|
||
January 29, 2007
Living on the Edge: The Precarious State of Health Care in Ohio Like a symptom-free grandfather who never misses his daily walk, Ohio seems on solid and healthy ground, boasting an uninsured rate below the national average and a consistently low unemployment rate. But a clogged artery discovered during a doctor’s visit – or a closer examination of the state of health care in Ohio – shows a bumpier landscape and potentially dangerous turns on the horizon. With a nearly stagnant population Ohio is failing to retain its college grads, draw residents from other states or even keep its retirees. The number of Ohioans living at or beneath the federal poverty level, however, continues to grow and rapidly outpace population growth. Ohio’s per capita income is declining relative to the national average and medical expenses are among the most important financial risks households face. As a result of a dampened job market, employer-sponsored health insurance continues to erode and an increasing number of Ohioans depend on public health insurance coverage such as Medicaid. Medicaid accounts for about 12.4 percent of a typical hospital’s admissions, outpatient and ED visits. Medicaid pays 95 cents for every $1 spent providing inpatient care and 89 cents for each outpatient dollar – but the small loss on each dollar adds up. In 2004, the payments hospitals received for Medicaid patients fell $212.6 million short of the costs of care provided. Government underpayment for these services does not decrease the demand for care, and private payers often feel the crunch as hospitals are forced to reduce or eliminate services, or increase charges for the entire community. But as Gov. Strickland and legislators look toward growing the state’s economy and increasing access health care coverage, OHA looks forward to building on the efforts of the previous General Assembly and partnering on positive changes to both the Medicaid program and the health care environment in Ohio. View the complete OHA Healthbeat article at www.ohanet.org/healthbeat/2007/0107.htm. New Proposed Medicare Local Coverage Determinations National Government Services (formerly AdminaStar Federal) this month issued four new draft Local Coverage Determinations (LCDs) for dental services, fluorescein angiography, fundus photography and scanning computerized ophthalmologic diagnostic imaging services. Copies of the draft LCDs are available at www.ohanet.org/finance/default.asp. National Government Services (NGS) requests comments and recommendations from hospitals and physicians for consideration prior to its policy publication. OHA encourages hospitals and physicians to comment if they disagree with any aspect of any of the policies and to be specific in remarks. Anyone providing comments should supply a clinical rationale for the position, including references from standard textbooks and/or peer-reviewed journals. Whenever possible, comments should also include alternative indications and guidelines. NGS also appreciates a written response from those who agree with the policies.
All comments will be carefully considered and appropriately reflected in the revised policies. Please direct comments to NGS no later than Feb. 26 to Draft_LCD_Comments_Part_A@anthem.com or to Richard K. Baer, MD, Medical Director, Medicare Part A, 225 N. Michigan Avenue, 22nd Floor, Chicago, Illinois 60601-7601. (Charles Cataline, charlesc@ohanet.org)
Hospitals’ Heartbeat A 2006 nominee for the Albert E. Dyckes Health Care Worker of the Year Award
Christine Blatnik, RN Hospital Services Representative, Business Development UHHS Geauga Regional Hospital Chardon
A look inside Christine’s nomination – Christine Blatnik, RN performs her daily responsibilities with a focus on ensuring quality patient care at UHHS Geauga Regional Hospital. She serves with distinction in the fast-paced medical environment, where she has earned the respect and trust of physicians, nurses and support staff. Her mission is to not only achieve, but surpass, aggressive organizational goals for success. She extends her professional reach beyond the confines of stated job parameters and creates winning results for all concerned. Further, Christine is a tireless volunteer and outspoken advocate on behalf of local and regional cancer-related organizations – stemming from her personal battle with a deadly and advanced form of cancer. Christine Blatnik brings compassion, warmth and a positive outlook to those whose privilege it is to know her.
Wednesday, January 31, 2007 In late-December, state lawmakers completed work on a number of bills, bringing a close to the 126th Ohio General Assembly. OHA this month provided a member bulletin highlighting the major hospital-related bills enacted and considered by the state legislature during the 126th Ohio General Assembly and a summary of key rules. Below are highlights of recently-enacted legislation with an impact on member hospitals:
Blood Alcohol Tests: House Bill 461, Effective April 4, 2007
Minimum Wage Implementation: House Bill 690, Effective April 4, 2007
Small Employer Health Insurance: SB 5, HB 5, Effective March 23, 2007
Mental Health Parity: Senate Bill 116, HB 180, Effective March 30, 2007
County Hospitals: Senate Bill 126, Effective March 30, 2007
Guaranty Fund: Senate Bill 279, Effective March 30, 2007
Egress Doors: Senate Bill 305, Effective April 4, 2007
Thursday,
February 1, 2007 Rule Changes Compliance Requirements for Hospitals A regulatory change that went into effect Jan. 26 contains a small change that could mean a significant change in compliance requirements for Medicare and EMTALA as well as medical records. Many hospitals rely on timed entries in medical records to help document care but some hospitals without electronic medical records were not using timed entries. Starting Jan. 26, every entry in the medical record must be timed (including orders, progress notes, procedure notes, patient assessments, etc.) The Centers for Medicaid & Medicare Services potentially could issue a standards level violation for a lack of times entries. Lack of timed entries could also provide legal fodder in medical malpractice lawsuits.
The change that took effect Jan. 26 also requires that all verbal orders be authenticated (electronic or manual signature) within 48 hours by the prescribing practitioner or another practitioner responsible for the care of the patient, even if the order did not originate with him or her. (Rosalie Weakland, rosaliew@ohanet.org)
Hospitals’ Heartbeat A 2006 nominee for the Albert E. Dyckes Health Care Worker of the Year Award
Cindi Swartzwelder, RN, BSN Staff Nurse, Emergency Department Union Hospital Dover
A look inside Cindi’s nomination – Skilled nurse, teacher, mentor, and patient advocate are some of the words that characterize Cindi Swartzwelder, RN, BSN. In one of the most challenging nursing venues, Cindi has become a leader in the ED, both as a Charge Nurse directing nursing care and as a Preceptor for nurses starting their careers. Mentoring new nurses carries great responsibility. Cindi meets that challenge, leading by example, and infusing young nurses with enthusiasm and compassion. As an advisor to the Kent State University Tuscarawas Nursing Program, Cindi is helping prepare a new generation of nurses as a preceptor for second year students in their ED rotations. The quality Emergency care we provide reflects the compassion and devotion to patients that Cindi brings to the job every day and that is emulated in the staff she mentors.
Friday, February 2, 2007 Hospitals have less than 120 days left to get and begin implementation and testing of a National Provider Identifier number (NPI). All providers must have an NPI by May 23, 2007, as required by the Health Insurance Portability and Accountability Act’s Administrative Simplification provision. Apply online and get more information at https://nppes.cms.hhs.gov or call 1-800-465-3203 (NPI Toll-Free). In a recent communication, the Centers for Medicare & Medicaid Services reminded providers that getting an NPI is free; not having one can be costly. Additional help in securing an NPI is available in a special edition of the Medicare Learning Network’s MLN Matters at www.cms.hhs.gov/MLNMattersArticles/downloads/SE0679.pdf. (Charles Cataline, charlesc@ohanet.org) Hospitals’ Heartbeat A 2006 nominee for the Albert E. Dyckes Health Care Worker of the Year Award
Alexander Grant, BSN Clinical Nurse, Medical-Surgical Nursing University Hospitals of Cleveland Cleveland
A look inside Alexander’s nomination – Alexander Grant has been an employee of University Hospitals of Cleveland since April of 1994. He was first hired as an environmental services employee then advanced to a clinical technical assistant. After acquiring his nursing degree he was hired as a clinical nurse. Once Alex decided to join the medical field he went about it with determination that he could make a better life for his family. After coming from Jamaica at age 11, Alex is the only of his 10 siblings to obtain a college degree. Not only did Alex attend college full time but he also remained a full time employee at University Hospitals of Cleveland being the sole provider of a family of six.
Throughout the past two years as a clinical nurse Alex has demonstrated his compassion for the profession not only to patients but also to his fellow employees. He has recently finished charge nurse classes and will soon be attending preceptor classes. Next month he will also attend classes to achieve certification for basic life support instructor. He has recently begun a process improvement project to help him obtain his advanced clinical nurse promotion. © 2001-2008 OHA. Last updated
January 03, 2008. |
