Monday, October 24, 2005
ODI Explores High Risk Pools
The Ohio Department of Insurance (ODI) continues to explore the possibility of establishing a high risk pool in Ohio with legislation expected in late 2005 or early 2006. More than 30 states offer high risk pools to provide health insurance benefits to federal-eligible citizens and uninsured Ohioans—offering insurance for those with pre-existing health conditions that preclude them from purchasing insurance. Though the pool would make a small dent in the 1.3 million uninsured Ohioans, it does not address the greater problem of health care insurance affordability.

Released in June, a study commissioned by ODI found a high risk pool to be a viable way for Ohio to provide health care coverage to people with serious, chronic health conditions. The study estimates approximately 2,800 individuals would participate the first year and eventually as many as 17,250 people would benefit from the program, though it only pertains to those who can afford the high premiums required by the pool.

Premiums would not cover the complete cost of the high risk pools, making additional funding sources necessary. ODI currently is examining funding options, including state appropriations, assessment of health insurers and reinsurers, service charges on hospital admissions and outpatient surgeries and licensing fees to pharmaceutical companies. All groups under consideration as funding sources have voiced concern about being asked to carry a disproportionate share of the cost. Though the pool may help hospitals recoup a small portion of the uncompensated care they provide each year, it only offers coverage to individuals able to purchase it, which still leaves hospitals providing millions of dollars in uncompensated care each year. (Bridget Gargan, bridgetg@ohanet.org)
 

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Tuesday, October 25, 2005
OHA Board Approves Alternative Data Disclosure Proposal

The OHA Board of Trustees last week approved an alternative to House Bill 197, which would require hospitals statewide to submit nearly 700 million lines of patient billing data to the Ohio Department of Health (ODH). Under the bill, sponsored by Rep. Jim Raussen (R-Cincinnati), ODH would use the data to determine outcomes measures, and it could sell the data to other entities that would use it to create their own hospital report cards. The bill is being supported by Humana Insurance and the Service Employees International Union District 1199.

 

The Board-approved alternative calls for hospital-specific information on quality, patient safety and infection rates to be submitted to the department annually in aggregate form. The specific measures would be taken from among those already adopted by the Agency on Healthcare Research and Quality, an arm of the U.S. Department of Health and Human Services.

 

The OHA proposal also calls for dissemination of structural information, such as types of services provided and information on hospital charges. Hospitals currently report much of this information in ODH Hospital Registration Reports and by submitting charge data for their top 100 inpatient procedures to ODH. 

 

OHA will begin sharing the OHA proposal with the bill’s sponsor, other legislators and interested parties in the coming weeks. For more information, visit http://www.ohanet.org/advocacy/state/issues/public_disclosure.htm. (Jeff Klingler, jeffk@ohanet.org)

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Wednesday, October 26, 2005
2006 Officers, Members Elected to OHA Board
Last week the OHA Board of Trustees elected officers and members for terms beginning Jan. 1, 2006. The following individuals will begin their terms at the start of next year:

Officers; 1-year term:

• Chair: Cathleen Nelson, president, United Health Partners, Toledo
• Chair-elect: William Harding, president and CEO, Union Hospital, Dover
• Secretary/treasurer: Kevin Martin, president and CEO, EMH Regional Medical Center, Elyria

New Board members; Trustees At-Large for 3-year terms:

• LaMar Wyse, president and CEO, Galion Community Hospital
• Fred Rothstein, MD, president and CEO, Rainbow Babies and Children’s Hospital, Cleveland
• John Clough, MD, director of health affairs, Cleveland Clinic Foundation
• Thomas Urban, president and CEO, Mercy Health Partners, Southwest Ohio

Current Board members; Trustees At-Large 3-year extensions:

• Mina Ubbing, CEO, Fairfield Medical Center, Lancaster
• Walter Wielkiewicz, MD, Ohio State Medical Association representative

To view a full list of OHA Board members or to view board minutes (members only) visit www.ohanet.org/about_oha/board/.

Hospitals’ Heartbeat
A 2005 nominee for the Albert E. Dyckes Health Care Worker of the Year Award

Dana Skaggs   
General Supervisor, Laboratory
Ashtabula County Medical Center, Ashtabula
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A look inside Dana’s nomination –
“Dana has been employed at ACMC laboratory for over 15 years as a general supervisor over the chemistry area.  Dana serves as a vital link between the laboratory and the medical/ nursing staffs.  Whenever there are questions regarding the performance of lab tests, specimen requirements, patient preparation or interpretation of test results, Dana is always the first person called and she is always diligent in finding and providing the correct information.  Dana is also the laboratory coordinator for the Point of Care Glucose Monitoring Program.  Dana oversees the routine operations of this program and coordinates the quality control program for POCT.”

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Thursday, October 27, 2005
OHA Board Approves Budget, Takes Position on State Issues
The OHA Board accepted a 2006 budget and took positions on two of five state ballot issues this month. The 2006 budget includes the first dues formula increase in five years and adds a one-year assessment of $0.015 per $1,000 in expenses to replenish the Special Litigation Fund and help build the Strategic Issue Fund created in August.

The Board endorsed State Issue 1, the economic development bond issue to create jobs and expand research in areas including biomedical studies. The Board took a position against State Issue 3, a proposal to tilt campaign finance law in favor of labor unions and against individuals and political action committees. Information on all five state issues is available at www.prosperityfund.net/oh/oha/.

The Board also endorsed an Executive Committee decision to pursue legal action challenging rate changes by the Bureau of Workers’ Compensation. A hearing on OHA’s request for an injunction is set for Monday, October 31.

The Board also accepted William Malarkey, MD, Director, Clinical Research Center, The Ohio State University Medical Center, as a new member for the board of the Foundation for Healthy Communities. The Board also named three current foundation directors to new three-year terms: Karen Bankston, Senior VP, External Affairs, Health Alliance, Cincinnati; David R. Lang, CFO, Magruder Hospital, Port Clinton, and Michael Maiberger, COO, UVMC Health System, Troy.

The Board endorsed a recommendation of the Research and Education Foundation to pursue quality and financial reporting alternatives to a pending transparency measure, House Bill 197. (Jim Castle, jimc@ohanet.org)

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Friday, October 28, 2005
A Broken System: Does requiring hospitals to offer more free care help Ohioans?
Ohio hospitals provide care free-of-charge to all Ohioans with incomes at or below the federal poverty level, but many people above that line still lack finances to pay for the health care they need. Legislation currently pending in the state Senate Health, Human Services and Aging Committee suggests a remedy of mandating that hospitals provide free care to patients with incomes up to 200 percent of the poverty line. But the answer to the underlying question “Could it really be that simple?” is “no.” The quest to provide access to affordable health care for all Ohioans must be an ongoing, cooperative effort involving government, employers and patients, not just hospitals.

The mission of hospitals to care for their patients and communities shows in the faces of hospitals’ caregivers, but it also appears in the numbers—in 2003, Ohio hospitals provided more than $1 billion in care for which they received no reimbursement. Senate Bill 186, sponsored by Sen. Ray Miller (D-Columbus), would require hospitals to provide care at no charge to all patients within 200 percent of the federal poverty guideline, double the current requirement. Hospitals have been a leading advocate of providing coverage for needed medical care to the growing number of uninsured and underinsured Ohioans, but shifting the financial obligation solely to hospitals fails to address the larger health care financing crisis and jeopardizes hospitals’ ability to care for all Ohioans.

The health care financing crisis needs more than a Band-Aid—it calls for a long-term solution involving employers, government, business, hospitals and patients. To read the full October Healthbeat article, visit www.ohanet.org/healthbeat/2005/1005.htm.

This article is the first in a two-part series on hospital charity care and billing and collection practices. See part two in the November Healthbeat. (Mary Sterenberg, marys@ohanet.org)

Hospitals’ Heartbeat
A 2005 nominee for the Albert E. Dyckes Health Care Worker of the Year Award

Sue Adkins, CCRN       
Staff Nurse, Cardiac Surgical Intensive Care Unit
Aultman Hospital, Canton  
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A look inside Sue’s nomination –
“The Aultman Health Foundation is honored to nominate Sue Adkins, CCRN, for the 2005 Albert E. Dyckes Health Care Worker of the Year Award. Sue as been a staff nurse in the Cardiac Surgical Intensive Care Unit (CSICU) since its inception in 1993, where she was instrumental in the development of the new unit. The countless contributions Sue has made to her profession and her community, the leadership skills she has personified, the passion and enthusiasm she brings to work every single day, and the odds she has overcome, both in her personal and professional life, exhibit why Sue is truly deserving of this acknowledgement.”