Added November 15, 2010

Links mentioned at Fall 2010 Meeting (provided by Jodi Mitchell)

Reference on Medical Home and Accountable Care Organization - http://diseasemanagementcareblog.blogspot.com/2009/08/patient-centered-medical-home.html

Diabetes Project – as this project pulls the data together, the National Changing Diabetes Program (Novo Nordisk) may be a good source of funding for this project and spotlight KY efforts to change the barometer

http://www.diabetesbarometer-us.com/

www.novonordisk-us.com/documents/promotion_page/document/ncdp_splash.asp

Health Reform Glossary - http://www.kff.org/healthreform/upload/7909.pdf

HAI Reporting

Model bill - http://www.safepatientproject.org/2010/01/kentucky_model_hospital_infect.html

Comparison of state laws - http://www.azdhs.gov/infectioncontrol/pdfs/Comparison%20of%20State%20HAI%20Reporting%20Laws%202008.pdf

Hospital Compare - http://www.hospitalcompare.hhs.gov/hospital-search.aspx?loc=40324&lat=38.2331136&lng=-84.564147&stype=GENERAL&=

 Health Watch USA Newsletter
www.healthwatchusa.org    Nov 1, 2010

Member of the National Quality Forum and a designated "Community Leader" for Value-Driven Healthcare by the U.S. Dept. of Health and Human Services
 

2010 HW USA Conference on Healthcare Policy and Value Purchasing 

Nov. 19th, 2010, Embassy Suites, Lexington, KY  www.healthconference.org
Keynote Speaker: Richard Wild, MD, JD  - Medical Director for the Centers for Medicare and Medicaid Services - Atlanta Regional Office. 



Cost is $50 including box lunch and 6.5 hrs of CEUs for MDs, Nurses, Dentists, Attorney's, Physical Therapists, Occupational Therapists, Nursing Home Administrators and Human Resource Managers.  Approval for CEUs for Pharmacists and Social Workers are Pending. 

Agenda, speakers and conference information are available at www.healthconference.org .

Keynotes:

Richard Wild, MD, JD, Medical Director from the Atlanta Regional Office for the Centers of Medicare and Medicaid Services (CMS).

Jim Battles, PhD, from AHRQ (Agency for Healthcare Research and Quality) Presenting on Quality and Safety Provisions in the New Healthcare Reform Law.

Dr. Joycelyn Elders, Past US Surgeon General.

Lisa McGiffert from Consumer Union presenting on Healthcare Acquired Infections.

Jeannie Cimiotti, DNSc, RN, Center for Health Outcomes and Policy Research, University of Pennsylvania, School of Nursing, presenting on the California Nurse-to-Patient Ratios. 

Jill Rosenthal, Program Director, National Academy for State Health Policy -- Presenting on State Medicaid Policy on Hospital Acquired Conditions. 

Download Brochure:  www.healthconference.org/2010conference_downloads/HCTPA_Brochure.pdf

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HW USA Presents on Public Reporting of Healthcare Acquired Conditions
Kentucky Interim Joint (House & Senate) Committee on Health and Welfare
 
Based upon population, it is estimated that Kentucky would have 23,000 hospital acquired infections and almost 1,400 deaths from these infections each year.     View video of presentation (Sound & Slides)  http://www.healthwatchusa.org/20100120-KY-House-Senate/20101020-KY-HAI-HW-Cmt.htm

Download PDF of Presentation     
http://www.healthwatchusa.org/20100120-KY-House-Senate/HAI-PublicReporting-20101020-Final.pdf

Download PDF of Handout and Documents 
http://www.healthwatchusa.org/20100120-KY-House-Senate/20101020-HAI-PublicReporting-HandOut-Final.pdf

The State of Arizona, with a population of 6 million, has been reported to have 2,000 deaths from hosptial acquired infections each year.  
http://azstarnet.com/news/science/health-med-fit/article_4f6cf025-2383-5724-a595-7a40335362a6.html 

On a very sad note.  One of our most active members and advocates, Catherine Harris had developed a hospital acquired MRSA infection after her total knee surgery.  Luckliy, it does not appear to involve the surgery site and we are hopeful for her full recovery.     

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Hospital Acquired Conditions Should be Rare and Unacceptable Events - Thomas R. Frieden, MD, MPH, Director of CDC  

"Evidence indicates that, with focused efforts, these once‐formidable infections can be greatly reduced in number, leading to a new normal for healthcare‐associated infections as rare, unacceptable events"
http://www.journals.uchicago.edu/doi/full/10.1086/656002 

White Paper by IDSA, APIC, SHEA, CSTE and ASTHO on the four pillars of HAI Control
--  Adherence to Evidence Based Prevention Practices
--  Align Incentives (payment incentives, oversight and accrediation, and public reporting)
--  Innovation Research
--  Data for Action
http://www.apic.org/Content/NavigationMenu/GovernmentAdvocacy/RegulatoryIssues/CDC/AJIC_Elimin.pdf 
 
Current Status of Public Reporting:
--  28 States require public reporting of Hospital Infection Rates.
--  22 States require use of NHSN (National Healthcare Safety Network).
--  20 States have issued reports.

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Patients with Medicaid have higher ER Utilization Rates:

In 2008, the majority of visits to primary care delivery sites (84%) occurred in physician offices, 11% in hospital outpatient departments (OPDs), and 5% in community health centers (CHCs).

Patients with Medicaid, State Children’s Health Insurance Plan (SCHIP) or no insurance accounted for a higher percentage of visits to CHCs (56%) and hospital OPDs (40%) than to physician offices (17%).

http://www.cdc.gov/nchs/data/databriefs/db47.htm

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Overutilization and Patient Safety of CT Scanners Comes Under Fire:

Federal Government Launches Probe into the Approval Process and the Pressuring of Government Regulators by Industry.  http://finance.yahoo.com/news/Feds-reopen-probe-into-apf-2838405684.html 

Hundreds of patients have received overdose of radiation in California hospitals:    http://articles.latimes.com/2010/aug/03/local/la-me-stroke-scans-20100803 

Use of CT and MRI scans triple in 10 years.   http://www.massdevice.com/news/emergency-room-ct-mri-use-triples-10-years    http://jama.ama-assn.org/cgi/content/abstract/304/13/1465  

Risk of developing cancer from low-dose radiation exposure may not decrease over time.
http://consumer.healthday.com/Article.asp?AID=644876

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Making Inpatient Medication Reconciliation Patient Centered,
Clinically Relevant and Implementable: A Consensus Statement
on Key Principles and Necessary First Step

From the The Joint Commission and Consumers Advancing Patient Safety
http://onlinelibrary.wiley.com/doi/10.1002/jhm.849/pdf 

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Doctor shortage looming? Use nurses, report says
 
http://www.reuters.com/article/idUSTRE69445L20101005 

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New Multi-Resistant Bacteria Causing Urinary Tract Infections

E. coli ST131 could be responsible for more than 3000 deaths each year. 

http://www.newsvine.com/_news/2010/10/05/5232660-drug-resistant-bladder-bug-raises-growing-concerns

Super Bug Klebsiella pneumoniae Carbapenemase is spreading in Chicago
http://www.chicagotribune.com/health/ct-met-superbug-20101022,0,6867309.story 

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Drug Companies Starting to Make Public Release Payments to Doctors and Nurses

Data beginning to appear online:  http://projects.propublica.org/docdollars/states/kentucky

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Upcoming Events

Nov. 6, 2010:   HW USA Meeting -- SKYPE Speaker -- Diane Parker (picture to right), a well-known pateint advocate from South Carolina.  In the picture, Senator Ralph Anderson presents a resolution by the South Carolina General Assembly designating July 4th as Patient Safety Day in Willie Parker's honor.   Willie died from a combination of medical errors and a hospital-acquired MRSA infection.
  
Nov 17, 2010:  McCreary County Chamber of Commerce -- Value Purchasing. 
  
Nov 19, 2010:  Health Watch USA's Conference on Healthcare Transparency and Patient Advocacy-- Embassy Suites in Lexington, Kentucky.  www.healthconference.org
  
Jan 15, 2019:  Health Watch USA Meeting -- Helen Haskell, Mothers Against Medical Error.

Feb 12, 2010:  Health Watch USA Meeting -- Dr. Barry Chaiken (picture to right), Chief Medical Officer from DocsNetwork Ltd, Boston Massachusetts on the Transition of Healthcare reform   http://wistechnology.com/dhc/2010/people/ 

Added July 28, 2010:

On December 14, 2009, the Board passed the following resolution regarding Federal health care reform:

In response to the strong interest by the membership to have the Committee take advantage of the opportunity available given the national efforts toward health care reform:

Be it resolved that the Friedell Committee enter into a working relationship with the Kentucky Voices for Health in which 1) KVH will analyze Federal legislation to determine how its provisions will affect Kentucky; and 2) a Work Group of the Committee will look at these provisions through the prism of the Committee Principles to assess their impact on health systems and the health of Kentuckians at both state and community levels, and based on this assessment will make policy recommendations concerning these provisions to the Board for its consideration and possible transmission to state and local policy makers.

Email to membership on December 3, 2009:

Dear FC members,

Last week we shared information from the Kaiser Foundation in regard to healthcare reform. The link below to the analysis of the House & Senate bills by the Commonwealth Fund is forwarded by Friedell Committee memberRichard Heine.

Carolyn

http://www.commonwealthfund.org/Content/Publications/Fund-Reports/2009/Nov/Starting-on-the-Path-to-a-High-Performance-Health-System.aspx?page=all 

November 24, 2009

From: Jodi Mitchell [mailto:jodi@mssgov.com]
Subject: Health Reform: Comparison of Senate and House Health Reform Bills & HHS Report on Impact of Proposed Health Reform

With the vote last Saturday evening to proceed with Senate floor debate on health care reform, the Senate is expected to begin formal debate next week after the Thanksgiving holiday.

Kaiser Family Foundation offers an interactive side-by-side compares the leading comprehensive reform proposals across a number of key characteristics and plan components. Included in this side-by-side are proposals for moving toward universal coverage that have been put forward by the President and Members of Congress. In an effort to capture the most important proposals, we have included those that have been formally introduced as legislation as well as those that have been offered as draft proposals or as policy options. It will be regularly updated to reflect changes in the proposals and to incorporate major new proposals as they are announced. This side-by-side offers a summary of the major components of these proposals; detailed descriptions of provisions relating to Medicare and Medicaid are also available online. See http://www.kff.org/healthreform/sidebyside.cfm.

In addition, Health and Human Services Secretary Kathleen Sebelius released a report yesterday that shows the impact proposed health reform would have on residents in each state. The report shows that if Congress doesn't pass healthcare reform legislation, the number of uninsured people will grow by more than 30 percent in 29 states and by at least 10 percent in every state by 2019. In addition, the report indicates the amount of uncompensated care provided will more than double in 45 states, businesses in 27 states will see their premiums more than double, and fewer people will have coverage through an employer. The report can be found online at www.healthreform.gov.

The following is a synopsis of the impact on Kentucky as reflected by the Administration:
Health Insurance Reform and Kentucky: The Case for Change

The health care status quo is not an option for our states. If we do nothing, by 2019 the number of uninsured people will grow by more than 30 percent in 29 states and by at least 10 percent in every state. The amount of uncompensated care provided will more than double in 45 states. Businesses in 27 states will see their premiums more than double. And fewer people will have coverage through an employer.1 The time for health insurance reform is now.

Under reform in Kentucky:

· 654,000 residents who do not currently have insurance and 196,000 residents who have nongroup insurance could get affordable coverage through the health insurance exchange.

· 444,000 residents could qualify for premium tax credits to help them purchase health coverage.

· 724,000 seniors would receive free preventive services.

· 129,000 seniors would have their brand-name drug costs in the Medicare Part D “doughnut hole” halved.

· 44,800 small businesses could be helped by a small business tax credit to make premiums more affordable.

Health Insurance Reform Provides Early Relief and Health Security.
Proposals implemented in 2010 and 2011 will produce real benefits for:

· Families: The 4.3 million residents of Kentucky will benefit as reform:

o Ensures consumer protections in the insurance market. Insurance companies will no longer be able to place lifetime limits on the coverage they provide, use of annual limits will be restricted, and they will not be able to arbitrarily drop coverage.

o Creates immediate options for people who can’t get insurance today. 10 percent of people in Kentucky have diabetes2, and 30 percent have high blood pressure3 – two conditions that insurance companies could use as a reason to deny health insurance coverage. Reform will establish a high-risk pool to enable people who cannot get insurance today to find an affordable health plan.

o Ensures free preventive services. 36 percent of Kentucky residents have not had a colorectal cancer screening, and 22 percent of women over 50 have not had a mammogram in the past two years.4 Health insurance reform will ensure that people can access preventive services for free through their health plans. It will also invest in a prevention and public health fund to encourage prevention and wellness programs.

o Supports health coverage for early retirees. An estimated 66,800 from Kentucky have early retiree coverage through their former employers, but early retiree coverage has eroded over time.5 A reinsurance program would stabilize early retiree coverage and provide premium relief to both early retirees and the workers in the firms that provide their health benefits. This could save families up to $1,200 on premiums.

· Seniors: Kentucky’s 724,000 Medicare beneficiaries6 will benefit as reform:

o Lowers premiums by reducing Medicare’s overpayments to private plans. All Medicare beneficiaries pay the price of excessive overpayments through higher premiums – even the 87 percent of seniors in Kentucky who are not enrolled in a Medicare Advantage plan.7 A typical couple in traditional Medicare will pay nearly $90 in additional Medicare premiums next year to subsidize these private plans.8 Health insurance reform clamps down on these excessive payments.

o Reduces prescription drug spending. Roughly 129,000 Medicare beneficiaries in Kentucky hit the “doughnut hole,” or gap in Medicare Part D drug coverage that can cost some seniors an average of $4,080 per year.9 Reform legislation will provide a 50 percent discount for brand-name drugs in this coverage gap.

o Covers free preventive services. Currently, seniors in Medicare must pay part of the cost of many preventive services on their own. For a colonoscopy that costs $637, this means that a senior must pay $14810 – a price that can be prohibitively expensive. Under reform, a senior will not pay anything for that colonoscopy, or for any other recommended preventive service. A senior will also get free annual wellness visits to his or her provider, with a personalized prevention plan to remain in good health.

· Small businesses: While small businesses make up 72 percent of Kentucky’s businesses, only 41 percent of them offered health coverage benefits in 2008.11 44,800 small businesses in Kentucky could be helped by a small businesses tax credit proposal that makes premiums more affordable.12 And these small businesses would be exempt from any employer responsibility provisions.

· States: State budgets will be relieved from rising health care costs as reform:

o Reduces state employee premiums. Coverage would immediately be expanded to the uninsured, decreasing the amount of uncompensated care costs that gets shifted to the premiums of state employees. For states that provide early retiree health benefits to their state employees, a reinsurance program would provide premium relief of up to $1,200 per family policy per year for all employees.

o Reduces uncompensated care. Right now, providers in Kentucky lose $1.1 billion in uncompensated care each year,13 which states subsidize at least in part. Instead, under reform, uncompensated care would begin to be reduced immediately as more uninsured people gain coverage.

Health Insurance Reform Provides Stability, Security, and Choice.

· Provides relief from rising health care costs.

o Ends the “hidden tax”. The $1.1 billion spent on uncompensated care in Kentucky often gets passed along to families in the form of a hidden premium “tax”.14 By expanding coverage to the uninsured, health insurance reform will eliminate this burden on people who already have insurance.

o Provides premium tax credits. Without reform, individuals and families in Kentucky will spend increasing amounts of money out-of-pocket to cover premiums, deductibles, and co-payments, from $4 billion today to up to $6.5 billion in 2019.15 Through health insurance reform, 444,000 Kentucky residents could be eligible for premium credits to ease the burden of these high costs.16

· Promotes health insurance portability and choice. Health insurance reform establishes a health insurance exchange that will provide individuals with a wide variety of choices and ensure that they will always have coverage, whether they change jobs, lose a job, move or get sick.

o Currently 654,000 residents of Kentucky do not have health insurance, and if nothing is done, by 2019 this population could swell to 830,000. The exchange will help the uninsured to obtain needed coverage and will also help the 196,000 Kentucky residents who currently purchase insurance in the individual insurance market to get quality coverage at an affordable price.17

· Supports long-term home and community based services: It is estimated that 65 percent of those who are 65 today will spend some time at home in need of long-term care services,18 which typically cost almost $18,000 per year.19 This means that 349,000 older residents of Kentucky who are aged 55 to 64 today will need home health services after they turn 6520 – services that are not always covered by Medicare, Medicaid, or private health insurance.

o Health insurance reform will create a new voluntary long-term care services insurance program, which will provide a cash benefit to help seniors and people with disabilities obtain services and supports that will enable them to remain in their homes and communities.

o Reform will encourage states to expand their home and community based services through Medicaid by providing enhanced funding, and it will create a program to provide community support services for disabled Medicaid enrollees who would otherwise need to be in a nursing home. These programs could help improve care for many of the 213,000 disabled Medicaid beneficiaries in Kentucky.21

Health Insurance Reform Improves Quality and Reforms the Delivery System.

· Reduces preventable readmissions. The current health care system does not place enough emphasis on improving quality of care. For example, nearly 20 percent of Medicare patients who are discharged from the hospital end up being readmitted within 30 days.22 For Kentucky, that’s 48,500 readmissions each year which could potentially be prevented with improved care coordination.23 Health insurance reform will invest in innovations in primary care and will provide financial incentives to hospitals to better coordinate care at discharge to avoid preventable readmissions.

· Lessens Paperwork. Physicians spend on average about 140 hours and $68,000 a year just dealing with health insurance bureaucracy.24 For the 11,318 physicians in Kentucky, this adds up to 1.6 million hours and $770 million in costs.25 By simplifying and standardizing paperwork and computerizing medical records, doctors will be able to focus on caring for their patients instead of dealing with bureaucracy.

· Incentivizes primary care. Roughly 4,400 doctors in Kentucky practice primary care and would qualify for a new 5 to 10 percent payment bonus under health insurance reform.26

· Invests in the health primary care. Approximately 480,000 people, or 11 percent of Kentucky’s population, cannot access a primary care provider due to shortages in their communities.27 Health insurance reform will expand and improve programs to increase the number of health care providers, including doctors, nurses, and dentists, especially in rural and other underserved areas.