Healthcare Policy

Feds question New Orleans hospital plans

Thu, 21 Jun 2007 20:01:35 -0400

While the state of Louisiana would like to put a 484-bed teaching and research hospital in downtown New Orleans, the federal Department of Housing and Urban Development isn't sure it's a good idea. HUD has agreed to release $74 million to buy land and prepare a design for the next Charity Hospital, which sat in downtown New Orleans until Hurricane Katrina hit in 2005. But HUD isn't thrilled about the idea of giving the state an additional $150 million or so to build the hospital. In a letter to Governor Kathleen Blanco (D), HUD Secretary Alphonso Jackson ripped apart the state's plans for the hospital, suggesting that the proposed hospital was bigger than needed to meet local demand, making it unlikely that the facility would be solvent over the long term.

To learn more about the dispute:
- read this Times-Picayune piece

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Community clinics face doctor shortage

Wed, 20 Jun 2007 20:01:35 -0400

While the federal government has greatly expanded funding for community health centers, it seems that its medical staff hasn't kept pace. Like their private sector counterparts, many of the country's clinics are now struggling to find the primary care physicians they need to function, despite paying reasonable salaries. Meanwhile, doctors who are on board are facing swelling caseloads, which could lead to turnover and make things worse. Health centers are coping, in part, by taking advantage of physicians participating in the National Health Service Corps, a program under which new doctors work in underserved areas in return for partial payment of their loans. The centers also use foreign-born doctors who work there in exchange for staying in the country. Still, neither of these sources are enough to fill the gap.

Federal officials note that they have increased clinic funding by $645 million since the 2002 fiscal year, much of which is bringing physicians, nurse practitioners and midwives to the underserved. Still, the average health center has a family physician staff vacancy rate of over 13 percent, with rural areas hitting 16 percent, according to one study.

To learn more about the shortage:
- read this piece from The Washington Post

TX county grapples with care for illegal immigrants

Thu, 14 Jun 2007 20:01:35 -0400

In a debate that resonates across the U.S., leaders in Tarrant County, TX are discovering what the real cost would be if they permit illegal immigrants access to the county's indigent care program. This week, a consultant hired by the JPS Health Network board of managers told executives and officials that the cost would be $41.2 million a year, or about 10 percent of the hospital's current operating budget. For that amount, the hospital could see 29,000 new patients and would probably end up admitting about 385 more people to the hospital. By 2017, the consulting firm said, the influx of immigrants would force the hospital to expand by 70 beds. However, a immigrant advocacy group contends that it would cost dramatically less, about $4.2 million a year, to provide care for this population. That's because illegal immigrants are generally young and healthy with little need for ongoing medical care, the advocates said.

To learn more about the debate:
- read this Fort Worth Star-Telegram article

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House mulls new pharma ad limits

Tue, 12 Jun 2007 20:01:36 -0400

Pharma lobbyists are facing new challenges this month as the House of Representatives takes on a new FDA overhaul bill which could limit consumer drug advertising. Critics have suggested that such advertising can boost spending unnecessarily, but observers--including some not on the pharmas' payroll--suggest that the ads help educate consumers about new treatment options.

The Senate version of the bill had imposed a ban on consumer drug advertising during the first two years a drug was on the market, but that provision was deleted. (Senators did approve additional FDA funding to increase the number of FDA employees who pre-review such ads, as well as giving the agency the ability to levy substantial fines for ads deemed false or misleading.) Now, pharma industry lobbyists must contend with another troublesome set of provisions, including a potential rule requiring pharmas to hold off on print, radio and TV ads for three years for drugs with the potential for serious harm.

To find out more about the measure:
- read this article in The Boston Globe

ALSO: FDA critics offer data on "cozy" industry ties. Report

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New Orleans fights doctor flight with loan paybacks

Mon, 11 Jun 2007 20:01:36 -0400

New Orleans physicians have been struggling since Hurricane Katrina, with practices and hospitals closed and the list of uninsured patients remaining high. Under these conditions, it's hardly surprising that they would want to leave the city. But the city doesn't want to see them go. So with the help of the state of Louisiana and the federal government, the city has developed a program which pays them to stay. The Greater New Orleans Health Services Corps has begun offering incentives of up to $110,000, including both student loan repayments and income guarantees, to doctors, dentists and other medical pros who will stay. To get the money, medical professionals must agree to stay in the area for three years, and Medicaid, Medicare and uninsured patients must make up at least one-third of their practice. To date, the program has already made 81 awards, to a group including primary care physicians, gynecologists, psychiatrists, dentists, nurses and counselors.

The program is funded with $15 million in federal dollars. Federal officials will be funneling in another $35 million to help the state recruit and retain a variety of health professionals, including nurses, pharmacists, doctors, dentists and med school faculty members.

To learn more about the program:
- read this piece in The Times-Picayune

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Wisconsin moving ahead with hospital tax plans

Thu, 07 Jun 2007 20:01:36 -0400

Nearly all of Wisconsin's hospitals--a full 95 percent--are not-for-profits that enjoy a state property tax exemption. Despite resistance from the hospitals, the state is continuing to look at recouping some of that revenue with a separate hospital-specific tax. State governor Jim Doyle (D) wants to impose an 0.8 percent tax on the state's 109 non-profit hospitals, which he says will generate $418 million in revenues for the state over the next two years. The proposal has been posted by a report suggesting that the non-profits had excess revenues of $837 million in 2004. Like its brethren in other states considering hospital taxes, the Wisconsin Hospital Association characterizes the proposed tax as a "sick tax" which will end up hurting patients.

To find out more about the tax proposal:
- read this Associated Press article

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New Orleans official challenges death rate data

Thu, 07 Jun 2007 20:01:35 -0400

The city of New Orleans' top medical official is angrily contesting new state data which conflicts with his findings that death rates have risen substantially since Hurricane Katrina. Officials with Louisiana's Department of Health and Hospitals yesterday released numbers which contradict an analysis by Dr. Kevin Stephens that mortality rates have spiked 47 percent since the disastrous storm. State officials concede that the city is still struggling, but said that Stephens' numbers are "exaggerated." They're also backed by a study from state epidemiologist arguing that death rates have leveled off since Katrina. But Stephens is charging that the state is victimizing already-traumatized city residents by downplaying the problem. He says that there are serious problems with the state's report, which he says uses incomplete data.

To learn more about the controversy:
- read this article from The Times-Picayune

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Feds study care effectiveness, practice patterns

Wed, 06 Jun 2007 20:01:34 -0400

The House Ways and Means Health Subcommittee is holding a hearing next week on the need to study variations in care practices. The stated purpose of the hearing is to consider funding new research on the comparative effectiveness of various treatments and procedures paid for under Medicare. However, such research would doubtless be used aggressively by private health plans, which are equally interested in seeing that their reimbursement policies make sense. Rep. Pete Stark (D), who chairs the subcommittee, argues that comparative effectiveness data gives planners their "best shot" at cutting healthcare costs. Former HCFA (now CMS) administrator Gail Wilensky is one of several public health experts who have argued for the creation of a neutral central entity tasked with doing comparative effectiveness research.

To find out more about the hearing:
- read this House press release

PA bill would forgive med school loans

Tue, 05 Jun 2007 20:01:34 -0400

Hoping to keep newly-minted physicians in the state, a Pennsylvania state legislator has introduced a bill under which the state would pay off med school loans for physicians who stay there for 10 years or more. Right now, only about 8 percent of physicians who train at the state's medical schools end up practicing there. Meanwhile, the state's physician population is aging, with only 3 percent of its physicians under age 35. To slow this exodus, the state would pay the loans off at a rate of 10 percent a year for 10 years. If the physician was to change their mind and leave the state, they'd have to reimburse the state for the payments the state had already made. Early estimates suggest that such a program would cost about $40 million per year once it got rolling.

To learn more about the proposed legislation:
- read this Pittsburgh Post-Gazette piece

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A look at mental health parity in action

Tue, 15 May 2007 20:01:34 -0400

As federal legislators debate bills that would create parity between mental health insurance benefits and traditional medical benefits, few have asked the question as to whether this approach has really expanded access in the past. However, if Connecticut's experience is any guide, parity of benefits may not close the mental health treatment gap completely. Connecticut, which has had a mental health parity law on the books since 2000, requires the state's insurers to pay for treatment of mental or nervous conditions accepted by the psychiatric profession. However, there are several flaws in the bill that make it almost useless, critics say. For example, insurers can still decide which treatments are "medically necessary," can pay mental health providers as little as possible and can force them to go through so much paperwork that they refuse to participate in plans. The state's critics say that unless proposed federal bills address these problems, the new federal rules will have no teeth either.

To learn more about Connecticut's experience:
- read this Hartford Courant article

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