Health & Medicine (HMPRG)

Companies and nonprofits unveiling new low-cost support resources for caregivers of the elderly

Read the February 12, 2012 Wall Street Journal article on some of the new low cost online, telephonic and other professional  resources for caregivers of the elderly. 

The article focuses on the companies and NPOs that are beginning to innovate new ways of supporting both professional and unpaid family caregivers in areas like care-coordination and quality assessment.

Read the full post

Uprising Radio Features Quentin Young Talking About Single-Payer Health Care

Venerated Physician & Activist Dr. Quentin Young Urges ‘Single-Payer Healthcare’

Single payer healthcare has been a hot topic since the great healthcare debates of 2009 and 2010, but the organization, Physicians for a National Health Program, has advocated for a single payer system since 1987. The National Coordinator for the program, Dr. Quentin Young, spoke with Uprising host Sonali Kolhatkar on February 13, 2012.

Being one of the founding members of the group is only one of many distinctions in Dr. Young’s storied career. Dr. Quentin Young was a founding member of the Medical Committee for Human Rights in 1964 and volunteered to provide medical care to civil rights protesters in Mississippi during Freedom Summer. He was a personal physician to Martin Luther King Jr and helped the Black Panthers and the Young Lords set up medical clinics in their communities. Dr. Young also provided medical care to protesters injured by police at the 1968 Democratic Convention in Chicago where 23,000 police officers were dispatched to quell protests. He is a personal friend of President Barack Obama with whom he disagrees on the need for single payer healthcare. Visit www.pnhp.org for more information.

Listen to or watch  a YouTube of the interview

In 2011, the Affordable Care Act (ACA) extended free preventive services to 54 million privately-insured and 32.5 million on Medicare

Read the post on the USDHHS website

Health and Human Services Secretary Kathleen Sebelius announced today that the Affordable Care Act provided approximately 54 million Americans with at least one new free preventive service in 2011 through their private health insurance plans. Secretary Sebelius also announced that an estimated 32.5 million people with Medicare received at least one free preventive benefit in 2011, including the new Annual Wellness Visit, since the health reform law was enacted.

Together, this means an estimated 86 million Americans were helped by health reform’s prevention coverage improvements. The new data were released in two new reports from HHS.

“Americans of all ages can now get the preventive services they need, like mammograms and the new Annual Wellness Visit, free of charge, as a result of the new health care law,” Secretary Sebelius said. “With more people taking advantage of these benefits, more lives can be saved, and costly, and often burdensome, diseases can be prevented or caught earlier.”

Read the post on the USDHHS website

Hospital Charity Care Becoming a Hot Issue Across the Country

Yesterday's Wall Street Journal Market Watch featured an article on the success California healthcare workers are having  in their efforts to build broad consumer support for two ballot measures to liminate price gouging at hospitals and increase charity care for the needy.

1.7  million signatures are required  to have The Fair Healthcare Pricing Act of 2012  and The Charity Care Act of 2012 included on California's November 2012 ballot. In the first three weeks since the signature initiative  was launched, 200,000 names have been collected.  Read the full post

 

 

http://www.marketwatch.com/story/healthcare-workers-crisscross-the-state-gaining-support-for-initiatives-to-end-hospital-price-gouging-increase-charity-care-2012-02-14

Nurse-Midwives in Massachusetts No Longer Required to Have Physician Approval to Practice

...across the country, states are increasingly moving away from requiring a supervising physician  for nurse-midwives; a move that will broaden health access for women...

Download the February 9, 2012 post from Kaiser Health Capsules on the Kaiser Health Network Blog

Certified nurse-midwives in Massachusetts no longer need to have a physician sign on the dotted line in order to work in the state.

Under a new state law, nurse-midwives do not have to practice under a physician’s supervision.  Instead, they will be required to practice within a health care system and have a clinical relationship with an obstetrician-gynecologist.

At a practical level, the law means that nurse-midwives, who long have been able to write prescriptions and order tests, won’t need a doctor to oversee their decisions.  Massachusetts only licenses certified nurse-midwives, so the law does not apply to any other midwives.

Kathryn Kravetz Carr, president of the Massachusetts Affiliate of the American College of Nurse-Midwives, said the changes will make it easier for women to access health care.

Read the full post

Center for Long-Term Care Reform Co-Director Martha Holstein Writes about Lack of Economic Security Among Older Women.

Download a pdf of the article

HMPRG's Center for Long-Term Care Reform Co-Director Martha Holstein has written an op-ed, "A Troubled Old Age: Women and Retirement Insecurity,” for the Center’s January, 2012,  Elder Economic Security Newsletter.
 
“Many years ago, Tish Sommers, the savvy co-founder of the Older Women’s League (now OWL), and one of my heroines, observed that “women are one man away from poverty.” For many women, especially women lower on the economic ladder, that observation remains painfully true. Across the income spectrum however, older women tend to be poorer than older men. 70% of the elderly poor are women. Blame that on women’s longer life expectancy though not necessarily better health, their shortened work histories and lower earnings when working, the kinds of jobs they have had (less likely to offer pension benefits or salaries that were adequate to permit savings), and the financial penalties of drop-out years to have and raise children or to care for older family members. As a result, “women’s median retirement income is 58% of men’s median retirement income” (Rappaport, 2008, p. 1). The now familiar phrase “the feminization of poverty,” introduced in the late 1970s, continues unabated not only in this country but around the world.” (Download and read entire op-ed article here.)
 
The Center for Long-Term Care Reform is the official state-partner of the Elder Economic Security Initiative™ (EESI) a program of Wider Opportunities for Women.  For more information about EESI, visit our website  or email Kristen Pavle, Associate Director, Center for Long-Term Care Reform. Use the link below to subscribe to HMPRG's monthly EESI Newsletter.

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A Chance to Hear the Cook County Health and Hospitals Systems' New CEO, Dr. Ramanathan Raju

Listen to the presentation made on January 30, 2012 at the City Club of Chicago by Dr. Ramanathan Raju, the new CEO of the  Cook County Health and Hospitals Systems

In this 45 minute presentation, Dr. Raju addresses the challenges faced by the CCHHS and his vision for guiding the system and improving health access for the people of Chicago.

Potential Resistance to Request for Cook County Medicaid Waiver

Earlier today we posted that the Illinois Department of Healthcare and Family Services submitted to CMS a request for a Medicaid waiver to expand coverage this year to people who would otherwise become eligible in 2014.  Before this waiver application is granted, the Illinois legislature must pass an exception to the Medicaid expansion moratorium passed last year. The notice below was just received and illustrates the opposition in the General Assembly to overriding last year’s moratorium.  We will keep you posted on the status of the application and the progress in the General Assembly as we hear.

Righter, Bellock: Administration Needs to Implement Medicaid Reforms, Drop Plans for Cook County Expansion

 Springfield, IL…..State Representative Patti Bellock (R-Hinsdale) and State Senator Dale Righter (R-Mattoon) today called on the Quinn administration to implement cost-saving Medicaid reforms already passed into law and to drop plans to seek a Medicaid expansion for Cook County.

“Governor Pat Quinn yesterday barely touched on the subject of Medicaid reform in his State of the State speech. Meanwhile, we have hundreds of millions of dollars in cost saving reforms we worked hard to pass into law that his administration has failed to implement, including the Medicaid Payment Recapture Audit that estimates say could recapture up to 10% of our total Medicaid costs through identifying fraud and other errors,” Bellock said. 

Other Medicaid reforms passed into law but not implemented include P.A 96-1501 requiring income and residency verification for Medicaid applicants; and P.A. 96-941 authorizing the Department of Health Care and Family Services to develop and implement an Internet-based transparency program that would be helpful in tracking provider fraud and improve service.

“Last year lawmakers passed bipartisan Medicaid reform that placed a moratorium on the creation or expansion of Medicaid programs, and established what I’m sure most people in this state would consider common sense income verification measures,” said Righter. “So I was dumbfounded to learn that even as the Administration drags its feet on filing the paperwork necessary to actually implement these reforms, they are expediting efforts in pursuit of an expansion of the Medicaid program in Cook County.”

The Illinois General Assembly passed and the Governor signed P.A. 96-1501 prohibiting any expansion of Medicaid programs for two years.  The moratorium took effect January 25, 2011.  This week it was learned that Quinn’s Director of Healthcare and Family Services is seeking a waiver to expedite by two years the influx of new Medicaid enrollees in Cook County expected under the new federal Affordable Care Act.  This expansion would unquestionably violate the moratorium and state law.

 “You don’t have to be a budget expert to understand that Illinois’ Medicaid program is growing at a rate that is unsustainable,” Righter added. “The Governor’s budget projections show that by Fiscal Year 2017 the Medicaid backlog will have reached $21 billion. These expansions are jeopardizing the entire program. Reforms are needed to pull this program back from the brink of insolvency, to ensure we still have a safety net for the people who truly need it.” 

Proponents argue this will not cost the state any money.  This is, at the least, a highly debatable point.  If we allow Cook County to add 100,000 people to its Medicaid rolls and the federal ACA is repealed or struck down in the courts, Cook County will turn to the State to make up the lost federal dollars it expected to receive. This could be as much as $125 million annually.

 “The moratorium was the top priority of our major reform bill of 2011, and it would set a bad precedent to ask for a waiver to expand the Medicaid population in this time of fiscal crisis,” said Bellock.  “We will be introducing legislation encouraging prompt enactment of our bi-partisan reforms already passed into law.”

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Hospital Penalties for Readmissions Make New Transitional Care Models Imperative

The Chicago Tribune's January 30th article  on the possibility of hospitals facing substantial financial penalties for high patient readmission rates - and the impact on low income patients - reaffirms the need for new transitional care models.

The Bridge Program - developed by The Illinois Transitional Care Consortium (in which Health & Medicine Policy Research Group plays a lead role) is an innovative model designed to assist older adults in the transition from the hospital back to the community, and reduce readmission rates.

Read the Tribune article

Learn more about the Bridge Program and the work of the Illinois Transitional Care Consortium

 

Illinois Pursuing Early Medicaid Expansion

 Download the Associated Press article that ran in the  State Journal Register on Jan 31, 2012

The State Journal Register

State pushes Cook County Medicaid plan

By CARLA K. JOHNSON

The Associated Press

Posted Jan 31, 2012 @ 10:20 PM

CHICAGO — Illinois is asking the federal government to allow an early expansion of Medicaid coverage to low-income childless adults in order to bring millions of federal dollars into the struggling Cook County health system. 

Illinois Department of Healthcare and Family Services Director Julie Hamos sent a letter Monday to the U.S. Department of Health and Human Services supporting the proposal and asking for an expedited review.  

Any change would require state lawmakers to lift a freeze they put on Medicaid eligibility expansion last year. 

The Cook County Health and Hospitals System collected only $190 million in patient fees last year when it was expecting nearly twice that amount. County health system officials estimate expanding Medicaid would cover 100,000 currently uninsured patients a year who already receive care, bringing in federal matching dollars now unavailable. Only legal residents would be eligible. 

Medicaid costs generally are shared by the federal and state governments. But the proposed expansion wouldn’t use state money because Cook County pays its share of Medicaid. 

“We are thankful and looking forward to approval” from the federal government, said Dr. Ramanathan Raju, the county’s new health system chief, who has been pushing for the expansion. 

It’s unclear what would happen if the expansion isn’t approved. Cook County health system spokeswoman Marisa Kollias said the system “would never turn a patient away.” The county already converted a suburban charity care hospital into an outpatient center last year because of financial difficulties. 

Hamos’ letter seeks a waiver under the Affordable Care Act to move up the date of expanded Medicaid coverage for Cook County. In 2014, under President Barack Obama’s health-care overhaul, Americans who earn less than 133 percent of the poverty level will be eligible to enroll in Medicaid. States will receive 100 percent federal funding to cover the expansion for the first three years. 

Illinois lawmakers placed a moratorium on expanding Medicaid eligibility last year as part of a Medicaid reform package.  

“I do need to inform you that the Illinois law currently on the books will need to be altered before this waiver request can proceed under the contemplated timeline,” states Hamos’ letter to HHS. 

Hamos said it will be up to Cook County to convince state lawmakers. “They’re going to have to really reach out to the legislature,” Hamos told The Associated Press. “They’ll have to explain why this is important.”

Five other states and Washington, D.C., have expanded Medicaid early under the Affordable Care Act, according to the Kaiser Family Foundation. The states are Connecticut, Minnesota, California, New Jersey and Washington, said Samantha Artiga, a Kaiser Family Foundation analyst.