Princess Health and Kentucky's life expectancy, a basic measure of health status, is 76; it fluctuates as many as 9 years from county to county. Princessiccia

Princess Health and Kentucky's life expectancy, a basic measure of health status, is 76; it fluctuates as many as 9 years from county to county. Princessiccia

county health health care life expectancy

Gusty 12:19 Add Comment

By Danielle Ray

Kentucky Health News

A life lived in Kentucky is expected to vary up to nine years in length depending on the county in which it's spent.

Life expectancy is perhaps the most basic measure of a community's overall health. Health researchers say life expectancy is driven by a complex web of factors that influence health: opportunities for education and jobs, safe and affordable housing, availability of nutritious food and places for physical activity, and access to health care, child care and social services.

The state average is 76 years. Twenty-four of 120 Kentucky counties exceed that figure, mostly in the counties near Louisville, Lexington, Frankfort, Bardstown, Elizabethtown, Owensboro and Bowling Green, with a few exceptions. Oldham County has the state's highest life expectancy, 79 years. Nine counties (Fayette, Jessamine, Scott, Garrard, Shelby, Bullitt, Meade, Boone, and Calloway) share a life expectancy of 78.

Differences become more apparent moving east along the Bert T. Combs Mountain Parkway and down its KY 15 extension. In general, the starkest comparisons in the state exist between the metropolitan areas of Louisville and Lexington versus southeastern Kentucky counties. Only one Eastern Kentucky county, Morgan, has a life expectancy equal to the state�s. Others range from 70 (Perry, Breathitt and Wolfe counties) to 75, mostly found in counties in northeastern Kentucky.

Eastern Kentucky counties are not the only ones with below-average numbers. Other counties ouitside that region with life expectancies of 74 or below are Fulton, Webster, Muhlenberg, Gallatin, Carroll, Casey, Monroe, Metcalfe, Cumberland and Clinton.

The numbers are on a Kentucky life expectancy map released Monday by researchers at the Virginia Commonwealth University Center on Society and Health and the Robert Wood Johnson Foundation. It shows that chances to lead a long and healthy life can vary dramatically by county.

�Health differences between communities are rarely due to a single cause,� the researchers said in a press release. �The health differences shown in these maps aren�t unique to one area. We see them in big cities, small towns, and rural areas across America,� said Derek Chapman, the VCU center�s associate director for research.

The map is the latest effort by the Robert Wood Johnson Foundation to raise public awareness of the many factors that shape health, particularly social and economic factors.

Another is the County Health Rankings, done annually by the University of Wisconsin Population Health Institute. The rankings don�t provide a comprehensive explanation for life expectancy, but they provide helpful correlations.

For example, Harlan County, with a life expectancy five years below the average, ranks 117^thin overall health outcomes and last in health factors. The county has rates of smoking, obesity and teen births that are higher than statewide. It also has less access to exercise opportunities. The rankings show that the county's unemployment rate is nearly 14 percent, more than double the state's. In addition, 43 percent of Harlan County children live in poverty, compared to the statewide figure, 26 percent.

The complete rankings are available at the County Health Rankings web site.

The state Department for Public Health says it and partners have several efforts underway to tackle the many factors that shape health:

�          Promotion of farmers� markets and their acceptance of federal food assistance benefits such as SNAP, WIC and Senior Farmers� Market Nutrition Program Vouchers, incentive programs to help with affordability and community outreach.

�          Promotion of walking and walkability by providing communities with targeted training and technical assistance to develop pedestrian plans.

�          Protecting youth from tobacco exposure through the �100 percent Tobacco Free Schools� program, which provides guidance to districts that wish to reduce tobacco use by students and staff.

Experts say local efforts are needed, too. �We must build a society where everyone, no matter where they live, the color of their skin, their financial or family situation, has the opportunity to lead a productive, healthy life,� said RWJF President and CEO Risa Lavizzo-Mourey.  �There�s no one-size-fits-all solution. Each community must chart its own course, and every person has a role to play in achieving better health in their homes, their communities, their schools and their workplaces.�

Princess Health and Feds strengthen anti-discrimination health rules. Princessiccia

Princess Health and Feds strengthen anti-discrimination health rules. Princessiccia

disabilities federal regulation gender disparities health health care health care access health care reform health communication obamacare Patient Protection and Affordable Health Care Act

Gusty 13:20 Add Comment

Photo from mdxipe.wordpress.com

By Danielle Ray
Kentucky Health News

The Department of Health and Human Services issued rules Friday in an effort to ensure equality in health care for women, the disabled and people who speak English as a second language.

The new provisions protect women from discrimination not only in the health coverage they obtain but in the health services they seek from providers. They also prohibit denial of health care or health coverage based on a person's sex, including discrimination based on pregnancy, gender identity and sex stereotyping.

The rule also requires providers to take reasonable steps to provide communication access to people with limited English proficiency. In addition, it requires that providers make electronic information and newly constructed or altered facilities accessible to individuals with disabilities, including providing auxiliary aids and services.

HHS Secretary Sylvia Burwell called the rule "a key step toward realizing equity within our health care system." She said in an agency news release that it reinforces the central goal of the Patient Protection and Affordable Health Care Act, to improve access to quality health care.

The rule covers any health program or activity that receives federal funding, such as providers who accept Medicare or Medicaid; any health program that HHS administers; and federal- and state-based health insurance marketplaces and insurers that participate in them.

The new rule implements Section 1557 of the 2010 health-reform law, which is the first federal civil-rights law to prohibit discrimination based on sex in federally-funded health programs. Previously, civil rights laws enforced by the agency's civil rights office barred discrimination based only on race, color, national origin, disability, and age.

The rule does not resolve whether discrimination on the basis of an individual�s sexual orientation status alone is a form of sex discrimination under the reform law. However, the provisions leave room for the agency's civil-rights office to evaluate complaints that allege sex discrimination related to a person�s sexual orientation to determine if they can be considered sex stereotyping, which the rule prohibits. In cases where religious freedom would be violated, health-care providers are not required to follow the regulation.

A summary of the new rule can be accessed here.

Princess Health andBaptist Health is first stand-alone health provider to become founding partner of Shaping our Appalachian Region effort.Princessiccia

Princess Health andBaptist Health is first stand-alone health provider to become founding partner of Shaping our Appalachian Region effort.Princessiccia

Appalachia Central Baptist Hospital economy governor health care

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Baptist Health has become the first stand-alone health-care provider to sign on as a founding partner in Shaping Our Appalachian Region, an initiative to improve the economy of Eastern Kentucky.

Baptist will work with SOAR to develop and implement health and education initiatives for residents of Appalachian Kentucky and has committed $150,000 to the initiative over the next three years, the organizations said in a press release.

�Baptist Health understands Eastern Kentucky because we have a proven and time-honored commitment to the health and well-being of our people,� Stephen C. Hanson, chief executive officer of Baptist Health, said in the press release. �Our participation in SOAR reflects this pledge. Besides Richmond, we�ve also got hospitals in Corbin and Lexington, along with outpatient facilities, doctors� offices and other services all over Eastern Kentucky, the rest of the commonwealth and indeed throughout the region."

The University of Kentucky was the first founding sponsor of SOAR, pledging $300,000 over the next three years and winning the right to use the UK HealthCare brand on SOAR materials as well as the university's general logo.

Gov. Steve Beshear and Congressman Hal Rogers formed SOAR in the fall of 2013 to create strategic plans to improve Eastern Kentucky's economy and quality of life.

�Our primary objective is creating and maintaining jobs across eastern Kentucky, and in order to do that, we need a healthy and well-educated workforce,� Beshear said in the release. �I�m pleased that Baptist Health understands the key connections among our efforts and the critical role that health will play in the future of this region."

Princess Health andHealth reform law drives a trend to include lifestyle changes in a patient's health care plan, alongside traditional medicine.Princessiccia

Princess Health andHealth reform law drives a trend to include lifestyle changes in a patient's health care plan, alongside traditional medicine.Princessiccia

health care Patient Protection and Affordable Care Act prevention

Gusty 16:23 Add Comment

Lifestyle changes can play a huge role in treating and warding off many health conditions and thanks to the Patient Protection and Affordable Care Act there is now a shift to include helping people make these changes part of their health care plan, Laura Ungar reports for The Courier-Journal and USA Today.

In the first of an occasional series called "HealthVoices" that focuses on "areas where policy, public health and people intersect," Ungar tells the story of Kevin French, who self-describes himself as "the quintessential unhealthy Kentuckian" and how lifestyle changes have made a difference in his health.

French tells Ungar that with the help of medical professionals and The KentuckyOne Healthy Lifestyle Center in Louisville he has "learned how to eat well, handle stress, exercise and "basically change everything."

"My medicine usage has declined somewhat. I'm still on medicines but not the dramatic type like I was. Some of them's been cut in half," French told Ungar. "Several costs of medicines have declined dramatically."

The center provides "medically supervised exercise, nutrition counseling, stress management and classes in disciplines such as yoga" and is the third such facility the medical system has opened in Louisville, Ungar writes.

Experts say that the ACA is driving this "colossal shift" in health care away from the "traditional reliance on pills and procedures by patients as well as the American medical system," Ungar writes, but she also notes that the patient must also make a commitment to these lifestyle changes if it is to work, as French has.

A cardiologist at the center, Paul Rogers, told Ungar about the importance of lifestyle changes, especially exercise. in warding off cardiovascular disease, one of the state's biggest killers.

"Compared to even the best medical therapy, we can decrease heart attacks, strokes and deaths by between 35 and 45 percent by changing lifestyle. The thing I see that holds people back most probably is effort and fear," Rogers told Ungar. "The recommendations these days are 30 minutes of�aerobic activity six times a week. I think if people started devoting themselves to that, that would change the health of our state dramatically."

Princess Health and Princess Health andMost Kentucky Medicaid members are allowed to switch managed-care organizations until June 18.Princessiccia

Princess Health and Princess Health andMost Kentucky Medicaid members are allowed to switch managed-care organizations until June 18.Princessiccia

health care managed care Medicaid

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Kentucky citizens with traditional Medicaid coverage may switch to a different managed-care organization (MCO) until June 18, Kentucky Voices for Health Board Chair Sheila Schuster notes in a press release.

The option is open to traditional Medicaid members enrolled with Coventry/MH Net or WellCare, except those in Region 3 (Jefferson and 15 area counties). Switching is voluntary. If members take advantage of the option, coverage with any new MCO will start July 1.

Until June 18 eligible Medicaid members can switch to Humana-CareSource, Passport Health Plan, Anthem Health Plans, CoventryCares/MH Net or WellCare. To learn details about each of the MCOs call 1-855-446-1245 or click here or here.

Eligible members can change MCOs by calling 1-855-446-1245 between 8 a.m. and 5 p.m. EDT and speaking with a Medicaid member representative. They should be prepared to give the birthdate and Social Security number of each person listed on their letter from Kentucky Medicaid. (Read more)

Princess Health and Princess Health andHumana Inc. bus travels the rural roads of Mississippi, looking to enroll people in Obamacare by March 31 deadline.Princessiccia

Princess Health and Princess Health andHumana Inc. bus travels the rural roads of Mississippi, looking to enroll people in Obamacare by March 31 deadline.Princessiccia

health care health care access health insurance health journalism health reform obamacare obesity Patient Protection and Affordable Care Act poverty rural health

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Insurance providers have been scared off by Mississippi, one of the poorest and unhealthiest states in the country. Only nine percent of eligible residents have signed up for insurance under federal health reform, ranking Mississippi near the bottom of all states in Obamacare, with only 25,554 residents having signed up as of early March.

Politico photo by Madeline Marshall: Humana bus

Louisville-based insurance company Humana Inc. is attempting a unique way to try to get Mississippi residents signed up. The company has a bus that travels the state, having made more than 200 stops "pulling into hospital parking lots and Wal-Mart shopping centers, parking at churches large and small and hitting other obvious targets to find and convince the uninsured that President Barack Obama�s signature health achievement will benefit them," Jennifer Haberkorn reports for Politico. "Sometimes the company�s agents see dozens of people per stop. Other times, just a few individuals climb aboard."

Mississippi is the only state where Humana has a bus, Haberkorn writes. "It�s also the only state where the company is covering the co-pay for customers� first doctor�s visit before June, immediate cash savings that it hopes will get people to start a relationship with a primary-care physician. Officials declined to say exactly how much is being spent on the dual strategies."

Based on the dismal number of residents signing up, the bus hasn't exactly been a hit. Part of the problem is that rates in Mississippi are the third highest in the country, and that Humana is only one of two insurers in the state. "Despite all the political rhetoric about a government-run health program, Obamacare relies on private insurers to sell policies on the state and federal exchanges. If there�s no insurance company, then there�s really no Obamacare," Haberkorn writes. "And Mississippi is one of the last places the typical risk-averse health insurance company would choose to sell policies under the law. Statistically, it�s one of the unhealthiest states, topping the charts in all kinds of negatives such as obesity, diabetes, hypertension and cardiovascular disease � conditions that can be stabilized with treatment or kill without."

"But Humana has every incentive to sell as many policies as possible," Haberkorn writes. "The math involved is simple: Insurance works when there are more people enrolled, which spreads the risk of high costs across hundreds or thousands of customers. To succeed in a state like Mississippi, it had to go all out to get customers."

Humana originally offered policies in only four counties, but the state insurance commissioner persuaded it to go to 40. The company's Mississippi market director, told Haberkorn, �Back in August, when we added on an additional 36 counties, we had to act really quickly on how we would get to all of the people in those counties at such a last minute. Operating this mobile tour has allowed us to get to people, instead of waiting for them to come to us.� (Read more)

Princess Health and Princess Health andHospitals try to do more with less while not compromising quality as they adjust to changes in the health-care marketplace.Princessiccia

Princess Health and Princess Health andHospitals try to do more with less while not compromising quality as they adjust to changes in the health-care marketplace.Princessiccia

health care health reform hospitals Medicaid obamacare Patient Protection and Affordable Care Act

Gusty 15:50 Add Comment

A. B. Chandler Medical Center at the University of Kentucky

Hospitals are laying off employees and cutting budgets because of changes in the marketplace and the ways consumers seek care, Editor Mark Green reports in an in-depth article for The Lane Report.

Now that consumers are paying more direct costs, they are paying more attention to prices and more likely to use out-patient procedures, which are cheaper, Green writes. Also, consumers are increasingly using wellness programs to avoid health problems, and "Taxpayer-funded government compensation models are making better medical outcomes and financial efficiency important bottom-line issues."

Less inpatient treatment means fewer employees are needed at Kentucky hospitals, but not all are financially burdened, Green reports; those who provide the best service at the least cost are increasingly reaping the profits.

While the Patient Protection and Affordable Care Act may make care more affordable, it also "puts pressure on health-care providers to keep costs in check,� Carl Herde, chief financial officer for Baptist Health, told Green. �However, many of the issues facing health care were in place before the ACA came into effect.�

Dr. Michael Karpf, administrator of UK HealthCare since 2003, told Green that hospitals are adjusting from a model that was based on volume to one that is based on value. Karpf has said for years that the "health-care industry is on an unsustainable financial course."

�There is a real need to decrease utilization to get healthcare costs under control. It just puts pressure on institutions,� Karpf told Green. �We won�t be doing business the same old-fashioned way we�ve been doing it.�

Some hospitals are still showing a healthy profit, but are also cutting costs and looking for increased efficiency, like UK HealthCare, whose $920 million hospital budget is producing a seven to eight percent cash flow, Green reports. But KentuckyOneHealth expects a $218 million deficit in its $2.5 billion budget, laid off 500 of its 15,000 workers last month, says that it won't fill 200 openings and will close the emergency room at Medical Center Jewish Northeast in Louisville on April 1. The company told Green that it might close an entire hospital, without telling which one.

KentuckyOne CEO Ruth Brinkley told Green, �The recession has come to health care, and that is causing the industry to transform. There are many causes for the changes, among them: the economy, reduced payments from government and commercial payers, increasing consumerism, and shifts in how care is organized and delivered. We have seen large and respected healthcare organizations announcing restructuring, budget cuts and layoffs. Among them are Vanderbilt University Medical Center and Cleveland Clinic. This situation is even more acute in Kentucky, with steep declines in inpatient volumes.�

Baptist Health, a Louisville-based system that has the most hospital beds in Kentucky, had a $22 million operating loss in fiscal 2013, but $78 million in investment income erased that deficit, Herde told Green: �There is increasing pressure for hospitals to do more with less without sacrificing quality, so we are exploring creative ways to contain costs, but we are financially sound now � and we are confident that we will remain so in the future.�

Owensboro Health's hospital (HGA.com photo)

When the state turned management of Medicaid over to insurance companies, that created higher administrative costs for hospitals, said John Hackbarth, chief financial officer for Owensboro Health, which in 2013 opened a $385 million medical center.

�After movement to a managed-care model, we have five insurance plans, plus some patients remaining on Kentucky Medicaid indemnity,� Hackbarth said. �This has increased costs in many areas such as contracting, compliance, billing, IT and case management because we are dealing with five times the amount of rules and hoops to jump through for a slower payment and ultimately less reimbursement.�

State officials say the expansion of Medicaid under health reform, to those with incomes up to 138 percent of the federal poverty level, is forecast to bring Kentucky providers an extra $15 billion for care and create 17,000 new jobs. But not yet.

Green reports that the most common response from five major hospital operators was that "Medicaid expansion eventually should lower their annual charity care and bad-debt burden, which is hundreds of millions of dollars." But first they are focused on adjusting their services to meet an increased demand for care by the formerly uninsured.

The Louisville region's biggest provider, non-profit Norton Healthcare expects that when the federal subsidy for expanded Medicaid is reduced, to 90 percent, the state will have to cut the number of Medicaid enrollees or reimbursements to providers. The reform law's overall impact to date, Gough said, is �decreases in Medicare reimbursements.�