Short Takes On News & Events

Talking Medicare’s Hospital Fines For Too Many Patient Injuries

KHN’s Jordan Rau was on NPR and C-SPAN Monday to talk about coming Medicare penalties for about a quarter of the nation’s hospitals as detailed in his story More Than 750 Hospitals Face Medicare Crackdown On Patient Injuries.

The penalties will ding hospitals up to 1 percent of their Medicare pay for having higher rates of patient injuries. Watch the C-SPAN video interview and listen to the NPR audio of his conversation below:

June 23rd, 2014, 12:44 PM by KHN Editors

Short Takes On News & Events

Senators Offer Bill To Ease Readmission Penalties On Some Hospitals

A bipartisan group of senators introduced legislation on Thursday to make Medicare take the financial status of hospital patients into account when deciding whether to punish a hospital for too many readmissions.

The bill attempts to address one of the main complaints about the readmissions program: that hospitals serving large numbers of low-income patients are more likely be penalized. Over the past two years, the federal government has reduced payments to two-thirds of the nation’s hospitals because they have high numbers of patients becoming ill and returning after being discharged. This fall the program will put as much as 3 percent of a hospital’s Medicare payments at risk and it will expand the number of conditions it bases the assessment on — currently heart attack, heart failure or pneumonia – to include chronic obstructive pulmonary disease and total hip and knee replacement.

Medicare does adjust for different levels of sickness of patients among hospitals, but it has said the Affordable Care Act, which created the program, does not give regulators the leeway to take socio-economic status into account.

An advisory committee to Congress last year recommended that lawmakers change the program.  The idea of taking socio-economic status into account has also been endorsed in a draft report from  a panel created by the National Quality Forum, which is a nonprofit group that reviews quality measures for the government.

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June 19th, 2014, 3:56 PM by Jordan Rau

Health Care In The States

How Your State Rates In Terms Of Long-Term Care

This copyrighted story comes from ‘s Shots blog. All rights reserved.

In just 12 years, the oldest members of the huge baby-boom generation will turn 80. Many will need some kind of long-term care. A new study from AARP says that care could vary dramatically in cost and quality depending on where they live.

The study was motivated by a simple fact: The number of available family caregivers is declining. In 2010, there were potentially seven for each person 80 years old or older. By the time baby boomers reach that age, there will be only four potential caregivers for each of them. And those numbers are expected to continue declining. Chalk it up to longer lives and smaller families.

Susan Reinhard, a senior vice president at AARP, says the study can show states where they need to improve. “The gradual pace of improvement has to pick up,” she says. “We don’t have the time to get ready for the demographic imperative that is before us.”

The study looked at 26 different variables in each state, from affordability and access to whether care is delivered in private homes or more expensive nursing homes. Reinhard says states that encouraged more care at home got higher marks. “It’s a philosophy, it’s a value that states have and they work hard to make that happen,” she says.

AARP calls its study a scorecard. So, if you’re keeping score, the state with the highest marks was Minnesota, followed by Washington, Oregon, Colorado and Alaska. Bringing up the rear were Indiana, Tennessee, Mississippi and Alabama, with Kentucky coming in last.

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June 19th, 2014, 2:14 PM by Ina Jaffe, NPR News

Short Takes On News & Events

Consumer Group Urges Hospitals To Stop Promoting Questionable Screenings

Consumer advocacy group Public Citizen on Thursday called on 20 hospital systems to stop partnering with companies that offer low-cost screenings for heart disease and stroke risk, saying the promotions are “unethical” and the exams are more likely to do harm than good.

In recent years, more hospitals have paired with firms offering such testing packages, partly to build community goodwill and referrals.  Hospitals say residents benefit from the testing packages, which can cost less than $150, because some will discover they are at higher risk for heart problems or stroke early enough to take steps to reduce their risks.

But some medical groups and consumer advocates object to the programs, saying they are a waste of money for most consumers.

Public Citizen argues “the promotions rely on fear mongering and erroneously suggest that for most adults in the general population, these screening tests are useful in the prevention of several potentially life-threatening cardiovascular illnesses.”

It sent letters to hospitals in eight states, including Inova in the Washington, D.C. area, Scottsdale Healthcare in Arizona, Dignity Health in California and the University of Iowa Health Alliance, urging them to stop promoting such tests.

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June 19th, 2014, 12:24 PM by Julie Appleby

Health Care In The States

Future Uncertain For VA Rural Health Pilot Program

TOPEKA — Sen. Jerry Moran, R-Kan., said a U.S. Department of Veterans Affairs pilot program offering timely, quality health care to rural veterans is being allowed to expire in a few months, even as major legislation moves through both houses of Congress that would have similar goals as the pilot program.

The pilot program is called Access Received Closer to Home, or ARCH. It’s offered at five sites — Pratt, Kansas; Caribou, Maine; Farmville, Virginia; Flagstaff, Arizona, and Billings and Anaconda, Montana. The program allows veterans to get health services from community providers if they live at least one hour from a VA health facility.

Five senators sent a letter to the VA secretary, asking why the program is ending. The letter reads, in part: “For reasons we do not understand, the Veterans Health Administration (VHA) is choosing — at VHA’s own initiative — to end this successful program despite the more than 90 percent satisfaction rate communicated by veterans. … All along, the VHA gave us the impression that they were waiting on analysis about the success of ARCH to inform their decision about extending the program — this is a misleading storyline at best. We are deeply disappointed by this breach of trust because those who suffer from this recklessness are veterans.”

In addition to Moran, the letter to Acting VA Secretary Sloan Gibson is signed by fellow Sens. Jon Tester, D-Mont., Angus King, I-Maine, Susan Collins, R-Maine, and John McCain, R-Ariz.

While VA officials have told members of Congress that no decision has been made on whether to let ARCH expire, Moran said veterans and VA employees in Kansas have told him that the national program director for ARCH directed the five pilot sites several months ago to begin contacting veterans who participate in ARCH to let them know the program would be ending. Moran suspects the VA is motivated by financial concerns.

“If they pay for services outside the VA, it’s less money that they’ve had to use within the VA, and of course the focus ought to be on the quality of service and the timely access to care that this kind of program can provide,” Moran said.

Moran said bipartisan legislation based on the ARCH program is moving through Congress, a response to the VA waiting times scandal. That legislation offers some veterans the opportunity to seek care outside of the VA system. It would cover some of the same services vets have been receiving under ARCH, but Moran and the other senators are concerned that ARCH vets could see a lapse in care if the VA doesn’t extend the pilot program. He’s calling on Gibson to halt plans to dismantle the program.

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June 19th, 2014, 5:00 AM by Bryan Thompson, Kansas Public Radio

Short Takes On News & Events

HHS Releases New Details About 2014 Marketplace Premiums, Subsidies

Federal officials on Wednesday released new data about who enrolled in the federal health marketplace plans for 2014, how much the law’s subsidies helped offset the cost and how many plans people from could choose from, among other details.

“What we’re finding is that the marketplace is working. Consumers have more choices and they’re paying less for their premiums,” newly installed Health and Human Services Secretary Sylvia Burwell said in a statement.

The report was one in a series of ongoing updates from HHS about enrollment in the online exchanges or marketplaces. Federal officials have said more than 8 million people signed up for coverage under the health law. The document analyzed trends in the 36 states where the federal government is running the online marketplace, or exchange. It did not include similar data for the 14 states and the District of Columbia that are running their own exchanges because the data is not available, according to the report.

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June 18th, 2014, 9:01 AM by Mary Agnes Carey

Short Takes On News & Events

Enroll America Pushes Ahead To Second Enrollment Period

Enroll America convened a national conference this week in Washington to review the strategies that proved successful during the inaugural Affordable Care Act open enrollment period and  to  gear up for the next one, which will start Nov. 15.

Organizers also want to ensure that the navigators and organizations working toward enrollment maintain their energy — despite reports of backlogged Medicaid applications and continuing struggles in some state-run exchanges.

“It’s energizing people and bringing them together and reminding them why they got into the work in the first place,” said Anne Filipic, president of Enroll America, a nonprofit group organized primarily to sign up consumers for new health coverage. “We’re five months out, so it’s time to be implementing and outreaching.”

Kentucky Gov. Steve Beshear, a Democrat, was among those at the conference Tuesday to offer a list of accomplishments. Kentucky, he said, enrolled 421,410 people in individual health coverage either via kynect, the state’s online insurance portal, or Medicaid.  Seventy-five percent of them had never had health care insurance before.

Beshear credits this public response to the decision to insulate kynect from the affiliation with the national health law The enrollment numbers suggest that worked. In Kentucky, traditionally considered a red state, 60 percent of voters supported Republican candidate Mitt Romney in 2012.

Looking forward, he also said that the re-election efforts of naysayer lawmakers — those who have worked so hard to discredit and disband the overhaul — will come down to how people with the new coverage experience the benefits of the law.

Meanwhile, former Health and Human Services Secretary Kathleen Sebelius told attendees that they were pivotal in making the first enrollment season successful. “You combated relentless misinformation and obstruction, people who were faced with getting fingerprinted and paying a fee in order to help access care,” Sebelius said.

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June 18th, 2014, 5:00 AM by Lisa Gillespie

Short Takes On News & Events

Insurer Begins Huge Palliative Care Program

“Person-centered care” is the buzz phrase  floating around the health care industry, and a Pacific Northwest-based giant insurer thinks it has hit the mark with a new palliative care program coming this summer.

Photo by ulrichkarljoho via Flickr

Cambia Health Solutions, which includes Regence Blue Cross Blue Shield,will offer training to providers and additional benefits for policyholders: more than 2.2 million members in Cambia’s family of health plan companies in Oregon, Washington, Idaho and Utah.

Palliative care improves the quality of life by managing pain and other problems for people who have serious life-threatening medical conditions, such as cancer, heart and kidney failure. It differs from hospice care, especially because patients do not necessarily have less than six months to live.

Mark Ganz, president and CEO of Cambia, said the company realized providers are focused on disease treatment but they “never stop to ask the patient and family ‘How do you want to live with this?’”

“Palliative care at its best is in partnership with curative care,” Ganz said. “It’s not after curative care when it no longer matters or no longer is working.”

The company is going to start paying for things not typically reimbursed by other insurance companies including home health aides and advanced care planning counseling. One of the larger initiatives is training physicians and caregivers in how to have appropriate conversations about end-of-life care.

Dr. Csaba Mera, chief medical officer at Cambia Health,  said the goal is to develop a holistic, comprehensive integrated program: “It’s about making sure (the patient’s) wishes are clearly documented, they’re respected and that they’re implemented so it’s not a crisis if they do at some point end up in terminal care and decisions have to be made,” Mera said.

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June 17th, 2014, 2:34 PM by Marissa Evans

Short Takes On News & Events

High Court Rules Anti-Abortion Group Can Sue Over Election ‘Truth-Telling’ Law

A group challenging an Ohio election law that makes it a crime to make “false statements” about a candidate’s record during a campaign has standing to challenge the constitutionality of that law, according to today’s unanimous Supreme Court decision.

Photo by Karl Eisenhower/KHN

The opinion, written by Justice Clarence Thomas, did NOT strike down Ohio’s false statement law. But it did hold that the Susan B. Anthony List demonstrated “a sufficiently imminent injury” from potential prosecution under the law that it can challenge it in federal court.

Michael Carvin, the attorney who argued the case before the court for the Susan B. Anthony List, told reporters in a conference call that he anticipates as a result of the ruling, however, Ohio’s measure and similar “truth-telling commissions” in more than a dozen other states “will be struck down” as a violation of free speech rights.

The case arose during the 2010 mid-term elections, when the group, which describes itself as “dedicated to electing candidates and pursuing policies that will reduce and ultimately end abortion,” targeted a number of anti-abortion Democrats who voted for the Affordable Care Act. The SBA List contends that the health law “supports taxpayer-funded abortion,” despite promises to the contrary and an executive order issued by President Barack Obama.

In an attempt to stop billboards accusing him of voting for taxpayer-funded abortions from being erected by the group, then-Rep. Steve Driehaus filed a complaint — at the height of the campaign season — with the Ohio Election Commission, which found “probable cause” that the statements were false.

Driehaus lost the election, and withdrew his complaint, but the SBA list and another group, the Coalition Opposed to Additional Spending and Taxes, sued the election commission anyway. They argued that the law violates the Constitution’s guarantee of free speech, and that it “chilled” them from making assertions about candidates due to fear of prosecution.

The Supreme Court agreed, as far as allowing them to pursue their claim. “The burdens that Commission proceedings can impose on electoral speech are of particular concern here,” said the opinion. “Moreover, the target of a false statement complaint may be forced to divert significant time and resources to hire legal counsel and respond to discovery requests in the crucial days leading up to an election.”

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June 16th, 2014, 4:20 PM by Julie Rovner

Health Care In The States

Obamacare Credited For Big Drop In Minnesota’s Uninsured Rate

This story is part of a partnership that includes MPR, NPR and Kaiser Health News. It can be republished for free. (details)

The website malfunctioned. The exchange chief was fired. And many people had to sign up the old fashioned way: pen, paper, with a person. So, Minnesota’s launch of the Affordable Care Act was a clear failure, right? Not so much.

A less modest state might call it the Minnesota Miracle: The rate of uninsured people in Minnesota tumbled to less than 5 percent, despite all the problems with its Obamacare website, a new study shows.

How did Minnesota do it? It wasn’t miraculous. The state started out ahead with a rate of uninsurance roughly half the national average. Then it used the health law to strengthen and publicize a health care safety net that was already more complete and generous than most other states.

The number of uninsured Minnesotans fell by nearly 41 percent since September and the rate of uninsurance in the state fell from 8.2 percent to 4.9 percent, according to the study from the University of Minnesota’s State Health Access Data Assistance Center.
The university crunched the numbers at the request of MNsure, the state’s troubled health insurance marketplace. “This is a pretty historic change in insurance coverage in Minnesota,” said Julie Sonier, the report’s lead researcher. “We have never seen anything like the change that we have seen between last fall and May 1st of this year.”

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June 16th, 2014, 8:10 AM by Elizabeth Stawicki, Minnesota Public Radio