Reporter roundup

Elana Gordon of KCUR in Kansas City has inquired about hospital workforce statistics. She's working on background for Gov. Jay Nixon's visit to UMKC to promote health education funding.

Alan Bavley of The Kansas City Star has requested (and will receive) Kansas City Area 1st Quarter utilization data for 2008 and 2009 today. An E-Lert to MHA KCMHC members will precede the delivery of the data.

Workforce data available

The Missouri Hospital Association has posted the 2009 MHA Workforce Survey on MHAnet. This year's report contains similar data as prior years, however the format is revised for ease of use. MHAnet also provides a quick link button on the Web site's front page.

Disciplining docs

Public Citizen has released a report critical of the nation's hospitals practices on physician discipline. Missouri has 140 hospitals registered with the National Practitioner Data Bank of which 70 have never filed a disciplinary report. ABC News covered the story yesterday.

Community benefit

The Springfield Business Journal has a fine article about the contributions of the areas hospitals and health systems to the economy and quality of life in Springfield. The statewide hospital community benefit and economic impact report from the Missouri Hospital Association should be available within the next several weeks. Hospital executives will be notified before MHA posts the data.

Updated: Consumer's Union report pending

The American Hospital Association has word that Consumer's Union is pitching a new report on patient safety to reporters. The study is timed to reflect the 10th anniversary of the Institute of Medicine's "To Err is Human" Report. Talking points are here.

Missourian dies of H1N1

St. Louis public health officials have announced that a St. Louis County man has died from H1N1 Influenza A. The announcement marks the first H1N1 related death in the state.

Hammering away

The St. Louis Post-Dispatch editorializes today on the failure of the hospital-sponsored coverage initiative. From the editorial:

"Mr. Nixon should call the lawmakers back into session. Show them big charts with easy-to-understand numbers. Make it clear that by failing to address the problem of the uninsured in Missouri, lawmakers have made a miserable situation even worse."

Billing and collections

There were two stories about hospital collections policies in the St. Joseph News-Press this morning. Just in case, here are the links to MHA's talking points on billing and collections and hospital charges.

Kuhn named MHA President

Herb Kuhn has been selected to lead Missouri Hospital Association. He will assume the position of president and chief executive officer in September.

Study: Specialty hospitals and competition

The Center for Studying Health System Change has released a report on competition between safety-net, general hospitals and specialty hospitals. HealthLeaders is covering the report here. Interestingly, none the three markets studied -- Indianapolis, Little Rock, Ark., and Phoenix -- operate under a Certificate of Need law.

The HealthLeaders report doesn't do justice to the report as a whole. I'd recommend reading the actual report.

A few interesting tidbits:

Safety net hospitals reported little impact on service volume because of the presence of specialty hospitals, since safety net hospitals generally do not compete intensely for patients with private insurance or Medicare. According to one safety net hospital respondent, “Our competitors don’t want us to fail…they don’t want us to compete, but don’t want us to go away because then they’d have to deal with our patients.”

...

Broader market changes and the worsening economic recession—characterized by job loss, increased number of uninsured, more difficult debt financing, reduced or stagnant reimbursement by private payers—likely will adversely affect specialty hospitals as well. Specialty hospitals burgeoned in times of relative economic prosperity. How specialty hospitals in the three communities will cope with a shrinking base of privately insured patients and reductions in elective procedures already reported by hospitals around the country remains to be seen.

Rage, rage against the dying of the light

Sorry for the Dylan Thomas.

It's the last day of the 2009 session of the Missouri General Assembly and health insurance expansion (funded entirely by Missouri's hospitals) remains incomplete. Barb Shelly has a cogent commentary on the state of the legislation in today's edition of The Kansas City Star.

U.S. House to move on reform

U.S. House Speaker Nancy Pelosi has pledged to bring health reform legislation to the floor of the House by July 31. According to media accounts, President Obama stated that "the stars are aligned" to pass health care reform this year.

Coverage on coverage

Today's St. Louis Post-Dispatch has both an editorial and a op-ed supporting expanded health insurance coverage using hospital FRA and DSH funds.

Policy and ideology

The Missouri General Assembly continue to debate the plan for expanding health care access to the working poor. Here's a sampling of the rhetoric.

Rep. Doug Ervin: "There's some who advocate that we should just do a straight Medicaid expansion. I'm not in that camp," Ervin said. "There are others who advocate that we should take a free-market approach and cover those healthy adults, able-bodied adults. I'm still not buying that."

Rep. Mary Still: "This plan does very little to help hard-working, but low paid folks afford insurance," Still stated during House floor debate."

Thanks to Brent Martin of the Missourinet for the great coverage.

State insurance commissioners weigh in on reform

On May 5, Kansas Insurance Commissioner Sandy Praeger testified before a U.S. Senate Finance Committee panel on expanding health insurance coverage. According to news reports, Praeger, who spoke as a representative of the National Association of Insurance Commissioners, believes cost control and a strong relationship with state regulators areessential elements of health care reform.

"Health insurance reform will not solve this problem since insurance is primarily a method of financing health care costs," said Praeger. "Whatever is done in insurance reform should be done in a manner that is consistent with sound cost control practices.

"As members of this committee know all too well, the preemption of state oversight of private Medicare plans has led to fraudulent and abusive marketing practices that would have been prevented under state law, bringing considerable harm to thousands of seniors," she said.

What we meant to say...

According to the American Hospital Association, early news reports on yesterday's meeting with President Obama to discuss health reform were inaccurate.

From AHA News:

"Early news reports that the AHA and five other national health care organizations pledged to reduce health care spending by 1.5 percentage points annually over the next 10 years were inaccurate. The group actually committed to helping achieve the administration's goal of a 1.5 percentage point reduction over the span of 10 years. AHA President and CEO Rich Umbdenstock noted that the $2 trillion in savings is a general estimate and can be achieved in multiple ways and across all sectors, public and private. Saying blunt cuts are not reform, he called on the administration to knock down the regulatory and legislative barriers that impede hospitals and physicians from working together to improve care for patients."

Lede poll: Flu coverage

The results of the online poll are in. Sixty percent of those surveyed believe that coverage of the H1N1 outbreak has been about right, while 40 percent think that coverage has been excessive. Incredible how a week can change things. There is a remarkable absence of coverage in this week's news.

Thanks for participating. More polls will follow.

Health leaders at the White House

Today, leaders from six advocacy groups met with President Obama to discuss a proposal to reduce health spending by $2 trillion dollars throughout the next 10 years. The White House issued a news release, "Coming together to bring down the cost of health care," following the event. From the release:

"These are important steps toward comprehensive health care reform both for the savings identified and the improvements these efforts will make to health care delivery in our country. Moreover, if groups as disparate as - AHIP, AMA, AHA, PhRMA, SEIU, and AdvaMed - can come together around the cause of cost-cutting and greater affordability, the possibility for fundamental reform in the weeks ahead is great."

Reporter roundup

Tom McClain of Columbia's KOMU TV-8 is working on a story on health care reform.

Wally Kennedy of The Joplin Globe is following President Obama's meeting with advocates from the health community. It is unclear whether a story is pending.

Hospital Week!

May 10 - 16 is National Hospital Week. Thank you for all you do for your communities.

On good omens

Nobel laureate economist and liberal columnist Paul Krugman calls the health-provider community's interest in working with the administration to save $2 trillion in health spending throughout the next decade, "the best policy news I've heard in a long time."

Weekend coverage initiative news roundup

The Kansas City Star and St. Louis Post-Dispatch both editorialized this weekend on the hospital funded health care expansion being discussed by the Missouri General Assembly. The Springfield News-Leader also covered the bill's progress and the political climate surrounding health insurance expansion.

Updated: Reporter roundup

Barbara Shelly of The Kansas City Star is working on an editorial related to the legislature's actions on House Bill 11. Here's her earlier commentary.

Mike Sherry of the Kansas City Business Journal is working on two stories. He has requested (and I have provided) information related to the surge in ER visits during the H1N1 outbreak. He is also investigating whether hospitals are finding compliance with the Federal Trade Commission's Red Flag Rules onerous.

World views

Today's St. Joseph News Press coverage of the Missouri General Assembly's debate over the state's 2010 budget exposes the very different world view of members of the House and Senate.

From the article:

Sen. Charlie Shields:

“This body has long believed that health care for Missourians is a good thing,” said Mr. Shields, who also is a chief marketing/communications officer for Heartland Regional Medical Center. “Anything we can do to bring 700,000 (uninsured) Missourians into health care is a good thing.”

Rep. Rob Schaaf:

“I think people are sick and tired of working harder and harder ... knowing their money is going to other people who could be taking care of themselves,” said Rep. Dr. Rob Schaaf, a St. Joseph Republican and member of the House budget committee. Calling it a large windfall for hospitals, he voted against a budget bill that included the proposal on Wednesday.

And in summary...

Barb Shelly, columnist at The Kansas City Star, hammers the Missouri House on the rejection of House Bill 11 here.

Coverage alive, contingent on SB 306

The Missouri House initially rejected House Bill 11, the appropriation for the Department of Social Services. However, upon return to conference an agreement has been reached to link the funding from HB 11 to passage of SB 306 -- a proposal similar to last year's Insure Missouri initiative. Tomorrow is the constitutional deadline for adoption of appropriation bills. Action on the revised HB 11 is likely today to meet the deadline.

Reactions to the defeat include the following.

GOVERNOR NIXON: "By voting today against providing health care to 35,000 Missourians at no extra cost to the state, House Republicans rejected a plan that would have pumped $145 million in new money into our economy at no cost to taxpayers. While this proposal to spur economic growth through health care expansion enjoyed broad bipartisan support in the Missouri Senate, the Missouri House let flawed ideology stand in the way of progress. House Republicans should explain to Missourians immediately why they allowed politics to interfere with our state’s opportunity to make health care more affordable and accessible."

MINORITY LEADER LEVOTA: "The ridiculousness of the House Republican position is exceeded only by its cruelty."

AMY BLOUIN, MO. BUDGET PROJECT: "In the case of this bill, our legislators decided that health care coverage for struggling Missouri moms and dads was not even worth doing for free."

AHRQ disparities report published

The Agency for Healthcare Research and Quality has released its 2008 report on the nation's health care quality and disparities. In its sixth year, the reports measures trends in effectiveness of care, patient safety, timeliness of care, patient centeredness and efficiency of care.

Health Data Management reports, "Patient safety measures have worsened and substantial disparities in health care treatment persist, according to two reports the U.S. Department of Health and Human Services has released. "

Kaiser: Are hospitals prepared for a pandemic?

National Public Radio is carrying a blog post from Kaiser Health News, "U.S. Hospitals Would Be Hard Pressed If Swine Flu Surges" on their Web site. The headline sums up the content. A good read in any case.

Legislative burnout

Yesterday, the Missouri General Assembly approved a bill requiring all cigarettes sold in the state be self extinguishing, beginning in 2011. The bill now moves to Gov. Jay Nixon. According to reports, the National Fire Protection Administration estimates that between 700 and 900 individuals die annually in cigarette-related house fires.

Medicaid expansion remains in limbo

Missouri House budget leaders are unclear about the future of HB 11. The bill provides the fiscal year 2010 appropriation for the Missouri Department of Social Services. Hospitals' funding of health insurance expansion is at the center of the debate. The House and Senate conference committee included funding to expand Medicaid or other state-sponsored health insurance in the bill. However, the measure remains controversial.

Failure to adopt the budget by the constitutional deadline of Friday could lead to a special legislative session to craft a new bill.

Health IT nightmare

HealthLeaders is reporting that a hacker has stolen 8 million patient records and 35.5 million prescription records from the Virginia Prescription Monitoring Program and is holding them hostage. The hacker has demanded $10 million for their release.

Reporter roundup

Mike Sherry of the Kansas City Business Journal is developing a story about hospitals' purchases of protective gear related to H1N1.

Kudos to SSM

Congratulations to Sr. Mary Jean Ryan, president and chief executive officer of SSM Health Care for receiving the C. Jackson Grayson Distinguished Quality Pioneer Medal from the American Productivity & Quality Center.

Congratulations to St. Mary's Health Center in Jefferson City for being recognized by the Commonwealth Fund as the 10th in the nation for quality (of 4,400 hospitals).

Updated: General Assembly to adopt insurance expansion

The Kansas City Star reports that state budget makers have agreed to fund health insurance expansion based on an increase in Federal Reimbursement Allowance and disproportionate share hospital fund reallocation.

Update: According to news reports, the House Republican caucus may contain as many as 35 members who are opposed to the expansion. From today's edition of The Kansas City Star:

“There are a number of members in the House Republican caucus who do not like the idea,” said House Budget Chairman Allen Icet, a St. Louis County Republican. “Where it goes, I don’t know.”

Rep. David Sater, a Cassville Republican, suggested that 25 to 35 Republicans might oppose the expansion.

The Republican opposition could present a difficult choice for Democrats. The party in recent years has opposed the budget bills for social services, arguing they don’t do enough to help the needy.

“The problem we’ve got is some Republicans think it’s too much and some Democrats think it’s not enough,” said Rep. Chris Kelly, a Columbia Democrat and the minority’s ranking budget member.

HHS reports on rural health access

The U.S. Department of Health and Human Services has issued a report on the status of rural health care. According to the research, rural Americans pay significantly more for health care that is tougher to find and less specialized than for citizens in urban areas. Moreover, the nation's economic situation is exacerbating the disparities.

Inconceivable

The Kansas City Star finds it nearly "inconceivable" that the Missouri General Assembly has not embraced the health insurance expansion proposal funded by Missouri's hospitals.

From the Star:

"A proposal that would enable an additional 35,000 adults to qualify for state-subsidized health insurance is still in limbo. Under the proposal, state hospitals would pay the state an extra $52.5 million a year. With that money, Missouri would qualify for an additional $93 million in federal funds for health care.

The agreement, which Gov. Jay Nixon worked out with the Missouri Hospital Association, would grant health-care coverage to more low-income Missourians without spending money from the general fund. It’s nearly inconceivable that legislators have taken so long to embrace this stellar opportunity."

Study: Family health spending increasing

A new report from Families USA finds that more than 1.3 million Missourians are in families that will spend more than 10 percent of their income on health care in 2009. According to the report:

• 1,277,000 non-elderly Missourians are in families that will spend more than 10 percent of their pre-tax income on health care in 2009.

• Between 2000 and 2009, the number of people in families spending more than 10 percent of their pre-tax income on health care will have increased by 433,000, or 51.3 percent.

• Nearly nine out of 10 people (86.1 percent) in families spending more than 10 percent of their pre-tax income on health care are insured.

• 1,100,000 non-elderly Missourians with insurance are in families that will spend more than 10 percent of their pre-tax income on health care in 2009.

CDC confirms Platte County H1N1

A new post on the the Kansas City Business Journal Web site reports that the Centers for Disease Control and Prevention has confirmed a suspected case of H1N1 influenza in Platte County, Mo.

Updated: Pig out?

The World Health Organization and the Centers for Disease Control and Prevention have shunned their earlier porcine proclivities and recast the current influenza outbreak "H1N1." Researchers disagree. As a health care flack it is clear to me that experts have left us with a linguistic pig in a poke. (Sorry.)

The New York Times has additional international coverage of the naming convention controversy.