Category Archives: Provider News

Medicaid expansion puts spotlight shortage of primary care providers

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Blue doctorBy Michael Ollove, Stateline

This story comes from our partner Stateline, the daily news service of the Pew Center on the States.

The Affordable Care Act will usher at least seven million more Americans into Medicaid next year, but the question of whether enough doctors will be there to welcome them is keeping some state health policymakers up at night.

A report published last year in Health Affairs signaled trouble ahead. According to that study by Sandra Decker, an economist at the National Center for Health Statistics, only two out of three primary care physicians surveyed in 2011 were willing to accept new Medicaid patients.

Larger numbers said they would take on new Medicare patients or see new patients with private insurance. Medicare, health care for the elderly, is a purely federal program; Medicaid, which covers many poor people, is a joint state and federal enterprise.

The latest findings are particularly worrisome because they come on top of an existing national shortage of primary care doctors. A report by the Association of American Medical Colleges found that the United States needed 9,000 more primary care doctors than it had in 2010 and projected that the shortfall would grow to nearly 30,000 in 2015, when millions more Americans will have health insurance coverage thanks to President Obama’s Affordable Care Act. (The Agency for Healthcare Research and Quality estimates that in 2010 there were 209,000 primary care physicians in the U.S.)

Poor compensation in relation to other specialties helps explain the primary care shortage.  Money is also a likely explanation for why those who do practice on the front lines of primary medicine are reluctant to take on new Medicaid patients.

On average, Medicaid pays physicians 59 percent of the amount Medicare pays for primary care services. And it’s not as if doctors regard Medicare as extremely generous.

Temporary Fix

The authors of the Affordable Care Act foresaw that there would be a growing shortage of primary care doctors for Medicaid when expansion occurs January 1, 2014.

That’s why the law includes a provision that raises the Medicaid fees paid to doctors practicing primary care medicine to the same levels Medicare pays for those services.

The Medicare-Medicaid match went into effect January 1 this year and will remain in effect for two years. Best of all from the states’ point of view, in most cases the federal government will bear the entire cost of that increase. (Most other Medicaid costs involve both state and federal contributions.)

As a result of the provision, Medicaid physician fees for primary care services have climbed an average of 73 percent, according to a report prepared for the Kaiser Family Foundation by the Urban Institute. It is the biggest fee increase in the history of Medicaid. (KHN is an editorially independent program of the Kaiser Family Foundation.)

But whether the pay raise will accomplish what its champions intended is hardly a given. One drawback is its sunset provision in two years. No one knows what will happen at that point. Will states be willing to contribute to the higher pay rates after two years? Will the federal government extend the pay raise?

Maybe not, says Matt Salo, executive director of the National Association of Medicaid Directors. “[The federal government is] going into deficit reduction mode now,” he says. “They’re not going to want to do increased spending.”

So, there is the possibility that in 2015, the primary care rates might drop to the levels that prevailed in past years, and that could affect whether doctors decide to take on new Medicaid patients in the interim. Why increase the number of Medicaid patients in your practice when you suspect your compensation for their care will plunge in 2015?

“If I choose to increase the number of Medicaid patients, and two years down the road that payment drops back to two-thirds, all of a sudden I’m going to have an awful lot of trouble keeping my doors open,” says Reid Blackwelder, a Tennessee family practitioner and incoming president of the American Academy of Family Physicians. That group supported the increased fee provision and is now lobbying to make it permanent.

The way the rate increase works is that the federal government will pay the difference between the Medicaid rates for primary care services that were in effect in each state on July 1, 2009 and whatever the Medicare rates for those same services are now. The amount varies greatly from state to state.

In 2012, the Medicaid-to-Medicare ratio ranged from a low of 37 percent in Rhode Island to a high of 134 percent in North Dakota, according to the Kaiser Family Foundation report. California, Florida, Michigan, Missouri, New Hampshire, New Jersey, New York and Rhode Island, where almost four out of every ten Medicaid recipients live, all paid less than 60 percent of Medicare prices. Overall, the report says, nearly half of the states paid Medicaid doctors 75 percent or less of the Medicare rates.

Some States Must Pay

While the price hike is a big help to most states and most physicians, there is a catch for nine states plus the District of Columbia. Because of the recession, each of those jurisdictions reduced their Medicaid physician fees after the July 1, 2009, cut-off date. As a result, they will have to make up that difference themselves before Uncle Sam kicks in the additional money.

Arizona, for example, reduced its Medicaid rates by 11 percent after July 1, 2009 and will now have to make up that cut. Monica Coury, a spokesperson for Arizona’s Medicaid program, says that the state share for getting back to the 2009 levels will be just above $100 million over two years.

Also irksome, she adds, is the fact that the Obama Administration waited a long time to put out the technical specifications, and Arizona and many other states were not ready to start paying the higher rates on January 1. Physicians in those states will be paid the higher rates retroactively.

Washington D.C. was unlucky in terms of the July 1, 2009, date. Less than three months before that day, the city, on its own initiative, had raised its Medicaid doctor pay to match its Medicare rates. Since then, however, the city has cut the Medicaid rate by 13 percent. Like Arizona, the District will now be on the hook for the difference between the July 1, 2009, primary care Medicaid rates and those rates now.

Will the Fix Work?

But more distressing for health policy makers is that when the District of Columbia first raised its Medicaid rates to match those of Medicare, there was no significant increase in the number of primary care doctors taking Medicaid patients, according to Linda Elam, head of Medicaid services in the District. That suggests the possibility that this new bump up in Medicaid rates may not have the hoped for impact.

“There will always be a set of providers that are not interested in participating in the Medicaid program whatever the incentives,” says Elam.

In contrast, Lawrence Kissner, commissioner for Health and Family Services in Kentucky, says that his state’s Medicaid pay raise in 2005 resulted in a 36 percent increase in the number of primary care doctors accepting Medicaid patients, precisely what the ACA’s authors hope will happen now.

Unfortunately, whether the new raise in rates has the same effect nationally may not be known before 2014, when states will have to decide whether to make the higher rates permanent. “It’s not that easy to monitor Medicaid participation in a short period of time,” says Stephen Zuckerman, a senior fellow at the Urban Institute and co-author of the Kaiser report.

Rebecca Jaffe, a family practitioner in a three-doctor practice in Wilmington, North Carolina, says that for now she’s not going to increase the number of Medicaid patients she accepts. She’s just grateful that the increase in Medicaid rates for the present means she’ll finally be able to replace the clinic’s ancient fax machine.

While the issue of having enough doctors to cover an expanded Medicaid population is serious, many state health policy makers say they have bigger concerns. “Certainly, as is the case in any state, there are docs that will not see Medicaid patients,” says Matt Kennicott, spokesman for the New Mexico Human Services Department. “Our issue, again as is the case in many other states, is that we do not have enough primary care doctors to handle the caseload we presently have.”

Which is why some are puzzled by one of the restrictions of the health law. The rate increase applies to physicians who provide primary and pediatric care services. Only doctors whose practices comprise at least 60 percent primary care will be eligible for the Medicaid pay raise.

Not covered, however, are nurse practitioners, who often provide primary care in rural and isolated areas that do not have doctors nearby. Seventeen states allow nurse practitioners to operate independently of the supervision of physicians, but the nurse practitioners in those states will not be eligible to receive higher fees.

“We think it will limit access and does create a discriminatory aspect that shouldn’t be there,” says Jan Towers, a senior policy adviser at the American Association of Nurse Practitioners.

Asked why she thought the nurse practitioners were excluded, Towers gave a simple answer:  money.

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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Washington Secretary of Health Mary Selecky to retire

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Washington State Secretary of Health Mary SeleckyWashington State Secretary of Health Mary Selecky plans to retire from state service and return to her longtime home in Colville, the Washingtion State Department of Health announced Tuesday.

Selecky informed Gov. Jay Inslee of her plans this week, and has agreed to stay on until a new secretary of health is found, the department said in a press release announcing her decision.

Details from the announcement:

Selecky has served three governors since first being appointed “acting secretary” by Gov. Gary Locke in October 1998. Her nearly 15 years as Washington’s secretary of health make her one of the longest serving state health leaders in the country.

Before being named secretary, Selecky was the administrator for the Northeast Tri County Health District in our state for nearly 20 years, and marks 38 years in public service this year.

Under Selecky’s leadership, Washington’s adult smoking rate has dropped 30 percent, and youth smoking rates are down by half; childhood vaccination rates are the highest in years.

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Patient loads often at unsafe levels, hospital doctors say

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By Alvin Tran

Nearly forty percent of hospital-based general practitioners who are responsible for overseeing patients’ care say they juggle unsafe patient workloads at least once a week, according to a study published Monday as a research letter in JAMA Internal Medicine.

In the study, researchers at Johns Hopkins University invited nearly 900 attending physicians, known as hospitalists, to complete an online survey that measured various characteristics, including the number of patients they thought they could manage safely during a typical shift.

Hospitalists are the physicians who coordinate a patient’s care and medications among various specialists while they’re in the hospital and oversee their transition home.

Physician and Nurse Pushing Gurney

Among the 506 doctors who completed the survey, forty percent reported that their patient workloads exceeded levels they deemed safe at least once a month.

Thirty-six percent said they exceeded their own notions of safe workloads more than once a week.

And nearly a quarter believe their workloads negatively affected patient outcomes by preventing full discussion of treatments.

“We know that with increased pressures from the health care system, with decreased reimbursement, present restrictions on work hours, and a focus on patient flow, that there is the concern that attending physician workload has increased,” said Dr. Henry Michtalik, an assistant professor of medicine and the study’s first author.

Michtalik and his colleagues also found that more than 20 percent of survey respondents believe their workload likely resulted in negative outcomes for patients by contributing to patient transfers, complications and even death.

Twenty-two percent said they’ve ordered unnecessary procedures, consultations, and other tests due to time constraints.

The study authors acknowledged, however, that the respondents were self-selected and they had no way of confirming whether the  doctors’ perceptions of risks correlated with actual risks.

“With an increased amount of patients into the health system, if there is an underlying issue with work load, we can expect it to get worse,” Michtalik added in an interview.

Though the findings don’t surprise Dr. Eugene Litvak, the president and chief executive officer of the Institute for Healthcare Optimization, a nonprofit research group, who said he thought the study was overdue.

“It may be common sense, but it’s important to have data to support it,” he said in an interview.

According to Litvak, physicians at hospitals across the country are regularly subjected to highly fluctuating patient demand.  “Those peaks [in demand] are mostly artificial in nature … and are the result of our mismanaged patient flow. Smoothing those peaks is the only alternative to reducing physician workloads short of hiring more physicians.”

Michtalik said the health care system has typically responded to increased costs by trying to decrease reimbursements, “assuming that providers and health care systems will become more efficient.”

“In actuality,” he said, “we may be focusing on a pennywise strategy, where we’re actually causing pounds of increased cost because of additional unnecessary testing, decreased discussions, and a paradoxical increase in costs.”

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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Northwest Kidney Centers opens extensively remodeled facility at 700 Broadway

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Northwest Kidney Centers has completed an extensive remodel its facility at 700 Broadway.

The $8 million remodel of the building, known as Haviland Pavilion, includes:

  • An updated 15-station dialysis clinic.
  • Surge capacity for emergency dialysis in case a disaster makes services impossible at another dialysis facility in the region.
  • An expanded pharmacy that serves the special needs of people with chronic kidney disease, on dialysis or with a kidney transplant. Compared to the old pharmacy, capacity is now tripled.
  • A clinical research center to allow Kidney Research Institute investigators to work with Northwest Kidney Centers patients on studies and advance research.
  • New space and increased capacity for physician and clinical staff training and community and patient education, including a demonstration kitchen to show patients and their families to prepare tasty, healthy food.
  • A museum and gallery that showcase important artifacts of the medical history made at Northwest Kidney Centers.

Northwest Kidney Centers purchased the 40,000-square-foot building in 1978. The building is named for Dr. James Haviland, a founding father of Northwest Kidney Centers.

Dr. Haviland was president of the King County Medical Society in the early 1960s, at the time Dr. Belding Scribner at the University of Washington was developing technology to enable people to live indefinitely with kidney failure.

The two are credited with marshaling the community resources to create the world’s first dialysis organization 50 years ago.

The facility, which provides dialysis for some of Northwest Kidney Centers’ poorest and most at-risk patients, is one of three dialysis facilities on First Hill. The other two are located at 548 15th Ave. and at 600 Broadway.

$1.7 million of the $8 million construction cost was raised via Northwest Kidney Centers’ Transforming 700 Broadway capital campaign. More than 100 donors made gifts to the campaign

Northwest Kidney Centers provides 234,000 treatments per year to nearly 1,500 patients in its 14 dialysis centers, in 11 hospitals and in homes.

It is the largest provider of dialysis services in King and Clallam counties, and it offers one of the largest home hemodialysis programs in the United States.

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Seattle Children’s Hospital to provide neonatal intensive care at Franciscan Health System Birth Centers

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Seattle Children’s Hospital neonatologists and neonatal nurse practitioners will provide 24/7 care to premature and critically ill newborns at St. Joseph Medical Center in Tacoma, and will provide 24/7 neonatal support and consultation at St. Francis Hospital in Federal Way and St. Elizabeth Hospital in Enumclaw beginning in early 2013.

This new partnership with Franciscan Health System will expand the availability of specialized neonatal care in the South Sound region through a collaborative neonatal medical team, and provide continuing education and training for Franciscan providers and staff.

In March, Franciscan received approval from the Washington State Department of Health to open a Level III neonatal intensive care unit (NICU) for premature and critically ill infants born at St. Joseph Medical Center.

The Level III designation allows the St. Joseph staff to care for newborns that are as young as 28 weeks’ gestation (born 12 weeks before the due-date) or as small as 1000 grams (2 pounds, 2 ounces). It also permits the hospital to offer more advanced care.

The 18-bed, Level II special care nursery at St. Joseph is being expanded and remodeled to include the new five-bed Level III NICU that is scheduled to open in the summer of 2013.

The Children’s team will work closely with the Franciscan team in on-site management of the daily operations of the Level II and Level lll beds at St. Joseph, and the Level II beds in the special care nursery at St. Francis Hospital.

The Franciscan Birth Centers in Tacoma, Federal Way and Enumclaw deliver more than 5,000 babies annually. More than 3,800 babies are born every year at St. Joseph Medical Center alone, making it the busiest birth center in the South Sound and the sixth-busiest in the state.

Approximately 10 percent of newborns need Level II or Level III intensive care. The addition of the Level III NICU at St. Joseph and the partnership with Children’s will help ensure that premature and critically ill newborns can receive the most advanced care where they are born, minimizing the need to transfer them to another hospital for special care.

Such transfers can be difficult and inconvenient for parents who are already emotionally stressed because their baby has been born prematurely or ill.

St. Joseph Medical Center is the fourth regional hospital with a Level III NICU to partner with Children’s neonatology services. The other NICUs are at Providence Regional Medical Center in Everett, Overlake Hospital Medical Center in Bellevue and Kadlec Regional Medical Center in Richland.

 

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Instagram comes to the OR

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Seattle’s Swedish Medical Center will cover a cochlear implant surgery live Oct. 2nd at 7 a.m., displaying images from the operation on the online photo website Instagram while narrating the procedure simultaneously on Twitter, the micro-blogging site.

The surgery, which can help restore hearing, will be performed by Dr. Douglas Backous, from the Swedish Neuroscience Institute.

The online program is part of a month-long web series on hearing loss produced by the medical center. Swedish has been releasing videos discussing hearing loss and cochlear implant surgery, since early September.

The web series will end with two live, text-based chats on Oct. 10 at 10 a.m. and 6 p.m. (PT) that will be led by Dr. Backous, a patient and other medical professionals.

The chat will provide the public with the opportunity to submit questions and interact with these leading hearing-loss experts, as well as view footage from a cochlear implant surgery. The chats will take place atwww.swedish.org/SwedishHear.

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Group Health Cooperative plans layoffs and cuts – Seattle Times

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Group Health Cooperative must cut $250 million over the next 16 months through layoffs, better cost control and some reorganization at the top, Seattle Times health reporter Carol Ostrom reports in today’s issue of the paper.

Ostrom writes:

Group Health, which insures about 600,000 people in Washington and has annual revenues of $3.5 billion, is aiming to climb back up to a 3 percent operating margin, Armstrong said in a Friday memo to staff, first reported by the Puget Sound Business Journal. The memo noted there had been three years of sharp declines in finances.

“This cannot continue,” Armstrong wrote. “We are better than this, and I am not going to let us have another year like this one.”

To learn more read Ostrom’s article: Group Health announces layoffs, cuts.

 

 

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State seal of Washington statePeriodically Washington State Department of Health issues an update on disciplinary actions taken against health care providers, including suspensions and revocations of licenses, certifications, or registrations of providers in the state.

The department has also suspends the credentials of people who have been prohibited from practicing in other states.

Information about health care providers is also on the agency’s website.

To find this information click on “Provider Credential Search” on the left hand side of the Department of Health home page (www.doh.wa.gov).

The site includes information about a health care provider’s license status, the expiration and renewal date of their credential, disciplinary actions and copies of legal documents issued after July 1998.

This information is also available by calling 360-236-4700.

Consumers who think a health care provider acted unprofessionally are also encouraged to call and report their complaint.

Here is the August 21st update issued by the Washington State Department of Health:

Note: Health care providers charged with unprofessional conduct have 20 days to respond to the Department of Health in writing. The case then enters the settlement process. If no disciplinary agreement can be reached, the case will go to a hearing.

State disciplines health care providers

OLYMPIA - The Washington State Department of Health has taken disciplinary actions or withdrawn charges against health care providers in our state.

The department’s Health Systems Quality Assurance Division works with boards, commissions, and advisory committees to set licensing standards for more than 70 health care professions (e.g., medical doctors, nurses, counselors).

Information about health care providers is on the agency website. Click on “Look up a healthcare provider license” in the “How Do I?” section of the Department of Health website (doh.wa.gov).

The site includes information about a health care provider’s license status, the expiration and renewal date of their credential, disciplinary actions and copies of legal documents issued after July 1998.

This information is also available by calling 360-236-4700. Consumers who think a health care provider acted unprofessionally are also encouraged to call and report their complaint.

Benton County

In August 2012 the Chiropractic Commission amended the statement of charges against chiropractor Russell S. Tagg (CH00002726). Tagg’s license was immediately suspended in March 2012 for alleged sexual misconduct. Charges say he touched more than one client inappropriately during massage treatments.

Clark County

In August 2012 the Nursing Assistant Program charged certified nursing assistant Cindy Higdon (NC10079361) with unprofessional conduct. Higdon allegedly documented that she had administered medications to several patients when she hadn’t.

In August 2012 the Pharmacy Board released pharmacy technician Cory A. Reese (VA00072656) from terms and conditions set against his credential.

King County

In August 2012 the Counselor Program ended the probation order against mental health counselor associate Kathi Lee Buchanan (MC60155168).

In July 2012 the Nursing Assistant Program denied the registered nursing assistant credential application of Mikia Tacarra Cain (NA60273563). Cain was convicted of first-degree identity theft in 2005.

In August 2012 the Pharmacy Board ended the probation order against pharmacist intern, pharmacy assistant, and pharmacist Richard P. Cole (IR00064870, VB00052991, PH60223078).

In August 2012 the Nursing Commission charged licensed practical nurse Roger S. Miller (LP00056350) with unprofessional conduct. Miller allegedly didn’t comply with a previous stipulation.

In August 2012 the Veterinary Board of Governors entered into an agreed order with veterinarian Eric E. Schneider (VT00002015). Schneider must comply with terms and conditions set against his license.

In August 2012 the Nursing Assistant Program charged certified nursing assistant Mabinty Williams (NC10093665) with unprofessional conduct. Williams was allegedly caring for a five-week old baby, when the infant suffered chemical burns on her face and a torn frenulum in her mouth requiring emergency hospitalization. Williams was convicted of third-degree assault.

Mason County

In August 2012 the Respiratory Care Practitioner Program charged Sheila Jorgenson (LR00001508) with unprofessional conduct. Jorgenson allegedly tested positive for methadone during a workplace urinalysis.

Pierce County

In August 2012 the Nursing Commission charged licensed practical nurse Ronni Marie Benson (LP00052126) with unprofessional conduct. Benson allegedly didn’t comply with a previous stipulation.

In August 2012 the Nursing Assistant Program charged certified nursing assistant LaShaunda LaShae Crocklem (NC60083783) with unprofessional conduct. Crocklem allegedly forged documents and a letter to Department of Social and Health Services in an attempt to get money from the agency.

In August 2012 the Nursing Assistant Program charged certified nursing assistant Teosia Paaga (NC10068759) with unprofessional conduct. Paaga allegedly took $30 from a resident at the assisted living facility where she worked.

In July 2012 the Nursing Commission reinstated the license of licensed practical nurse Karen E. Riveness (LP00048682). Riveness must comply with terms and conditions set against her license.

Snohomish County

In August 2012 the Nursing Assistant Program reinstated the credential of registered nursing assistant Paulette L. Alston (NA00108145) and placed it on probation for at least six months. Alston must comply with terms and conditions set against her credential.

In August 2012 the Pharmacy Board ended the probation order against pharmacist Christopher M. Karwoski (PH00040262).

In August 2012 the Nursing Assistant Program denied the registered nursing assistant credential application of Amanda Rose Kullman (NA60178223). Kullman was convicted of third-degree theft in Oregon in 2004 or 2005 and third-degree theft in Washington in 2008, and didn’t disclose the convictions on her application.

Spokane County

In August 2012 the Counselor Program denied the licensed social worker credential application of Corey M. Bauer (SA60281666). Bauer’s registered counselor credential was revoked for 10 years in 2005.

In August 2012 the Chiropractic Commission entered into an agreed order with chiropractor Kevin L. Bond (CH00001649). Bond must comply with terms and conditions set against his license.

In August 2012 the Nursing Assistant Program charged registered nursing assistant Jacob F. Colliton (NA00141987) with unprofessional conduct. Colliton allegedly sought emergency care after ingesting ecstasy. During the hospital visit, he allegedly said he had been snorting and smoking Oxycontin for several months. Colliton also allegedly failed to cooperate with an investigation.

In August 2012 the Nursing Assistant Program charged registered nursing assistant Ashley D. Muzatko (NA60258332) with unprofessional conduct. Muzatko allegedly used a patient’s Electronic Benefit Transfer (EBT) card without permission.

In August 2012 the Chemical Dependency Professional Program denied the chemical dependency professional trainee credential application of Martina Jane Nelson(CO60264488). Nelson’s social worker license in Montana was indefinitely suspended in 2010.

Thurston County

In August 2012 the Nursing Assistant Program reinstated the credential of certified nursing assistant Pabior C. Ajang (NC10085671). Ajang must comply with terms and conditions set against his credential including participation in a substance abuse monitoring program.

In August 2012 the Counselor Program charged certified sex offender treatment provider and independent clinical licensed social worker Brian O. Cobb (FC00000165, LW00006992) with unprofessional conduct. Cobb allegedly failed to provide proper supervision, maintain client files, develop community protection contracts, and provided substandard care to several patients.

In August 2012 the Respiratory Care Practitioner Program charged Carolyn R. Parris (LR00003991) with unprofessional conduct. Parris allegedly failed to comply with a previous stipulation.

Out of state

Florida: In August 2012 the Medical Commission charged physician Darrin L. Frye (MD60041498) with unprofessional conduct. Frye’s license to practice medicine in Florida was suspended.

Note to Editors: Health care providers charged with unprofessional conduct have 20 days to respond to the Department of Health in writing. The case then enters the settlement process. If no disciplinary agreement can be reached, the case will go to a hearing.

The Department of Health website (www.doh.wa.gov) is your source for a healthy dose of information. Also, find us on Facebook and follow us on Twitter.


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Catholic Health Initiatives, PeaceHealth agree to form regional health care network

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Catholic Health Initiatives and PeaceHealth, two nonprofit health care systems, have signed a non-binding letter of intent to create a new regional health care system in the Northwest, the two health systems have announced,

The partnership will create an integrated health system in the region, combining seven Catholic Health Initiatives hospitals in Washington and Oregon with nine PeaceHealth hospitals in Washington, Oregon and Alaska.

The new organization will include nearly 26,000 employees and about 950 employed physicians serving in hospitals, physician clinics, outpatient care clinics, long-term care facilities, laboratories and private homes across the region.

The new organization will have annual revenues of almost $4 billion.

“Catholic Health Initiatives and PeaceHealth share common cultures and values,” said Kevin E. Lofton, president and chief executive officer of Englewood, Colorado-based CHI, the nation’s second largest faith-based health system. “We see this as a natural evolution – a perfect way to share economies of skill and scale, improve health services and reinforce our common mission to create and nurture healthier communities.”

The nonbinding letter of intent is the first step in the partnership process. Leaders of Catholic Health Initiatives and PeaceHealth expect to form the new system before June 30, 2013, after completing the due diligence and approval process.

The two organizations will be equal partners in the fully integrated health care system serving the northwest region.

Discussions were prompted by a rapidly changing health care environment that demands a more coordinated, integrated approach to the way health and wellness services are delivered to individuals and communities, the systems said in a statement announcing the new agreement.

It also demands the ability to accept more financial risk in caring for defined populations, such as Medicaid recipients, they said.

The size and scale of the new organization will allow it to form additional collaborations and networks of care that will include physicians, hospitals, insurers and other caregivers, increasing access to high-quality health services while reducing costs, they said.

The partners plans to reduce costs by making infrastructure investments more efficiently as a single organization in areas such as information technology systems.

The new organization will include two CHI hospitals in Oregon – Mercy Medical Center, Roseburg; and St. Anthony Hospital, Pendleton – and five facilities in Washington that comprise Tacoma-based Franciscan Health System: St. Joseph Medical Center, Tacoma; St. Francis Hospital, Federal Way; St. Clare Hospital, Lakewood; St. Anthony Hospital, Gig Harbor; and St. Elizabeth Hospital, Enumclaw. Also included are Franciscan Medical Group and Franciscan Hospice and Palliative Care.

PeaceHealth operates four hospitals in Oregon: PeaceHealth Cottage Grove Community Hospital – Cottage Grove; PeaceHealth Peace Harbor Hospital – Florence; PeaceHealth Sacred Heart Medical Center at RiverBend – Springfield; and PeaceHealth Sacred Heart Medical Center, University District – Eugene; three hospitals in Washington: PeaceHealth St. Joseph Medical Center – Bellingham; PeaceHealth St. John Medical Center – Longview; and PeaceHealth Southwest Medical Center – Vancouver, with a fourth, PeaceHealth Peace Island Medical Center – Friday Harbor, scheduled to open in November; and one in Alaska: PeaceHealth Ketchikan Medical Center – Ketchikan.

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Four appointed to Harborview leadership posts.

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UW Medicine has appointed four to leadership posts at Harborview Medical Center:

Chief of Trauma: Dr. Eileen Bulger

Harborview Medical Center’s new chief of trauma is Dr. Eileen Bulger, UW professor of surgery. Bulger has more than twenty years of experience working at Harborview as a trauma surgeon and, since 2009, has been the Medical Director of the Emergency Services.

Dr. Bulger has been active in the Washington State Trauma System and serves as the Chair of the Governor’s Steering Committee for EMS and Trauma.

Dr. Bulger has held numerous other leadership positions nationally and regionally, including Chair of the Washington State American College of Surgeons Committee on Trauma, Region Chief for the four states of Region X (Washington, Oregon, Alaska and Idaho) and President of the Washington State Chapter of the American College of Surgeons.

She is known for her research into trauma resuscitation and injury prevention.

Associate Administrator, Chief Nursing Officer: Darcy Jaffee

Darcy Jaffe has been named Associate Administrator, Chief Nursing Officer at Harborview Medical Center, where she will be responsible for the overall accountability for nursing practice across the medical center.

Jaffe has worked at Harborview since 1986 and has provided service in a variety of progressive leadership roles.

She received her undergraduate and graduate degrees in Nursing from the University of Washington and is credentialed as an Advanced Nurse Practitioner.

Assistant Administrator of Finance: Kera Rabbitt

Kera Rabbitt, has been named Assistant Administrator of Finance at Harborview, where she will serve as a financial resource for the medical center’s executive team and as a primary point of integration between Harborview and the UW Medicine health system finance team.

Previously, Rabbitt served as Director of Finance for the Oregon Health and Science University (OHSU) and the Knight Cancer Institute at OHSU, and as Manager of the Finance Division at University Medical Center in Tucson, Arizona.

Rabbitt received her Bachelor of Science degree in Finance from the Eller College of Management at the University of Arizona and her Master’s in Business Administration from the Lundquist College of Business at the University of Oregon.

Associate Administrator for Surgical, Emergent and Integrated Services: Becky Pierce

Becky Pierce has assumed the role of Associate Administrator for Surgical, Emergent and Integrated Services.

She is a registered nurse who has served in a variety of progressive leadership positions during her 22 years at Harborview, including most recently serving as Assistant Administrator, Patient Care Services.

She has published and lectured nationally on topics related to critical care and trauma nursing, and is an advocate for patient and family-centered care.

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King County naturopaths charged in medical marijuana cases

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From the Washington State Department of Health:

OLYMPIA – Two naturopathic physicians face state charges of providing sub-standard care in conducting patient examinations to authorize medical marijuana.

The Board of Naturopathy and the state Department of Health have issued charges against King County naturopathic physicians Carolyn Lee Bearss (NATU.NT.60134517) and Dimitrios Jimmy Magiasis (NATU.NT.60199408) in separate legal actions.

The statements of charges say Bearss and Magiasis examined and treated more than 200 patients seeking medical marijuana authorization at the 2011 “Hempfest” event in Seattle.

The charges say the examinations were below the standard of care. Allegations include inadequate review of patient medical histories; inadequate documentation of the examinations and diagnoses; and failure to establish an ongoing patient care relationship.

The allegations say that in some cases the patients’ conditions did not meet state requirements for a medical marijuana authorization.

Bearss and Magiasis each have 20 days to respond to the statement of charges, which are available online by clicking, “Look up a health care provider” on the Department of Health home page (doh.wa.gov) or by calling 360-236-4700.

Anyone who believes a health care provider acted unprofessionally is encouraged to call that number to report the complaint.

The Board of Naturopathy regulates naturopathic physicians in Washington. The board establishes, monitors, and enforces qualifications for licensing, consistent standards of practice, continuing competency mechanisms and discipline. Rules, policies and procedures promote the delivery of quality health care to state residents.

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Dr. Ruth McDonald

Ruth McDonald has been appointed pediatrician-in-chief at Seattle Children’s

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Dr. Ruth McDonald has been appointed pediatrician-in-chief at Seattle Children’s Hospital.

Dr. McDonald, a pediatric nephrologist, has been with Seattle Children’s for 19 years, most recently as medical director of Ambulatory Services where she focused on improving communications and aligning hospital and clinic needs with the needs of referring physicians.

Continuing to enhance such communications will become part of Dr. McDonald’s responsibilities in her new pediatrician-in-chief role, hospital officials said.

Dr. McDonald is also an at-large member of the Children’s University Medical Group Board of Directors and chairs the group’s Clinical Practice Committee.

Dr. McDonald also serves as principal investigator in many multicenter research studies on pediatric renal transplantation. Additionally, she serves on the pediatric nephrology sub-board of the American Board of Pediatrics.

Dr. Mark Del Beccaro, former pediatrician-in-chief, has moved into his new position as vice president of medical affairs at Seattle Children’s.

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Neighborcare Logo

Federal grant to fund new North Seattle community health center

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Neighborcare is one of five community health centers in Washington State to receive a federal New Access Point grant under the Affordable Care Act.

The grant will provide $650,000 per year to support the operation of a new clinic focused on the area of North Seattle from Lake Union to the King County northern border, including the residents of 22 public housing communities.

The proposal includes providing more than 30,000 patient visits in the two years of the grant project period.

In May 2012, Neighborcare was also the recipient of two federal capital grants to remodel its 45th Street Medical & Dental Clinic in Wallingford to improve disabled access, and to build a replacement facility for its undersized Greenwood Medical Clinic.

North Seattle has the greatest percentage of low-income people not yet served by a community health center in the city of Seattle: 22% of the total population (68,600 individuals) is low-income, living at or below 200% of the Federal Poverty Level, and 70% (48,220) of those individuals are not served by a community health center.

Neighborcare clinics provide a wide range of primary health care services for men, women and children, including:

  • Preventive medical and dental care
  • Obstetrics and newborn care, including midwifery services
  • Gynecology and reproductive health care
  • Pediatrics and well-child care
  • Immunizations
  • Geriatrics
  • Adolescent medicine
  • Home health care referrals
  • HIV/AIDS screening and treatment
  • Outreach and case management
  • Pharmacy and laboratory services
  • Nutrition counseling and health education
  • Substance abuse counseling
  • Individual, marital, family counseling
  • Social work services, including referrals for housing and financial assistance

To learn more:

Local resources:

Community Clinics

Community Resources:

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Job Thumb

Growth in health jobs is a good thing, isn’t it?

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The Downside Of Health Care Job Growth

By Jenny Gold

Health care employment has been the bright spot in the otherwise lackluster recent jobs reports. As overall employment decreased by 2 percent from 2000 to 2010, employment in the health care sector actually increased by 25 percent.

But that’s not necessarily a good thing, according to an opinion piece published in the most recent edition of the New England Journal of Medicine.

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“Treating the health care system like a (wildly inefficient) jobs program conflicts directly with the goal of ensuring that all Americans have access to care at an affordable price,” write Katherine Baicker and Amitabh Chandra, two researchers from Harvard.

By 2020, almost one out of nine American jobs will be in health care, an April study from the Center for Health Workforce Studies projects.

As the country wrestles to reduce health care spending, which already consumes about 18 percent of GDP, those extra jobs could be a step in the wrong direction.

“Salaries for health care jobs are not manufactured out of thin air—they are produced by someone paying higher taxes, a patient paying more money for health care, or an employee taking home lower wages because higher health insurance premiums are deducted from his or her paycheck,” write the authors of the NEJM column.

Yet hospitals and politicians alike often tout the jobs that the health care industry creates in local communities.

“The health care sector is an economic mainstay, providing stability and even growth during times of recession,” the American Hospital Association wrote in a fact sheet entitled “Economic Contribution of Hospitals Often Overlooked.”

The authors argue that the focus should instead be on improving health outcomes and efficiency, rather than simply more people working in the field, pointing  to “mounting evidence that out health care system could deliver better care without spending more and that there are tremendous opportunities for improvements in productivity.”

Several provisions of the 2010 health care law aim to reduce inefficiencies by rewarding higher-value care and reducing some of the incentives for doctors to deliver more testing and care with unproven benefits.

Such policies may serve to reduce health care employment, the authors argue, by “allowing us to get the same health outcomes with fewer health care workers.”

Some jobs in health care could be lost; however, taxpayers and workers in other fields would likely pay less in premiums.

“The bottom line is that employment in the health care sector should be neither a policy goal nor a metric of success,” they conclude.


This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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Nurse holding a stethoscope

Health care employment continues growing faster than other sectors

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By Jay Hancock

Health-care employers continued hiring at a brisk pace last month even as overall employment growth slowed down, today’s jobs report shows.

Hospitals, doctor offices and other medical employers added 19,000 jobs in April.

That represents a sixth of the total April increase of 115,000 jobs, even though health care makes up only 11 percent of the employment base.

While some insurers have reported continued moderation in health-cost increases this year, the job gains suggest that health care continues to claim larger portions of the economy, analysts say.

With an aging population and a continued struggle by policymakers to contain medical spending, health care ”is almost recession proof,” said Nariman Behravesh, chief economist for IHS, an economic research company

Of the 1.8 million jobs added by the economy in the last 12 months, 17 percent have been in medicine. Health spending represents 18 percent of the U.S. economy – a higher portion than in any other nation.

“As we try to grapple with health-care costs and try to get them under control, I suspect that will take its toll in one of two ways: either in terms of [slowing growth of] the average salaries in health care or in employment growth. I suspect in employment growth,” Behravesh said. However, he added: “It may not happen in the next couple of years.”


This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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