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June Media Coverage

WakeMed, Physicians Group Coordinate to Improve Care and Avoid Penalties
News & Observer - June 17, 2013
WakeMed Health & Hospitals and one of the state's biggest physicians practices announced a partnership Monday designed to minimize federal penalties and maximize financial rewards under the national health care reform law.

Obamacare's Big Question: What's It Going to Cost Me?
News & Observer - June 17, 2013
The cost of health coverage under Obamacare remains one the biggest mysteries of the nation's health care overhaul. But nagging cost questions will slowly be answered this summer as insurers and state officials set 2014 health plan rates for people who buy coverage outside of work or purchase it through small employers. Those two coverage areas - the individual and small group markets - face the biggest rule and cost changes next year, when the main provisions of the Affordable Care Act finally kick in.

Why Nonprofits are Fretting Tax Code Edit
Triangle Business Journal - June 14, 2013
A proposed change in the tax code has leaders of nonprofits up in arms. A closer look, though, shows the change would affect mostly large organizations, many of which don't conjure up traditional images of a charity. Legislators have looked at several ways to reform the tax system in this state. One of those changes would eliminate sales tax refunds to nonprofits for any amount over $100,000. That would impact 250 nonprofits, or about 2.5 percent of all such organizations in the state. Large charities like the Red Cross and Easter Seals are included in that number, but so are 93 hospitals, 33 private colleges and 15 private schools, according to data compiled by the N.C. Center for Nonprofits. The N.C. Hospital Association has already spoken out against some of the new tax proposals.

Hospital Mergers May be Good for Business, But Patients Don't Always Benefit
AARP (Online) - June 2013
Note: Features Wilson, N.C.
Wilson Medical Center has served the residents of the small, leafy town of Wilson, N.C., for almost 50 years. But now this profitable 294-bed hospital -- the only hospital in the county -- may have to become affiliated with a larger medical system. What's the impact on patients when smaller hospitals merge? -- Butch Martin/ Getty Images Rick Hudson, Wilson's chief executive, has hired a consulting firm to advise the hospital on its options. He thinks the hospital may not survive if it remains independent.

Hospitals Group Calls Out Against Tax Plans
Triangle Business Journal - June 12, 2013
If one portion of tax reform goes into place in North Carolina, hospitals would be on the hook for millions in new taxes, states the association representing the hospitals. North Carolina's hospitals inserted themselves in the tax reform talks, calling out against that provision, saying they need that protection to continue providing care for the neediest patients. Legislators have looked at several ways to reform the tax system in this state. One of those changes would eliminate sales tax refunds to nonprofits for any amount over $100,000. The N.C. Hospital Association says this "would mean that hospitals would lose hundreds of millions of dollars that are currently devoted to caring for the patients in North Carolina and employing caregivers." 

Sen. Rucho Resigns Finance Committee Post; Sen. Berger Isn't Having It
News & Observer, Charlotte Observer - June 13, 2013
Sen. Bob Rucho, a Republican from Mecklenburg County who was the chief architect of the Senate's original tax plan, has resigned as co-chairman of the Senate Finance Committee. Rucho's resignation came just days after Senate President Pro Tem Phil Berger unveiled a new tax plan that walked back several provisions in Rucho's plan, including a proposal to add a state sales tax to food and prescription medicine, and expand the sales tax to numerous services.

Nonprofits Warily Eye Tax Reform
WRAL - June 11, 2013
Various tax reform plans under consideration in the General Assembly could affect nonprofit organizations in North Carolina in different ways, says David Heinen, director of public policy for the N.C. Center for Nonprofits.

Senate's New Tax Plan Avoids Expanding Tax on Services 
News & Observer - June 11, 2013
Senate President Pro Tem Phil Berger on Tuesday unveiled a new plan to rewrite the state's tax code that walked back from the Senate's earlier proposal to add a state sales tax to food and expand the sales tax to numerous services. Berger said this latest version would be a break for most taxpayers, move North Carolina forward economically and avoid some of the concerns that have been raised about earlier proposals.

N.C. State Research Finds Treating Mental Illness Lowers Arrest Rates, Saves Tax Dollars
Triangle Business Journal - June 10, 2013
Proper outpatient care for mental illness could save the state money, according to research released Monday. "This study shows that providing mental health care is not only in the best interest of people with mental illness, but in the best interests of society," says Sarah Desmarais, an assistant professor of psychology at N.C. State University and co-author of a paper describing the research.

For Some Workers, Health Reform Brings No Coverage, Fewer Hours
News & Observer - June 11, 2013
McCoy Faulkner collects $81 a day as a substitute teacher in the Wake County (N.C.) Public School System. A mere sub, he has no benefits. The 62-year-old former Raleigh, N.C., police officer shells out $580 a month for an individual insurance policy, more than half his monthly pay. The full-time teachers for whom Faulkner fills in, however, are eligible for free health insurance, with no monthly premiums, through their employer.

Opinion: The Failure of Quick Mental Health Fixes in N.C.
News & Observer - June 8, 2013
North Carolina has a long history of adopting simple, quick-fix solutions to complex problems facing the mental health system. In 2001, in response to the Supreme Court's 1999 Olmstead decision, North Carolina began reducing its state psychiatric hospital capacity and shifting care to less restrictive local settings, without ensuring that adequate community-based services were in place.

N.C. Health Insurers' Lagging 'Medical Loss Ratios'
Triangle Business Journal - June 7, 2013
In North Carolina, health insurers spent a smaller portion of revenue on medical claims than insurers in at least half of the other states. As part of the Patient Protection and Affordable Care Act, health insurers must comply with a "medical loss ratio," which stipulates that the insurers spend the majority of premiums collected on actual health care as opposed to administrative and other expenses.

Cost to Treat Medicare Patients at Cape Fear Region Hospital Varies
Fayetteville Observer - June 9, 2013
A government database shows the cost of treating Medicare patients for common ailments can vary widely from one Cape Fear region hospital to the next. The database compares the average Medicare charges for 100 of the most common inpatient procedures at more than 3,300 hospitals in the nation, including five in the region. The database shows the average cost for treatment of pneumonia at Cape Fear Valley Medical Center in Fayetteville is $44,253, nearly double the average cost for the same treatment at Betsy Johnson Regional Hospital in Harnett County.

Chart: Here's How Obamacare's Markets are Shaping Up
Washington Post (Wonk Blog) - June 9, 2013
We are starting to get a sense of what health insurance competition will look like under Obamacare, with a dozen states now having made public data on which carriers want to sell on the new marketplaces. As you can see in this chart that I've put together, there is widespread geographic variation in how many plans want to participate in the exchanges.

Obamacare Leaves Millions Uninsured.  Here's Who They Are
Washington Post (Wonk Blog) - June 7, 2013
When we talk about the Affordable Care Act, we mostly focus on the millions of Americans who will gain health insurance coverage. We talk less about the millions who will remain uninsured. And there are a lot of them: 30 million Americans will not have coverage under Obamacare, according to a new analysis in the journal Health Affairs.  "Even if the law were fully implemented, there would have been 26 million uninsured people," co-author Steffie Woolhandler said in an interview Thursday.

N.C. Decision Against Medicaid Expansion Could be Costly
Triangle Business Journal - June 4, 2013
North Carolina should expect increased costs after deciding not to expand Medicaid as part of federal health-care reform, according to a new study by the RAND Corp. That nonprofit research organization looked at 14 states -- including North Carolina -- that decided against expanding Medicaid in their states. It found that opting out of expansion will leave millions without health insurance.

New N.C. Medicaid Claims System to Go Live July 1
Triangle Business Journal - June 4, 2013
Fewer than 14 days after an audit found the Medicaid claims payment system had not gone through sufficient testing, state leaders say the system is ready to go live on July 1. "We're almost ready for the launch," said Aldona Wos, secretary of the N.C. Department of Health and Human Services, which manages the state's Medicaid program. "Since we arrived in January, we have diverted all available departmental resources to complete testing and push this project over the finish line." In North Carolina, Medicaid pays between $13 billion and $14 billion in health care expenses mostly for women and children in low-income households and the disabled and elderly.

Health Care Workers Join Protests at Legislature
North Carolina Health News - June 4, 2013
Jonathan Kotch is 65 years old and is something of a political firebrand. As the leader of the group Health Care for All NC, he's worked to create access to health care as a human right and advocated for a single-payer health insurance plan for all Americans for years. But the public health professor from UNC-Chapel Hill has never been arrested as a form of protest.

May 2013 Coverage

Study: N.C. Could Save $58M in Medicaid Each Year
Triangle Business Journal - May 31, 2013
North Carolina could cut its share of Medicaid pharmacy spending by nearly $58 million per year if it would manage the program better, according to a recent study by the Lewin Group. More precisely, the Lewin Group estimates the North Carolina Medicaid Pharmacy Program could cut total spending by close to 15 percent each year, saving nearly $2 billion in a 10-year period. Because the federal government pays for about two-thirds of Medicaid spending in North Carolina, the estimated savings for the taxpayers here would amount to $579 million from 2012-2021, the group estimates.

Obama Calls for National Conversation about Mental Health
Washington Post - June 3, 2013
President Obama on Monday called for a more open dialogue on the issue of mental illness, which he said is poorly understood and under-treated because of the stigma it carries. "We wouldn't accept it if only 40 percent of Americans with cancer got treatment," he said. "We wouldn't accept it if only half of the young people with diabetes got help. Why should we accept it when it comes to mental health?"

Medicare's Trust Fund Will Last Two More Years. What Does that Mean?
Washington Post (Wonk Blog) - May 31, 2013
The annual release of the Medicare Board of Trustees' Report is, by its nature, never a fun event. Each year, reporters shuffle into a big Treasury Department conference room. There, health policy experts stand in front of a podium and tell them about the exact moment that the country's largest health insurer will run out of money.

Will Health Reform Bring Changes to Health Care Wages?
Triangle Business Journal - May 30, 2013
As physicians feel the pinch of decreased reimbursements, they can find it hard to give employees pay raises. Still, it's important to keep employees satisfied at work in order to get the most productivity out of the workforce, say health care workplace experts. It's worth paying attention to in the Triangle, where some nursing salaries tend to be slightly higher than in the eastern or Triad regions of North Carolina, according to salary survey information compiled by CAI, a human resource management firm in Raleigh.

NC Senate Budget Plan Pushes Pregnant Women Out of Medicaid
News & Observer - May 29, 2013
Largely unnoticed and unremarked in the budget recently passed by the N.C. Senate was a troubling reduction in the eligibility of pregnant women for the state's Medicaid program. While Republicans have made it clear they don't want to accept federal money to expand the state's Medicaid program under the Affordable Care Act, this attempt to cut eligibility levels for women currently on Medicaid marks a new effort to limit health options for low-income North Carolinians.

Young Adults Protected From ER Costs under Affordable Care Act
CBS Health (Online) - May 29, 2013
The Affordable Care Act has provided financial protections for young adults facing medical emergencies, according to a new study.  President Barack Obama signed the law in March 2010, and one of its provisions that kicked in that September allowed young adults between the ages of 19 and 25 to stay on their parents' private health insurance plans. The extra coverage stops when they turn 26 years old.

More Doctors, Hospitals Using Electronic Records
News & Observer - May 22, 2013
The Obama administration says more doctors and hospitals are embracing technology as adoption of computerized medical records reaches a "tipping point" in America.A report Wednesday from Health and Human Services says more than 50 percent of doctors' offices and 4 in 5 hospitals have transitioned from paper to electronic records, thanks partly to more than $14 billion in government incentive payments.

NC Medicaid Shortfall Now $330 Million-Plus
News & Observer - May 22, 2013
The North Carolina office that oversees Medicaid says the funding shortfall for the government health insurance program is more than $330 million. Health and Human Services Secretary Aldona Wos (vahsh) said Tuesday the shortfall has grown $85 million above the $248 million projected by Gov. Pat McCrory's administration earlier this month.

Governor Pat McCrory Announces Joint Effort to Reform Medicaid
Press Release - May 17, 2013
Governor Pat McCrory, Senate President Pro Tempore Phil Berger and House Speaker Thom Tillis joined forces today in pursuit of Medicaid reform.  A waiver is the next crucial step in pursuing innovative reform for North Carolina's Medicaid system. The federal government grants waivers that allow flexibility in how states operate and finance their Medicaid programs.

Huge ranges in hospital prices, health care data show
The News & Observer - May 8, 2013
A previously unreleased set of hospital prices and resulting payments made public Wednesday revealed a hidden world where charges set by some institutions can be three or four times higher than their competitors'

Heart care costs to skyrocket in the coming years, AHA estimates
Triangle Business Journal - April 29, 2013
The American Heart Association projects the cost of care for heart failure to increase from $30.7 billion in 2012 to $43.6 billion by 2020 and nearly $70 billion by 2030. Those 65 and older will account for nearly 80 percent of the total cost.

Could price transparency actually increase health costs?
Advisory Board - April 10, 2013
Duke University physician and behavioral scientist Peter Ubel warns that hospital price transparency legislation intended to reduce health care costs may fail because price can have a "placebo effect" on patients...

NC's Rising Uninsured Need Help
The News & Observer - April 10, 2013
The portion of North Carolinians under age 65 with employer-sponsored insurance declined from 69 percent in 2000 to 56 percent in 2011, according to the report released Thursday by the Robert Wood Johnson Foundation.  North Carolina's decision not to expand Medicaid eligibility as proposed by the federal Affordable Care Act will likely mean that health care access will remain a struggle for many lower-income residents, advocates say.

The Economics of Health Care Quality and Medical Errors
...based on recent reports, approximately 200,000 Americans die from preventable medical errors including facility-acquired conditions and millions may experience errors. In 2008, medical errors cost the United States $19.5 billion. About 87 percent or $17 billion were directly associated with additional medical cost, including: ancillary services, prescription drug services, and inpatient and outpatient care...

The Costs of Emergency Room Cost-Cutting
The New York Times - March 28, 2013
For close to 50 years, emergency rooms have been fingered as a major source of excessive health care costs. And while some newer research has challenged the idea that a large proportion of patients visit the emergency room for routine problems, many payers and policy makers continue to focus on these patients as a major source of wasteful spending.

Reporter's Take: Still no specifics on N.C.'s Medicaid reform
Triangle Business Journal - May 16, 2013

The state's top Medicaid leaders are still short on details when faced with questions about what they envision for an overhaul of that system. After spending a couple of hours in Durham listening to N.C. Department of Health and Human Services Secretary Dr. Aldona Wos and state Medicaid Director Carol Steckel answer questions from doctors, health care advocates and concerned citizens, this is my take - state leaders failed to impress most in attendance who were interested in knowing about Medicaid reform.

Certificate of Need Study Bill Passes First House Vote
Carolina Journal - May 15, 2013

 Blaming an onslaught of lobbying by hospitals, state Rep. Marilyn Avila, R-Wake, scaled back a bill that would have allowed for an expanded presence of physician-owned ambulatory surgery centers in North Carolina. House Bill 177, which passed an initial floor vote Tuesday 112-2, would shift the legislation to a legislative study committee.

Hospitals Could Lose $500M in Federal Funds
News & Observer - May 13, 2013 (AP Story - National Pickup)
Hospitals nationwide could lose half a billion dollars in federal funding meant to offset the cost of covering the uninsured next year. The loss that will be especially felt in states where lawmakers have decided against expanding Medicaid coverage. According to rough estimates released Monday by federal health officials, cuts could jump to $4 billion in 2020, Hospitals around the country that treat a large number of uninsured residents rely on federal funds to offset costs.

Opinion: NC Medicaid Reform Must Keep Medical-Home Model
News & Observer - May 13, 2013
I am one in a group of eight pediatric providers who care for 38,000 patient visits per year, a signi?cant number of which are covered through the N.C. Medicaid program. While making Medicaid more efficient, the state must not out-source management to for-pro?t insurance companies. I remember the days before the medical-home model came to Medicaid, when patients went from provider to provider or ER to ER because there was no one provider identi?ed as a child's doctor. My partners and I eagerly welcomed the ?rst iteration of community-based care when the Carolina Access program began in the 1990s.

Most Doctors Still Reject Medicaid as Program Expansion Nears
News & Observer - May 13, 2013 (AP Story - National Pickup)
Sandra Duck thinks she's the victim of an undeclared Medicaid boycott. And she's probably right. When her artificial right hip became infected with the superbug MRSA in late 2009, Dr. Dale Mitchum, a general surgeon, drained, cleaned and closed the infected area. But when the infection returned in early 2010, Mitchum knew Duck needed another hip replacement surgery, which he couldn't perform. He tried to find an orthopedic surgeon who would operate.