Beats this week: 

1) While this might not be surprising to some, here’s a piece that is most definitely good news: Illinois Health Connect saved Illinois millions in FY2008! This program, which links Medicaid patients with a medical home, where treatment and patient referrals are coordinated centrally, saved Illinois approximately $140 million, according to the Robert Graham Center.

2) And now here is more good news! Illinois has just begun providing new high-risk insurance pools for individuals with pre-existing conditions who are without medical covered. The program, Illinois Pre-Existing Condition Insurance Plan, was implemented as part of health care reform and works on a first come, first serve basis.  

3) Have you been eating your leafy green veggies lately? Well, if not then you should! According to a study released recently by the University of Leicester, people who add more green leafy vegetables to their diet may significantly reduce their risk of developing type 2 diabetes. Bring on the spinach!  

4) In a sign that the recession is continuing to hit home for Illinois families, birth rates in Illinois have dropped by approximately 5% according the data made available by the Illinois Department of Public Health and the National Center for Health Statistics. The results compare birth data from similar months in 2007 and 2009.

5) And finally to round out Health Beats this week, let’s talk about eggs. Are you unsure what eggs were recalled? Want to keep up to date on all the recent news related to the egg recall to ensure you throw out recalled eggs? Then be sure to check out these links for the latest news and updates.   

Beats this week: 

1) Great news for health centers around the country: late last week the House Labor-HHS Subcommittee on Appropriations proposed that the Health Centers program be funded at 2010 levels. So what exactly does all this fancy language mean? Well, when coupled with the funds from the Affordable Care Act, health centers will now be able to serve more patients than ever before – to the tune of 20 million more patients over the next five years!   

2) Have you ever heard of mystery patients? This phrase does not even have a Wikipedia page! So just think mystery shoppers – only they are medical patients! A recent study conducted by six Chicago-area research institutions utilized mystery patients who served as actors for a doctor visit in order to measure how often physicians were able to identify social factors that could impact a patient’s health or their treatment (such as homelessness). The results: these factors were often overlooked or missed.

3) Want to give yourself nightmares? Then check out this list of agencies that still need to be paid by the state of Illinois for services rendered in the last fiscal year.

4) This week Michelle Obama and Jill Biden teamed up to announce an important new health initiative. Starting in the Fall, health insurance plans will be required to cover preventive care, such as some cancer screenings, diabetes and blood pressure screenings and routine vaccines, without charging a deductible or co-payment.

5) You heard it first here at Health Beats: Erie is proud to celebrate National Health Center Week by inviting all to attend the Erie Helping Hands Health Fair on August 12 from 3:00-7:00pm. Come by to learn important health education and receive free blood pressure and glucose screenings!

Beats this week:

1) Happy Fiscal Year 2011 blogosphere! Unfortunately, for some in Illinois, this new fiscal year brings a great deal of unhappiness. On July 1, Governor Quinn held a press conference in which he laid out nearly $1.4 billion in cuts to the state budget.

2) This week President Obama made a key recess appointment, placing Dr. Donald Berwick in charge of the Medicare and Medicaid programs. The appointment of this position is even more important than before because of health care reform’s impact on the Medicaid and Medicare programs.

3) Around 40 million doses the swine flu vaccine (around $260 million worth) are set to be destroyed in the United States because they have expired. And that’s not the end of it: another 30 million doses are still available but set to expire in the near future.

4) Starting out the summer with some pep in their step, the White House launched a new health care reform website for consumers on July 1. This new website is part of an overall strategy to use the internet and social media as a means to inform people about health care reform. Earlier this week, the White House used their YouTube page to solicit questions from constituents about health care reform, which were then answered by HHS Secretary Kathleen Sebelius earlier today.

5) Twitter and the blogosphere have been abuzz lately with health care folks linking to and discussing the pros and cons of electronic medical records. Erie was even featured in one of the many news stories that came out within the last week. Check us out in the Chicago Sun-Times over the weekend!

Beats this week:

1) Over the summer, many children who normally received free or reduced lunch from their school now find themselves with less to eat. Check out this great story about some local food pantries that are attempting to meet the need to feed Chicagoland children during the summer. And the bonus is that they are super healthy lunches!

2) Today, Health and Human Services Secretary, Kathleen Sebelius announced a new $250 million investment that will aim to develop new medical providers. This program, which was created using Affordable Care Act funds, will help ease the shortage of primary care providers by training and developing nearly 16,000 new medical providers over the next five years.

3) More sad news for the state of Illinois: for the second time in a little more than a week, the credit rating for Illinois has been downgraded due to the state’s inability to balance the budget. Currently, the only state with a worse rating than Illinois is California.

4)  In April, Health Beats reported on an announcement of a plan from the FDA that would reduce the amount of salt consumed by Americans. Well, nearly two months later over one dozen major US food companies have announced they will voluntarily reduce the level of salt in the foods they produce. That’s right, in the next few years you can expect to see the sodium levels decrease in Heinz ketchup!

5) Key delegations in the American Medical Association called for revisions to the AMA’s endorsement of health care reform this week. Specifically, these delegations would like the AMA to revise its stance on Medicare payment cuts, raise the doctor payment for Medicaid and enact sweeping liability reform.

The idea of just handing out health insurance to those in need of it seems wonderful.  Unfortunately, it isn’t that simple.  In a way, it’s like giving everyone in Chicago a free CTA pass for one day.   You may have the means to ride the El, but if the train is full, you’re not going anywhere.   The same idea goes for health care.  In April, Dr. Francis blogged on Beats Per Minute about the shortage of primary care doctors available to care for this surge of now-insured patients and how community health centers could be the new training ground for upcoming generations of primary care doctors.  Also back in April, Health Beats blogged about the upcoming physician shortage, as well as the possibility of reducing some of the restrictions on nurse practitioners to help lessen the blow of incoming health care demand surge.

Nursing Our Way Out

 Twenty-eight states are taking the same route in addressing the shortage of primary care physicians.  These states, which include Illinois, are considering loosening the regulations and restrictions of nurse practitioners (NPs) and expanding the types of services that NPs can provide.   The Patient Protection and Affordable Care Act, which was recently signed into law by President Obama, will bring nursing midwives to the same Medicare pay rate as OB-GYNs.  This new health care law will also give $50 million to nurse-managed health clinics that offer primary care to low-income patients, $50 million for hospitals to train advanced degree nurses to care for Medicare patients as well as 10% bonuses for medical providers, including NPs, who work in areas where physicians are limited.

 Recently, the National Nurse Act of 2010 has been introduced into the House.  This Act would create a “National Nurse” who would be nominated by the Secretary of Health and Human Services and would be equal in standing with the Deputy Surgeon General.  Regardless of whether or not this Act makes it all the way through Congress, it is still another piece of evidence that nurses are continuing to make head way in health care. 

The Other Side

Currently, laws vary widely across all states on what NPs can and cannot do.  Many states place doctors in charge of NPs, while Montana doesn’t require doctor collaboration with NPs in any way.  Also, some states bar the use of the ‘Dr.’ abbreviation for nurses who hold Doctorates of Nursing while a majority of other states allow it. 

The Macy Foundation, a New York-based non-partisan charity that focuses on the education of health professionals, recently called for NPs to be amongst the leaders in primary health care and urged the removal of state and federal barriers that keep NPs from being able to provide primary care. While acknowledging the need for additional health care providers, the American Medical Association (AMA), however, but does not see increasing the roles of NPs as a solution to the physician shortage. “A shortage of one type of professional is not a reason to change the standards of medical care,” said Dr. Cecil Wilson, the AMA president. “We need to train more physicians.”

Whatever the solution, the health care world does recognize the need for exponential growth of primary care providers over the coming years. Getting everyone a ticket to health care is only half the battle – getting them through the exam room doors is what’s going to be the tricky part.

Beats this week:

1) An estimated15,000 people converged on the Capitol today in Springfield to show support for Governor Quinn’s proposed tax increase. If the crowd estimates are correct, this would be the largest Capitol protest since the Equal Rights Amendment protests over 25 years ago.  The rally, which is being called ‘Save Our State,’ seeks to create a responsible budget by increasing tax revenue rather than cutting services.

2) The Food and Drug Administration announced a plan to reduce the amount of salt that is consumed by Americans. The FDA will begin by requesting a voluntary reduction in sodium levels from the food industry and then possibly creating a mandate later down the line.

3) This week President Obama handed down an order to his Health and Human Services Secretary, Kathleen Sebelius, to begin drafting rules that would require hospitals receiving Medicaid and Medicare payments to allow all patients to designate what individuals can visit them and consult with them on medical decisions. This move is being hailed as a victory for same sex couples who often experience challenges when it comes to consulting with their partner on medical decisions.

4) Earlier this week, Michelle Obama made a stop at a community farm in California on her way back from her first solo trip abroad. The tour at the New Roots Community Farm was meant to highlight her new childhood obesity prevention campaign, Let’s Move! 

5) Three large insurance companies – UnitedHealthcare, Wellpoint and Humana – all took steps this week to begin implementing health care reform legislation months ahead of time. These three insurance companies are going to allow adults under age 26 to be covered under their parent’s insurance until September 23, when they are guaranteed coverage under health care reform legislation. This decision comes at an ideal time for students graduating this Spring who are without job placements.

Millions more to seek primary care by 2014

With the ink of President Obama’s signature barely dry on the Patient Protection and Affordable Care Act, a transformation is about to happen over the next decade.  For the first time in our country’s history, there will be a major effort to make health insurance available to almost all Americans – nearly 32 million will be added to the health insurance rolls. 

Most community health centers like Erie care for high volumes of patients without insurance (34% at Erie) or covered by Medicaid (62% at Erie). Medicaid is the federal-state partnership to provide health care coverage for those living at the federal poverty level or below.  Starting in 2014, some 16 million more people  will become eligible for Medicaid as the income limits to qualify are raised from 100% of the federal poverty level (about $22,000 per year for a family of 4) to 133% of the federal poverty level (about $30,000 per year for a family of 4). 

Where will 16 million more Americans seek health care?  Community health centers already serve almost 20 million Americans; over a million in Illinois and over 600,000 in the Cook County area.  Located in neighborhoods and towns which are some of the most medically underserved and economically challenged in the country, community health centers are perfectly positioned to expand services. 

Placing a brand new Medicaid card in the hands of millions will not solve the daily challenges people living in poverty face every day:  challenges in literacy, joblessness and lack of transportation.  Although the health care reform bill makes efforts to pay private doctors better for seeing Medicaid-covered patients, many private physicians, private physician groups and university-based practices do not accept or severely limit access for Medicaid patients.  A massive increase will be needed in primary care capacity at the community level. 

Overall, this is good news for community health centers.  Many health center patients who have no health insurance will now be eligible, either for Medicaid or for more affordable insurance through their employer or purchased on their own.  Let’s not forget, that another 16 million Americans will get on the health insurance bus through insurance exchanges, employer-based insurance and other means. 

More bricks and mortar are needed

The health care bill provides $11 billion in new funding for the health center programs over the next five years.  Health centers successfully competing for these funds will be able to expand.  Expect 20 million more people to access high quality, culturally competent behavioral, medical and oral health care at community health centers over the next 10 years – a doubling of the current capacity.

There’s not enough primary care work force

Currently, there simply is not enough primary care doctors and advanced practice nurses to meet the coming demand.  The health care reform bill provides funding for health centers to become teaching centers for the next generation of primary care doctors. Erie is already launching a training program sponsored by Northwestern McGaw Medical Center and Norwegian American Hospital.  Within 3 years, twenty-four family physicians-to-be will be in training at Erie.

Once physicians are trained, they need an incentive to work in medically underserved communities.  Many graduating medical students carry the burden of well over $100,000 in school loans.  The health care bill includes $1.5 billion over the next 5 years to expand the National Health Service Corps, a loan repayment program for doctors who choose to practice in medically underserved areas.  This initiative will place an additional 15,000 primary care doctors, nurse practitioners, dentists, and behavioral health specialists in communities of need.

Will community health centers vanish?

With the demand for primary care services increasing by 32 million over the next decade and low acceptance of Medicaid amongst healthcare providers, the need for community health centers has never been greater.

Push the throttle forward, fasten seat belts and get ready for take-off!

Beats this week:

1) Months ago, Beats Per Minute wrote about how health care reform would strain the already existing primary care shortage in the United States. This week, the Associated Press also discussed the issue.

2) Modern Healthcare featured the Thomson Reuters 100 Top Hospitals, which included Erie’s long-standing partner, Northwestern Memorial Hospital. Other Chicago hospitals recognized include Advocate Illinois Masonic Medical Center and Rush University Medical Center.

3) While Republicans vowed that they would repeal health care reform, it seems that most have backed off from that sentiment over concerns that it might negatively impact the GOP in the November elections.

4) What’s better than eating chocolate for fun? Eating chocolate because it might reduce your risk of having a heart attack or stroke! German researchers concluded this week that individuals who consumed around six grams of chocolate a day had a 39 percent lower risk of either a heart attack or stroke. The researchers stated, though, that it was too early to start making recommendations for individuals to consume daily amounts of chocolate.

5) H1N1 is still going strong in some parts of the country. This week, the CDC and Surgeon General reported that the Southeast, mainly Georgia, Alabama and South Carolina, are experiencing an uptick in cases of H1N1.

Beats this week:

1) This week has been a busy week for health care reform. On Sunday, the House passed health care reform and sent the bill to President Obama’s desk. On Tuesday, the President signed the bill, which will provide up to 32 million individuals with health insurance.

2) The health care reform bill is over 2,400 pages and contains a few lesser known provisions. Some highlights include: chain restaurants and vending machines will have to post nutritional information and companies with at least 50 employees will have to set aside “reasonable” break times for nursing mothers and create private spaces for breastfeeding. To read more about the bill, check out Beats Per Minutes post this week.

3) It was reported this week that Chicago Public School officials are moving to revamp the school lunch program. Starting in June, schools will eliminate or reduce the availability of unhealthy food options, such as nachos, doughnuts and Pop-Tarts.

4) The Illinois Supreme Court handed down a decision this week that was met with great disappointment for many nonprofit hospitals in the state: hospitals that are designated nonprofit must provide certain levels of charitable giving to their patients in order to maintain their nonprofit status.

5) Who are we kidding?! The only thing being talked about this week is health care reform! Let’s skip the back and forth politics, though, and check out the video of President Obama signing this historic legislation.

Last night we sat around our television screens, anxiously waiting for an historic moment to occur and we were not disappointed. With members of the House chanting “Yes we can!” millions around our country felt relief: comprehensive health care reform had finally passed. This was a truly historical moment for the entire country and particularly for the millions of uninsured individuals who will now be afforded access to health insurance.  

The Patient Protection and Affordable Care Act will make its way to the President’s desk on Tuesday for his signature of this momentous legislation. The Reconciliation Act of 2010 will also move to the Senate this week for approval. After both of these steps are completed, health care reform can begin to be enacted.

But what happens then? The full text of the bill is around 2,400 pages so it is doubtful that many Americans have read the bill from cover to cover (Who has that kind of time?). Look no further! Now that change has come to America, here is a summary of what changes will actually occur for everyday Americans.

In the first year of enactment

Within months of health care reform law taking effect, many of uninsured and underinsured individuals will begin to see benefits. For example, many insurance plans would be prohibited from placing lifetime spending limits on medical care and the law would prevent insurance companies from cancelling insurance plans for individuals who have fallen ill. Additionally, this law would make it illegal for insurance companies to deny coverage to any child with pre-existing medical conditions.

Do you know a recent college graduate who does not have health insurance coverage? Health care reform law would allow these individuals to remain on their parents’ insurance plans until they are 26. Finally, adults with pre-existing conditions who had previously been denied coverage would be able to buy subsidized plans within a high-risk insurance pool. And most of this will occur within the first six months of enactment!

In 2014

2014 is the magical year that the full health care reform law will be implemented. In 2014, coverage will expand even more through Medicaid and state-run exchanges. The exchanges provide a competitive online marketplace for consumers to ‘shop’ for private insurance plans. Medicaid coverage would be expanded so that more individuals can qualify for the insurance plan.   These two steps would afford nearly 32 million more Americans with health insurance.

In 2014, reform will also create greater parameters for insurance companies and individuals. For example, insurance companies will be prohibited from denying anyone coverage because of pre-existing conditions and the law would ban lifetime spending limits for medical care. Additionally, all individuals who meet certain income requirements would be mandated to have health insurance, either through private or public (Medicaid) plans. For private plans, insurance premiums would be capped based on an individual’s income. For individuals who already have employer-based health insurance that they like, very little change will occur for them.

Before the vote last night, House Speaker Nancy Pelosi gave a speech to the House of Representatives and the country in which she said what many before her have declared: ‘All politics is personal.’ Speaker Pelosi was absolutely right. For the millions of Americans who will now be provided with the health care they need and deserve, health care reform politics is incredibly personal. While this may be the first step in many towards complete health care reform, it was a momentous step taken in the journey to make ‘health care a right, not a privilege.’ Erie stands ready to be a part of this change, expanding our services to meet the needs of our patients, as well as the newly insured patients that will be coming our way.