Friday, 11 May 2012

Princess Health and Hopkinsville paper examines doctor shortage, reasons for it.Princessiccia

Albert Delaney waits for his wife Agnes in Hopkinsville.
(Photo by Kentucky New Era's Tom Kane)
Nick Tabor of the Kentucky New Era examines Christian County's doctor shortage, with the area averaging just one primary care physician for every 2,000 people. It's the latest health story in the small daily newspaper, which is committed to quality health reporting.

The shortage creates problems for residents, who must either travel to another area to see a doctor or go without preventive services because there is no one to see until serious illness occurs. When that happens, that "puts an undue burden" on the local hospital's emergency room.

The shortage is affected by the fact that "primary care physicians, which rural areas need in higher volumers than specialists, are entering the job market at alarmingly low rates," Tabor reports. "More medical students are becoming specialists, as these jobs promise better salaries and hours." Secondly, it is difficult to recruit doctors to rural areas. "Little old Hopkinsville is up against Boston and Chicago and all of these bigger cities," said Teresa Bowers, Jennie Stuart Medical Center's physician recruitment director. "They're not throwing darts at a map and saying, 'I'm going to Hopkinsville.'"

The problem is not a new one. A 2007 report by the Kentucky Institute of Medicine shows there have been shortage issues for decades. "Even if all the barriers that have prevented a sufficient and well-dispersed supply of physicians were suddenly to disappear, the task of recruiting and educating an ample cohort of doctors would take years to accomplish," it reads.

The problem is liken to worsen, however, if the federal health-reform law is upheld by the U.S. Supreme Court, as 30 million more Americans will have insurance to see the doctor. A recent report found medical school enrollment is up by 30 percent, but more residency placements are needed to accommodate the influx. (Read more)

Princess Health and Medicaid managed-care firm Coventry plans to stop paying for expensive drug that curtails addiction.Princessiccia

Coventry Cares, one of the four firms that manage patient care for the state Medicaid program, has once again hit the headlines, this time for its plans to stop paying for medicine that helps addicts keep their opioid addiction at bay. State officials quickly condemned the move Thursday and called it a contract violation, reports Beth Musgrave of the Lexington Herald-Leader.

Coventry decided to stop paying for buprenorphine, more commonly known as Suboxone, which helps curtain cravings for drugs such as Oxycontin and Vicodin. A 30-day supply of the drug can cost more than $450, Musgrave reports.

"They will be at risk for relapsing and going back to using illegal opioids," Dr. Michelle Lofwall, an addiction specialist and assistant professor at the University of Kentucky, told Musgrave. "Whenever you are using illegal opioids, there is a risk of overdose and death."

Coventry said it will no longer offer the coverage because only pregnant women, women who recently gave birth and those under the age of 21 are eligible for addiction treatment in Kentucky's Medicaid program. "What we've done is align our coverage with the cabinet's Medicaid policy," said Matt Eyles, a Coventry spokesman.

However, the state Cabinet for Health and Family Services said the decision violates the contract and "cannot take this unilateral action without the cabinet's approval," said Jill Midkiff, a cabinet spokeswoman. 

A company that operates addiction treatment centers across the state was planning to file suit over the move Friday, but, after learning of the cabinet's reaction, "We are going to give them the chance to work this out," Anna Whites, an attorney who represents SelfRefind.

Coventry already caused controversy this week when it informed Baptist Health System wants to renegotiate its contract. The move comes just a week after Coventry and Appalachian Regional Healthcare came to a temporary agreement after Coventry threatened to terminate its contract and ARH sued Coventry. The company has also told King's Daughters Medical Center in Ashland it will terminate its contract after May 26. (Read more)
Princess Health and Cancer battle of UK faculty member to air on KET.Princessiccia

Princess Health and Cancer battle of UK faculty member to air on KET.Princessiccia



A documentary chronicling a former University of Kentucky faculty member's battle with cancer will air six times in May on KET.

Nancy Clauder, an oboist whose research focused on arranging and performance, was diagnosed with multiple myeloma in 2008 when she went to the doctor with what she thought were symptoms of the flu. She was diagnosed with the disease, a rare, blood-related cancer with no cure. Clauder underwent a stem cell transplant, endured high-dose chemotherapy and lost her ability to play her instrument for six months, a UK press release says.

Eventually, she was able play again and recorded a CD with artists from UK and the Lexington Philharmonic. "This is the right time, and I'm so grateful that there was the opportunity to do it through UK, and a grant research program, because I would not be able to afford the musicians," she said.

The documentary "The Ascending Journey" will air at 4 p.m. and 10:30 p.m. May 13; at 10:30 p.m. Thursday, May 17 on KET2; midnight Monday, May 21 on KET2; 5 a.m. Monday, May 28 on KETKY; and 9:30 p.m. May 30 on KETKY. (Read more)

Thursday, 10 May 2012

Princess Health and 42 percent of Americans will be obese by 2030, study predicts.Princessiccia

If trends continue, 42 percent of American adults will be obese by 2030 and about one quarter of whom will be grossly obese, a new study warns. The results are only slightly less troubling than those published four years ago, which forecast that 51 percent of the population would be obese by 2030.

Right now, 34 percent of American adults are obese and some evidence indicates obesity rates have reached a plateau. "Regardless which is correct, we still have a very serious problem," said William H. Dietz, head of the Centers for Disease Control and Prevention's obesity program. The results were discussed Monday at the "Weight of the Nation" conference in Washington, D.C.

The study, published in the American Journal of Preventive Medicine, used obesity prevalence data from 1990 to 2008 to analyze trends. Information came from the widely regarded Behavioral Risk Factor Surveillance System, but because people tend to underestimate their weight when asked on the phone, a mathematical equation was used to compensate for the shortfalls, David Brown reports for The Washington Post. (Read more)
Princess Health and Without a partner, University Hospital's viability is 'questionable at best,' consulting group concludes.Princessiccia

Princess Health and Without a partner, University Hospital's viability is 'questionable at best,' consulting group concludes.Princessiccia

University Hospital in Louisville needs a partner that will help it grow, a consulting firm informed a committee reviewing the facility's operations Wednesday. "Even with operational and strategic improvements, the economic viability of University Hospital is questionable at best," they said.

"While the organization is working very hard to make improvements ... the gap between where you are as an organization and where you need to get to be a viable organization is very steep," said consultant Craig Anderson Sr. of Dixon Hughes Goodman of Hudson, Ohio. "At the end of the day, any organization need an access to capital."

Laura Ungar of The Courier-Journal notes that the findings are in keeping with University Hospital's search for a partner, which it has long been looking to find. Last year, Gov. Steve Beshear nixed plans for the publicly-owned hospital to join, among others, a Catholic-based organization that would have limited some procedures it could offer because of the organization's religious tenets.

University Hospital has delayed its selection of a new partner until the end of June to give more time for negotiation.

"The two major conclusions are what the university would like to have heard: That partners and capital are needed," said Dr. Peter Hasselbacher, a merger critic and former professor of medicine at U of L who attended the meeting. "We need to ask: How did we get here?" (Read more)

Princess Health and Managed-care firm Coventry threatens to terminate contracts of Baptist Healthcare and big Ashland hospital.Princessiccia

Lexington Herald-Leader photo by Charles Bertram
Issues with the state's managed-care companies continue to mount. Now Coventry Cares has told Baptist Healthcare System, which has hospitals in Lexington, Louisville, La Grange, Paducah and Corbin, that it wants to renegotiate its contract. 

The move comes just a week after Coventry and Appalachian Regional Healthcare came to a temporary agreement after Coventry threatened to terminate its contract and ARH sued Coventry. The managed-care firm has also told King's Daughters Medical Center in Ashland it will terminate its contract after May 26.

Kentucky moved its Medicaid population to managed care Nov. 1, a move that is expected to save the state a lot of money. The three managed-care organizations that coordinate care for Medicaid recipients outside the Louisville area are paid on a per-month, per-patient basis, regardless of what care is needed. Coventry alleges "that it has too many high-risk patients and that the state needs to adjust the risk model so Coventry can receive more money for sicker patients," report Beth Musgrave and Valarie Honeycutt-Spears for the Lexington Herald-Leader.

Unlike the state's other two managed-care companies, Kentucky Spirit and Well Care, Coventry "opted not to charge patients a co-pay for pharmacy services. That business decision meant it got more people into the system who likely had more complicated health problems," Musgrave and Honeycutt-Spears report. House Speaker Greg Stumbo has questioned the move not to charge a co-pay and wondered if it was akin to Medicaid fraud. (Read more)
Princess Health and Former head of Massachusetts health exchange says it's better to offer fewer, well-defined plans than set general criteria.Princessiccia

Princess Health and Former head of Massachusetts health exchange says it's better to offer fewer, well-defined plans than set general criteria.Princessiccia

With  Kentucky stakeholders discussing their options to set up a state-run health insurance exchange � something Gov. Steve Beshear said last week he intends to do if the Affordable Care Act is upheld by the U.S. Supreme Court � research shows the fewer plans offered in the exchange, the better.

An article in Health Affairs says officials should follow the lead Massachusetts' health-reform system when creating their own exchanges. "A hands-on exchange with the power to set standards on top of the federal health-care law will help prevent consumers from being 'overwhelmed' by the process of buying insurance," reports Sam Baker for The Hill's global affairs blog.

The Health Affairs article's lead author, Rosemarie Day, is a former deputy director of the Massachusetts exchange. She said consumers prefer choosing from "a handful of carefully vetted, clearly described health-care plans," Baker reports. The model used in Utah to allow any plan that meets criteria to be featured in the exchange is less popular, the paper found, but was more popular among conservatives.

"Findings from consumer research emphasized the value of limiting insurance plan choices on the exchange," the analysis states. "Specifically, early focus groups showed that consumers wanted four to six carrier options at 'low, medium and high' benefit levels." (Read more)