The health insurance giant rode huge success in its Optum health-services unit to better-than-expected results.
Reported by Motley Fool 50 minutes ago.
UnitedHealth Keeps Optum-izing Its Growth Opportunities
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Revolving door: Ex-Obamacare official to lead health insurers' trade group
The trade association representing the health insurance industry will now be led by the woman who headed the federal agency in charge of the Affordable Care Act’s health insurance exchanges. America’s Health Insurance Plans named Marilyn Tavenner, former director of the Centers for Medicare and Medicaid Services, as its new CEO on Thursday. The hiring confirms that health insurers are more interested in making Obamacare work for them than in rolling back the health care reform law. Tavenner’s…
Reported by bizjournals 23 hours ago.
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The Sullivan Institute, WEDI, HIMSS, MGMA Unveil Pilot Design for Virtual Clipboard Initiative
Pilot will utilize mobile technology to automate the patient intake process with the goal of enhancing system efficiency and improving patient satisfaction.
RESTON, Va. (PRWEB) July 16, 2015
The Sullivan Institute for Healthcare Innovation, in collaboration with the Workgroup for Electronic Data Interchange (WEDI), the Healthcare Information and Management Systems Society (HIMSS) and the Medical Group Management Association (MGMA), announced the release of its Virtual Clipboard Initiative pilot solution definition and design document. This document outlines the specifications for the Virtual Clipboard Initiative pilot program, including defined user functionality, pilot scope and functionality, as well as documenting future strategic design considerations.
“We expect the Virtual Clipboard Initiative to significantly improve the burdensome patient intake process – a critical and overlooked component of the healthcare delivery system,” said Devin Jopp, Ed.D, president and CEO of WEDI. “In an unprecedented collaborative effort, key stakeholders from across the healthcare continuum have come together to define initial standards for mobile healthcare applications. Leveraging the technology that many patients already use, the pilot seeks to demonstrate dramatic improvements to the healthcare registration process.”
The initial phase of the Virtual Clipboard Initiative pilot will be to facilitate the automated collection of critical patient health insurance and demographic information. Ultimately, the goal of the Virtual Clipboard Initiative is to create consistent standards, integration points and security that will add value to the entire healthcare delivery system by increasing the quality of care, improving patient safety and reducing administrative costs.
“We are very excited to see the Virtual Clipboard project move into the pilot phase,” stated Robert Tennant, director of health information technology policy for the Medical Group Management Association. “Once implemented, this automated approach to patient intake and data transmission will significantly improve administrative efficiency – while at same time increasing patient satisfaction. By bringing together a powerful alliance of patient advocates, providers, health plans and vendors, the Sullivan Institute, along with WEDI, are forging a clear pathway forward to better patient care.”
“The Virtual Clipboard Initiative pilot is an important step forward as we progress in the multi-phased approach of re-engineering the flow of healthcare information between health plans, patients and providers,” said Lisa Gallagher, BSEE, CISM, CPHIMS, FHIMSS, vice president of technology solutions for HIMSS. “HIMSS is eager to bring the work we’ve undertaken with the other aligned organizations to fruition in this pilot phase of the Virtual Clipboard Initiative.”
About the Sullivan Institute
In 1993, the original WEDI Report brought together public and private industry to develop a roadmap for healthcare information exchange. In 2013, on the 20th anniversary of that original report and with Then Honorable Louis W. Sullivan, M.D.’s leadership, WEDI developed a new report which laid out the future of healthcare information exchange. The Louis W. Sullivan Institute for Healthcare Innovation is a 501(c)(3) non-profit organization, named in honor of The Honorable Louis W. Sullivan, M.D. Its mission is to bring healthcare leaders together to share knowledge needed to transform the quality and efficiency of healthcare delivery through education, cooperation, communication and innovation. To learn more, visit http://www.sullivaninstitute.org. Reported by PRWeb 12 hours ago.
RESTON, Va. (PRWEB) July 16, 2015
The Sullivan Institute for Healthcare Innovation, in collaboration with the Workgroup for Electronic Data Interchange (WEDI), the Healthcare Information and Management Systems Society (HIMSS) and the Medical Group Management Association (MGMA), announced the release of its Virtual Clipboard Initiative pilot solution definition and design document. This document outlines the specifications for the Virtual Clipboard Initiative pilot program, including defined user functionality, pilot scope and functionality, as well as documenting future strategic design considerations.
“We expect the Virtual Clipboard Initiative to significantly improve the burdensome patient intake process – a critical and overlooked component of the healthcare delivery system,” said Devin Jopp, Ed.D, president and CEO of WEDI. “In an unprecedented collaborative effort, key stakeholders from across the healthcare continuum have come together to define initial standards for mobile healthcare applications. Leveraging the technology that many patients already use, the pilot seeks to demonstrate dramatic improvements to the healthcare registration process.”
The initial phase of the Virtual Clipboard Initiative pilot will be to facilitate the automated collection of critical patient health insurance and demographic information. Ultimately, the goal of the Virtual Clipboard Initiative is to create consistent standards, integration points and security that will add value to the entire healthcare delivery system by increasing the quality of care, improving patient safety and reducing administrative costs.
“We are very excited to see the Virtual Clipboard project move into the pilot phase,” stated Robert Tennant, director of health information technology policy for the Medical Group Management Association. “Once implemented, this automated approach to patient intake and data transmission will significantly improve administrative efficiency – while at same time increasing patient satisfaction. By bringing together a powerful alliance of patient advocates, providers, health plans and vendors, the Sullivan Institute, along with WEDI, are forging a clear pathway forward to better patient care.”
“The Virtual Clipboard Initiative pilot is an important step forward as we progress in the multi-phased approach of re-engineering the flow of healthcare information between health plans, patients and providers,” said Lisa Gallagher, BSEE, CISM, CPHIMS, FHIMSS, vice president of technology solutions for HIMSS. “HIMSS is eager to bring the work we’ve undertaken with the other aligned organizations to fruition in this pilot phase of the Virtual Clipboard Initiative.”
About the Sullivan Institute
In 1993, the original WEDI Report brought together public and private industry to develop a roadmap for healthcare information exchange. In 2013, on the 20th anniversary of that original report and with Then Honorable Louis W. Sullivan, M.D.’s leadership, WEDI developed a new report which laid out the future of healthcare information exchange. The Louis W. Sullivan Institute for Healthcare Innovation is a 501(c)(3) non-profit organization, named in honor of The Honorable Louis W. Sullivan, M.D. Its mission is to bring healthcare leaders together to share knowledge needed to transform the quality and efficiency of healthcare delivery through education, cooperation, communication and innovation. To learn more, visit http://www.sullivaninstitute.org. Reported by PRWeb 12 hours ago.
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UnitedHealth earnings top forecasts
UnitedHealth continued to juice up its business outside health insurance in a better-than-expected second quarter while rivals scrambled to add enrollment in a wave of mega-mergers sweeping the sector.
Reported by L.A. Times 20 hours ago.
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Aetna's 21% rate hike amounts to 'price gouging,' California regulator says
California's managed-care regulator slammed health insurance giant Aetna Inc. on Thursday for "price gouging" after it raised rates on small employers by 21%.
Reported by L.A. Times 20 hours ago.
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UnitedHealth tops Street 2Q forecasts, raises forecasts
ealth continued to juice up its business outside health insurance in a better-than-expected second quarter while rivals...
Reported by Deseret News 20 hours ago.
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Christian college drops student health insurance, rather than comply with contraceptive mandate
A small Christian college in Massachusetts has elected not to offer health insurance to students, in order to avoid complying with the federal contraceptive mandate. Wheaton College has ...
Reported by Catholic Culture 19 hours ago.
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Alaska Governor Expands Medicaid By Skirting GOP Lawmakers
WASHINGTON -- Alaska would become the latest state to sign on to a major expansion of Medicaid under the Affordable Care Act through a plan announced by Gov. Bill Walker on Thursday.
Walker, an independent elected in 2014 on a platform that included Medicaid expansion, had been courting the Republican-led state legislature on the issue. But after lawmakers failed to advance his proposal in their latest session, he decided to carry out the policy on his own authority, Walker said during a press conference at the Alaska Native Tribal Health Consortium headquarters in Anchorage.
Broadening eligibility for the federal-state health care program could give coverage to as many as 42,000 Alaskans, according to the governor's office. Walker informed the state legislature's joint budget committee of his intent to accept federal funding for the expansion in a letter Thursday.
“It’s time to expand Medicaid so thousands of our friends, coworkers, neighbors and family members don’t have to make the choice between health care or bankruptcy,” the governor said in a press release announcing his decision.
When Congress enacted the Affordable Care Act in 2010, the law called for a nationwide expansion of Medicaid to anyone earning up to 133 percent of the federal poverty level, which is about $15,650 for a single person and $32,250 for a family of four. But in 2012, the Supreme Court ruled that states could opt out of the expansion. Under Walker's plan, Alaska would join 30 other states and the District of Columbia in voluntarily adopting the policy.
Medicaid expansion has been a major contributor to a historic drop in the uninsured rate since 2014. The 19 states that still reject the expansion are mainly in the South.
Besides Alaska, two other states have joined the Medicaid expansion this year. Montana's version of the policy, favored by Democratic Gov. Steve Bullock and enacted by a majority Republican legislature, awaits federal approval. The plan faces obstacles because the state seeks to add requirements for new enrollees, such as the paying of monthly premiums, that aren't part of traditional Medicaid programs. Indiana officials, led by Republican Gov. Mike Pence, won a federal OK to use the Affordable Care Act's Medicaid financing to expand a state program that uses private health insurance plans and health savings accounts to cover low-income people.
The Obama administration had previously approved modified Medicaid expansions in several other states, including Arkansas, Iowa, Michigan and Ohio.
Fresh off his victory against another Supreme Court challenge to the Affordable Care Act last month, President Barack Obama has vowed to promote Medicaid expansion in the holdout states. He made his case in person during a visit to Nashville, Tennessee, in June. Tennessee Gov. Bill Haslam (R) presented a plan for a version of Medicaid expansion to the state's GOP-majority legislature this year, but lawmakers rejected it. Utah Gov. Gary Herbert (R) also is trying to move a Medicaid plan through his state's Republican-led legislature, but the plan has suffered setbacks.
Walker's plan in Alaska could similarly face resistance from GOP state lawmakers, even with the legislature currently out of session. The budget committee that Walker notified Thursday operates even when the legislature isn't in session, and has 45 days to endorse Walker's plan, recommend against it or take no action, according to the press release.
While the governor didn't call for lawmakers to reconvene, they could choose to do so in order to debate, and possibly attempt to block, his plan. Earlier this year, Republicans in the legislature attempted to prevent Walker from acting on Medicaid without new legislation by including language in the state's budget prohibiting any such move. Official opinions from the Alaska Department of Law and from the legislature's legal counsel, however, declared that the effort to block Walker likely doesn't adhere to the state's constitution.
-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 19 hours ago.
Walker, an independent elected in 2014 on a platform that included Medicaid expansion, had been courting the Republican-led state legislature on the issue. But after lawmakers failed to advance his proposal in their latest session, he decided to carry out the policy on his own authority, Walker said during a press conference at the Alaska Native Tribal Health Consortium headquarters in Anchorage.
Broadening eligibility for the federal-state health care program could give coverage to as many as 42,000 Alaskans, according to the governor's office. Walker informed the state legislature's joint budget committee of his intent to accept federal funding for the expansion in a letter Thursday.
“It’s time to expand Medicaid so thousands of our friends, coworkers, neighbors and family members don’t have to make the choice between health care or bankruptcy,” the governor said in a press release announcing his decision.
When Congress enacted the Affordable Care Act in 2010, the law called for a nationwide expansion of Medicaid to anyone earning up to 133 percent of the federal poverty level, which is about $15,650 for a single person and $32,250 for a family of four. But in 2012, the Supreme Court ruled that states could opt out of the expansion. Under Walker's plan, Alaska would join 30 other states and the District of Columbia in voluntarily adopting the policy.
Medicaid expansion has been a major contributor to a historic drop in the uninsured rate since 2014. The 19 states that still reject the expansion are mainly in the South.
Besides Alaska, two other states have joined the Medicaid expansion this year. Montana's version of the policy, favored by Democratic Gov. Steve Bullock and enacted by a majority Republican legislature, awaits federal approval. The plan faces obstacles because the state seeks to add requirements for new enrollees, such as the paying of monthly premiums, that aren't part of traditional Medicaid programs. Indiana officials, led by Republican Gov. Mike Pence, won a federal OK to use the Affordable Care Act's Medicaid financing to expand a state program that uses private health insurance plans and health savings accounts to cover low-income people.
The Obama administration had previously approved modified Medicaid expansions in several other states, including Arkansas, Iowa, Michigan and Ohio.
Fresh off his victory against another Supreme Court challenge to the Affordable Care Act last month, President Barack Obama has vowed to promote Medicaid expansion in the holdout states. He made his case in person during a visit to Nashville, Tennessee, in June. Tennessee Gov. Bill Haslam (R) presented a plan for a version of Medicaid expansion to the state's GOP-majority legislature this year, but lawmakers rejected it. Utah Gov. Gary Herbert (R) also is trying to move a Medicaid plan through his state's Republican-led legislature, but the plan has suffered setbacks.
Walker's plan in Alaska could similarly face resistance from GOP state lawmakers, even with the legislature currently out of session. The budget committee that Walker notified Thursday operates even when the legislature isn't in session, and has 45 days to endorse Walker's plan, recommend against it or take no action, according to the press release.
While the governor didn't call for lawmakers to reconvene, they could choose to do so in order to debate, and possibly attempt to block, his plan. Earlier this year, Republicans in the legislature attempted to prevent Walker from acting on Medicaid without new legislation by including language in the state's budget prohibiting any such move. Official opinions from the Alaska Department of Law and from the legislature's legal counsel, however, declared that the effort to block Walker likely doesn't adhere to the state's constitution.
-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 19 hours ago.
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Louisiana extends health insurance to same-sex state workers' spouses
BATON ROUGE -- The health insurance program for Louisiana state employees, retirees and some public school systems is taking applications for coverage for same-sex spouses and their dependents. Those who were married before June 26 -- the date that the...
Reported by nola.com 19 hours ago.
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Hillary Clinton Twists Jeb Bush’s Words
The following post first appeared on FactCheck.org.Hillary Clinton has continued to twist Jeb Bush’s words, suggesting that he thinks “the nurse who stands on her feet all day or the trucker who drives all night” needs to “work longer hours.” Bush did say “people need to work longer hours,” but he has since said he was talking about part-time workers who want full-time hours.
We don’t know what Bush had in mind when he first spoke, but his explanation is consistent with his previous statements about the underemployed.
Bush’s “longer hours” comment exploded on social media, and in traditional media, as Democrats pounced on a carelessly worded response to a question about tax reform that the Republican presidential candidate fielded in New Hampshire from The Union Leader:
*Bush, July 8*: My aspiration for the country and I believe we can achieve it, is 4 percent growth as far as the eye can see. Which means we have to be a lot more productive, workforce participation has to rise from its all-time modern lows. It means that people need to work longer hours and, through their productivity, gain more income for their families. That’s the only way we’re going to get out of this rut that we’re in.
His campaign quickly clarified that the “longer hours” quote was a reference to the underemployed and part-time workers. According to the Bureau of Labor Statistics, there were 6.5 million people in June who said they were working part-time because they couldn’t find full-time work or because business was slow. By comparison, that figure was 4.6 million when the Great Recession started in December 2007.
Nonetheless, a number of Democrats criticized Bush for being out-of-touch, accusing him of saying Americans ought to work more than the standard 40 hours a week.
“Americans already work the longest hours of any people in the western industrialized world,” said Democratic presidential candidate Bernie Sanders. “In fact, 80 percent of working men work longer than 40 hours a week.”
(Actually, Sanders was wrong. According to the Organisation for Economic Co-operation and Development, Americans worked more hours than the average for OECD-member countries, but ranked 15th out of the 34 countries surveyed. And, OECD reported, 83 percent of men and 65 percent of women in the U.S. worked 40 hours or more — but that’s not the same as working more than 40 hours.)
The jabs continued on Twitter, where Rep. Steve Israel wrote: “Bush: ‘People should work longer hours’; next up: Bush: ‘GDP could double without those lazy weekends.’ ”
The Clinton campaign tweeted out, “Anyone who believes Americans aren’t working hard enough hasn’t met enough American workers.”
Bush addressed the budding controversy himself the same day, telling reporters, “If we’re going to grow the economy, people need to stop being part-time workers, they need to be having access to greater opportunities to work.”
*Bush, July 8*: You can take it out of context all you want, but high-sustained growth means that people work 40 hours rather than 30 hours and that by our success, they have money, disposable income for their families to decide how they want to spend it rather than getting in line and being dependent on government.
Health-care costs are rising. In many places, the cost of doing business is extraordinarily high and the net result of that is that business start-up rates are at an all-time low. Workforce participation rates are low. If anyone is celebrating this anemic recovery then they’re totally out of touch. The simple fact is that people are really struggling. So giving people a chance to work longer hours has got to be part of the answer. If not, you’re going to see people lose hope.
That explanation is not only a plausible clarification of his original comment, it is consistent with previous statements Bush has made about the problem of underemployment.
For example, when laying out his economic plan on Feb. 4 at the Detroit Economic Club, Bush said the Obama economy had led to workers’ hours being cut (at the 14:51 mark of the video).
*Bush, Feb. 4*: For several years now, they have been recklessly degrading the value of work, the incentive to work, and the rewards of work. We have seen them cut the definition of a full-time job from 40 hours to 30 hours, slashing the ability of paycheck earners to make ends meet. We have seen them create welfare programs and tax rules that punish people with lost benefits and higher taxes for moving up those first rungs of the economic ladder.
Bush was referring to the Affordable Care Act’s requirement for employers with at least 50 workers to provide health insurance to full-time employees, defined as those who work 30 hours or more per week. Bush and other critics of the ACA say that encourages employers to cut workers’ hours to avoid the insurance requirement.
The Bush campaign also addressed the issue of underemployment in a July 5 Medium blog post, stating: “More than 6 million people are working part-time jobs when they’d prefer full-time.” That same post blamed the Obama-backed Affordable Care Act for “holding down worker hours and reducing the payoff from working.”
And in an interview with Neil Cavuto on Fox News on June 2, Bush lamented that the “work force participation rate is lower than it was 30 years ago.”
(As an aside, we have noted that the ratio of part-time workers to all workers is about the same as when Obama took office. We also addressed the reasons for the declining workforce participation rate.)
Some Democrats have softened their tone on the “longer hours” quote in light of Bush’s clarification. For example, Sanders said this July 10 after CNN anchor Chris Cuomo accused Sanders of twisting Bush’s words: “Well, if [Bush] is talking about the need for more full-time jobs rather than part-time jobs, he’s absolutely correct. That’s — that’s what we have to. But I want to reiterate. We work — our people work today the longest hours of any people in any major industrialized country.”
Clinton has continued to take digs at Bush’s “longer hours” comment, suggesting that Bush thinks that already hard-working Americans need to work harder still. One example came during a speech on July 13 at the National Council of La Raza’s annual conference. (starting at the 11:36 mark)
*Clinton, July 13*: Now you probably heard Governor Bush say last week that Americans just need to work longer hours. Well, he should tell that to the farm workers breaking their backs picking fruit in Southern California. Or he should tell that to the dishwashers working their hands raw in the kitchens of Las Vegas. Or he should tell that to the nurse who stands on her feet all day or the trucker who drives all night or the fast-food workers marching in the streets for better pay. They don’t need a lecture; they need a raise.
Clinton made nearly identical remarks when outlining her economic policy plan the same day in New York City (starting at the 21:30 mark).
*Clinton, July 13*: Now, you may have heard Governor Bush say last week that Americans just need to work longer hours. Well, he must not have met very many American workers. Let him tell that to the nurse who stands on her feet all day or the teacher who is in that classroom or the trucker who drives all night. Let him tell that to the fast food workers marching in the streets for better pay. They don’t need a lecture; they need a raise.
The Clinton campaign says she was simply making the point that the central economic problem for American workers is not that they need to work longer hours, but rather that they are not paid enough for the hours they do work.
“During this speech, Hillary Clinton laid out what she views as the defining economic challenge of our time: Raising incomes for hardworking Americans so they can afford a middle class life,” Clinton spokesman Josh Schwerin told us via email. “The contrast she was making with Bush is that he’s not offering any ideas to address this central economic challenge.”
That’s an argument worthy of political debate. But by highlighting Bush’s comment about people needing to work longer hours and following that with the suggestion that Bush needs to “tell that to the nurse who stands on her feet all day or the teacher who is in that classroom or the trucker who drives all night,” Clinton implies that Bush thinks those workers need to work more hours. Those are full-time workers, but Bush says he wasn’t referring to them at all.
Misrepresenting your opponent’s words is a campaign staple, of course. It reminds us at FactCheck.org of Republicans twisting Obama’s quote, “If you’ve got a business — you didn’t build that,” and of Obama spinning Mitt Romney’s quote that “we shouldn’t move heaven and earth to get one man,” referring to Osama bin Laden.
Bush’s “longer hours” comment makes for hard-to-resist material during a heated campaign, appealing to full-time workers who might be offended by someone saying he or she needs to work longer hours. We’d be surprised if this doesn’t continue to be a frequent attack point. But Bush has since clarified that his words were being misinterpreted, and that he was making an argument in favor of part-time workers who want more hours to be given those opportunities.
-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 18 hours ago.
We don’t know what Bush had in mind when he first spoke, but his explanation is consistent with his previous statements about the underemployed.
Bush’s “longer hours” comment exploded on social media, and in traditional media, as Democrats pounced on a carelessly worded response to a question about tax reform that the Republican presidential candidate fielded in New Hampshire from The Union Leader:
*Bush, July 8*: My aspiration for the country and I believe we can achieve it, is 4 percent growth as far as the eye can see. Which means we have to be a lot more productive, workforce participation has to rise from its all-time modern lows. It means that people need to work longer hours and, through their productivity, gain more income for their families. That’s the only way we’re going to get out of this rut that we’re in.
His campaign quickly clarified that the “longer hours” quote was a reference to the underemployed and part-time workers. According to the Bureau of Labor Statistics, there were 6.5 million people in June who said they were working part-time because they couldn’t find full-time work or because business was slow. By comparison, that figure was 4.6 million when the Great Recession started in December 2007.
Nonetheless, a number of Democrats criticized Bush for being out-of-touch, accusing him of saying Americans ought to work more than the standard 40 hours a week.
“Americans already work the longest hours of any people in the western industrialized world,” said Democratic presidential candidate Bernie Sanders. “In fact, 80 percent of working men work longer than 40 hours a week.”
(Actually, Sanders was wrong. According to the Organisation for Economic Co-operation and Development, Americans worked more hours than the average for OECD-member countries, but ranked 15th out of the 34 countries surveyed. And, OECD reported, 83 percent of men and 65 percent of women in the U.S. worked 40 hours or more — but that’s not the same as working more than 40 hours.)
The jabs continued on Twitter, where Rep. Steve Israel wrote: “Bush: ‘People should work longer hours’; next up: Bush: ‘GDP could double without those lazy weekends.’ ”
The Clinton campaign tweeted out, “Anyone who believes Americans aren’t working hard enough hasn’t met enough American workers.”
Bush addressed the budding controversy himself the same day, telling reporters, “If we’re going to grow the economy, people need to stop being part-time workers, they need to be having access to greater opportunities to work.”
*Bush, July 8*: You can take it out of context all you want, but high-sustained growth means that people work 40 hours rather than 30 hours and that by our success, they have money, disposable income for their families to decide how they want to spend it rather than getting in line and being dependent on government.
Health-care costs are rising. In many places, the cost of doing business is extraordinarily high and the net result of that is that business start-up rates are at an all-time low. Workforce participation rates are low. If anyone is celebrating this anemic recovery then they’re totally out of touch. The simple fact is that people are really struggling. So giving people a chance to work longer hours has got to be part of the answer. If not, you’re going to see people lose hope.
That explanation is not only a plausible clarification of his original comment, it is consistent with previous statements Bush has made about the problem of underemployment.
For example, when laying out his economic plan on Feb. 4 at the Detroit Economic Club, Bush said the Obama economy had led to workers’ hours being cut (at the 14:51 mark of the video).
*Bush, Feb. 4*: For several years now, they have been recklessly degrading the value of work, the incentive to work, and the rewards of work. We have seen them cut the definition of a full-time job from 40 hours to 30 hours, slashing the ability of paycheck earners to make ends meet. We have seen them create welfare programs and tax rules that punish people with lost benefits and higher taxes for moving up those first rungs of the economic ladder.
Bush was referring to the Affordable Care Act’s requirement for employers with at least 50 workers to provide health insurance to full-time employees, defined as those who work 30 hours or more per week. Bush and other critics of the ACA say that encourages employers to cut workers’ hours to avoid the insurance requirement.
The Bush campaign also addressed the issue of underemployment in a July 5 Medium blog post, stating: “More than 6 million people are working part-time jobs when they’d prefer full-time.” That same post blamed the Obama-backed Affordable Care Act for “holding down worker hours and reducing the payoff from working.”
And in an interview with Neil Cavuto on Fox News on June 2, Bush lamented that the “work force participation rate is lower than it was 30 years ago.”
(As an aside, we have noted that the ratio of part-time workers to all workers is about the same as when Obama took office. We also addressed the reasons for the declining workforce participation rate.)
Some Democrats have softened their tone on the “longer hours” quote in light of Bush’s clarification. For example, Sanders said this July 10 after CNN anchor Chris Cuomo accused Sanders of twisting Bush’s words: “Well, if [Bush] is talking about the need for more full-time jobs rather than part-time jobs, he’s absolutely correct. That’s — that’s what we have to. But I want to reiterate. We work — our people work today the longest hours of any people in any major industrialized country.”
Clinton has continued to take digs at Bush’s “longer hours” comment, suggesting that Bush thinks that already hard-working Americans need to work harder still. One example came during a speech on July 13 at the National Council of La Raza’s annual conference. (starting at the 11:36 mark)
*Clinton, July 13*: Now you probably heard Governor Bush say last week that Americans just need to work longer hours. Well, he should tell that to the farm workers breaking their backs picking fruit in Southern California. Or he should tell that to the dishwashers working their hands raw in the kitchens of Las Vegas. Or he should tell that to the nurse who stands on her feet all day or the trucker who drives all night or the fast-food workers marching in the streets for better pay. They don’t need a lecture; they need a raise.
Clinton made nearly identical remarks when outlining her economic policy plan the same day in New York City (starting at the 21:30 mark).
*Clinton, July 13*: Now, you may have heard Governor Bush say last week that Americans just need to work longer hours. Well, he must not have met very many American workers. Let him tell that to the nurse who stands on her feet all day or the teacher who is in that classroom or the trucker who drives all night. Let him tell that to the fast food workers marching in the streets for better pay. They don’t need a lecture; they need a raise.
The Clinton campaign says she was simply making the point that the central economic problem for American workers is not that they need to work longer hours, but rather that they are not paid enough for the hours they do work.
“During this speech, Hillary Clinton laid out what she views as the defining economic challenge of our time: Raising incomes for hardworking Americans so they can afford a middle class life,” Clinton spokesman Josh Schwerin told us via email. “The contrast she was making with Bush is that he’s not offering any ideas to address this central economic challenge.”
That’s an argument worthy of political debate. But by highlighting Bush’s comment about people needing to work longer hours and following that with the suggestion that Bush needs to “tell that to the nurse who stands on her feet all day or the teacher who is in that classroom or the trucker who drives all night,” Clinton implies that Bush thinks those workers need to work more hours. Those are full-time workers, but Bush says he wasn’t referring to them at all.
Misrepresenting your opponent’s words is a campaign staple, of course. It reminds us at FactCheck.org of Republicans twisting Obama’s quote, “If you’ve got a business — you didn’t build that,” and of Obama spinning Mitt Romney’s quote that “we shouldn’t move heaven and earth to get one man,” referring to Osama bin Laden.
Bush’s “longer hours” comment makes for hard-to-resist material during a heated campaign, appealing to full-time workers who might be offended by someone saying he or she needs to work longer hours. We’d be surprised if this doesn’t continue to be a frequent attack point. But Bush has since clarified that his words were being misinterpreted, and that he was making an argument in favor of part-time workers who want more hours to be given those opportunities.
-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 18 hours ago.
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Health Reform Task Force gets update on Medicaid expansion negotiations
Salt Lake City, Utah- (ABC 4 Utah) – Lawmakers who are working behind closed doors on a solution to close the Medicaid coverage gap in our state offered a public update.
The self imposed deadline for the Gang of 6 is two weeks away, but they are already admitting it will likely go beyond that.
Advocates for medicaid expansion say that is a mistake.
Negotiations are happening out of the public eye for now, but two members of the Gang of 6, Senator Brian Shiozawa and Representative Jim Dunnigan went before the Health Reform Task Force on Thursday.
Senator Shiozawa says one of the main things they are working on is an adequate funding source.
He says those who benefit should help shoulder the burden.
"That would be doctors, hospitals, pharmacy, different groups like that we would expect that there would be contributions from those groups. So, that this program would be viable for them, because after all they would benefit from this particular group of insureds," said Shiozawa, ( R ) Salt Lake City.
For now the group made up of tens of thousands of Utahns has no option for health insurance.
Advocates for Medicaid expansion say every day that goes by puts them at risk and in some cases it's too late.
"We're having more and more individuals that we hear about not only having health care dilemma's, but actually passing away due to those dilemma's. This is a very, very here and now issue," said Utah Health Policy Project Executive Director, Matt Slonaker.
He says Utahns have made it clear where they stand.
"We want a solution and we want it now, we want it quickly,” said Slonaker.
As a medical doctor who sees the consequences from the front lines himself, Senator Shiozawa says he understands the urgency.
He says the extra time will result in a plan superior to the governor's Healthy Utah Plan and the house backed Utah Cares Plan which both failed during the session.
"We have to do a responsible job. We want to do this as best we can before we put it on paper," said Shiozawa.
Even if they don't have an agreement by the end of the month members of the Gang of 6 remain confident they can get this wrapped up before the next general session.
The Gang of 6 has been communicating with other states to learn from their experiences.
They say right now all options are still on the table. Reported by abc4 15 hours ago.
The self imposed deadline for the Gang of 6 is two weeks away, but they are already admitting it will likely go beyond that.
Advocates for medicaid expansion say that is a mistake.
Negotiations are happening out of the public eye for now, but two members of the Gang of 6, Senator Brian Shiozawa and Representative Jim Dunnigan went before the Health Reform Task Force on Thursday.
Senator Shiozawa says one of the main things they are working on is an adequate funding source.
He says those who benefit should help shoulder the burden.
"That would be doctors, hospitals, pharmacy, different groups like that we would expect that there would be contributions from those groups. So, that this program would be viable for them, because after all they would benefit from this particular group of insureds," said Shiozawa, ( R ) Salt Lake City.
For now the group made up of tens of thousands of Utahns has no option for health insurance.
Advocates for Medicaid expansion say every day that goes by puts them at risk and in some cases it's too late.
"We're having more and more individuals that we hear about not only having health care dilemma's, but actually passing away due to those dilemma's. This is a very, very here and now issue," said Utah Health Policy Project Executive Director, Matt Slonaker.
He says Utahns have made it clear where they stand.
"We want a solution and we want it now, we want it quickly,” said Slonaker.
As a medical doctor who sees the consequences from the front lines himself, Senator Shiozawa says he understands the urgency.
He says the extra time will result in a plan superior to the governor's Healthy Utah Plan and the house backed Utah Cares Plan which both failed during the session.
"We have to do a responsible job. We want to do this as best we can before we put it on paper," said Shiozawa.
Even if they don't have an agreement by the end of the month members of the Gang of 6 remain confident they can get this wrapped up before the next general session.
The Gang of 6 has been communicating with other states to learn from their experiences.
They say right now all options are still on the table. Reported by abc4 15 hours ago.
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Health Care Reform Task Force gets update on Medicaid expansion negotiations
SALT LAKE CITY (ABC 4 Utah) – Lawmakers who are working behind closed doors on a solution to close the Medicaid coverage gap in our state offered a public update.
The self imposed deadline for the Gang of 6 is two weeks away, but they are already admitting it will likely go beyond that.
Advocates for medicaid expansion say that is a mistake.
Negotiations are happening out of the public eye for now, but two members of the Gang of 6, Senator Brian Shiozawa and Representative Jim Dunnigan went before the Health Reform Task Force on Thursday.
Senator Shiozawa says one of the main things they are working on is an adequate funding source.
He says those who benefit should help shoulder the burden.
"That would be doctors, hospitals, pharmacy, different groups like that we would expect that there would be contributions from those groups. So, that this program would be viable for them, because after all they would benefit from this particular group of insureds," said Shiozawa, ( R ) Salt Lake City.
For now the group made up of tens of thousands of Utahns has no option for health insurance.
Advocates for Medicaid expansion say every day that goes by puts them at risk and in some cases it's too late.
"We're having more and more individuals that we hear about not only having health care dilemma's, but actually passing away due to those dilemma's. This is a very, very here and now issue," said Utah Health Policy Project Executive Director, Matt Slonaker.
He says Utahns have made it clear where they stand.
"We want a solution and we want it now, we want it quickly,” said Slonaker.
As a medical doctor who sees the consequences from the front lines himself, Senator Shiozawa says he understands the urgency.
He says the extra time will result in a plan superior to the governor's Healthy Utah Plan and the house backed Utah Cares Plan which both failed during the session.
"We have to do a responsible job. We want to do this as best we can before we put it on paper," said Shiozawa.
Even if they don't have an agreement by the end of the month members of the Gang of 6 remain confident they can get this wrapped up before the next general session.
The Gang of 6 has been communicating with other states to learn from their experiences.
They say right now all options are still on the table. Reported by abc4 12 hours ago.
The self imposed deadline for the Gang of 6 is two weeks away, but they are already admitting it will likely go beyond that.
Advocates for medicaid expansion say that is a mistake.
Negotiations are happening out of the public eye for now, but two members of the Gang of 6, Senator Brian Shiozawa and Representative Jim Dunnigan went before the Health Reform Task Force on Thursday.
Senator Shiozawa says one of the main things they are working on is an adequate funding source.
He says those who benefit should help shoulder the burden.
"That would be doctors, hospitals, pharmacy, different groups like that we would expect that there would be contributions from those groups. So, that this program would be viable for them, because after all they would benefit from this particular group of insureds," said Shiozawa, ( R ) Salt Lake City.
For now the group made up of tens of thousands of Utahns has no option for health insurance.
Advocates for Medicaid expansion say every day that goes by puts them at risk and in some cases it's too late.
"We're having more and more individuals that we hear about not only having health care dilemma's, but actually passing away due to those dilemma's. This is a very, very here and now issue," said Utah Health Policy Project Executive Director, Matt Slonaker.
He says Utahns have made it clear where they stand.
"We want a solution and we want it now, we want it quickly,” said Slonaker.
As a medical doctor who sees the consequences from the front lines himself, Senator Shiozawa says he understands the urgency.
He says the extra time will result in a plan superior to the governor's Healthy Utah Plan and the house backed Utah Cares Plan which both failed during the session.
"We have to do a responsible job. We want to do this as best we can before we put it on paper," said Shiozawa.
Even if they don't have an agreement by the end of the month members of the Gang of 6 remain confident they can get this wrapped up before the next general session.
The Gang of 6 has been communicating with other states to learn from their experiences.
They say right now all options are still on the table. Reported by abc4 12 hours ago.
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Americans need a new social contract for the sharing economy
Nick Hanauer and David Rolf outline a solution to what they (and Hillary Clinton, it seems) argue is a big, big problem right now: economic insecurity created by the growing sharing/on-demand/gig economy. Americans need a new social contract, one that brings more certainty and tangible benefits to all these part-timers and independent contractors. As they explain in Democracy Journal:This is the new “you’re on your own,” benefit-free, race-to-the-bottom reality for millions of American workers. And as more new innovative businesses and business models are invented, this process will only accelerate. As the sharing economy kicks into high gear, more and more Americans will become independent contractors activated at the touch of a button on an app, working for a fleet of employers. … A robust set of mandatory universal benefits would put all employees and employers alike on an equal footing, while providing the economic security and certainty necessary for the middle class to thrive.
So what does this new social contract look like? It consists of two parts, what Hanauer and Rolf have termed a “Shared Security Account” and “Shared Security Standards.” here is how this system works:
Mandatory accrued benefits should include a minimum of five days a year of paid sick leave, 15 days a year of paid vacation leave, a matching 401(k) contribution, and the same health insurance premium contribution as currently required under the Affordable Care Act (ideally, health care would fall into the insurance benefit category, but that is a larger battle). Employers—that is to say entity is paying the worker—would be required to contribute to the worker’s Shared Security Account with each paycheck, with the contributions prorated based on a standard eight-hour day, 40-hour week, and 2,080-hour year. For example, 20 days a year of combined vacation and sick leave is equivalent to a contribution of $0.0769 for every dollar of wages paid, and that is the rate at which companies like TaskRabbit and Uber would contribute for non-hourly piecework. … Mandatory insurance benefits should include unemployment, workers’ compensation, and paid maternity, paternity, family, and medical leave. These would not be cash benefits that the employee could accrue and cash out, but rather pooled insurance to which both the employer and employee would contribute small premiums as a percentage of pay, based on actuarial tables.
These SSAs would be prorated, portable, and universal:
But all mandatory benefits that normally accrue to full-time employees on a daily basis—sick days, vacation days, health insurance, unemployment insurance, workers’ compensation insurance, retirement matching, Social Security, and Medicare—should also accrue to part-time employees (hourly, salaried, or contract) and sharing-economy providers on a prorated hourly or equivalent basis. … Job-based benefits no longer make sense in an economy where fewer and fewer workers hold traditional jobs. This is why these accrued benefits must be fully portable, following the worker from job to job, or contract to contract. … Because benefits from multiple employers are pooled into the same account, portability and proration work together to provide workers with the full panoply of benefits, even within the flexible micro-employment environment of the sharing economy. …
In the new economy, a basic set of benefits and labor standards must be universal across all employers and all forms of employment, with few exceptions or exemptions. While there is much to recommend the innovations introduced by companies like Uber and TaskRabbit, they are currently exploiting gigantic loopholes in our social contract by transforming jobholders into independent contractors, thus stripping them of essential benefits. A robust set of mandatory universal benefits would put all employees and employers alike on an equal footing, while providing the economic security and certainty necessary for the middle class to thrive.
Let’s assume for moment that concern about the uncertainty of the “gig economy” is widespread — far more than just among journalists in the Acela corridor who take Uber and worry they will soon be paid per story. Let’s assume this is a serious problem needing a solution, and ASAP. So maybe this alternative approach: Rather than running all those mandated benefits through employers as H&R propose, allow wages to rise in offset and make it easier for workers to save their own dough to meet the vicissitudes of life. Even nudging workers to do so. And also maybe even different tax-preferred savings accounts for different purposes. (Obviously this is a simplified version.) I mean, isn’t it generally accepted, for instance, that workers pay for the majority of health insurance costs, through lower wages as well as through explicit premiums? Why would we want to double-down and considerably expand that approach?
Join the conversation about this story »
NOW WATCH: Scientists are astonished by these Goby fish that can climb 300-foot waterfalls Reported by Business Insider 11 hours ago.
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American Academy of Nursing Designates Dr. Brenda Reiss-Brennan as “Edge Runner” for Bringing Mental Health to the Forefront of Primary Care
Dr. Brenda Reiss-Brennan’s model of care integrates mental health services with primary care.
Washington, D.C. (PRWEB) July 17, 2015
The American Academy of Nursing today announced the designation of Brenda Reiss-Brennan, PhD, APRN, as an Academy Edge Runner for her nurse-designed model of care to integrate mental health services with primary care. Dr. Reiss-Brennan is the APRN Mental Health Integration Director of Intermountain Healthcare.
Edge Runners are an integral part of the Academy’s Raise the Voice campaign, which promotes innovative, evidence-based health models that better serve patients at lower costs, and have measurable results.
“The Academy is proud to recognize Dr. Brenda Reiss-Brennan for her work in creating a replicable model that fully integrates mental health and primary care,” said Academy President, Diana J. Mason, PhD, RN, FAAN. “Mental health care has long been a challenge for health systems in the U.S., and finding a way to effectively integrate mental health with primary care is imperative to ensuring patients are receiving the full spectrum of care to fit their needs.”
Dr. Reiss-Brennan’s model trains primary care providers and clinic staff in mental health care and coordinated-team care concepts—taking into account the dynamic and complex conditions that contribute to a patient and their family’s overall mental and physical health.
“Over the years, many patients were referred to me from local primary care physicians and nurse practitioners who were burdened with the rising mental health needs of their patients, and the growing black hole of community resources. There was a clear need for an integrated model that would address mental health care in communities,” said Dr. Reiss-Brennan. “In working with local care-providers and community members, I developed a collaborative mental health integration model for patients and their families.”
Since its inception, Dr. Reiss-Brennan’s mental health integration (MHI) model has been implemented in over 90 of the 160 clinics operated by Intermountain Healthcare, a not-for-profit integrated healthcare system which oversees 22 hospital facilities in Utah and Idaho. MHI has also been influential in disseminating Intermountain’s implementation science of clinical integration in Maine, Mississippi, New Hampshire, Oregon, Arizona and overseas in France, the UK and Singapore.
Measurable results from the MHI model include:· Patients with depression who are treated in MHI clinics are 54 percent less likely to have emergency room visits than patients with depression in non-MHI clinics.
· Patients with depression who are involved with one of the MHI clinics saw their health insurance claims decrease by $667 in the year following their diagnosis.
· Diabetic patients with depression have their diabetes in better control (53.1% vs. 47.5%) with MHI.
· Patients in MHI clinics reported improved overall functioning in their lives. Eighty-one percent of patients surveyed said they were hopeful they could get well or stay well.
More recently, Dr. Reiss-Brennan and her research team at Intermountain had the opportunity to measure the longitudinal impact of routinized MHI-Team Based Care (TBC) on clinical and financial outcomes and have quantified the value of integrating mental health as an organized team process within the context of primary care medical homes.
Through its Raise the Voice campaign, the Academy is mobilizing its fellows, health leaders and partner organizations to recognize nurses who are leading the way with new ideas to transform the health system and to ensure that they are heard.
About the American Academy of Nursing
The American Academy of Nursing (http://www.AANnet.org) serves the public and the nursing profession by advancing health policy and practice through the generation, synthesis, and dissemination of nursing knowledge. The Academy's more than 2,300 fellows are nursing's most accomplished leaders in education, management, practice, policy, and research. They have been recognized for their extraordinary contributions to nursing and health care.
### Reported by PRWeb 4 hours ago.
Washington, D.C. (PRWEB) July 17, 2015
The American Academy of Nursing today announced the designation of Brenda Reiss-Brennan, PhD, APRN, as an Academy Edge Runner for her nurse-designed model of care to integrate mental health services with primary care. Dr. Reiss-Brennan is the APRN Mental Health Integration Director of Intermountain Healthcare.
Edge Runners are an integral part of the Academy’s Raise the Voice campaign, which promotes innovative, evidence-based health models that better serve patients at lower costs, and have measurable results.
“The Academy is proud to recognize Dr. Brenda Reiss-Brennan for her work in creating a replicable model that fully integrates mental health and primary care,” said Academy President, Diana J. Mason, PhD, RN, FAAN. “Mental health care has long been a challenge for health systems in the U.S., and finding a way to effectively integrate mental health with primary care is imperative to ensuring patients are receiving the full spectrum of care to fit their needs.”
Dr. Reiss-Brennan’s model trains primary care providers and clinic staff in mental health care and coordinated-team care concepts—taking into account the dynamic and complex conditions that contribute to a patient and their family’s overall mental and physical health.
“Over the years, many patients were referred to me from local primary care physicians and nurse practitioners who were burdened with the rising mental health needs of their patients, and the growing black hole of community resources. There was a clear need for an integrated model that would address mental health care in communities,” said Dr. Reiss-Brennan. “In working with local care-providers and community members, I developed a collaborative mental health integration model for patients and their families.”
Since its inception, Dr. Reiss-Brennan’s mental health integration (MHI) model has been implemented in over 90 of the 160 clinics operated by Intermountain Healthcare, a not-for-profit integrated healthcare system which oversees 22 hospital facilities in Utah and Idaho. MHI has also been influential in disseminating Intermountain’s implementation science of clinical integration in Maine, Mississippi, New Hampshire, Oregon, Arizona and overseas in France, the UK and Singapore.
Measurable results from the MHI model include:· Patients with depression who are treated in MHI clinics are 54 percent less likely to have emergency room visits than patients with depression in non-MHI clinics.
· Patients with depression who are involved with one of the MHI clinics saw their health insurance claims decrease by $667 in the year following their diagnosis.
· Diabetic patients with depression have their diabetes in better control (53.1% vs. 47.5%) with MHI.
· Patients in MHI clinics reported improved overall functioning in their lives. Eighty-one percent of patients surveyed said they were hopeful they could get well or stay well.
More recently, Dr. Reiss-Brennan and her research team at Intermountain had the opportunity to measure the longitudinal impact of routinized MHI-Team Based Care (TBC) on clinical and financial outcomes and have quantified the value of integrating mental health as an organized team process within the context of primary care medical homes.
Through its Raise the Voice campaign, the Academy is mobilizing its fellows, health leaders and partner organizations to recognize nurses who are leading the way with new ideas to transform the health system and to ensure that they are heard.
About the American Academy of Nursing
The American Academy of Nursing (http://www.AANnet.org) serves the public and the nursing profession by advancing health policy and practice through the generation, synthesis, and dissemination of nursing knowledge. The Academy's more than 2,300 fellows are nursing's most accomplished leaders in education, management, practice, policy, and research. They have been recognized for their extraordinary contributions to nursing and health care.
### Reported by PRWeb 4 hours ago.
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NATO Supreme Headquarters Allied Powers Europe (SHAPE) Deploys Desktop Alert Networked Mass Notification Platform
After conducting extensive market research and subjecting all potential solutions to rigorous security analysis, NATO SHAPE selects Desktop Alert
(PRWEB) July 17, 2015
Today, Desktop Alert, Inc., the award winning industry leader in emergency communications, mass notification and first-responder interoperable communications, announced NATO Supreme Headquarters Allied Powers Europe (SHAPE) has successfully deployed the Desktop Alert Networked Mass Notification Platform.
Supreme Headquarters Allied Powers Europe (SHAPE) is the headquarters of the North Atlantic Treaty Organization’s Allied Command Operations. Since 2003 it has been the headquarters of Allied Command Operations (ACO), controlling all NATO operations worldwide.
After conducting extensive market research and subjecting all potential solutions to rigorous security analysis, NATO SHAPE chose Desktop Alert based on six crucial criteria: alert speed, ease of installation and system usage, cross-domain integration, security, privacy, and return on investment (ROI).· Alert Speed: The patented Desktop Alert System delivers notifications to all personnel in less than one minute.
· Ease of Installation and System Usage: Desktop Alert server application installs remotely in less than 3 hours without the need for a vendor’s on-site engineer. Our proprietary training methodology, conducted in person or remotely, ensures personnel gain system proficiency in as little as 90 minutes.
· Cross Domain Integration: Our innovative 'DTAConnect' module enables seamless cross-domain alerting, messaging and administration without limitation. Our approach uses industry standard Common Alerting Protocol (CAP) and cross-domain mobile technology integration's to empower organizations with unparalleled levels of inter-agency, cross-agency, and multi-national communication, coordination, and collaboration. Connections are controlled locally and can be updated on the fly as collaboration needs evolve.
· Security: The Desktop Alert system is built on a modern .NET framework and has been awarded the highest levels of security accreditation available from the US Government, the European Union, and NATO.
· Privacy: Our system ensures personally identifiable information (PII) and Health Insurance Portability and Accountably (HIPPA) information is never transmitted outside secure channels.
· Return on Investment: Seamlessly integrates with existing IT infrastructure which allows the DTA system to be installed and operational before engineers from other MNS providers have booked plane tickets. The ability to automate an organization’s notifications processes with a robust and auditable multi-modal application ensures near real-time message receipt and accountably while saving thousands of man-hours per year.
“We are honored that NATO selected Desktop Alert to satisfy their stringent emergency communication and mass notification needs,” said Chris Brown, Vice President for Desktop Alert’s Global Operations.
“The Desktop Alert Mass Notification platform was installed by local NATO engineers in hours without any Desktop Alert on-site engineering assistance. When customers compare the value, features, and security of our award winning and patented software the choice for Desktop Alert is clear. We look forward to ongoing efforts with NATO member nations to implement the Desktop Alert Communications Suite.” Brown added.
About Desktop Alert: https://www.desktopalert.net
Desktop Alert’s innovative and patented software, internationally recognized as the “Best Mass Notification” and “Best First Responder Interoperable Communications” system is the leader in providing comprehensive notification, accountability and situational awareness solutions. The Desktop Alert Notification system is designed to provide a suite of scalable, flexible, and adaptable communication, coordination, and collaboration tools in environments ranging from austere - no terrestrial infrastructure support - to fully modern with extensive IP and legacy system integrations. Desktop Alert allows individuals and organizations to accelerate the flow of information in order to ensure effective decision making, coordination, proactive community engagement, and public awareness. Reported by PRWeb 3 hours ago.
(PRWEB) July 17, 2015
Today, Desktop Alert, Inc., the award winning industry leader in emergency communications, mass notification and first-responder interoperable communications, announced NATO Supreme Headquarters Allied Powers Europe (SHAPE) has successfully deployed the Desktop Alert Networked Mass Notification Platform.
Supreme Headquarters Allied Powers Europe (SHAPE) is the headquarters of the North Atlantic Treaty Organization’s Allied Command Operations. Since 2003 it has been the headquarters of Allied Command Operations (ACO), controlling all NATO operations worldwide.
After conducting extensive market research and subjecting all potential solutions to rigorous security analysis, NATO SHAPE chose Desktop Alert based on six crucial criteria: alert speed, ease of installation and system usage, cross-domain integration, security, privacy, and return on investment (ROI).· Alert Speed: The patented Desktop Alert System delivers notifications to all personnel in less than one minute.
· Ease of Installation and System Usage: Desktop Alert server application installs remotely in less than 3 hours without the need for a vendor’s on-site engineer. Our proprietary training methodology, conducted in person or remotely, ensures personnel gain system proficiency in as little as 90 minutes.
· Cross Domain Integration: Our innovative 'DTAConnect' module enables seamless cross-domain alerting, messaging and administration without limitation. Our approach uses industry standard Common Alerting Protocol (CAP) and cross-domain mobile technology integration's to empower organizations with unparalleled levels of inter-agency, cross-agency, and multi-national communication, coordination, and collaboration. Connections are controlled locally and can be updated on the fly as collaboration needs evolve.
· Security: The Desktop Alert system is built on a modern .NET framework and has been awarded the highest levels of security accreditation available from the US Government, the European Union, and NATO.
· Privacy: Our system ensures personally identifiable information (PII) and Health Insurance Portability and Accountably (HIPPA) information is never transmitted outside secure channels.
· Return on Investment: Seamlessly integrates with existing IT infrastructure which allows the DTA system to be installed and operational before engineers from other MNS providers have booked plane tickets. The ability to automate an organization’s notifications processes with a robust and auditable multi-modal application ensures near real-time message receipt and accountably while saving thousands of man-hours per year.
“We are honored that NATO selected Desktop Alert to satisfy their stringent emergency communication and mass notification needs,” said Chris Brown, Vice President for Desktop Alert’s Global Operations.
“The Desktop Alert Mass Notification platform was installed by local NATO engineers in hours without any Desktop Alert on-site engineering assistance. When customers compare the value, features, and security of our award winning and patented software the choice for Desktop Alert is clear. We look forward to ongoing efforts with NATO member nations to implement the Desktop Alert Communications Suite.” Brown added.
About Desktop Alert: https://www.desktopalert.net
Desktop Alert’s innovative and patented software, internationally recognized as the “Best Mass Notification” and “Best First Responder Interoperable Communications” system is the leader in providing comprehensive notification, accountability and situational awareness solutions. The Desktop Alert Notification system is designed to provide a suite of scalable, flexible, and adaptable communication, coordination, and collaboration tools in environments ranging from austere - no terrestrial infrastructure support - to fully modern with extensive IP and legacy system integrations. Desktop Alert allows individuals and organizations to accelerate the flow of information in order to ensure effective decision making, coordination, proactive community engagement, and public awareness. Reported by PRWeb 3 hours ago.
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SynapseIndia Distributes iPads and Android Tablets to its Over 500 Employees.
SynapseIndia, a leading IT solutions provider recently distributed iPads and Android tablets to its employees on the occasion of its 15th Foundation day. The CMMI certified company offers a range of benefits to its employees like Cars & SUVs, Provident fund, Medical Programs, Health Insurance, Performance Bonuses, and more.
Noida, India (PRWEB) July 17, 2015
IT outsourcing company SynapseIndia recently distributed tablet phones to its employees. The announcement of this distribution had come during the company's 15th Foundation Day celebration. High-tech tablets were distributed to more than 500 SynapseIndians during a ceremony held at the company's premises.
As per the company CEO, Mr. Shamit Khemka: "We feel pleased in distributing these iPads and Android tablets to our employees as they have helped us to attain the leading position in the industry. By presenting these high-tech gadgets to our employees, we want to honor their efforts and hard work in our own unique way"
SynapseIndia's wide range of employee benefits makes it an ideal company to work in. Prominent employee benefits offered by the company include Cars & SUVs, Provident fund, Medical Programs, Health Insurance, Performance Bonuses, Stock Options, etc. One of the company's employees mentioned in a highly excited tone, "It really feels great. Every year there is excitement around this time and I am glad to say that this time as well, SynapseIndia did not disappoint. We are honored to be a part of the company that values employee efforts above anything else. Thanks a lot SynapseIndia".
Be it a project for developing a website for automobiles, luxury products or some other, SynapseIndia has been highly successful in delivering the assigned PHP development projects with high efficiency and the same is evident from the positive feedback of its clients located in the US, UK, Australia, New Zealand etc. Clients appreciate SynapseIndia's PHP development standards and hence keep coming back to assign new projects to the company's developers whenever required.
SynapseIndia is a leading IT solutions provider serving clients for their web & mobile app development needs. The company offers a range of website development solutions based on WordPress, PHP, ASP.NET, Drupal and more. Mobile app solutions based on platforms like iOS, Android, BlackBerry, Windows 8 and more are also available for clients. SynapseIndia also provides reliable e-commerce solutions based on Magento, Shopify, PrestaShop, OpenCart and more to clients across the globe.
Over the past 15 years, the company has solidified its position in the industry due to its employee-centric policy, fair business ethics, and excellent client satisfaction record. In the coming years, the ISO and CMMI certified company looks forward to fully implementing its expansion plan of opening more registered offices across the globe while also bringing in more innovation in its service offerings to impress more clients. Reported by PRWeb 2 hours ago.
Noida, India (PRWEB) July 17, 2015
IT outsourcing company SynapseIndia recently distributed tablet phones to its employees. The announcement of this distribution had come during the company's 15th Foundation Day celebration. High-tech tablets were distributed to more than 500 SynapseIndians during a ceremony held at the company's premises.
As per the company CEO, Mr. Shamit Khemka: "We feel pleased in distributing these iPads and Android tablets to our employees as they have helped us to attain the leading position in the industry. By presenting these high-tech gadgets to our employees, we want to honor their efforts and hard work in our own unique way"
SynapseIndia's wide range of employee benefits makes it an ideal company to work in. Prominent employee benefits offered by the company include Cars & SUVs, Provident fund, Medical Programs, Health Insurance, Performance Bonuses, Stock Options, etc. One of the company's employees mentioned in a highly excited tone, "It really feels great. Every year there is excitement around this time and I am glad to say that this time as well, SynapseIndia did not disappoint. We are honored to be a part of the company that values employee efforts above anything else. Thanks a lot SynapseIndia".
Be it a project for developing a website for automobiles, luxury products or some other, SynapseIndia has been highly successful in delivering the assigned PHP development projects with high efficiency and the same is evident from the positive feedback of its clients located in the US, UK, Australia, New Zealand etc. Clients appreciate SynapseIndia's PHP development standards and hence keep coming back to assign new projects to the company's developers whenever required.
SynapseIndia is a leading IT solutions provider serving clients for their web & mobile app development needs. The company offers a range of website development solutions based on WordPress, PHP, ASP.NET, Drupal and more. Mobile app solutions based on platforms like iOS, Android, BlackBerry, Windows 8 and more are also available for clients. SynapseIndia also provides reliable e-commerce solutions based on Magento, Shopify, PrestaShop, OpenCart and more to clients across the globe.
Over the past 15 years, the company has solidified its position in the industry due to its employee-centric policy, fair business ethics, and excellent client satisfaction record. In the coming years, the ISO and CMMI certified company looks forward to fully implementing its expansion plan of opening more registered offices across the globe while also bringing in more innovation in its service offerings to impress more clients. Reported by PRWeb 2 hours ago.
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Five things to know, and get ready for the Grand Prix this weekend
The state budget deadlock continues in Harrisburg as Christian Alexandersen explains, but let’s get Friday off to a marching start here in Pittsburgh with a taste of New Orleans. Bring your own kazoo. Peduto's musical awareness for health insurance Mayor Bill Peduto has kicked off New Orleans-style second-line parading on city streets to build awareness around low-cost or free health care insurance enrollment options that are available for kids. Residents and passerbys are encouraged towalk behind…
Reported by bizjournals 2 hours ago.
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TMG Health to Sponsor and Exhibit at RISE Summit July 19-21
Business Process Outsourcing Company to Offer Opportunities for Health Plan Executives to Learn About Administrative Solutions for Government Health Plans
King of Prussia, PA (PRWEB) July 17, 2015
TMG Health, the leading national provider of Business Process Outsourcing solutions for health plans in the Medicare Advantage, Medicare Part D, and Managed Medicaid markets, announces their participation as a sponsor and exhibitor at the fifth annual RISE California Summit presented by Healthcare Education Associates and the Resource Initiative & Society for Education (RISE). The conference will be held July 19-21 in Hollywood, Calif.
The TMG Health exhibition booth, #40, will offer opportunities for health plan executives to learn about TMG Health’s customizable administrative solutions for Government Health Programs. Leveraging more than 17 years of experience serving the government health programs market exclusively, the company offers compliant solutions comprised of experienced people, proven processes and innovative technology. Services include Enrollment & Eligibility Processing; Eligibility & Payment Reconciliation; Premium Billing; Member Materials Fulfillment Services; Member and Provider Call Center Services; Claims Administration; Encounter Reporting; CMS and State Reporting; Compliance Tracking and Audit Services; Fraud, Waste & Abuse Prevention & Detection Programs; and more.
“Quality and accountability requirements are changing the game for Medicare Advantage plans, requiring them to adapt and update their strategies in order to mitigate risk, improve Star Quality Ratings and, ultimately, improve the quality of care to seniors,” explained William Haggett, Executive Vice President of Corporate Development and Strategy at TMG Health. “TMG Health is poised to provide the operational excellence and overall data strategy to partner with plans to achieve these results.”
Themed “Driving Change with Our Sights on Managing Risk, Delivering Quality and Achieving the Triple Aim,” the RISE California Summit provides insights and strategic discussions on a deep array of timely topics, including Risk Adjustment & Financial Management, Star & Quality Ratings Across Product Lines, and Health Insurance Exchanges.
About TMG Health
TMG Health is the leading national provider of Business Process Outsourcing solutions for Medicare Advantage, Medicare Part D and Managed Medicaid plans. With more than 17 years of experience in providing technology-enabled services to the government market exclusively, our knowledge of health plan processes, regulatory requirements, and the daily challenges plans face within the government market is second to none. Our expertise, coupled with a strong commitment to our Clients’ success, positions us as a trusted partner who can help solve the challenges of today and prepare for those of tomorrow.
TMG Health is headquartered in King of Prussia, Pa. and is a subsidiary of Health Care Service Corporation (HCSC), the largest customer-owned health insurer in the United States and fourth largest overall, operating through its Blue Cross and Blue Shield® Plans in Illinois, Montana, New Mexico, Oklahoma and Texas. HCSC’s headquarters is located in Chicago, IL.
About RISE
RISE is the first national association totally dedicated to enabling healthcare professionals working in organizations and aspiring to meet the challenges of the emerging landscape of accountable care and health care reform. We strive to serve our members on four fronts: Education, Industry Intelligence, Networking and Career Development.
About Healthcare Education Associates
Healthcare Education Associates is a division of Financial Research Associates, LLC. HEA is a resource for the healthcare and pharmaceutical communities to improve their businesses by providing access to timely and focused business information and networking opportunities in topical areas.
Contact:
Kim Rollman, Marketing Manager
TMG Health
Phone: 570-903-5198
krollman(at)tmghealth(dot)com Reported by PRWeb 28 minutes ago.
King of Prussia, PA (PRWEB) July 17, 2015
TMG Health, the leading national provider of Business Process Outsourcing solutions for health plans in the Medicare Advantage, Medicare Part D, and Managed Medicaid markets, announces their participation as a sponsor and exhibitor at the fifth annual RISE California Summit presented by Healthcare Education Associates and the Resource Initiative & Society for Education (RISE). The conference will be held July 19-21 in Hollywood, Calif.
The TMG Health exhibition booth, #40, will offer opportunities for health plan executives to learn about TMG Health’s customizable administrative solutions for Government Health Programs. Leveraging more than 17 years of experience serving the government health programs market exclusively, the company offers compliant solutions comprised of experienced people, proven processes and innovative technology. Services include Enrollment & Eligibility Processing; Eligibility & Payment Reconciliation; Premium Billing; Member Materials Fulfillment Services; Member and Provider Call Center Services; Claims Administration; Encounter Reporting; CMS and State Reporting; Compliance Tracking and Audit Services; Fraud, Waste & Abuse Prevention & Detection Programs; and more.
“Quality and accountability requirements are changing the game for Medicare Advantage plans, requiring them to adapt and update their strategies in order to mitigate risk, improve Star Quality Ratings and, ultimately, improve the quality of care to seniors,” explained William Haggett, Executive Vice President of Corporate Development and Strategy at TMG Health. “TMG Health is poised to provide the operational excellence and overall data strategy to partner with plans to achieve these results.”
Themed “Driving Change with Our Sights on Managing Risk, Delivering Quality and Achieving the Triple Aim,” the RISE California Summit provides insights and strategic discussions on a deep array of timely topics, including Risk Adjustment & Financial Management, Star & Quality Ratings Across Product Lines, and Health Insurance Exchanges.
About TMG Health
TMG Health is the leading national provider of Business Process Outsourcing solutions for Medicare Advantage, Medicare Part D and Managed Medicaid plans. With more than 17 years of experience in providing technology-enabled services to the government market exclusively, our knowledge of health plan processes, regulatory requirements, and the daily challenges plans face within the government market is second to none. Our expertise, coupled with a strong commitment to our Clients’ success, positions us as a trusted partner who can help solve the challenges of today and prepare for those of tomorrow.
TMG Health is headquartered in King of Prussia, Pa. and is a subsidiary of Health Care Service Corporation (HCSC), the largest customer-owned health insurer in the United States and fourth largest overall, operating through its Blue Cross and Blue Shield® Plans in Illinois, Montana, New Mexico, Oklahoma and Texas. HCSC’s headquarters is located in Chicago, IL.
About RISE
RISE is the first national association totally dedicated to enabling healthcare professionals working in organizations and aspiring to meet the challenges of the emerging landscape of accountable care and health care reform. We strive to serve our members on four fronts: Education, Industry Intelligence, Networking and Career Development.
About Healthcare Education Associates
Healthcare Education Associates is a division of Financial Research Associates, LLC. HEA is a resource for the healthcare and pharmaceutical communities to improve their businesses by providing access to timely and focused business information and networking opportunities in topical areas.
Contact:
Kim Rollman, Marketing Manager
TMG Health
Phone: 570-903-5198
krollman(at)tmghealth(dot)com Reported by PRWeb 28 minutes ago.
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Union authorizes strike against Trump Taj Mahal
Workers at Trump Taj Mahal have authorized a strike against the troubled Atlantic City casino as they await a federal appeals court ruling on whether the casino must restore health insurance and pension benefits that it scrapped last year. Members of UNITE HERE Local 54, which represents nearly 1,000 service workers including bartenders, cooks, housekeepers […]
Reported by Seattle Times 23 hours ago.
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Medicaid Officials Work To Find A Formula For 'Medically Complex' Kids
This piece comes to us courtesy of Stateline. Stateline is a nonpartisan, nonprofit news service of the Pew Charitable Trusts that provides daily reporting and analysis on trends in state policy.TAMPA, Florida — Five-year-old Lakota Lockhart talks about Batman nonstop. When his mom, Krystal, can wedge in a word, she describes what life has been like since Lakota was born with a rare central nervous system disorder that causes his breathing to stop every time he falls asleep.
She says they’re lucky Lakota was born across the street, at Brandon Regional Hospital, or she might never have known about the Chronic Complex Clinic at St. Joseph’s Children’s Hospital.
The brainchild of Dr. Daniel Plasencia, the St. Joseph’s clinic was created 14 years ago to improve care for kids with chronic conditions affecting more than one organ system. “Their treatment was too complex for most pediatricians,” Plasencia said. “They needed a medical home and we provided it for them.”
Approximately 3 million children in the U.S. are medically complex, meaning they require intensive treatment from a wide array of specialists. That number is expected to reach nearly 5 million in the next decade as medical advances improve life expectancy for kids with congenital heart defects, sickle cell anemia, cerebral palsy and cystic fibrosis. Kids like Lakota who have rare conditions, those born extremely prematurely and survivors of near drownings, auto accidents and other catastrophic events are also living longer thanks to new technology.
Research shows that programs like St. Joseph’s save Medicaid and commercial insurers money by reducing emergency room visits and hospital stays. But while a few complex care units in places like Little Rock, Arkansas, Milwaukee and Cleveland have cropped up around the country, the idea has not caught on nationwide. That’s largely because Medicaid and other insurers do not fully reimburse hospitals for specialized services, such as 24/7 phone consultations and hourlong meetings between parents and specialists, that are crucial to success in complex care.
A study published in December by the Journal of the American Medical Association found that children who were enrolled in complex care clinics had lower medical costs than complex care kids who were not enrolled, $16,523 per year compared with $26,781 per year. More than 90 percent of the children in the study were covered by Medicaid.
Still, “no one has come up with a viable payment model,” Plasencia said. “We get 20 cents on the dollar for what we do. There’s no incentive for other hospitals to do it.”
-Small Population, Huge Costs-
Of the 32 million mostly healthy children Medicaid covers nationwide, only 2 million or about 6 percent, have complex conditions. But their care represents more than 40 percent of overall Medicaid spending for children.
In Florida and the rest of the country, hundreds of thousands of kids stand to benefit from the type of seamless care Lakota and about 800 other children receive here each year. The Children’s Hospital of Wisconsin in Milwaukee and the Arkansas Children’s Hospital in Little Rock serve about 700 kids each. Many families travel long distances to get to these clinics.
The staff at the St. Joseph’s clinic, which provides 24-hour coverage, includes 10 pediatricians, a nutritionist, a pharmacist, three nurses, a social worker, a behavioral health specialist, a scheduler and an expert to help parents navigate Medicaid and the Children's Health Insurance Program.
Instead of leaving parents to fend for themselves, the staff helps coordinate appointments with local pediatric specialists who are on call in the hospital and arranges for transportation when necessary. The clinic also teaches parents how to care for their kids at home and supplies them with the needed medical equipment, all of which has resulted in fewer emergency room visits and fewer and shorter stays in the hospital.
-A Money Losing Proposition-
“We know this works for kids and we know it saves money for the payers, whoever they are,” Plasencia said. “Now we have to make it financially sustainable for hospitals.”
To do that, St. Joseph’s last year joined nine other hospitals in California, Colorado, the District of Columbia, Florida, Ohio, Pennsylvania and Texas in a federally funded project aimed at finding a payment formula that will allow Medicaid to reimburse hospitals and other providers for the extra services that make it possible to limit the amount of time kids with complex conditions spend in hospitals.
The goal of the $23 million grant from the U.S. Department of Health and Human Services is to enroll about 9,000 Medicaid-covered children in complex clinics and achieve a 6.8 percent decrease in total spending over the three-year period of the grant, which ends in 2017.
A separate federal grant for $9.4 million was awarded last year to Wisconsin to expand the Milwaukee-based clinic statewide.
“Medicaid liked our program and saw we were saving money and started to give us a small care coordination fee for nurses and doctors,” said Dr. John Gordon, who runs the complex care clinic at the Children’s Hospital in Wisconsin. “We’ve had a good relationship with Medicaid. But over the years we cost the hospital money and we cost the medical college money because we all work for them. So we had this ongoing discussion with Medicaid about how it would be nice to provide this care for more kids, but it wasn’t possible given that it was a money losing proposition.”
Dr. Dennis Kuo heads the complex care unit at Arkansas Children’s Hospital. Over the last 15 years, he said, “Folks around the country have independently started these programs. They have similar criteria, but their differences reflect the people who started them.”
Pediatricians and intensive care specialists were seeing kids who fell through the cracks between specialists and between inpatient and outpatient care, he said.
According to Kuo, doctors and nurses across the country were seeing very sick kids who spent a lot of time in hospitals. They wanted to improve kids’ lives and cut hospital bills at the same time.
“That’s a very noble thing to do,” he said, especially because they were not getting paid for it. Nationwide, Kuo said, “We need to learn how to stop taking care of kids who are sick and learn how to pay for care to keep kids well.”
Complex care experts say that any care delivery or financial model that results from these federally funded projects must be flexible. The same plan will not work everywhere. “One of the most critical pieces of the grant is that we need other people to test this,” Plasencia said.
In Florida and elsewhere, it will also be critical for health insurers, including Medicaid managed care organizations, to agree to take on the risk of paying hospitals for the extra care they provide to keep kids as well as possible.
-Lakota’s Birthday-
“There were no indications during pregnancy that there were any problems,” Krystal recalled. But when Lakota was born by cesarean section, he cried once and she heard the nurses shout, “Breathe, breathe!” Two days later, Lakota was transferred to St. Joseph’s intensive care unit for newborns, where he was treated and diagnosed. From there he graduated to the complex care clinic where he saw pulmonologists, neurologists, gastroenterologists and other specialists.
After 68 days and a couple of surgeries to insert a breathing tube in his trachea and a feeding tube in his stomach, the clinic’s staff prepared Krystal and her husband to take Lakota home. “It was like military boot camp. Not only was he our first child, he was a sick child. We knew nothing. When he came home, he came with lots of accessories and instruction books,” she said.
For the first year, Krystal said they visited the clinic twice a week to make sure everything was working right. “It was a huge learning curve.” Now, she said, “I have my own rolling hospital unit with me,” which includes a tank of oxygen and tubes, a carbon dioxide monitor to make sure he’s breathing, and a ventilator in case he’s not. Lakota reminded her about the suction pump to clean out his breathing tube.
“We’ve definitely avoided ER visits and hospital admissions,” Krystal said. “This year alone, I’ve called in three times when he’s had a fever or some other problem. They tell me what to do and set up an appointment at the clinic the same day. Our safe zone doesn’t need to be in a hospital,” she said. “I’m grateful to have the clinic here to avoid all that.”
This weekend, Lakota will celebrate his sixth birthday. Batman was the theme last year. This year, Krystal said, he had a hard time deciding what he wanted. At first it was Scooby Doo, but then they settled on the Justice League — an entire team of superheroes.
-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 23 hours ago.
She says they’re lucky Lakota was born across the street, at Brandon Regional Hospital, or she might never have known about the Chronic Complex Clinic at St. Joseph’s Children’s Hospital.
The brainchild of Dr. Daniel Plasencia, the St. Joseph’s clinic was created 14 years ago to improve care for kids with chronic conditions affecting more than one organ system. “Their treatment was too complex for most pediatricians,” Plasencia said. “They needed a medical home and we provided it for them.”
Approximately 3 million children in the U.S. are medically complex, meaning they require intensive treatment from a wide array of specialists. That number is expected to reach nearly 5 million in the next decade as medical advances improve life expectancy for kids with congenital heart defects, sickle cell anemia, cerebral palsy and cystic fibrosis. Kids like Lakota who have rare conditions, those born extremely prematurely and survivors of near drownings, auto accidents and other catastrophic events are also living longer thanks to new technology.
Research shows that programs like St. Joseph’s save Medicaid and commercial insurers money by reducing emergency room visits and hospital stays. But while a few complex care units in places like Little Rock, Arkansas, Milwaukee and Cleveland have cropped up around the country, the idea has not caught on nationwide. That’s largely because Medicaid and other insurers do not fully reimburse hospitals for specialized services, such as 24/7 phone consultations and hourlong meetings between parents and specialists, that are crucial to success in complex care.
A study published in December by the Journal of the American Medical Association found that children who were enrolled in complex care clinics had lower medical costs than complex care kids who were not enrolled, $16,523 per year compared with $26,781 per year. More than 90 percent of the children in the study were covered by Medicaid.
Still, “no one has come up with a viable payment model,” Plasencia said. “We get 20 cents on the dollar for what we do. There’s no incentive for other hospitals to do it.”
-Small Population, Huge Costs-
Of the 32 million mostly healthy children Medicaid covers nationwide, only 2 million or about 6 percent, have complex conditions. But their care represents more than 40 percent of overall Medicaid spending for children.
In Florida and the rest of the country, hundreds of thousands of kids stand to benefit from the type of seamless care Lakota and about 800 other children receive here each year. The Children’s Hospital of Wisconsin in Milwaukee and the Arkansas Children’s Hospital in Little Rock serve about 700 kids each. Many families travel long distances to get to these clinics.
The staff at the St. Joseph’s clinic, which provides 24-hour coverage, includes 10 pediatricians, a nutritionist, a pharmacist, three nurses, a social worker, a behavioral health specialist, a scheduler and an expert to help parents navigate Medicaid and the Children's Health Insurance Program.
Instead of leaving parents to fend for themselves, the staff helps coordinate appointments with local pediatric specialists who are on call in the hospital and arranges for transportation when necessary. The clinic also teaches parents how to care for their kids at home and supplies them with the needed medical equipment, all of which has resulted in fewer emergency room visits and fewer and shorter stays in the hospital.
-A Money Losing Proposition-
“We know this works for kids and we know it saves money for the payers, whoever they are,” Plasencia said. “Now we have to make it financially sustainable for hospitals.”
To do that, St. Joseph’s last year joined nine other hospitals in California, Colorado, the District of Columbia, Florida, Ohio, Pennsylvania and Texas in a federally funded project aimed at finding a payment formula that will allow Medicaid to reimburse hospitals and other providers for the extra services that make it possible to limit the amount of time kids with complex conditions spend in hospitals.
The goal of the $23 million grant from the U.S. Department of Health and Human Services is to enroll about 9,000 Medicaid-covered children in complex clinics and achieve a 6.8 percent decrease in total spending over the three-year period of the grant, which ends in 2017.
A separate federal grant for $9.4 million was awarded last year to Wisconsin to expand the Milwaukee-based clinic statewide.
“Medicaid liked our program and saw we were saving money and started to give us a small care coordination fee for nurses and doctors,” said Dr. John Gordon, who runs the complex care clinic at the Children’s Hospital in Wisconsin. “We’ve had a good relationship with Medicaid. But over the years we cost the hospital money and we cost the medical college money because we all work for them. So we had this ongoing discussion with Medicaid about how it would be nice to provide this care for more kids, but it wasn’t possible given that it was a money losing proposition.”
Dr. Dennis Kuo heads the complex care unit at Arkansas Children’s Hospital. Over the last 15 years, he said, “Folks around the country have independently started these programs. They have similar criteria, but their differences reflect the people who started them.”
Pediatricians and intensive care specialists were seeing kids who fell through the cracks between specialists and between inpatient and outpatient care, he said.
According to Kuo, doctors and nurses across the country were seeing very sick kids who spent a lot of time in hospitals. They wanted to improve kids’ lives and cut hospital bills at the same time.
“That’s a very noble thing to do,” he said, especially because they were not getting paid for it. Nationwide, Kuo said, “We need to learn how to stop taking care of kids who are sick and learn how to pay for care to keep kids well.”
Complex care experts say that any care delivery or financial model that results from these federally funded projects must be flexible. The same plan will not work everywhere. “One of the most critical pieces of the grant is that we need other people to test this,” Plasencia said.
In Florida and elsewhere, it will also be critical for health insurers, including Medicaid managed care organizations, to agree to take on the risk of paying hospitals for the extra care they provide to keep kids as well as possible.
-Lakota’s Birthday-
“There were no indications during pregnancy that there were any problems,” Krystal recalled. But when Lakota was born by cesarean section, he cried once and she heard the nurses shout, “Breathe, breathe!” Two days later, Lakota was transferred to St. Joseph’s intensive care unit for newborns, where he was treated and diagnosed. From there he graduated to the complex care clinic where he saw pulmonologists, neurologists, gastroenterologists and other specialists.
After 68 days and a couple of surgeries to insert a breathing tube in his trachea and a feeding tube in his stomach, the clinic’s staff prepared Krystal and her husband to take Lakota home. “It was like military boot camp. Not only was he our first child, he was a sick child. We knew nothing. When he came home, he came with lots of accessories and instruction books,” she said.
For the first year, Krystal said they visited the clinic twice a week to make sure everything was working right. “It was a huge learning curve.” Now, she said, “I have my own rolling hospital unit with me,” which includes a tank of oxygen and tubes, a carbon dioxide monitor to make sure he’s breathing, and a ventilator in case he’s not. Lakota reminded her about the suction pump to clean out his breathing tube.
“We’ve definitely avoided ER visits and hospital admissions,” Krystal said. “This year alone, I’ve called in three times when he’s had a fever or some other problem. They tell me what to do and set up an appointment at the clinic the same day. Our safe zone doesn’t need to be in a hospital,” she said. “I’m grateful to have the clinic here to avoid all that.”
This weekend, Lakota will celebrate his sixth birthday. Batman was the theme last year. This year, Krystal said, he had a hard time deciding what he wanted. At first it was Scooby Doo, but then they settled on the Justice League — an entire team of superheroes.
-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 23 hours ago.
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