Category Archives: Hospital News

Federal funds for charity care at risk in states that refuse to expand Medicaid

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Flag-map_of_Florida.svgBy Christine Vestal
KHN

The federal government is quietly warning states that failure to expand Medicaid under the Affordable Care Act could imperil billions in federal subsidies for hospitals and doctors who care for the poor.

In an April 14 letter to Florida Medicaid director Justin Senior, Vikki Wachino, acting director of the U.S. Centers for Medicare and Medicaid Services (CMS) wrote: “Uncompensated care pool funding should not pay for costs that would be covered in a Medicaid expansion.”

Federal money to support low-income clinics and hospitals is slated to decline under the Affordable Care Act as more people become insured.

Medicaid is the joint federal-state government health insurance program for the poor. Under the Affordable Care Act, states can choose to expand coverage to more people, with the federal government paying the entire costs of expansion through next year.

Florida has asked CMS to renew $1.3 billion in federal funding for its 2016 “low-income pool,” even though the state has rejected Medicaid expansion.

CMS maintains that any extension must take into account the more than 800,000 residents whose medical bills would be covered by Medicaid were the state to expand the program.

Photo courtesy of Darwinek via Wikimedia Commons CC Continue reading

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Losing a hospital in the heart of a small city

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By Sarah Jane Tribble, WCPN

In a leafy suburb of Cleveland, 108-year-old Lakewood Hospital is expected to close in the next two years.

Mike Summers points to the fourth floor windows on the far left side of the historic brick building. He recalls spending three weeks in one of those rooms. It was Christmas 1965 and Summers had a broken hip.

“I remember hearing Christmas bells from the church across the street,” he says.

Lakewood Hospital, which opened its doors in 1907, is slated to close. Across the country, small hospitals are closing and redirecting residents to newer hospitals as patient populations shift with changing economies. (Photo by Sarah Jane Tribble/WCPN)

Lakewood Hospital, which opened its doors in 1907, is slated to close. Across the country, small hospitals are closing and redirecting residents to newer hospitals as patient populations shift with changing economies. (Photo by Sarah Jane Tribble/WCPN)

Summers was born at this hospital. His sister was born here. This hospital has a special place in his heart. But then he became mayor of Lakewood four years ago and realized the hospital was a financial liability for the small city, which has seen a sharp increase in poverty levels in the past two decades.

The hospital, operated for the city by the large nonprofit Cleveland Clinic system, has lost money since 2005. Executives say they need to close it and replace it with a smaller outpatient health center and emergency room.

“I’ve grown to understand the situation we are in is not unique. There are considerable forces at play and we are in the middle of all of them and a lot of communities are just like us,” Summers says.

Lakewood Hospital is this community’s biggest employer, with 1,000 workers. It has been a rich source of municipal revenues even as manufacturing jobs left the region.

But the hospital, operated for the city by the large nonprofit Cleveland Clinic system, has lost money since 2005. Executives say they need to close it and replace it with a smaller outpatient health center and emergency room.
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Patients Not Hurt When Their Hospitals Close, Study Finds

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By Jordan Rau
KHN

A hospital closure can send tremors through a city or town, leaving residents fearful about how they will be cared for in emergencies and serious illnesses. A study released Monday offers some comfort, finding that when hospitals shut down, death rates and other markers of quality generally do not worsen.

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Researchers at the Harvard School of Public Health examined 195 hospital closures between 2003 and 2011, looking at health experiences in the year before and the year after the hospital went out of business.

Their paper, published in the journal Health Affairs, found that changes in death rates of people on Medicare — both those who had been in the hospital and among the broader populace — were no different than those for people in similar places where no hospital had closed.

While the researchers noted that some people might be inconvenienced by having to travel further for care, they found no significant changes in how often Medicare beneficiaries were admitted to hospitals, how long they stayed or how much their care cost.

The closed hospitals tended to be financially troubled, with revenues averaging 13 percent less than the cost of running the institutions.

“It’s possible that we didn’t see any change in outcomes because patients instead went to nearby hospitals that had better finances and may have had more resources to provide care,” said Dr. Karen Joynt, the lead researcher on the study.

She cautioned that the study looked at the average experience of a hospital closure and should not be interpreted to mean that every hospital loss is harmless. “I would be shocked if you couldn’t find an example where access is really threatened,” she said. Continue reading

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Hospitals turn to patients for advice

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H for hospitalBy Shefali Luthra
KHN

The system, which is now being phased in, will help coordinate services and reshape how patients and doctors find and read medical information.

The fact that Partners sought the perspective of patients highlights how hospitals increasingly care about what their customers think.

“It’s such a great experience,” Maier said. “They treat us as a member – a partner – in their review process.”

Jane Maier was one of a select group of patients invited in early 2012 to help Partners HealthCare, Massachusetts’ largest health system, pick its new electronic health record system – a critical investment of close to $700 million.

Jane Maier was one of a select group of patients invited in early 2012 to help Partners HealthCare, Massachusetts’ largest health system, pick its new electronic health record system – a critical investment of close to $700 million.

Patient advisory councils, like the one Maier belongs to, often serve as sounding boards for hospital leaders – offering advice on a range of issues.

Members are usually patients and relatives who had bad hospital experiences and want to change how things work, or who liked their stay and want to remain involved.

For Maier, it all started in 2009 when she had surgery at Brigham and Women’s Faulkner Hospital, a Partners facility.

Her husband wrote to the hospital’s CEO, praising her experience.

The couple was then invited to speak at a hospital leadership retreat, sharing with top executives both the good and the not-so-good, and Maier was recruited to serve on a new patient advisory panel.

This hunt for patient perspective, which is becoming more and more common, is fueled in part by the health law’s quality-improvement provisions and other federal financial incentives, such as the link between Medicare payments and patient satisfaction scores. Continue reading

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Hospitals leave downtown for more prosperous digs

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hospital-sign-ofallon

A sign marks the location of a proposed new St. Elizabeth’s hospital in O’Fallon, Mo., on 114 acres of farmland just off Interstate 64. (Photo by Phil Galewitz/KHN)

By Phil Galewitz
KHN

BELLEVILLE, Ill. – Nearly as old as the railroad that slices through this southern Illinois city just east of the Mississippi River, St. Elizabeth’s Hospital has been a downtown bedrock since 1875.

Started by three nuns from a Franciscan order in Germany, the Catholic hospital still seeks “to embody Christ’s healing love” to the sick, the aged and the poor, according to its mission statement.

It is so tied to the city that when the local economy slumped in 2009, the nonprofit St. Elizabeth’s gave $20 to every employee to spend on Main Street, sending hundreds of shoppers out to the mostly mom- and pop-owned stores.

But St. E’s, as locals call it, now faces its own financial troubles, largely a result of the costs of maintaining an obsolete facility and of treating more low-income and uninsured patients from Belleville and neighboring East St. Louis, one of the poorest cities in the Midwest.

After a decade of losing money, St. Elizabeth’s officials are taking a radical step: Like a small but growing number of hospitals around the country, they plan to close the 303-bed hospital and move elsewhere.

They are seeking state approval to build a $300-million facility seven miles northeast, in O’Fallon, a wealthier city that is one of the fastest-growing communities in the St. Louis region with new subdivisions, proximity to a regional mall and quick access to Interstate 64.

Describing plans to leave behind some services, including a walk-in clinic, St. Elizabeth’s CEO Maryann Reese insists the hospital is not abandoning the city or the poor. Continue reading

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The Salty Truth: Many Popular Foods With Unhealthy Amounts of Salt – ABC News

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pizzaYou may be consuming more salt than you need — and the salt shaker is probably not to blame.

When researchers at the Centers for Disease Control and Prevention sought to shake out how much sodium — a major component of table salt — was in various food items nationwide, they found that the biggest high sodium offenders were pizzas, pastas and meats, nearly 75 percent of which exceeded national sodium thresholds. Additionally, more than half of cold cuts, soups and sandwiches contained more than a healthy amount of sodium.

via The Salty Truth: Many Popular Foods With Unhealthy Amounts of Salt – ABC News.

 

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In pursuit of patient satisfaction, hospitals update the hated hospital gown

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By Shefali Luthra
KHN

Whether a patient is in the hospital for an organ transplant, an appendectomy or to have a baby, one complaint is common: the gown.

You know the one. It might as well have been stitched together with paper towels and duct tape, and it usually leaves the wearer’s behind hanging out.

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“You’re at the hospital because something’s wrong with you –  you’re vulnerable – then you get to wear the most vulnerable garment ever invented to make the whole experience that much worse,” said Ted Streuli, who lives in Edmond, Okla., and has had to wear hospital gowns on multiple occasions.

“They are horrible. They are demeaning. They are belittling.”

 Put another way: “They are horrible. They are demeaning. They are belittling. They are disempowering,” said Camilla McRory of Olney, Md.

Hospital gowns have gotten a face-lift after some help from fashion designers like these from Patient Style and the Henry Ford Innovation Institute.

The gowns are among the most vexing parts of being in the hospital. But if efforts by some health systems are an indicator, the design may be on its way out of style. Continue reading

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VA distance requirement will no longer be “as the crow flies”

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A black crowWashington — In order to expand eligibility for the Veterans Choice Program, the Department of Veterans Affairs (VA) today announced that it will change the calculation used to determine the distance between a Veteran’s residence and the nearest VA medical facility from a straight line distance to driving distance.

The policy change will be made through regulatory action in the coming weeks.

The method of determining driving distance will be through distance as calculated by using a commercial product. The change is expected to roughly double the number of eligible Veterans.

Continue reading

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VA makes it easier for you to get your benefits

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See the changes to VA benefits
Its now faster, easier and more efficient to file claims
See the changes to VA benefits

Today, claims become faster, easier and more accurate

Starting today, March 25th, VA is streamlining claims processes; to deliver benefits faster and more accurately.

See the changes to VA benefits

Three important changes are now in affect.

Informal claims have migrated to a new intent to fileprocess.

Use of standardized forms is now required when filing for benefits.

Initiating an appeal requires a standardized notice of disagreement form.

To learn how the new standardized forms and intent to fileprocess affects you:

See the changes to VA benefits
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New, easier, online way to apply for VA benefits

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Online Tools, Standardized Forms, and More

veteran-affairs-seal-vaEffective March 24th, 2015, VA is implementing improvements to make it easier for you to apply for benefits.

Online application tools, standardized forms, and a new intent to file process will create faster and more accurate decisions on your claims and appeals.

As part of the VA’s full-scale transformation in 2015, these new changes will:

  • Streamline the benefits process, making it faster and easier
  • Use standardized forms to file disability claims and compensation appeals
  • Establish a new intent to file a claim process

See how the changes affect you:

See the changes to VA benefits
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VA eliminates net worth as health-care eligibility factor

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Instead of combining the sum of Veterans’ income with their assets to determine eligibility for medical care and copayment obligations, VA will now only consider a Veteran’s gross household income and deductible expenses from the previous year.

From the Department of Veterans Affairs

veteran-affairs-seal-vaWashington – The Department of Veterans Affairs is updating the way it determines eligibility for VA health care, a change that will result in more Veterans having access to the health care benefits they’ve earned and deserve.

Effective 2015, VA has eliminated the use of net worth as a determining factor for both health care programs and copayment responsibilities.

This change makes VA health care benefits more accessible to lower-income Veterans and brings VA policies in line with Secretary Robert A. McDonald’s MyVA initiative which reorients VA around Veterans’ needs.

“Everything that we do and every decision we make has to be focused on the Veterans we serve,” said VA Secretary Robert A. McDonald. “We are working every day to earn their trust. Changing the way we determine eligibility to make the process easier for Veterans is part of our promise to our Veterans.”

Instead of combining the sum of Veterans’ income with their assets to determine eligibility for medical care and copayment obligations, VA will now only consider a Veteran’s gross household income and deductible expenses from the previous year. Continue reading

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Rural hospitals, one of the cornerstones of small town life, face increasing pressure

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Farm with red barnBy Guy Gugliotta
KHN

MOUNT VERNON, Texas — Despite residents’ concerns and a continuing need for services, the 25-bed hospital that served this small East Texas town for more than 25 years closed its doors at the end of 2014, joining the ranks of dozens of other small rural hospitals that have been unable to weather the punishment of a changing national health care environment.

For the high percentages of elderly and uninsured patients who live in rural areas, closures mean longer trips for treatment and uncertainty during times of crisis. “I came to the emergency room when I had panic attacks,” said George Taylor, 60, a retired federal government employee. “It was very soothing and the staff was great. I can’t imagine Mount Vernon without a hospital.”

Since 2010, 48 rural hospitals have closed, the majority in Southern states, and 283 are in trouble.

The Kansas-based National Rural Health Association, which represents around 2,000 small hospitals throughout the country and other rural care providers, says that 48 rural hospitals have closed since 2010, the majority in Southern states, and 283 others are in trouble. In Texas along, 10 have changed. 

“If there was one particular policy causing the trouble, it would be easy to understand,” said health economist Mark Holmes, from the University of North Carolina, whose rural health research program studies national trends in rural health care. “But there are a lot of things going on.” Continue reading

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Hospitals struggle to improve patient satisfaction

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hospital magnify 300By Jordan Rau
KHN

SALISBURY, N.C. — Lillie Robinson came to Rowan Medical Center for surgery on her left foot. She expected to be in and out in a day, returning weeks later for her surgeon to operate on the other foot.

But that’s not how things turned out. “When I got here I found out he was doing both,” she said. “We didn’t realize that until they started medicating me for the procedure.” Robinson signed a consent form and the operation went fine, but she was told she would be in the hospital far longer than she had expected.

“I wasn’t prepared for that,” she said.

Disappointing patients such as Robinson is a persistent problem for Rowan, a hospital with some the lowest levels of patient satisfaction in the country. In surveys sent to patients after they leave, Rowan’s patients are less likely than those at most hospitals to say that they always received help promptly and that their pain was controlled well. Rowan’s patients say they would recommend the hospital far less often than patients do elsewhere.

In April, the government will begin boiling down the patient feedback into a five-star rating for hospitals. Hospitals say judging them on a one-to-five scale is too simplistic.

Feedback from patients such as Robinson matters to Rowan and to hospitals across the country. Since Medicare began requiring hospitals to collect information about patient satisfaction and report it to the government in 2007, these patient surveys have grown in influence.  For the past three years, the federal government has considered survey results when setting pay levels for hospitals. Some private insurers do as well.

In April, the government will begin boiling down the patient feedback into a five-star rating for hospitals. Federal officials say they hope that will make it easier for consumers to digest the information now available on Medicare’s Hospital Compare website. Hospitals say judging them on a one-to-five scale is too simplistic.

Some Hospitals Improve As Others Stagnate 

Nationally, the hospital industry has improved in all the areas the surveys track, including clean and quiet their rooms are and how well doctors and nurses communicate.But hundreds of hospitals have not made headway in boosting their ratings, federal records show. Continue reading

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UW medical school to be ranked in the top 10 for research and primary care by US News & World Report

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UW US News & World Report is offering a “sneak peek” at its 2016 Best Graduate School Rankings due out next week. University of Washington will be ranked in the top 10 in the nation for research and for primary care.

via 2016 Best Graduate Schools Preview: Top 10 Medical Schools – US News.

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Widow sues Virginia Mason; hospital begins notifying ‘superbug’ victims | The Seattle Times

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creTheresa Bigler, of Woodway, is suing Virginia Mason Medical Center and a medical-device manufacturer after the death of her husband following a “superbug” infection. Hospital officials have reversed course to reach out to affected patients and families.

via Widow sues Virginia Mason; hospital begins notifying ‘superbug’ victims | The Seattle Times.

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