Midwest Healthcare News

In Iowa, A Possible Opening On Medicaid Expansion

Branstad's Stance Seems to Soften

May 21, 2013 By Ron Shinkman

Iowa has been among the most steadfast of the states in the Midwest against expanding Medicaid eligibility as part of the Affordable Care Act. But its Republican governor began to signal a softening on that stance this week.

At a Monday press conference, Gov. Terry Branstad indicated he would support Medicaid expansion to those earning as much as 138% of the federal poverty level if the federal government provides some assurances about long-term funding.

Feds Relax ACA Rules On Enrollment

Medicaid Process is to be Streamlined

May 21, 2013 By Phil Galewitz

The Obama administration is making it easier for states to sign up the poor for health coverage – and to help those people stay covered.
Last Friday, it informed state officials that they could simplify enrollment in Medicaid to handle the onslaught of millions of anticipated enrollees next year when the health care law expands coverage. The administration said the changes are geared to states that are expanding their programs, but they may also be adopted by others.

Doctors Invest In Remaking Practices

ACA, Other Factors Pressuring Reforms

May 21, 2013 By Ankita Rao

Thomas Bellavia, M.D., transformed his traditional medical practice in Hasbrouck Heights, N.J., into a so-called medical home where patients are seen by teams of doctors and nurses. He says it has paid off in better, more coordinated care for his patients and healthier income for the nurse practitioners and physicians in his group.
Mark Holthouse, M.D., took a different tack -- limiting his El Dorado, Calif., clinic to 400 patients a year, and adding services such as acupuncture and fitness coaching. He said he and his team now spend more time with patients, who pay a monthly fee of $220 for a package of basic services, on top of what their insurance plans reimburse the practice.

In Brief: Uneven Leapfrog Grades For Midwest Hospitals; Missouri Medicaid Chief Departs Abruptly

May 21, 2013 By Payers & Providers Staff

In Brief: Centene Wins California Medicaid Pact; WellPoint Directors Resign

May 14, 2013 By Payers & Providers Staff

Michigan Still Grappling Over Medicaid Expansion

Latest Proposal Would Impose Lifetime Benefit Cap

May 14, 2013 By Ron Shinkman

The struggles to expand Medicaid under the Affordable Care Act in Michigan are continuing, with Republican lawmakers suggesting that enrollees should receive coverage for only a limited time.

The proposal was put in a bill late last week that would require Michigan to obtain a waiver from the Centers for Medicare and Medicaid Services that would allow a lifetime enrollment cap of 48 months per individual. Children, the disabled and those over the age of 65 would be excluded from the restriction.

Wisconsin Hospitals Curb Most Infection Rates

But C. Diff Continues To Rise

May 14, 2013 By Payers & Providers Staff

Wisconsin's hospitals made significant headway in 2012 reducing infections their patients acquire during treatment, according to a new report released this week.

The report by the Wisconsin Division of Public Health concluded that the state's inpatient facilities had cut the rate of expensive to treat central line infections by 21% compared to 2011. Last year's central line infection rate was also 56% below the national average. Such an infection can often be eliminated entirely if a protocol developed by Johns Hopkins University is followed when inserting a central line.

CMS Delays DSH Cuts In States Blocking Medicaid Expansion

Decision Seen As Needed Relief

May 14, 2013 By Phil Galewitz

That sigh of relief you heard Monday was from hospital administrators in nearly two dozen states, including Michigan, Indiana, Nebraska and others in the Midwest.

That’s because the Obama administration announced that for the next two years, it doesn’t plan to penalize states that have yet to expand Medicaid coverage under the federal health law by targeting them for reduced Medicaid funding, according to a proposed rule unveiled Monday. That money goes to hospitals that treat large numbers of poor people.

In Brief: Minnesota Blues Delays Payment Cuts To Rural Hospitals; Large Majority of Minnesotans Support Big Raise In Tobacco Tax

May 7, 2013 By Payers & Providers Staff

HCA Picks Up Two Hospitals In Kansas City Area

Terms Not Disclosed For Deal With Carondelet

May 7, 2013 By Payers & Providers Staff

Carondelet Health has come to terms to sell two Kansas City-area hospitals and a variety of allied healthcare businesses to an affiliate of HCA Healthcare.
The facilities, 310-bed St. Joseph Medical Center in Kansas City and 146-bed St. Mary's Medical Center Blue Springs, Mo., 20 miles to the southeast. The not-for-profit facilities will be transferred to the for-profit HCA Healthcare Midwest for an undisclosed sum.

Diabetes Coverage For Low-Income Children Differs In Midwest

Ranges From Relatively Generous Coverage to None at All

May 7, 2013 By Ron Shinkman

The Midwest provides a mixed bag in term of which states provide safety net healthcare coverage for children from low-income households suffering from diabetes, according to a new study by the University of Michigan.
For example, Minnesota and Illinois – considered two of the more progressive states in the country in terms of healthcare coverage, do not provide any coverage at all under the Children with with Special Health Care Needs Program, which is funded under the Title V portion of the Social Security Act.

State Spending On Consumer Assistance Likely To Impact ACA Enrollment

States lukewarm on reform reform unlikely to have access to large pool of funds

May 7, 2013 By Phil Galewitz

Florida is on course to spend $6 million to reach out to nearly 4 million uninsured people and help them sign up for coverage in the federal health law’s online marketplace this fall.
Maryland will spend more than four times as much, or about $24.8 million, to help about 730,000 uninsured. The District of Columbia expects to spend about $9 million assisting 42,000 uninsured.

Michigan Voters Support Medicaid Expansion; Ohio Hospital Association Hires Veteran GOP operative

Apr 30, 2013 By Payers & Providers Staff

Trinity, Michigan Blues Collaborate To Change Payment System

Will be Based on Quality of Care

Apr 30, 2013 By Payers & Providers Staff

Trinity Health-Michigan and Blue Cross Blue Shield of Michigan have entered into a collaboration intended to move the former's hospitals away from accepting fee-for-service payments for care.
Under the three-year agreement, Trinity's 12 hospitals will receive payments based on population health-related outcomes. The entities will also collaborate on a “shared” performance management system and work processes that integrate best practices into as many facets of care delivery as possible.

Northwest Memorial Improves Process For Treating Heart Attacks

Focus On STMI 'widowmakers'

Apr 30, 2013 By Ron Shinkman

Northwestern Medicine has reported dramatic gains in the treatment of an ST segment elevation myocardial infarction (STMI) more commonly known as the “widow maker” heart attack.
The Chicago-based healthcare system has reordered its priorities when treating the victims of STMIs at Northwestern Memorial Hospital in order to cut the time between inpatient admission and undergoing a balloon angioplasty. Clinical standard of care guidelines suggest that no more than 90 minutes should pass between admission and angioplasty, but studies suggest cutting the time to 60 minutes or less improves overall outcomes.

Nurses Fighting In Midwest For Minimum Staffing Laws

Bills Pending in Iowa, Minnesota, Michigan

Apr 30, 2013 By David Schultz

So far, only one state has such a law. California's state legislature passed a minimum nurse staffing law in 1999. Since then, similar nurse staffing laws have failed in every other state where they were proposed. But the nursing unions backing the bills have grown increasingly powerful in statehouses across the country.
Hospital administrators are vehemently opposed. They argue the bills would strip them of their ability to make basic staffing decisions and be a financial burden. Many nurses and nursing unions say legislation is needed to prevent cost-conscious hospitals from endangering patients by putting too large of a workload on too few nurses.

Iowa Health System Renamed; Burn Center Expands To Kansas City

Apr 23, 2013 By Payers & Providers Staff

Priority Health Veers Toward Price Transparency

Will Post Prices For Hundreds of Procedures For Enrollees

Apr 23, 2013 By Payers & Providers Staff

In a bid toward greater price transparency in healthcare, Grands Rapids-based Priority Health plans to publish specific healthcare costs and quality data by procedure, hospital and physician.
Officials said the data publication, which will occur in conjunction with the Healthcare Blue Book, is in response to higher costs for consumers. More than 300 different procedures will be priced out and the associated data published, officials said.

Projected Soaring Of Premiums Under ACA Brings Actuaries Under Scrutiny

Their Close Ties to Insurers Draws Curiosity of Lawmakers

Apr 23, 2013 By Jay Hancock

Few aspects of the Affordable Care Act are more critical to its success than affordability, but in recent weeks experts have predicted costs for some health plans could soar next year.
Now health law supporters are pushing back, noting close ties between the actuaries making the forecasts and an insurance industry that has been complaining about taxes and other factors it says will lead to rate shock for consumers.

Chicago Hospital Execs, Docs Face Kickback Charges

Payments For Patient Referrals Allegedly Disguised

Apr 23, 2013 By Ron Shinkman

The two top executives of Sacred Heart Hospital in Chicago and four physicians affiliated with the facility were charged by federal authorities last week to pay and receive kickbacks for referrals of Medicare and Medicaid patients.
Agents with the FBI and the Office of the Inspector General also seized about $2 million in Medicare payments from various bank accounts attached to the 119-bed hospital, which is located on the Windy City's West Side.

In Brief: Kindred Acquires St. Louis Hospital, Cardinal Health, Ohio State Team On Campus Drug Abuse

Apr 16, 2013 By Payers & Providers Staff

Even Under ACA, Some Could Get Hit With Huge Out-Of-Pocket Costs

Obama Administration Exempts Some Plans For 2014

Apr 16, 2013 By Julie Appleby

Some consumers may continue to face out-of-pocket health costs of $12,500 or more next year – double the amount allowed by the health law – because the Obama administration won’t enforce that provision for some plans for another year.
"This is a very important consumer protection that is being undermined," said Stephen Finan, policy director for the American Cancer Society Cancer Action Network. "Someone with a high drug bill could have out-of-pocket costs well in excess of the law."

Physician-Owned Hospitals Rake In Quality Bonuses

But Many Are Accused Of Cherry-Picking Patients

Apr 16, 2013 By Jordan Rau

Doctor-owned hospitals – many of which are in the Midwest – are earning many of the largest bonuses from the federal health law's new quality programs, even as the law halts their growth.
The hospitals, many of which specialize in heart or orthopedic surgeries, have long drawn the ire of federal lawmakers and competitors. They say physicians often direct the best-insured and more lucrative cases to their own facilities, while leaving the most severely ill patients to others.

Missouri Hospitals: Without Medicaid Expansion, Uncompensated Care Will Explode

Costs Will Be Part of "Hidden Tax"

Apr 16, 2013 By Ron Shinkman

The Missouri Hospital Association has cautioned that if the state does not participate in the Medicaid expansion that is part of the Affordable Care Act, the levels of uncompensated care provided by hospitals will nearly triple by the end of the decade.
MHA called the potential rise in uncompensated care a “hidden” tax expected to be borne by many of the Show Me State's 6 million residents through cost-shifting to those with insurance.

Walgreens Expands Retail Clinics To Treat Chronic Conditions

Take Care Will Take on Asthma, Diabetes

Apr 9, 2013 By Julie Appleby

It’s not just sore throats and flu shots anymore. Chicago-based drugstore giant Walgreens has become the first retail store chain to expand its healthcare services to include diagnosing and treating patients for chronic conditions such as asthma, diabetes and high cholesterol.
Walgreens officials say they will have nurse practitioners and physician assistants at more than 300 Take Care Clinics in 18 states and the District of Columbia to do tests and make diagnoses – and also write prescriptions, refer patients for additional tests and help them manage their conditions.

Minneapolis-Area Clinics Form ACO

FUHN Collaborative First Involving Outpatient, Safety Net Providers

Apr 9, 2013 By Payers & Providers Staff

A group of federally-qualified health clinics in the Minneapolis area have banded together to create one of the nation's first accountable care organizations that focuses specifically on outpatients and providing safety net care.
The 10 clinics have formed what is known as the Federally Qualified Health Center Urban Health Network, or FUHN. It has entered into a contract with the Minnesota Department of Human Services to provide care to 22,000 Medicaid enrollees. The clinics provide service at 40 sites across seven counties in the Twin Cities region.

Joint Commission Issues Advisory On Medical Alarms

Contends They're so Commonplace They're Ignored

Apr 9, 2013 By Ron Shinkman

The Joint Commission has issued a warning about too many warnings.
The Oakbrook Terrace, Ill.-based organization that surveys and accredits most of the nation's hospitals alerted its membership on Monday about the dangers posed by an excess of alarms that go off in inpatient settings.

In Brief: Henry Ford Redesigns Patient Gowns; Mental Health Services For Teens Falling Short

Apr 9, 2013 By Payers & Providers Staff

In Brief: Michigan Blues Ordered To Provide Autism Therapy, GERD Medications Overused

Apr 2, 2013 By Payers & Providers Staff

Minnesota Payers Report 2012 Spending Increase

Expenditures Approached $19 Billion

Apr 2, 2013 By Payers & Providers Staff

Payers in spent just under $19 billion last year to provide care to their enrollees in Minnesota, according to a new report.

The data from the Minnesota Council of Health Plans, which represents not-for-profit payers, concluded that spending was up $1.3 billion in 2012 compared to 2011, an uptick of 7% overall. Per person spending rose an average of 5%.

Prime Closes Deal On Two Kansas Hospitals

AG Supports Transaction For Kansas City, Leavenworth Facilities

Apr 2, 2013 By Ron Shinkman

California hospital operator Prime Healthcare Services has acquired two hospitals in Kansas, the company announced this week.
The for-profit Prime closed on the acquisition of 400-bed Providence Medical Center in Kansas City and 80-bed Saint John Hospital in Leavenworth from SCL Health System. Terms of the transaction, which was originally announced in January, were not disclosed.
Kansas Attorney General Derek Schmidt said earlier this week that he would allow the deal to proceed after Prime promised to maintain levels of charity care at the two hospitals for at least the next five years.

Providers Getting Little Pay Based On Quality

New Catalyst Study Shows Little Progress Made

Apr 2, 2013 By Russ Mitchell

For decades, reformers have sought to change how doctors and hospitals are paid to reward quality and efficiency – efforts that accelerated as a result of the health care overhaul. But surprisingly little progress has been made to date, a consortium of large employers has reported.

Only 10.9% of healthcare spending last year by employer-sponsored plans was based on "value," as opposed to “volume,” or the number of services performed, according to the study by Catalyst for Payment Reform, a nonprofit group that represents 21 U.S. employers, including Verizon, Walmart, eBay and Boeing.

In Brief: Cleveland Clinic, CHS Enter Into Alliance; Minnesota Medical Societies Receive ABIM Grants

Mar 26, 2013 By Payers & Providers Staff

Mayo Clinic To Merge Two Rochester Hospitals

Both Will Operate Under Single Name, License

Mar 26, 2013 By Payers & Providers Staff

It's no secret that the two hospitals in Rochester, Minn. – Saint Marys Hospital and Rochester Methodist Hospital – have been under the management of that city's most renown business, the Mayo Clinic.
But the Mayo, which has been on a decade-long campaign to strengthen its brand and positioning in healthcare delivery, has decided to merge the operations of the two facilities under a single license. Beginning in 2014, their campuses will be renamed the Mayo Clinic Hospital – Rochester.

Iowa Senate Approves Medicaid Expansion

But Branstad, House Seem At Odds

Mar 26, 2013 By Ron Shinkman

The Iowa Senate passed a bill on Monday that would expand Medicaid under the auspices of the Affordable Care Act, but Gov. Terry Branstad is still firmly against such a plan.
The Senate passed the bill, SF 296, by a 26-23 mostly party-line vote with overwhelmingly Democratic support. Lawmakers in support of expanding Medicaid spoke at length regarding how not expanding Medicaid would put pressure on hospitals to continue to care for uninsured patients without hope of reimbursement.

Dayton Creates Health Exchange For Minnesota

MNSURE Created With Republican Input, But No Votes

Mar 25, 2013 By Elizabeth Stawicki

Minnesota Gov. Mark Dayton signed into law last week historic and controversial legislation enacting the centerpiece of President Barack Obama's health care overhaul.
The legislation creates a new marketplace for health insurance, which Dayton's administration has given the name, "MNSURE." Starting in October, more than a million Minnesotans, including 300,000 uninsured, are expected to shop and sign up for health plans using the exchange.

Hospital Ratings Are All Over The Map

A Facility on One Top List May Fall Far Short of Making Another's

Mar 19, 2013 By Jordan Rau

How good a hospital is St. Mary Mercy Livonia Hospital in Michigan? Depends on whom you ask.
The Leapfrog Group, a respected nonprofit that promotes patient safety, gave an “A” to St. Mary Mercy. The company Healthgrades named it one of America's best 50 hospitals.
But the Joint Commission and U.S. News and World Report omitted St. Mary from their best hospital lists. Consumer Reports gave it an average safety score of 47 points out of 100, citing high numbers of readmissions, poor communication with patients and excessive use of scans. Medicare, which has a new program rewarding hospitals for meeting certain quality measures, is reducing St. Mary's payments by a fraction this year.

Midwest Home To Hospital "Wastelands"

Professor Charting Facility Closings Back to 1930s

Mar 19, 2013 By Ron Shinkman

A Boston University healthcare economics professor who closely studies healthcare finance has located what he terms “hospital wastelands” in two major cities in the Midwest.
According to Alan Sager, a professor of health policy and management at BU's school of public health and director of its health reform program, both the northern portion of St. Louis and the entire city of Detroit should be considered hospital wastelands because they are virtually devoid of acute care providers. Indeed, the Motor City has just four hospitals for nearly 800,000 inhabitants.

Michigan Medicaid Recipients Report Easier Access To Primary Care

But Individual Enrollees in Commercial Plans Having More Troubles

Mar 19, 2013 By Payers & Providers Staff

A growing number of Michiganders enrolled in Medicaid say they are having an easier time accessing primary care services via the program, while individually insured residents are experiencing the opposite, according to a new survey.
Data compiled by the Center for Healthcare Research & Transformation indicated that 91% of Medicaid recipients said it was relatively easy for them to schedule an appointment with a primary care provider, compared to 74% of those polled in 2010.

In Brief: Northwestern Entities To Merge; Monaghan Wins Preliminary Injunction on Contraceptive Issue

Mar 19, 2013 By Payers & Providers Staff

In Brief: Indiana University Tables Critical Care Tower; Feds Raid Chicago Clinic

Mar 12, 2013 By Payers & Providers Staff

Medicaid Payers Prepare For Reform

Focused on Expanding Care While Eyeing Costs

Mar 12, 2013 By Phil Galewitz

After his back injury kept him out of work last year, Sergio Mera enrolled his family in Medicaid, the state-federal health insurance program for the poor.

These days when they need to see a doctor, the Meras travel less than a mile from their home to a new clinic in a suburban shopping center. “They take good care of you,” said Mera, 37, as he sat in an exam room with his wife and two kids.

Illinois Will Steeply Hike Physician Licensing Fees

First Increase Since 1987 Addresses Deep Budget Cuts on Enforcement

Mar 12, 2013 By Ron Shinkman

Illinois plans to more than double the annual licensing fees it charges physicians in an attempt to strengthen sanctions against bad physicians and speed up the disciplinary process.
Gov. Pat Quinn said he intended to sign the bill, which was passed by the state House of Representatives last week, into law

Minnesota Lawmakers Approve Exchange Bill

Dayton Expected to Sign it Into Law

Mar 12, 2013 By Payers & Providers Staff

Minnesota lawmakers have signed off on a law to create a state-run health insurance exchange that is expected to accept its first enrollees in October and provide insurance coverage to as many as 1.3 million state residents beginning in January 2014.
The Senate passed the bill last Thursday on a 37-28 vote, mostly along party lines split between Republicans, which opposed the bill, and Democratic Farmer Laborers, which is Minnesota's Democratic party. Lawmakers in the House approved it the prior Monday, also mostly along party lines. Gov. Mark Dayton, a Democrat, is expected to sign the bill into law.

In Brief: Few Participate In Medical Research; CORE Institute Joint Ventures With Porretta

Mar 5, 2013 By Payers & Providers Staff

Illinois Moving Closer To Medicaid Expansion

But Nebraska Lawmakers Will Have Tougher Time

Mar 4, 2013 By Payers & Providers Staff

The Illinois Senate has passed along party lines a bill to expand Medicaid coverage under the auspices of the Patient Protection and Affordable Care Act, while redder Midwest states such as Nebraska continue to struggle with the issue.
The Illinois Senate passed the bill by a 40-19 margin earlier this week. All 40 supporters were Democrats, while the 19 naysayers were Republicans. The bill has gone to the Illinois House of Representatives, which given its Democratic majority, is expected to pass it.

Aon Hewitt Says Most Employers Will Keep Coverage In Place

But More Employees Will Be Asked To Improve Their Health

Mar 5, 2013 By Payers & Providers Staff

Despite skyrocketing costs for both businesses and their employees to maintain healthcare insurance coverage, both parties are expected to shell out ever-increasing amounts to keep it in place, according to a new survey by Illinois-based employee benefits consulting firm Aon Hewitt.

OhioHealth CEO Discusses Impact of Sequestration

Blom Says Blow Relatively Mild, But Worried About Future Cuts

Mar 5, 2013 By Mary Agnes Carey

David P. Blom is one of thousands of hospital executives across the country who are bracing for a reduction in Medicare payments as part of a series of federal spending cuts that began last week. Blom, 58, is president and chief executive officer of OhioHealth, a Columbus, Ohio, based not-for-profit healthcare system that includes 18 hospitals, 23 health and surgery centers, home-health providers and other facilities.

In Brief: Iowa Won't Expand Medicaid; Michigan Blues Bill Progresses

Feb 25, 2013 By By Payers & Providers Staff

Truven Names Top U.S. Hospitals

Midwest Facilities Dominate Among Major Teaching Facilities

Feb 26, 2013 By By Payers & Providers Staff

Ann Arbor, Mich.-based Truven Analytics has released its list of the top 100 hospitals in the United States, with the majority of the large teaching facilities based in the Midwest.
The list, formerly known as the Thomson Reuters Top 100 Hospitals in America, included 32 hospitals in the Midwest.

Hospitals Clamp Down On Dangerous Early Elective Deliveries

Leapfrog Group Pushing For Their Reduction

Feb 26, 2013 By By Phil Galewitz

For decades, doctors have been warned about the dangers of delivering babies early without a medical reason. But the practice remained stubbornly persistent.
Now, with pressure on doctors and hospitals from the federal government, private and public insurers and patient advocacy groups, the rate of elective deliveries before 39 weeks is dropping significantly, according to latest hospital survey from The Leapfrog Group, a coalition of some of the nation's largest corporations that buy health benefits for their employees.

Kansas Hospitals Pushing Medicaid Expansion Hard

Releases Economic Impact Report, Opinion Poll

Feb 26, 2013 By By Ron Shinkman

Expanding the Medicaid program in Kansas as part of the Patient Protection and Affordable Care Act could prove a boon to the Sunflower State, creating thousands of jobs and saving taxpayers tens of millions of dollars a year, according to a new report.

The report, released last week by the Kansas Hospital Association, comes at a critical juncture for states still on the fence as to whether to expand their Medicaid programs under the relaxed income cutoffs that are part of the ACA.