Monday, January 28, 2008
Hospitals, Nurses, Legislators Unite to Support Evolving Health Care
Workforce
Increasing the number of qualified health care workers and creating
mechanisms for obtaining nurse input on how to best staff patient
units are key issues to address in workforce policy and the Ohio
House Health Committee this week is expected to accept substitute
House Bill 346, which will give nurses more say on staffing
decisions while protecting the flexibility needed to respond to
patient needs.
Where does the health care workforce stand?
Hospitals are the buzzing hub of many communities, with
hospitals statewide employing more than 250,000 people, and 20
hospitals and health systems ranking among Ohio’s 100 largest
employers. But hospitals still struggle to fill key vacancies
and prepare for an impending one-two punch: the baby boomer
generation’s retirement from the workforce and its growing need
for hospital care.
What are the dangers of mandated nurse-to-patient ratios?
Currently there is a movement driven by the National Nurses
Organizing Committee of the California Nurses Association to set
mandatory RN-to-patient staffing ratios in Ohio – an approach
with potentially devastating consequences for nurses, hospitals
and ultimately patients. The American Organization of Nurse
Executives, the American Nurses Association, the Ohio Nurses
Association (ONA), OHA and other groups do not support mandatory
ratios because they take flexibility and options away from the
professional nurse managers most in tune with the many factors
that impact their patients.
Why does a statewide nurse staffing plan make sense?
The nurse staffing legislation (HB 346) currently under
consideration by the House Health Committee is an alternative to
mandatory ratios. HB 346, supported by OHA, OONE and ONA,
provides for greater nurse input in staffing decisions while
maintaining the flexibility needed to appropriately respond to
patient needs. HB 346 is a common-sense step in the right
direction – a direct result of open communication and
collaboration between Ohio’s nurses, hospitals and legislators.
For more information on HB 346 and the Ohio health care
workforce, view OHA’s January
HealthBeat article.
(Jean Scholz,
jeans@ohanet.org; Jeff Klingler,
jeffk@ohanet.org)
Tuesday, January 29, 2008
Rep. Raussen Introduces New Health Care Reform Bill
Rep. Jim Raussen
(R-Springdale), chairman of the House Health Care Access and
Affordability Committee, today introduced new health care reform
legislation. OHA is currently analyzing the potential impact of
House Bill 456 on the state’s hospitals but below are several
key provisions:
-
Require
tax-exempt hospitals with Medicaid utilization rates under
35% annually to publish the cost of charity care provided
and property and sales tax savings.
-
Require
non disproportionate share hospitals (DSH) to contract with
every Medicaid managed care organization (MCO) in their
region to be eligible for Hospital Care Assurance Program (HCAP)
funds. Require DSH hospitals to contract with every Medicaid
MCO in their region to be eligible for more than the minimum
HCAP funds.
-
Require
ambulatory surgical facilities to annually report certain
data to the Director of Health.
-
Offer
discounts on Bureau of Workers’ Compensation premiums for
employers who offer health and wellness programs.
-
Create a
pilot program and advisory board with OHA representation to
explore health information technology.
-
Increase
compensation for nursing instructors.
OHA and
hospital representatives testified at a series of regional
hearings held by Rep. Raussen’s committee last summer in
preparation for this legislation, and Rep. Raussen addressed
hospital government relations officials late last year noting
that HCAP would not be a major target. OHA will be meeting with
Rep. Raussen and members of the legislature on key hospital
issues in HB 456 and will provide additional information to
member hospitals after further examination of the proposed
legislation. (Bridget Gargan,
bridgetg@ohanet.org)
OHA
Meets with Governor on Medicaid Update
OHA, the Ohio Children’s Hospital Association, the Ohio
Osteopathic Association and the Ohio State Medical Association
met today with Gov. Ted Strickland to request that the
administration reinstate an increase in Medicaid reimbursement
that providers were scheduled to receive effective Jan. 1. The
associations noted that failure to reinstate the funding will
pass on an invisible tax of $159 million to the Ohio business
community through increased costs for insurers. Though the state
faces an economic downturn, restricting payments to health care
providers is counterproductive and ultimately creates higher
costs.
Though he does
not currently plan to reinstate the reimbursement increase, the
governor was empathetic to hospital concerns. The meeting also
gave providers an opportunity to articulate ongoing frustrations
with Medicaid managed care, including lack of prompt payment and
the inability of managed care organizations to build adequate
provider networks. The governor expressed a willingness to look
at these challenges. (Jim Castle,
jimc@ohanet.org)
Wednesday, January 23, 2008
Energy Costs Increasing, Learn More at OHA Energy Conference
The Public Utilities
Commission of Ohio (PUCO) is working to respond to requests by Ohio
utilities to increase natural gas and electric rates. On Jan. 23, PUCO
adopted a settlement involving Columbia Gas of Ohio that
benefits some ratepayers with a $36.5 million credit and will lead to a
wholesale gas supply auction and implementation of a demand side
management program. In the long term, this may modestly increase natural
gas transportation costs for hospitals. View an
analysis of the settlement as it affects hospitals.
OHA also was
recently involved in settlement of a complex case that will
increase rates for Ohio Power Company by about 3 percent and
Columbus Southern Power Company by about 7 percent. That case
dealt with issues such as carrying charges and line losses
(components of electric rates called “riders”). Hospitals will
see those increases in their bills beginning in March or April.
A number of
other natural gas and electric cases are pending or expected to
be filed soon. For example, a Duke Energy Ohio gas distribution
case will soon go to hearing as well as several cases proposing
increases in various electric rate riders. FirstEnergy
Corporation proposed to set its electric rates based on energy
auctions and will be seeking increased rates in the form of
riders. Vectored Energy has a case related to its exit from the
Dayton area as a regulated natural gas supplier. Dominion East
Ohio is seeking a rate increase for its natural gas distribution
services.
Meanwhile, the
legislature continues to hear testimony about the electric
restructuring bill, Senate Bill 221. Electric rates after this
year are expected to increase, potentially dramatically as in
states with deregulated electric rates.
To assist
hospitals in understanding the energy environment, OHA is
offering an
Energy Conference Feb. 1 in Columbus. The workshop will
examine the future of energy costs, the impact of restructuring
Ohio’s electric rate-setting process, and strategies for
hospitals to manage rates that have increased dramatically.
(Rick Sites,
ricks@ohanet.org)
Thursday, January 31,
2008
Hospitals Support Physician Medicaid Increase, Hospital Recalibration
Halt
In a news conference
today, Gov. Ted Strickland announced he will halt the planned 2008
recalibration of Medicaid rates for hospitals and provide physicians
with their first Medicaid update in seven years, effective July 1.
“The governor
should be applauded for his action today to ensure Ohioans have
access to primary care by providing necessary reimbursement to the
health care community in this difficult economic time,” said James
R. Castle, president & CEO of OHA. “I would be remiss if I did not
mention our members’ disappointment that we have not found the funds
to provide hospitals a Medicaid update in 2008.”
According to
original estimates, the delayed recalibration will spare hospitals
$13 million in losses statewide on care provided in Medicaid
fee-for-service settings. OHA is working with the Ohio Department of
Job of Family Services to verify the accuracy of the fee-for-service
estimate as well as obtain a managed care estimate.
The state most
recently estimated the freeze on hospital reimbursement will save
$32.6 million over the biennium on fee-for-service. With managed
care and federal Medicaid funds included, OHA estimates the impact
could be as high as $159 million over two years.
Although disappointed to learn hospitals will not receive a
reimbursement update, the association commends the governor’s
decision to provide physicians with their first Medicaid update
since 2001. Another freeze could have forced physicians to stop
accepting new Medicaid patients, who would then turn to already
overflowing hospital emergency departments for primary care or
chronic care for untreated conditions. Ohio emergency room visits
increased by 9.5 percent between 2003 and 2006 overall, by nearly 14
percent for Medicaid patients, and by over 19 percent for uninsured
patients. On Monday, representatives of OHA, the Ohio Osteopathic
Association, the Ohio State Medical Association and the Ohio
Children’s Hospital Association met with the governor and his staff
to ask that the Medicaid reimbursement increase be restored for all
providers. (Bridget Gargan,
bridgetg@ohanet.org)
Errors in HCAHPS Preview Data Corrected
The
hospital-specific Hospital Care Quality Information from the
Consumer Perspective (HCAHPS) data posted at
http://www.qualitynet.org/ for preview contained errors and
hospitals should re-check their data between today and Feb. 15. The
Centers for Medicare & Medicaid Services noted a mathematical error
dramatically reduces the proportion of patients who rate hospitals
as “always” doing the right thing and inflates the proportion who
rate hospitals as “usually” doing the right thing.
The error affects
composite scores 3-6, which deal with responsiveness of staff, pain
management, communication about medications and discharge
information. The information will be available to the
public at
www.hospitalcompare.hhs.gov/ by the end of March.
Those reviewing
the data also should communicate the information to hospital
leadership and media relations personnel. Hospitals may choose not
to share HCAHPS data through Hospital Compare for the upcoming
update without incurring a payment penalty if they find significant
errors in the data. In subsequent updates, all data must be publicly
shared or hospitals will suffer reductions in payments.
Hospital Compare
is a Web site that provides hospital quality data to consumers. It
is a public-private collaborative knows as the Hospital Quality
Alliance: Centers for Medicare & Medicaid Services, American
Hospital Association, Federation of American Hospitals and
Association of American Medical Colleges. (Rosalie Weakland,
rosaliew@ohanet.org)
Friday,
February 1, 2008
FDA Recalls
Contaminated Syringes
The U.S. Food and Drug
Administration (FDA) announced a nationwide recall of heparin and saline
pre-filled flush syringes manufactured by AM2 PAT Inc. Two lots were
found to be contaminated with
Serratia marcescens,
a bacterium that can cause serious injury or death. The FDA advised all
health care facilities to stop using this product immediately, and
quarantine the products in their inventory and return them to their
distributor. Any adverse reactions to the products should be reported to
the FDA’s MedWatch Program by phone at 800.FDA.0178, by mail at MedWatch,
HF-2, FDA, 5600 Fishers Lane, Rockville, M.D. 20852-9787, or on the
MedWatch Web site at
www.fda.gov/medwatch. View an FDA
news release for additional information. (Carol Jacobson,
carolj@ohanet.org)
2008 Hospital Law Handbook Available
A new edition of the OHA Hospital Law Handbook is now available.
The handbook is a compendium of select Ohio statutes and
regulations applicable to hospitals, physicians, nurses and
other health care workers. The new edition consists of more than
900 pages, organized into 11 chapters, with the
approximately 950 statutes and regulations current to Jan. 1,
2008. More than 70 new provisions were added and the index was
expanded, ranging from "abandoned baby" to "x-ray." Certain
provisions, such as those related to Medicaid and Workers'
Compensation reimbursement, are not included. OHA will identify
changes to the handbook through postings on the OHA web site.
The cost is $100 for OHA members and $150 for nonmembers. View
ordering information. (Rick Sites,
ricks@ohanet.org)
