New Mexico’s nurse hotline touted as a model for other states

Share

red-telephoneBy Christine Vestal
Stateline

If your infant has a high fever or you’re experiencing an unusual pain in your abdomen and you live in New Mexico, you may want to call the NurseAdvice line before you do anything else.

New Mexico is the only state with a 24/7 registered nurse call center that is free to all residents, whether insured or not. In operation since 2006, it has kept tens of thousands of New Mexicans out of emergency rooms and saved the state more than $68 million in health care expenses.

It has provided a basic form of health care to thousands of uninsured people who have no other access to care. It also has relieved demand on doctors and hospitals in a sparsely populated state where all but a few counties have a severe shortage of health care providers.

On top of that, the statewide call center has generated real-time public health data that has served as an early warning system during epidemics and natural disasters.

In April, the U.S. Centers for Disease Control and Prevention (CDC) will recommend New Mexico’s advice line as a national model that other states adopt during an emergency preparedness summit in Atlanta. Continue reading

Share

Your insurance questions answered

Share

Share your story flat illustrationBy Michelle Andrews
KHN

May I Move My Son From My Insurance Plan To A Better Option On The Marketplace?

Some readers want to figure out how to become eligible for coverage on the health insurance marketplaces, while others want to figure out how to avoid it.

This week I answered questions from both.

I am covered by my employer’s health plan, but I’m not happy with it. My son is 21 and currently covered under my plan. While I realize that I am not eligible for Obamacare, I am curious if I can terminate my son’s policy so that he might be eligible.   Continue reading

Share

How much does it cost?

Share

A new website, www.guroo.com, allows you to find out how much care for common conditions will cost. The site provides local, state and national average charges for these conditions. The site was created by the Health Care Cost Institute (HCCI), an independent, non-partisan, non-profit organization that promotes research and analysis on the causes of rising US health spending.

Guroo.com Demo from Health Care Cost Institute on Vimeo.

Share

Fancy hospital flourishes don’t impress patients, study

Share
john-hopkins-570

(Photo courtesy of Johns Hopkins Medicine)

By Jordan Rau
KHN

The sleek hospital tower that Johns Hopkins Medicine built in 2012 has the frills of a luxury hotel, including a meditation garden, 500 works of art, free wi-fi and a library of books, games and audio.

As Dr. Zishan Siddiqui watched patients and some fellow physicians in Baltimore move from their decades-old building into the Sheikh Zayed Tower, the internist saw a rare opportunity to test a widespread assumption in the hospital industry: that patients rate their care more highly when it is given in a nicer place.

For decades, hospital executives across the country have justified expensive renovation and expansion projects by saying they will lead to better patient reviews and recommendations. One study estimated $200 billion might have been spent over a decade on new building.

Hopkins’ construction of the tower and a new children’s hospital cost $1.1 billion. Patient judgments have become even more important to hospitals since Medicare started publishing ratings and basing some of its pay on surveys patients fill out after they have left the hospital.

Siddiqui’s study, published this month by the Journal of Hospital Medicine, contradicts the presumption that better facilities translate into better patient reviews. Siddiqui examined how patient satisfaction scores changed when doctors started practicing in the new tower, which has 355 beds and units for neurology, cardiology, radiology, labor and delivery and other specialties.

Siddiqui discovered that for the most part, patients’ assessments of the quality of the clinical care they received did not improve any more than they did for patients treated in the older Hopkins building, which had remained open. Units there were constructed as early as 1913 and as late as 1980, Hopkins officials said. They functioned as the control group in the study, since a hospital’s satisfaction scores often change over time even when a hospital’s physical environment remains constant. Continue reading

Share

States strive to keep Medicaid patients out of ERs

Share

Sign for an emergency room.By Michael Ollove
Stateline

Nearly half the states use higher copayments to dissuade Medicaid recipients from unnecessary visits to emergency rooms, where care is more costly.

These states require patients to make the payments, which are as high as $30 per visit in Oklahoma, when it is later determined that they did not experience a true medical emergency.

But at least one multistate study has found that charging higher copayments does not reduce emergency department (ED) use by Medicaid recipients.

One reason might be that copays are hard to enforce, since EDs are legally obligated to examine anyone who walks through the doors, whether or not they can pay.

ED doctors and others in health policy also criticize copays as potentially dangerous, since they may lead people to think twice about seeking emergency care when they really need it.

Washington state and some Medicaid managed care plans around the country are trying a different approach. Instead of using financial disincentives, they are trying to keep frequent users out of the emergency department (practitioners prefer the name “emergency department” to “emergency room”) by enrolling them in primary care practices, scheduling appointments for them and, in some cases, making sure they get to the doctor’s office on time. The hope is that giving people comprehensive health care will make many ED trips unnecessary.

Reliable data are still sparse, but the early signs are encouraging: Washington state reported that a year after implementing its program, emergency room visits by Medicaid beneficiaries had declined by nearly 10 percent. Among frequent ED users, the drop was slightly greater. Continue reading

Share

Health news headlines – February 24, 2015

Share

Boy gets shot vaccine injection

Share

Global health news – February 24, 2015

Share

Globe floating in air

Share

Seattle Children’s and Mayo Clinic team to slash genetic testing costs – Puget Sound Business Journal

Share

Seattle Children's Whale LogoSeattle Children’s hospital and Mayo Medical Laboratories are creating a partnership to develop ways for children’s hospitals around the country to decrease costs and errors that come from unnecessary lab testing.

via Seattle Children’s and Mayo Clinic team to slash genetic testing costs – Puget Sound Business Journal.

Share

Few seniors benefiting from Medicare obesity counseling

Share

ScaleBy Sarah Varney
KHN

VISALIA, Calif. — In the farming town of Exeter, deep in California’s Central Valley, Anne Roberson walks a quarter mile down the road each day to her mailbox. Her walk and housekeeping chores are the 68-year-old’s only exercise, and her weight has remained stubbornly over 200 pounds for some time now.

“You get to a certain point in your life and you say, ‘What’s the use?’”

For older adults, being mildly overweight causes little harm, physicians say. But too much weight is especially hazardous for an aging body: Obesity increases inflammation, exacerbates bone and muscle loss and significantly raises the risk of heart disease, stroke, and diabetes.

Dr. Mylene Middleton Rucker, a primary care physician in Visalia, Calif., is using the new obesity counseling benefit with her patients, but many doctors aren’t aware of it yet. (Sarah Varney/KHN)

Dr. Mylene Middleton Rucker, a primary care physician in Visalia, Calif., is using the new obesity counseling benefit with her patients, but many doctors aren’t aware of it yet. (Sarah Varney/KHN)

To help the 13 million obese seniors in the U.S., the Affordable Care Act included a new Medicare benefit offering face-to-face weight-loss counseling in primary care doctors’ offices.

Doctors are paid to provide the service, which is free to obese patients , with no co-pay. But only 50,000 seniors participated in 2013, the latest year for which data is available.

“We think it’s the perfect storm of several factors,” says Dr. Scott Kahan, an obesity medicine specialist at George Washington University.

Kahan says obese patients and doctors aren’t aware of the benefit, and doctors who want to intervene are often reluctant to do so. It’s a touchy subject to bring up, and some hold outmoded beliefs about weight problems and the elderly. Continue reading

Share

Health news headlines – February 23, 2015

Share

Woman_doctor_surgeon

Share

Global health news – February 23, 2015

Share

Globe floating in air

Share

UCLA outbreak highlights challenges of curbing infections

Share
carbapenem-resistan, Enterobacteriaceae - CDC

Carbapenem-resistan Enterobacteriaceae – CDC

By Jordan Rau
KHN

The bacterial outbreak at a Los Angeles hospital highlights shortcomings in the federal government’s efforts to avert the most lethal hospital infections, which are becoming increasingly impervious to treatment.

Government efforts are hobbled, infection control experts say, by gaps in monitoring the prevalence of these germs both within hospitals and beyond. The continued overuse of antibiotics — due to over-prescription by doctors, patients’ insistence and the widespread use in animals and crops — has helped these bacteria evolve into more dangerous forms and flourish.

In the outbreak at UCLA’s Ronald Reagan Medical Center, two patients have died and more than 100 may have been exposed to CRE, an antibiotic-resistant bacteria commonly found in the digestive tract. When this germ reaches the bloodstream, fatality rates are 40 percent. The government estimates about 9,000 infections, leading to 600 deaths, are caused each year by CRE, which stands for carbapenem-resistant Enterobacteriaceae.

ucm434882

Close up of ERCP endoscope tip

UCLA Health says the infections probably were passed around by inadequately sterilized scopes used to peer inside a body.

Previous CRE outbreaks have occurred elsewhere in the country, including hospitals in Illinois and Seattle.

The immediate public health response has focused on the safety of the scopes and tracking down people who may have been exposed.

The U.S. Food and Drug Administration Thursday issued a warning about the devices. But the California outbreak comes amid the government’s broader struggle to spot and battle the swelling ranks of bacteria that are resistant to most, if not all, antibiotics. Continue reading

Share

Top five stories of the week

Share
Credit: Dan Shirly

Credit: Dan Shirly

Share

Fourth case of measles in Clallam County

Share

A fourth case of measles was identified in Clallam County. The fourth case is a 14-year old male who is a sibling of the second case. The 14-year old male was quarantined during his infectious period so he had no public contact.

640px-Map_of_Washington_highlighting_Clallam_County.svg

Dr. Jeanette Stehr-Green, Clallam County Health Officer, again under scored the importance of adherence to quarantine among exposed persons, daily reports to Public Health nurses regarding symptoms, and no contacts with unvaccinated individuals as critical to stopping the spread of measles.

A person with measles is contagious from approximately four days before the onset of rash to four days after the rash appears and should not be in contact with any susceptible persons during this time.

Clallam County Health and Human Service, Public Health Section will continue with no cost clinics on February 23, 24, 26, and 27.

Clinics will be held at 111 3rd St, Port Angeles.

Feb. 23 Feb. 24 Feb. 26 Feb. 27

8:30 a.m. – 4:00 p.m. 8:30 a.m. – 12:00 noon 8:30 a.m. – 4:00 p.m. 8:30 a.m. – 4:00 p.m.

People are encouraged to call 360-417-2274 to make appointments. Walk-ins will be served but there may be a wait.

HHS continues to evaluate when and where to have clinics outside of the Port Angeles area. All parents are encouraged to check the vaccination status of children. Two vaccinations for children are needed for protection.

Share

Health news headlines – February 21, 2015

Share

Egg cracked

Share