Legislative Bills 952, 926 strive to stop Medicaid cuts
LINCOLN—For a long time, Maura Farruggia of Omaha thought she would never hear her granddaughter, Kareaden, say "grandma." Farruggia and her husband have cared for the 6-year-old, who is inflicted with cerebral palsy, legal blindness and other disorders, since 2006. Medicaid changed everything.Kareaden can walk with assistance, speak and attend school, thanks to Medicaid-funded respite care — a temporary professional care for the disabled. But assistance for many like Kareaden may be on the line with the Division of Medicaid & Long-Term Care's $21 million in Medicaid spending cuts, mostly relating to private and home nursing services. Read more»
— The Daily Nebraskan, Jan. 14, 2012
Medicare shortchanges hospitals on strokes
ROCHESTER, Minn., Jan. 17 (UPI) -- Medicare may be shortchanging U.S. hospitals for the cost of treating stroke, researchers at the Mayo Clinic find. Dr. Waleed Brinjikji, Dr. Alejandro A. Rabinstein and Dr. Harry J. Cloft of the Mayo Clinic in Rochester, Minn., used data from the the National Inpatient Sample to evaluate hospitalization costs for patients treated with intravenous thrombolysis for acute ischemic stroke in the United States from 2001 to 2008. Read more>>
-- UPI.com, Jan. 17, 2012
NHA 2012 Advocacy Day is March 21!
NHA’s Advocacy Day highlights the 2012 legislative issues impacting Nebraska hospitals and health systems, and how they deliver quality and affordable care to their communities.
Additionally, Advocacy Day provides health care advocates and leaders with the opportunity to visit with and educate state senators about how health care legislation will affect them.
Your participation is important! Having a strong understanding of legislative issues and how they impact your hospital and community is critical for health care executives. Your knowledge of the legislative issues and state health care policy allow you to effectively be a voice and advocate. We will be the most successful when legislators and policymakers hear your grassroots stories describing the realities of health care in Nebraska.
Please plan to join us on Wednesday, Mar. 21, 2012, at The Cornhusker Marriott in Lincoln for NHA 2012 Advocacy Day.
Click here to download a brochure or click here to register online.
Collaborative Efforts Can Save Money And Improve Care
Experts say employers, hospitals, physicians and health plans increasingly are willing to work together because cost and quality problems have reached crisis levels. The goal is to carve out health-care spending that’s wasteful and doesn’t help patients. Sometimes there’s an implicit threat that if a provider or health plan doesn’t participate, the large employer will buy health care from someone else.
Read more>>
This is good news! Glad to hear it from the first lady today. Veterans health care initiative is announced:
First lady Michelle Obama Wednesday announced a coordinated effort by 130 colleges to train doctors to deal with U.S. military veterans' health issues.
The goal of the Obama administration's collaboration with the Association of American Medical Colleges and the American Association of Colleges of Osteopathic Medicine is to produce doctors, medical schools and research facilities that provide healthcare that meets the needs of the military and veterans communities, Obama said in a statement released by the White House.
Read more>>
The Next Phase of Cost Control
This third report in a series of four from the inaugural HealthLeaders Media CFO Exchange provides insight on cost containment from leaders at Banner Health, Wellmont Health System, Parkland Health & Hospital System, Floyd Memorial Hospital & Health Services, and Trinity Regional Health System. Eighteen percent cite "no culture of being cost-conscious" as their greatest organizational challenge to cost reduction.
Read more>>
Commentary: Rural Hospitals Band Together for Insurance-Buying Power
By: Alexandra Wilson Pecci, for HealthLeaders Media, January 11, 2012
A group of Texas community and rural hospitals launches a campaign to encourage a proactive, rather than reactive, approach to buying insurance.
Read more>>
20% of Healthcare Dollars Spent on 1% of Population
By: Cheryl Clark, for HealthLeaders Media, January 12, 2012
The top 5% of the U.S. population, which accounts for half of all healthcare expenditures, may yield the biggest opportunity for realizing savings, suggests a report from the Agency for Healthcare Research and Quality.
Read more>>
Do No Harm — And Keep An Eye On Costs
The American College of Physicians hit a nerve when it released an updated ethics manual calling for doctors to provide "parsimonious care" – in other words, "to practice effective and efficient health care and to use health care resources responsibly."
This recommendation, included in the Jan. 3 Annals of Internal Medicine special supplement, drew immediate reaction – and not just because of its use of the infrequently heard "parsimonious." It's been viewed as a definitive statement of medical ethics directed at the organization's 132,000 members – physicians who practice internal medicine and its related specialties, among them cardiology and oncology, that often involve expensive procedures. And, the guidance comes at a time when health care costs are central to the national policy debate.
Read more from Kaiser Health News.
Slower Growth in Health Spending
The New York Times Editorial:
Health care spending in the United States increased at the slowest rate in half a century in 2009 and 2010, essentially keeping pace with the growth of the economy, according to the latest federal data.
That looks like good news after decades of soaring health care spending that outpaced economic growth. The hitch: the main factor was the recession that left millions of Americans unemployed, uninsured, short of income, and unable or unwilling to spend money on health care.
Read more>>
Walgreen Is Firm on End of Express Scripts Deal
By BRUCE JAPSEN, The New York Times
Published: January 11, 2012
CHICAGO — The chief executive of the Walgreen Company defended the chain’s decision to end its relationship with the prescription benefit manager Express Scripts, even as rivals have stepped up their efforts to attract pharmacy customers covered by Express Scripts plans.
Speaking to about 2,500 shareholders at the Walgreen annual meeting, the executive, Gregory D. Wasson said that Express Scripts was offering to pay below-average rates, which was unacceptable to Walgreen. The agreement ended Dec. 31.
Read more>>
Good news! U.S. cancer death rates continue to decline
Cancer death rates dropped 1.8% per year in men and 1.6% per year in women between 2004 and 2008, according to a report examining cancer in the U.S. released yesterday by the American Cancer Society. Overall cancer incidence rates declined by about 0.6% each year in men and remained stable in women during this period. From 1999-2008, cancer death rates declined by more than 1.0% per year in men and women of every racial and ethnic group with the exception of American Indians/Alaska Natives, among whom rates have remained stable. The report says the overall reduction in cancer death rates in men since 1990 and women since 1991 translates into more than 1 million deaths avoided. Despite declines in incidence rates for the most common cancers - lung, colorectal, breast and prostate, a companion report shows increased incidences of cancers of the pancreas, liver, thyroid, kidney, skin and esophagus.
AHA issues 2010 data on hospitals' uncompensated care
U.S. hospitals provided $39.3 billion in uncompensated care in 2010, according to the latest data from the AHA's Annual Survey of Hospitals. That's $200 million more than in 2009. The total includes "bad debt," services for which hospitals anticipated but did not receive payment, and charity care, services for which hospitals neither received nor expected payment because they determined, with help from the patient, the patient's inability to pay. It does not include Medicaid and Medicare underpayment.
— AHA, Jan. 5, 2012
Health Care Reform Tops Bloomberg BNA List of Most Important Health Law Issues for 2012
ARLINGTON, VA—Health care industry changes driven by the federal health care reform law, challenges in complying with and implementing the law, and the long shadow cast by a possible invalidation of the statute, in whole or in part, by the U.S. Supreme Court will dominate the field of health law in 2012, according to a survey of 27 health law practitioners from Bloomberg BNA's Health Law Reporter advisory board conducted in December, 2011. Read more»
— Bloomberg BNA, Jan. 5, 2012
Report Finds Most Errors at Hospitals Go Unreported
Hospital employees recognize and report only one out of seven errors, accidents and other events that harm Medicare patients while they are hospitalized, federal investigators say in a new report. Yet even after hospitals investigate preventable injuries and infections that have been reported, they rarely change their practices to prevent repetition of the “adverse events,” according to the study, from Daniel R. Levinson, inspector general of the Department of Health and Human Services. Read more»
— The New York Times, Jan. 6, 2012
Doctors going broke
NEW YORK—Doctors in America are harboring an embarrassing secret: Many of them are going broke. This quiet reality, which is spreading nationwide, is claiming a wide range of casualties, including family physicians, cardiologists and oncologists. Industry watchers say the trend is worrisome. Half of all doctors in the nation operate a private practice. So if a cash crunch forces the death of an independent practice, it robs a community of a vital health care resource. Read more.
— CNN Money, Jan. 6, 2012
The Affordable Care Act, helping Americans curb health-care costs
WASHINGTON, D.C.—In an Op Ed in the Washington Post, Health and Human Services Secretary Kathleen Sebelius writes: "The rising cost of health insurance coverage has imposed a heavy burden on our nation. Over the past decade, insurance premiums for working families have grown three times faster than have wages. Small businesses have seen health care become one of their biggest operating expenses. And rising state and federal spending on health programs has crowded out critical investments in better schools, new roads and other areas.” Read more»
— The Washington Post, Jan. 5, 2012
Medicare Penalties For Readmissions Could Be A Tough Hit On Hospitals Serving The Poor
James Breedin cannot keep track of how often he has been admitted to Howard University Hospital for heart problems. "It's been so many," said Breedin, a 75-year-old disabled former truck driver from Northeast Washington.
Ralph Rust meets with Dr. George Ruiz at Washington Hospital Center. Rust has struggled for decades to stay out of the hospital.
One reason for his frequent returns, he says, is that he often can't afford the medications his doctor prescribes to keep his heart problems in check, "so I have to do without." Another is that he fears exercising outside because of neighborhood violence.
Read more from Kaiser Health News and The Washington Post.
Feds: Neb. man ran $1.4 million health care scam
LINCOLN, Neb. (AP) - Federal prosecutors have charged the former business manager of a Norfolk health care provider with bank and health care fraud. The U.S. Attorney's office says Mark Koehler of Norfolk submitted $1.4 million in false claims to Medicare, Nebraska Medicaid and private insurers. Koehler worked as the business manager for Heartland Physical Therapy in Norfolk.
Prosecutors say he also defrauded a Norfolk bank by including the false billings in reports that were used to secure cash advances. Prosecutors say bank officials relied on the reports when they advanced Heartland Physical Therapy about $500,000, which the company should not have received.
A woman who answered the phone Thursday at Heartland Physical Therapy's Norfolk office said Koehler hasn't worked for the company for nearly two years. She declined to comment further.
Panel: Increasing health care availability doesn't necessarily mean improved health
NEBRASKA—A series of statewide health care dialogues concluded Dec. 1 in Lincoln with a five-person panel discussion about the overall health of Americans in general and Nebraskans in particular. Among the key points was the distinction between leading healthy lives and health care.
Panelist Andrew Holtz, an Oregon-based independent journalist and former CNN correspondent, said it is a common misconception that increasing health care will also increase health. Read more»
— Nebraska News Service, Dec. 7, 2011
House GOP Leaders Agree to Pass Two-Month Tax Bill
(The Hill) -- TheHill.com reports that "House Republican leaders have agreed to pass a two-month extension of the payroll tax cut and unemployment benefits." The agreement was announced last night. "The deal is contingent on support from rank-and-file House Republicans."
Read more here:
http://thehill.com/homenews/house/201081-house-republicans-cave-agree-to-two-month-tax-bill
Supercommittee fails to reach an agreement
WASHINGTON—The co-chairs of the Joint Select Committee on Deficit Reduction Monday announced that the committee has failed to come to an agreement on a deficit reduction strategy.
The bipartisan 12-member committee—chaired by Senate Democratic Conference Secretary Patty Murray (D-WA) and House Republican Conference Chairman Jeb Hensarling (R-TX)—was created by this summer's Budget Control Act to craft a far-reaching plan by November 23 to reduce the national deficit by at least $1.2 trillion. The committee's failure to reach an agreement means automatic spending cuts totaling $1.2 trillion split between defense spending and non-defense programs will take effect in January 2013. Under the trigger, reductions in Medicare payments to hospitals and other providers of 2 percent over nine years (2013 to 2021) will take effect.
"Sequestration means that arbitrary reductions in resources for patient care under Medicare will now be set to take effect under the law for the remainder of the decade," said AHA President and CEO Rich Umbdenstock today. "This will have an impact not just on the elderly and disabled beneficiaries of the program, but on their families. It will also have an impact on the ability of hospitals to provide essential public services to the communities they serve given the impact that Medicare has on the entire health care system."
He added, "It is likely that Congress will reconsider whether this approach should take effect in January 2013 as required under current law. America's hospitals will work with Congress as these discussions continue."
— AHA, November 21, 2011
HHS expands initiative to protect Medicare and seniors from fraud
WASHINGTON—The U.S. Department of Health and Human Services (HHS) announced today the award of $9 million from the Centers for Medicare & Medicaid Services (CMS) to help Senior Medicare Patrol (SMP) programs across the nation continue their work fighting Medicare fraud. This is part of President Obama’s initiative to educate people with Medicare about how to protect themselves and Medicare from fraud. SMPs rely on approximately 5,000 volunteers nationwide to enhance their efforts.
— HHS news release, November 22, 2011
Nebraska Medical Center oncology services now available at Bellevue Medical Center
BELLEVUE—Cancer patients come to Nebraska from all over the world to receive expert cancer care from physicians at The Nebraska Medical Center. Now, that same expertise is available in Bellevue. In partnership with The Nebraska Medical Center, Bellevue Medical Center has opened a full-service outpatient hematology/oncology clinic and infusion center. Read more.
— NHA, November 21, 2011
CMS announces three payment demonstrations
WASHINGTON—The Centers for Medicare & Medicaid Services (CMS) Wednesday announced two new demonstration projects, beginning January 1, aimed at reducing improper payments under the Medicare Recovery Audit Contractor (RAC) program and one for durable medical equipment.
Under the three-year Recovery Audit Prepayment Review Demonstration, Medicare RACs will be authorized to conduct pre-payment reviews of certain types of inpatient hospital claims in 11 states: California, Florida, Illinois, Louisiana, Michigan, Missouri, New York, North Carolina, Ohio, Pennsylvania and Texas. RACs currently are authorized to conduct only post-payment reviews. CMS will use multiple data sources to develop pre-payment review targets and will instruct RACs to review specific claim types. According to CMS, “payment determinations will be made following the same processes with which providers are familiar.” Current Medicare RAC program appeal rights will apply.
The Part A to Part B Rebilling Demonstration will allow hospitals to rebill for up to 90 percent of the Part B outpatient payment after a Part A inpatient short-stay claim is denied on the basis that the inpatient admission was not reasonable and necessary. Up to 380 hospital participants will be selected on a first-come, first-served basis, with targets for hospitals based on size and location. Under current rules, hospitals are not allowed to resubmit claims for outpatient reimbursement even when a RAC deems the care to be medically necessary.
Under the Prior Authorization for Certain Medical Equipment Demonstration, preauthorization will be required for certain DME for Medicare beneficiaries in seven states: California, Florida, Illinois, Michigan, New York, North Carolina and Texas.
— NHA, November 17, 2011
Merritt Hawkins releases survey of final-year medical residents
Click here to read this article and more.
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The ICD-10 Impact on Hospitals and Transition Strategies to Meet the Deadline - A Four Part Webinar Series
November 16, 2011 thru February 15, 2012
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CMS CoP Patient Visitation Rights: Ensuring Compliance
January 31, 2012
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Preventing Avoidable Hospital Readmissions
February 2, 2012
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Medicare Provider Enrollment and the CMS-855 Forms: Ensuring Compliance
February 7, 2012
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Positioning Hospitals and Physicians for Success: Understanding How Providers and Payors are Responding to Health Care Reform
February 7, 2012
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Advance Directives Update 2012
February 14, 2012
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Mission/Market Critical: Moving from All-Things-to-All-People to a High-Value Hospital
February 14, 2012
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Hospital and Physician Alignment: 20 Critical Bylaws Touchstones
February 15, 2012
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The Basics of PCI Compliance/Credit Card Processing for Hospitals & Health Care Associations Webinar
February 21, 2012
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EMTALA and Physician On-Call Requirements: Ensuring Compliance
February 28, 2012
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