The Kentucky House budget committee has approved a measure to expand the ICARE program, which helps small businesses provide health insurance. If passed, the bill would make the ICARE program available to employers with two to 50 workers, compared with the current range of two to 25. ICARE gives eligible companies a subsidy of $40 per employee if they begin offering a health plan for the first time in at least a year. The bill will now goes to the full Kentucky House for consideration.
Child-welfare advocates have expressed disappointment over a legislative effort to provide health insurance to all Iowa children, saying a recent bill was watered down nearly to the point of ineffectiveness. During a meeting with Des Moines Register editors and reporters, the advocates said the bill has few specifics about how the state would get all children covered. In addition, while the bill says the Legislature wants all Iowa children covered by 2011, it adds that government coverage would be expanded only "if sufficient funding is available," said Charles Bruner, executive director of the Child and Family Policy Center.
Physicians at the University of Kansas Medical Center are working to educate and change minds on the best way to treat certain cancers. They also are striving to develop innovative treatment tools, including new drugs. This attitude is shared by physicians, government, and top hospital officials as they drive a broader attack against cancer throughout the Kansas City region. Through a campaign, Kansas City and the surrounding region are working to recruit new doctors, expand research and build additional clinics and labs.
With revenues of $1.4 billion, West Penn Allegheny Health System--the combination of the Western Pennsylvania Hospitals, Forbes Health System, Allegheny General Hospital and its affiliates--is a significant health system. But in Pittsburgh, West Penn is a smaller player. Highmark Inc. brought in $11.9 billion and the University of Pittsburgh Medical Center, with all of its affiliated hospitals, brought in $6.8 billion.
If I had to boil down my healthcare technology worldview into one sentence, it would be this: "The technology shows great merit, but financial and other political issues remain." Time and time again, we see examples of how technological innovation is hindered by the financial question of who should pay for it. The industry has done a great job of promoting the development of high-end imaging equipment. But that's in part due to the fact the payers are willing to ante up for the procedures.
IT is a different story, however, and the jury is still out on who should rightfully bear the burden of implementing the technology everyone says the industry so desperately needs. With physicians, this issue surfaces frequently. They say, rightfully, that everyone else (read: payers, employers, pharmacies, even patients) stands to benefit if physicians automate clinical documentation. So why shouldn't others pay for it?
The question has become even more muddied, given the recent revelation from Blue Cross of Massachusetts that the financial return of an EMR system for a physician practice is dubious. Hoping to spur IT adoption, Blue Cross had chipped in $50 million to help spark a statewide data exchange. Now it is saying it won't require physicians to have an EMR to participate in its bonus program. Physician order entry systems, for hospitals, on the other hand, will be required down the line.
The economic conundrum came up at a telemedicine seminar I attended at last fall's conference of the American Medical Informatics Association. The presenters discussed how various telemedicine applications that connected patients and clinicians--sometimes across large geographic regions--worked, and worked well. For example, a program in Oklahoma improved outcomes and avoided hospitalization costs for wound care patients. Based on videoconferencing, the system brought together physicians, nurses, and educators. Another project in Rochester, NY, enabled children at remote locations to get pediatric consults without leaving school. That's a winner for the kids and their parents, who may avoid ER trips or skipping work to cart Susie to the doc.
Both projects were sparked by federal grants. But as the grant money runs out, their future remains unclear. To create an economically sustainable business model, the technology would need to be supported by payers in the same way that imaging is. And even if it were, other questions would arise about how the pie should best be split among the participating clinicians. Collaboration across formerly competing organizations is great, but people still need to get paid.
"Who pays?" is a simple question. However, it can elicit a remarkably complicated response, or none at all.
Editor's note: Don't forget to submit your entries for the 2008 HealthLeaders Media Top Leadership Teams Conference and Awards. Deadline for entries is March 27.
In an effort to make basic healthcare information more accessible, the Mayo Clinic has teamed with wellness company Gaiam on a series of 10 DVDs that address common conditions and the best methods for dealing with them. Individual DVDs focus on arthritis, back pain, obesity, Type 2 diabetes, high blood pressure, the need to improve heart health, irritable bowel syndrome, menopause, fibromyalgia and insomnia.
Florida emergency doctors, hospitals and health leaders are pushing a bill that would protect emergency healthcare workers and hospitals from large legal claims. The bill would make healthcare workers "agents of the state" when they are treating emergencies, and any lawsuits against such workers would be limited to $200,000 unless legislators pass a special bill to authorize more. But opponents to the bill say such protection would be unfair to injured patients and open the door to extending protection to doctors in non-emergency cases.
UCLA's neuropsychiatric hospital has banned all cellphones and laptop computers after a patient posted group photos of other patients on a social networking website. The decision was part of "UCLA Health System's ongoing efforts to enhance patient privacy and confidentiality in compliance with California's patient rights law," according to a statement from the hospital. In response to UCLA's move, officials at the California Hospital Assn. said they are hearing more and more hospitals express concern over how to deal with cellphone cameras.
The millions of dollars promised to Atlanta's Grady Memorial Hospital could start rolling in within weeks, according to the head of the hospital's new nonprofit board. The first check of $50 million would be placed in an escrow account, and it could not be cashed until the new board assumes operating control over the hospital. The operating change could could occur sometime between May to September 2008.
The Pennsylvania House of Representatives has passed a bill aimed at providing health coverage to about 270,000 uninsured Pennsylvanians. The vote would establish the Pennsylvania Access to Basic Care program, covering legal U.S. residents ages 19 to 64 who meet income guidelines and who have gone six months without insurance. The bill, however, faces long odds when it goes before the state Senate.
