Hospital employees and families on Medicaid

The St. Louis Post-Dispatch has an editorial this morning (11/2) about Missouri's large employers that have employees receiving Medicaid coverage. It does not distinguish between traditional medicaid and S-CHIP. The editorial is here. Hospitals are listed -- although not individually -- in the editorial.

Inside Connection - moving forward

MHA's Inside Connection newsletter has been discontinued in print form. However, we will continue to move forward with "Around the Districts" on MHAnet. Information on how to participate will be forthcoming.

Please submit information about developments at your hospital to news@mail.mhanet.com.

Reporter roundup

A reporter from the Springfield News-Leader has inquired about hospital visitation policies related to H1N1. Note: No specific guidance has been offered by the Missouri Department of Health and Senior Services or the Centers for Disease Control and Prevention on hospital visitation policy changes.

Robert Joiner from the St. Louis Beacon is interested in historical hospital closures in north St. Louis City and north county.

Medicaid in the news

The Missouri Department of Social Services has issued a report listing the state's employers whose workers receive Medicaid. Warning: Some Missouri hospitals are on the list.

The media has not, as of this posting, discussed hospitals inclusion on the list. Any media inquiries will be posted on the Lede.

Kudos

A round of applause for St. Mary's Health Center in Jefferson City for receiving a 2009 Missouri Quality Award.

Update: "To Err Is Human" packet

The Missouri Hospital Association will be e-mailing a media packet today to prepare hospitals for inquiries about the 10th anniversary of the Institute of Medicine's 1999 groundbreaking report on medical errors. If you do not receive the materials, please contact the flack at ddillon@mail.mhanet.com. We also will be pitching an op-ed from MHA, the Missouri Center for Patient Safety, the Missouri State Medical Association and Primaris to Missouri's major daily newspapers.

Update: The St. Louis Post-Dispatch and the St. Joseph News-Press have published the op-ed.

Visitation policies

Association PR folks around the country are buzzing about hospitals' revised visitation policies related to nH1N1 Influenza. If your hospital has adjusted its policy, e-mail the flack with information about the changes.

Evans, Hailstone elected to MHA Board

Ballots for the election of trustees in Missouri Hospital Association Districts 1 and 4 were counted on September 16. Myra L. Evans, administrator of Community Hospital - Fairfax, was elected from District 1, and Sherlyn A. Hailstone, president of SSM Cardinal Glennon Children’s Medical Center in St. Louis, was elected from District 4. The three-year terms of these trustees will begin January 1, 2010.

Two at-large trustee elections, along with the election of MHA’s 2010 chair-elect, will take place during the association’s annual business meeting Wednesday, November 4 at Tan‑Tar‑A Resort in Osage Beach.

Congratulations Tess

Tess Niehaus has been named president elect of the Society for Healthcare Strategy & Market Development, the nation's premier organization for health care planners, marketers and communications and public relations professionals. SHSMD is an American Hospital Association affiliated organization.

EMR usage

Mike Sherry of the Kansas City Business Journal has inquired about hospitals' use of electronic medical records technologies. Specifically he is interested in critical access hospital adoption rates. Apparently he also is interested in physician adoption rates.

MHAnet revised and improved

MHA has enhanced its Web site, MHAnet, to improve its aesthetics and functionality. If you are an infrequent visitor, you should click over to take a look.

Herb Kuhn, new MHA President

Herb Kuhn has officially hit the ground as MHA President and CEO. His first day was Sept. 1. He will be very busy getting to know Missouri's hospital leaders in the coming months. If you see him at your hospital, give him a warm hello.

nH1N1 talking points, information available

MHA has posted general talking points on nH1N1 Influenza here. Additional resources from the Centers for Disease Control and Prevention and the Missouri Department of Health and Senior Services are available on MHAnet.

The Flack is back, Jack

I've been on a brief sabbatical. Now the flack returns with a vengeance.

Medical errors in the news

The Hearst chain of newspapers is syndicating a story about medical errors. The link to the story in the Houston Chronicle is here.

Consumer Reports to rate hospitals

Consumer Reports Health has launched a patient satisfaction based hospital rating interface on their Web site. The new system will add Consumer Reports' familiar quality scoring system to hospitals' HCAHPS scores. Hospitals should understand that this is not new data. CR is simply repackaging the federal HCAHPS data.

Hospital IT news

David Lieb of the Associated Press has penned an article on the federal economic stimulus for rural hospitals' health information technology adoption. Sac Osage Hospital in Osceola is featured.

Bluford in line for 2011 AHA chair

Congratulations John.

From AHA News:

The AHA Board of Trustees has elected as its chair-elect designate John Bluford, president and CEO of Truman Medical Centers in Kansas City, MO. Bluford will assume the chairmanship in 2011 and become chairman-elect on Jan. 1, 2010. "Hospitals support extending coverage to millions of Americans while keeping hospitals strong to fulfill their mission of caring for communities," Bluford said. "It is an honor to be chosen to represent my colleagues in the field at this critical juncture in our nation's history. A special area of focus for me will be finding ways to create a culture of wellness among health care employees that hopefully will extend into the communities they serve."

News of the obvious?

The Institute on Aging, in conjunction with the U.S. Census Bureau has released a study indicating... wait for it... the world's population is aging quickly.

From the authors:

“Aging is affecting every country in every part of the world,” said Richard Suzman, director of NIA’s Division of Behavioral and Social Research. “While there are important differences between developed and developing countries, global aging is changing the social and economic nature of the planet and presenting difficult challenges. The fact that, within 10 years, for the first time in human history there will be more people aged 65 and older than children under 5 in the world underlines the extent of this change.”

RWJF: Consumer trends released

According to a new study from the Robert Wood Johnson Foundation, consumer's confidence in the health care system improved in June. The foundation indicated in its news release that the progress on federal health reform legislation may be driving an increase in positive feelings about the future of health care. The research found also:

• Americans believe health reform is an important part of addressing the nation’s economic crisis. More than 8 in 10 people (84.7%) believe that it is important for President Obama to reform the health care system as a step in solving the nation’s economic woes.
• People are worried about being able to afford future care. More than four in 10 of all Americans (43.3%) are worried that they will not be able to pay for their future health care needs in the event of a serious illness. Additionally, nearly four in 10 (39.8%) are worried that they will not be able to afford all of the routine health care services they need (39.8%).
• Americans are afraid of losing their insurance in the coming year. Nearly one in four currently insured adults (23.3%) fear losing their health insurance at some point in the next 12 months.
• Americans are having trouble paying their medical bills. One in four people (25.8%) report having had trouble paying medical bills during the past year.
• People are worried that medical bills will lead to bankruptcy. Nearly a quarter (22.9%) report being worried that they will go bankrupt from not being able to pay their medical bills.

Missouri's uninsured

Families USA has released a report on the increase in the number of the uninsured state-by-state. The Kansas City Star has coverage of the report in this morning's edition.

Crisis media training

The Missouri State Emergency Management Agency has announced a training session for communications professionals related to public information operations in terrorist and weapons of mass destruction incidents. Hospital staff interested in attending the session, which will be held in Springfield, Mo., on October 27-28, should contact June Simonton at 573/526-9121.

Health care rationing

Rationing is one of the most heated points of discussion in the health reform debate. The New York Times has an interesting perspective on health care rationing in today's edition.

U.S. News top hospitals listing out

U.S. News & World Report has published its list of America's Best Hospitals. St. Louis' Barnes-Jewish Hospital ranks 9th nationally, a gain from its 12th place listing last year.

Update: Hospital Compare

The American Hospital Association is now indicating that the CMS' update to its Hospital Compare Web site will now occur on Thursday, July 9, rather than tomorrow July 8th.

$155 billion deal?

According to an article in today's edition of The Washington Post, hospitals have reached a deal with Congress and the White House to contribute $155 billion throughout 10 years to help provide coverage for the nation's uninsured. The deal was struck last night. The American Hospital Association has yet to release a public comment.

Uninsured by choice

A new survey from the Employment Policies Institute finds that many of the nation's uninsured have chosen to decline coverage. Young, single and higher income individuals are disproportionately represented among those declining insurance. Others spurn coverage due to the lack of inclusion of alternative or religion-based therapies in traditional health plans.

Hospital Compare update

The American Hospital Association is indicating that the Centers for Medicare & Medicaid Services will be updating data on their Hospital Compare Web site on Wednesday, July 8. According to AHA, the USA TODAY has received an advance copy of the data and other Gannett newspapers may have access as well. The USA Today has contacted hospitals outside of Missouri about their data, however there are currently no reports from Missouri hospitals of media contact.

Talking points on prior Hospital Compare updates are available on MHAnet.

AHA has issued a Quality Advisory related to the data.

More information will follow as the date approaches.

Reporter roundup

David Lieb of the Associated Press is working on a story about health care information technology. His deadline was unclear and he appears to be seeking more information and may contact hospitals.

Mike Sherry of the Kansas City Business Journal has requested information about changes to the 2009 IRS form 990 schedule H.

Alyson Raletz of the St. Joseph News-Press called to identify MHA's position on the 34th Senate District race (St. Joseph area). Specifically she was interested in MHA's support or opposition to Rep. Rob Schaaf's candidacy.

Ad section

The St. Louis Post-Dispatch is developing a health care recruiting advertising section for mid-July. Hospitals interested in spotlighting a member of their staff as a feature article for the section should send a note to ddillon@mail.mhanet.com.

Regional variations in utilization

Alan Bavley of The Kansas City Star is making inquiries regarding a recent article from The New Yorker on health reform and health care utilization. The story uses a town in Texas as an example of the type of variation in care that Dartmouth researchers have studied throughout the last decade. MHA has talking points on the Dartmouth Atlas here.

Community benefit coverage

Yesterday's release of statewide community investment information was covered in both the St. Louis Business Journal and Kansas City Business Journal.

WHO: Pandemic

The World Health Organization has officially declared the H1N1 outbreak a pandemic.

Pitch perfect

Kansas City's entertainment-focused weekly newspaper, The Pitch, has a great review of the legislative maneuvering from this session's health care coverage debates.

Significant disparities

A new report from the U.S. Department of Health and Human Services found that 40 percent of low-income Americans have no health insurance. In contrast, only six percent of high-income Americans lack health insurance.

According to coverage in The Washington Post:

"Approximately one-third of the uninsured have a chronic disease and they are six times less likely to receive health-care services than those with insurance"

Updated: Look for the data...

The 2009 Community Investment Report from MHA will be available tomorrow at noon (6/10). A link to talking points will be posted when they are finalized. An E-Lert should be out by close of business today. A copy of the news release will be sent to hospital PR and Marketing staff prior to release to the media.

Talking points are here.

Community benefit

Keep this in the back of you mind when discussing charity care and bad debt -- especially in light of the study on medical bill related bankruptcy. In 2007, Missouri hospitals were given authority by the legislature to garnish tax refunds of patients with hospital debt. We didn't.

A busy week

The Missouri Hospital Association's 2009 Leadership Forum begins Wednesday in Branson, Mo. The Excellence in Governance Awards will be announced on Thursday for outstanding hospital trustees.

Later in the week -- most likely Wednesday -- MHA's annual Community Investment Report will be posted to www.focusonhospitals.com. Talking points will precede the announcement.

Update: Bankruptcy report

According to an online report from the American Journal of Medicine, medical bills -- plus related problems such as lost wages for the ill and their caregivers -- contributed to 62 percent of all bankruptcies filed in 2007. The rate is an increase from 55 percent in 2001.

While the rate increase is important, arguably more important is the fact that the majority of those filing for bankruptcy due to medical expenses were middle class, college educated and owned their home. In addition, 78 percent had health insurance.

Talking points on hospitals' billing and collection practices and hospital charges can be found here.

The St. Louis Post-Dispatch editorialized on the report over the weekend.

Report cards

Tomorrow, HealthGrades will announce their Outstanding Patient Experience Awards. The awards are based on ranking in the top 15 percent of hospitals submitting HCAHPS scores. The link will be provided when available. MHA's HCAHPS talking points from the Hospital Compare roll out are here.

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.

H1N1 here?

According to multiple sources, a probable case of H1N1 has been identified in Platte County, Missouri. Platte County is immediately north of Jackson County -- which includes the Kansas City metropolitan area. The St. Louis Post-Dispatch editorialized this morning on the swine flu outbreak in an attempt to calm fears of widespread and deadly pandemic. However, as several of my colleagues have pointed out, using Keynes' quote, "In the long run, we're all dead" was a cute, but probably counterproductive sub headline.

Reporter roundup

Mike Sherry of the Kansas City Business Journal is sniffing around about nurse organizing in the wake of the decertification at Centerpoint Medical Center in Independence. He wrote a short piece on the decertification on Monday.

AHA meeting news summary

The Hill provides coverage of the American Hospital Association meeting.

H1N1 in Illinois

The AP now reports that nine probable cases of swine flu have been logged in northern Illinois.

Uninsured admissions down?

According to an article in today's edition of The Tennessean, several health systems are reporting uninsured admissions as either stable or in decline in the first quarter.

Updated: DHSS all-hazard communication plan

The Missouri Department of Health and Senior Services' all-hazards communication plan contains a valuable annex on public communication. Hospital public relations executives should review the DHSS document to understand the scope of the department's role in communicating in the event the current outbreak is upgraded to a pandemic.

The Missouri Department of Mental Health also has disaster communications resources available.

Nixon traveling on health care

This Friday, Gov. Jay Nixon is scheduled to visit Heartland Health in St. Joseph to discuss the Next Generation Jobs initiative and Children's Mercy Hospitals and Clinics in Kansas City to promote autism funding.

For word nerds

Today's St. Louis Post-Dispatch has a wonderful feature article on the city's response to the 1918-1919 "Spanish Flu" pandemic.

Emancipation Proclamation

Rep. Rob Schaaf, R-St. Joseph, has apologized for linking efforts to expand government health care programs for children to slavery. After a heated committee hearing, the House ethics panel rejected a remonstrance resolution scolding Schaaf for his floor speech connecting the two issues. Schaaf's apology, delivered on the House floor, offered in expanation he had intended his words to be linked to the concept of economic slavery rather than the nation's historical connection to African slavery.

Swine flu resources

MHA has posted links to state, federal and international resources on their Web site. Updates will be sent through EMSystem as well.

Bandwidth hog

A Blog post yesterday at TechCrunch highlights the growing use of Web technologies to research and communicate information about the swine flu outbreak.

Updated: Hospitals' financial health

The American Hospital Association has released data on the health of the nations' hospitals. A news release has been sent to national health reporters; however, media coverage was minimal over the weekend.

The findings include a continuation of tight credit markets, reduced hospital capital expenditures and increasing pressure on the existing hospital workforce.

Upping the ante

Several recent articles, including today's commentary from Barb Shelly at The Kansas City Star, point to increased use of ADHD drugs by college students to improve their academic performance and cope with fast paced lifestyles. A much more in depth look at the problem is available in The New Yorker.

Microsoft on health IT spending

Peter Neupert, corporate vice-president in Microsoft's Health Solutions Group, believes the federal government's health IT spending plan has the objectives backwards. According to a commentary piece in Forbes, Neupert argues that federal spending should focus on addressing the high costs of chronic illness with IT investments targeted to support that effort.

Neupert:

"Given that 75% of health care costs stem from six chronic diseases, I'd argue that we should focus on preventing and managing these conditions, and then figure out the right technologies to support those goals. This type of focus on specific goals will enable us to deliver better care at lower costs to the whole system and get a real return on investment for health IT"

Also in Forbes, two partners at the Boston Consulting Group make the case for federal investment in health IT.

Insurers feeling recession pain

WellPoint Inc., the nation's largest health insurer, has announced a 1.3 percent drop in first quarter income and a loss of 500,000 members since December. According to reports (WSJ, subscription required), WellPoint had expected a loss in membership, but was surprised by the loss of 325,000 members due to layoffs or discontinuance of employer-sponsored plans.

UK researchers study organ donation

The timing of the request and makeup of the personnel approaching the family are important considerations in successful organ donation efforts according to researchers in the United Kingdom.

MHA's winter edition of Inside Connection contained an update on Missouri's organ and tissue donation law.

NYT - Pricing commentary

Today's edition of The New York Times has and interesting commentary on hospital pricing and billing.

Survey: 1 in 5 delay care

A new survey from Thomson Reuters finds the poor economy has led 1 in 5 Americans to delay or postpone medical care. Researchers correlate the reduction in patients seeking care with decreasing rates of employer-sponsored health insurance.

AG Koster requests billing data

Missouri Attorney General Chris Koster has requested billing data from several hospital systems. According to the request for information, his office is conducting a preliminary investigation into whether hospitals are engaged in pricing and billing conduct that may violate the Missouri Merchandising Practices Act.

Hospitals receiving a reguest should contact MHA's General Counsel, Jerry Sill.

Medicare narrows health disparities

A new report published in the Annals of Internal Medicine finds universal health coverage in the form of Medicare eligibility narrowed the health gaps between Americans of different races, ethnicities and education levels.

Haynes in Top 25

MHA board member and former board chair Crystal Haynes has been named one of the Top 25 Women in Health Care in 2009 by Modern Healthcare. Haynes is the chief executive officer of Saint Louis University Hospital.

Hospital advocacy update

The Missouri Hospital Association mailed 75,000 newsletters to self-identified grass roots supporters of hospitals last week. MHA also launched a revised version of the MyHealthCareMatters.org Web site in conjunction with the mailing. The new site has updated graphics and exclusive content.

Mid afternoon reflection

Stanley Fish, columnist at The New York Times, penned a wonderful reflection on the art of headline writing in Sunday's edition. Read, smile.

Stimulus program funds health internships

The Missouri Hospital Association is working with the State of Missouri to find hospitals interested in participating in a program that funds internships for young adults ages 16 to 24 with federal stimulus funds. Interested hospitals and youth participants can access the program at http://www.summerjobs.mo.gov/.

Consumer Reports critical of individual health plans

An investigation by Consumer Reports finds individually purchased health plans may not offer coverage consumers expect and may place policy holders in jeopardy of significant medical bills.

"Individual insurance has become a nightmare for consumers," Nancy Metcalf, senior program editor at Consumer Reports, said in a news release. "It's expensive and difficult to get for people who have a less-than-perfect medical history. And people who do purchase a policy often don't understand what they've bought until it's too late and they're faced with hospital bills that their plan won't pay."

Explaining health care, simply?

I found this video (developed to suit the interests of the insurance industry) and thought it was worth sharing. I'm not sure I agree with their numbers, but the presentation is compelling. I suspect we'll see a lot more of this from the insurance lobby if the health reform debate moves forward with a "public" plan.

Senate endorses coverage plan structure

The Missouri Senate has endorsed Sen. Tom Dempsey's SB 306 to create the "Show-Me Health Coverage" program. The proposal -- which is very similar to last-year's Insure Missouri plan -- would extend coverage to low income care givers through a market-base insurance model. The bill is not required to implement the coverage expansion included in the Senate's budget proposal. However, Senate Appropriations Committee chair Sen. Gary Nodler, has indicated that the fund the Senate included could be used for either Dempsey's plan or a traditional Medicaid expansion as proposed by Gov. Jay Nixon.

Bass boats and castor oil

Barbara Shelly, editorial writer for The Kansas City Star, skewers Rep. Rob Schaaf in a commentary piece in today's paper.

HFMA reports on hospital margins

The Healthcare Financial Management Association has issued a report on hospitals' financial condition in the troubled economy. According to researchers, fifty-four percent of hospitals had negative total margins during the first-quarter of fiscal year 2009, including 80 percent of hospitals with 500 or more beds. Eight in 10 hospitals report declines in non-operating revenue since the economic recession began last summer, and seven in 10 report fewer days cash on hand. Four in 10 hospitals report a decline in net patient revenue and investment losses of 25 percent or more.

According to the American Hospital Association, the report is consistent with their analysis released last month.

UPDATED: Reporter round-up

Barbara Shelly of The Kansas City Star is working on a story (actually an editorial) about the coverage initiative, with specific interest in general Medicaid expansion versus an expansion plan similar to that proposed by Sen. Dempsey.

Bob Joiner of the St. Louis Beacon wants to understand the impact of the federal stimulus package on health care... especially in St. Louis. Look for him to be calling around.

David Lieb of the Associated Press is writing on the Senate's budget proposal. Specifically he is interested in the amendment to have hospitals fund and additional $5.8 million in Medicaid to offset certain SCHIP premiums.

Coverage initiative advances

The Missouri Senate has advanced its version of the state budget, including hospital FRA and DSH funds to expand MO HealthNet coverage. The Missouri House will have the opportunity to adopt the Senate's budget (not going to happen) or meet in conference to hammer out the differences.

Last night the Senate rejected an amendment that would have called on hospitals to add an additional $5.8 million in FRA/DSH funding to reduce certain SCHIP premiums.

Opening salvo

Welcome to The buried lede.

I promise not to tell you about my dog (I don't have one) or post pictures of my children (I have six). This Blog is for you, not me.

Let's start a conversation. I'll provide the forum.

When I find news, research or editorial content about hospitals or health related subjects, I'll post them here for you. Hopefully, they will help you bring context and contrast to your hospitals' services. They might generate an idea or two. Then again, maybe not.

If I'm not giving you what you want or need, tell me. I encourage engagement. Also, humor is welcome.

Please overlook the occasional comma splice or split infinitive. It makes me human.

D.