The nation's health care systems are in transition. And while hospitals across the country are grappling with changes to payment systems and quality measures, the tiniest hospitals in rural areas must work even harder to keep up. In Iowa, the rural health care system is made up of 82 Critical Access Hospitals — a special Medicare designation for smaller 25-bed facilities — and 142 rural health clinics, making it one of the largest rural health systems in the country, said Gloria Vermie, director of the State Office of Rural Health Director, which is part of the Iowa Department of Public Health.
Nassau University Medical Center and Stony Brook University Hospital expect to hear news within the next few months that could mean hundreds of millions of dollars for Long Island and fundamentally change how they and scores of other local health care organizations do business. Both have been designated lead organizations on Long Island in the state's Delivery System Reform Incentive Payment, or DSRIP, program. Part of the state's attempt to overhaul the health care system to improve care for low-income patients, DSRIP will allocate $6.42 billion to safety net or public hospitals and their community collaborators statewide over the next five years.
Officials from the state's public health care provider, Hawaii Health Systems Corporation, say they will likely need more than a quarter of a billion dollars in taxpayer money over the next two fiscal years to fully offset potentially crippling debts, ranging from new federal changes to collective bargaining raises. Some officials, however, say they are not convinced the request should be approved. "I don't think they're going to get that," Rep. Daynette "Dee" Morikawa, D, Koloa-Niihau, said about the financial projections, which were released during a joint informational session Wednesday for the Senate Ways and Means Committee and House Finance Committee. "It's going to be very interesting. I think, when those numbers came out to the budget committee, their jaws dropped."
This past week, more than 2,000 mental health workers for the HMO health care giant Kaiser Permanente in California went on strike. The strike was organized by the National Union of Healthcare Workers. The union says Kaiser Permanente patients have been the victims of "chronic failure to provide its members with timely, quality mental health care." On Thursday, about 150 Kaiser Permanente employees picketed the Woodland Hills Medical Center in the San Fernando Valley. One of them was therapist Deborah Silverman. In her eyes, the biggest problem at Kaiser right now is understaffing.
When voters in rural Weiser went to the polls in November, the vast majority gave their blessing to St. Luke's Health System's takeover of their local hospital - and agreed to continue paying a special tax to support that hospital. St. Luke's expects the acquisition to take place this spring. It will be the third time in five years that Boise-based St. Luke's has acquired a hospital from a taxing district. The first was a McCall hospital in 2010. The second was a Mountain Home hospital in 2013. Each of those hospitals was a community medical center - a public facility supported by local property taxpayers and overseen by elected boards.
Hospitals across the nation are financially stressed, none more so than those in states whose legislatures have not expanded Medicaid coverage under the Affordable Care Act. And Centra — the parent of Lynchburg General, Virginia Baptist, Bedford Memorial and Southside Community (Farmville) hospitals — is no different. Increasingly, leaders of hospitals across the commonwealth are becoming more outspoken about the fiscal futures their institutions face in the coming years as the nation's health care system changes. Walker Sydnor, the chairman of Centra's board of directors, is front and center locally in the discussion about the nation's health care system and his advocacy for the General Assembly to find a way to expand Medicaid rolls in Virginia.