as an antidote to more expensive doctor offices and emergency rooms, may actually boost medical spending by leading consumers to get more care, a new study shows.

    Rather than substituting for a physician office visit or trip to the hospital, 58 percent of retail clinic visits for minor conditions represented a new use of medical services, according to the study published Monday in the journal Health Affairs. Those additional visits led to a modest increase in overall health care spending of $14 per person per year.

  • Americans Cool to Sanders' Single-Payer Proposal

    Most Support is Among Democrats; Alternatives Are Preferred

    Mar 1, 2016 By Jordan Rau

     

    Americans are divided about the idea of creating a single-payer government health insurance system, as Democratic presidential candidate Bernie Sanders has proposed, but support shrinks when negative arguments are highlighted and alternatives are presented, according to a poll released last week.

  • Power Couples Exacerbate Rural Doctor Shortage

    Higher Earners More Likely to Marry, Creating Reluctance to Relocate

    Mar 1, 2016 By Shefali Luthra

     

    If someone is well-educated, the odds are that he or she will marry someone with similar credentials, according to census data. And that trend has consequences when it comes to access to health care in rural areas.

    Rural areas have for years been facing a doctor shortage. That means for the roughly 20% of Americans who live in those areas, it’s harder to get care when it’s needed.

  • Funding Cuts Make It Difficult For Poor Kansas Women To Obtain Health Services

    Many Have to Travel Hours to Clinics

    Mar 1, 2016 By Esther Honig

     

    At a domestic violence shelter in Hays, director Tiffany Kershner sits with a client in a small meeting room. Leyila, 35, who asks that only her first name be used to protect her privacy, recently left an abusive marriage.

    Today she’s hoping she can get an appointment with an OB-GYN, but Kershner knows that’s no easy task in Hays. “We’re looking for the money to try and help with the exams and help with the doctor’s visits,” Kershner said. “But there’s just not a lot of money for it, so we’re just looking for any particular grant we can write.”

  • Many Public Health Departments Unprepared For Zika Virus

    Budget, Staffing Cuts During Recession Linger

    Feb 23, 2016 By Michael Ollove

     

    State health officials were heartened when President Barack Obama this month asked Congress for $1.8 billion to combat the spread of the Zika virus because they fear they don’t have the resources to fight the potentially debilitating disease on their own.

    Budget cuts have left state and local health departments seriously understaffed and, officials say, in a precariously dangerous situation if the country has to face outbreaks of two or more infectious diseases — such as Zika, new strains of flu, or the West Nile and Ebola viruses — at the same time.

  • Flint Water Crisis Impacts Tap Water Initiatives Elsewhere

    Wariness Prompts Many to Consumer Sugary Drinks Over Tapwater

    Feb 23, 2016 By John Daley

     

    The water crisis in Flint, Mich., is making some public health messages harder to get across — namely, in most communities, the tap water is perfectly safe. And it is so much healthier than sugary drinks.

    It’s a message Patty Braun, M.D., a pediatrician and oral health specialist at Denver Health, spends a lot of time on in Denver, even before lead was found in the water system of Flint.

  • Kansas' Refusal To Expand Medicaid Has Cost Hospitals More Than $1B

    No Softening of Stance in Sight

    Feb 23, 2016 By Jim McLean

     

    Kansas’ rejection of Medicaid expansion has cost the state more than $1 billion, according to the association that represents the state’s hospitals.

    “This 10-figure sum represents a loss of nearly 11 Kansas taxpayer dollars every second since Jan. 1, 2014 — funds that go to the federal government to be spent in other states for Medicaid expansion,” the Kansas Hospital Association, which keeps a running total of the amount on its website, said in a news release issued Monday.

  • Kansas Cannot Move The Needle On Coverage For Minorities

    Their Rates of Uninsured Remain Far Higher Than Whites

    Feb 16, 2016 By Bryan Thompson

     

    A recent national report credits the Affordable Care Act, or Obamacare, for helping to reduce racial and ethnic inequalities in health insurance coverage. But Kansas has not made as much progress as other states.

    Before the Affordable Care Act, blacks, Hispanics, American Indians and Asian-Americans were much more likely than whites to be uninsured. But an analysis by the nonprofit Center for Global Policy Solutions shows that gap has narrowed because of the health reform law.

  • Few Doctors Willing And Able To Prescribe Anti-Opioid Drugs

    Federal Rules And Attitudes Are Among Issues

    Feb 16, 2016 By Christine Vestal

     

    After more than a decade of getting high on illicit opioid painkillers and heroin every day, Christopher Dezotelle decided to quit. He saw too many people overdose and die. “I couldn’t do that to my mom or my children,” he said.

    He also got tired of having to commit crimes to pay for his habit — or at least the consequences of those crimes. At 33, he has spent more than 11 of his last 17 years incarcerated. The oldest of seven children, he started using marijuana and alcohol when he was 12.

  • Feds Don't Endorse Autism Screening

    U.S. Preventive Services Task Force Says There Not Enough Evidence to Show Benefit

    Feb 16, 2016 By Shefali Luthra

     

    Sparking strong reaction from doctors and child development experts, an influential task force says there’s “insufficient evidence” to argue definitely that the benefits of screening all young children for autism outweigh the harms.

    “There’s not enough evidence for us to recommend for or against screening in children for autism under 30 months,” said David Grossman, M.D., vice chair of the U.S. Preventive Services Task Force and a Seattle pediatrician. “Clinicians need to make a judgment on their own about whether to screen. There is no right answer on that.”

  • Insurers Backing Away From ACA

    Many Cut Commissions to Brokers to Discourage Enrollment

    Feb 9, 2016 By Michelle Andrews

     

    Stung by losses under the federal health law, major insurers are seeking to sharply limit how policies are sold to individuals in ways that consumer advocates say seem to discriminate against the sickest and could hold down future enrollment.

    In recent days Anthem, Aetna and Cigna, all among the top five health insurers, told brokers they will stop paying them sales commissions to sign up most customers who qualify for new coverage outside the normal enrollment period, according to the companies and broker documents.

  • Midwest States Lead Fight On Obtaining Hep C Drugs

    Indiana, Minnesota File Lawsuits For Prisoners, Medicaid Enrollees

    Feb 9, 2016 By Michael Ollove

     

    A handful of federal lawsuits against states that have denied highly effective but costly hepatitis C drugs to Medicaid patients and prisoners could cost states hundreds of millions of dollars.

    The drugs boast cure rates of 95% or better, compared to 40% for previous treatments. But they cost between $83,000 and $95,000 for a single course of treatment.

  • Kansas Seeking Solutions To Medicaid Backlog

    Presumed Eligibility For Some Applicants Considered

    Feb 9, 2016 By Andy Marso

     

    Kansas Department of Health and Environment Secretary Susan Mosier said last week that she’s open to ideas to streamline the state's current backlog of Medicaid applicants, including presumed Medicaid eligibility for nursing home residents.

    When asked about a temporary lifeline for nursing homes drowning in uncompensated care while the department works through a computer system transition, Mosier said it was a “good concept” and that she liked the idea.

  • Minnesota Offers Low Cost Insurance Program

    Aimed at Individuals Who Earn Too Much For Medicaid

    Feb 2, 2016 By Michelle Andrews

     

    In January, more than 350,000 lower income New Yorkers began paying $20 a month or less for comprehensive health insurance with no deductibles and low copayments, under a federal health law program. Minnesota has similar coverage in place through the same program, with more than 125,000 enrollees.

  • Lack Of Weapons Against Chronic Conditions Killing Whites

    Compounded by Sinking Socioeconomic Status

    Feb 2, 2016 By Lisa Gillespie

     

    Don’t blame suicide and substance abuse entirely for rising death rates among middle-aged white Americans, asserts a new study out last week.

    They’re both factors, but the bigger culprit is almost two decades of stalled progress in fighting leading causes of death — such as heart disease, diabetes and respiratory disease — according to a Commonwealth Fund analysis of data from the federal Centers for Disease Control and Prevention. The fund studied actual and expected death rates, and causes of death, for working-age adults from 1968 through 2014.

  • Kansas Medicaid System Is Fouled Up

    New Computer System Kicks Many Out of Program Without Notice

    Feb 2, 2016 By Andy Marso

     

    Thousands of Kansans seeking Medicaid benefits are being forced to wait months because of continuing problems with a new computer system and a change in the state agency responsible for handling some eligibility determinations.

    The application backlog began to form in July when state officials moved Medicaid eligibility processing to the long-delayed Kansas Eligibility Enforcement System, or KEES. The software switch forced employees to use dozens of time-consuming workarounds to make the system function.

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