Princess Health and U of L dean says $50 billion in annual health costs could be saved if Americans just walked more.Princessiccia

Princess Health and U of L dean says $50 billion in annual health costs could be saved if Americans just walked more.Princessiccia

chronic disease dental care dental health exercise physical activity public health smoking smoking ban tobacco tobacco prevention

Gusty 10:38 Add Comment

Small changes in health behavior can have a huge impact on the public's overall health and well-being, and during National Public Health Week discussions last week, Dr. Craig Blakely, the new dean of the University of Louisville School of Public Health and Information Sciences, talked about the important role played by public health in promoting healthy behavior, preventing disease and saving both lives and money.

Blakely pointed to obesity as an example of an emerging health-related crisis, which can be addressed with behavioral changes that make a significant difference like adding more physical activity to your day, according to a U of L release.

�If we all took exercise seriously by just walking, we could save $50 billion in cardiovascular disease-related costs,� Blakely said. �A 10 percent weight loss equals a $5,000 savings in health-related complications. A typical desk worker could lose a pound a month by standing two hours a day.�

Blakely also addressed smoking bans, which are becoming popular in Kentucky, even though the state has the highest share of smokers (29 percent) of any state, leads the nation in high-school smokers (24 percent) and spends only a minuscule portion of its tobacco revenues to fight tobacco use, according to the Centers for Disease Control and Prevention.

If every state adopted comprehensive smoke-free policies, said Blakely, $2 billion would be saved in smoking-related deaths, lung cancer treatments and care for related health complications over the course of several years, says the release.

Blakely highlighted several other examples of public health�s potential return on investment. For example, says the release, every dollar spent on childhood immunizations saves $18 on vaccine-preventable disease-related costs, every dollar spent in prenatal care translates to $6 in health care cost savings and for every dollar spent on fluoridated water saves $20 in dental care.

Public health research will continue to find effective ways to generate these cost savings, such as finding researching how to modify environments to encourage exercise or how to send strong messages that promote regular physical activity (Read more)

Princess Health and Beshear vetoes prompt-pay bill but takes several steps to address problems in Medicaid; he and Haynes say it's working.Princessiccia

Princess Health and Beshear vetoes prompt-pay bill but takes several steps to address problems in Medicaid; he and Haynes say it's working.Princessiccia

General Assembly governor health care costs health insurance legislature managed care Medicaid prevention

Gusty 12:10 Add Comment

Gov. Steve Beshear has vetoed the bill designed to make Medicaid managed-care firms pay health-care providers more quickly, but is taking administrative steps to address the issue.

Beshear said he agreed with the intent of House Bill 5 but it might have interfered with the contractual relationship between the state and the four managed-care companies. The bill would have subjected that relationship to the state Department of Insurance's review and investigation process for private-insurance payment complaints. 

"That language would have resulted in excessive costs for state government and taxpayers due to the expansion of the review process beyond the current parameters used for private insurance," Beshear's office said in a press release.

Instead, Beshear ordered the department to take over responsibility for review of prompt-payment complaints from the Department for Medicaid Services. "If improper payment practices are discovered, DOI can impose sanctions," the release said. He also ordered the department to audit each of the managed-care firms operating statewide � Wellcare, Coventry Cares, and Kentucky Spirit � at their cost.

Meanwhile, the firms have agreed to meet with every hospital they have under contract to reconcile outstanding accounts.  "This effort will begin immediately and continue until every hospital�s accounts receivable has been reconciled," the release said.  "The results will . . . be made public, in order to provide transparency and accountability." The firms have  agreed to meet with any other provider who wants a meeting.

Also, the Cabinet for Health and Family Services will hold eight regional forums for providers, managed-care firms, and Insurance Department representatives to discuss concerns and how to improve the system. Part of this effort will focus on "emergency room management that meets community needs without an ER operating as a de facto primary-care office," the release said. "A key component of controlling costs and improving health in a healthcare system is to provide the right treatment in the most cost-effective setting."

CHFS Secretary Audrey Tayse Haynes said the switch to managed care, made in November 2011, is working. �We are already seeing a tremendous increase in the use of preventive services, which improve health-care outcomes, while also reducing the enormous costs for treating chronic health conditions� such as diabetes-related amputations, she said.

Beshear said his plan would solve "lingering implementation problems" with managed care "while preserving the significant improvements in patient care and health care cost savings."

"Getting our people healthy and keeping them that way is not just good health policy, it�s good economics," Beshear said. "That�s why we will never return to the old fee-for-service system.  This is a significant cultural shift in medical care that has already happened across the country in both the private insurance market and in the Medicaid system."

Princess Health andH+P at the 2013 ATB.Princessiccia

Princess Health andH+P at the 2013 ATB.Princessiccia

Gusty 14:58 Add Comment

The team had a great showing at the 2013 Around the Bay Race.  Here is a quick summary of the team results!  For full results click HERE.

Luke:1:58:50.4
Lucas: 2:01:09.1
Jordan: 2:10:24.1 (Including a new 5K PB!)
Aaron:2:14:17.1
Mike P: 2:26:55.7
Helen: 2:46:25.7
Jeremy: 3:01:32.4
Jessica: 3:12:20.4
Natalie: 3:18:50.8

Princess Health and Confused or concerned about the impact of health reform on Kentucky businesses? There's a seminar for that..Princessiccia

Princess Health and Confused or concerned about the impact of health reform on Kentucky businesses? There's a seminar for that..Princessiccia

health care health care access health care costs health care law health care reform health reform insurance insurance exchange

Gusty 11:13 Add Comment

To address possible confusion or concern of business people and the public about the Patient Protection and Affordable Care Act, or "Obamacare," health-care reform experts will address its impact on small and large companies across Kentucky at half-day seminars in Lexington and Louisville on May 8 and 9.

The Kentucky Health Care Reform Seminar will include specific discussions about expected cost increases and tax implications for businesses once reform is implemented, including the role of the health insurance exchange and the changing ways that coverage premiums will be determined. The seminar will be presented by The Iasis Group Inc., The Lane Report and the Kentucky Chamber of Commerce, says a chamber release.  

Guidance to employers will be provided on complying with the new rules surrounding insurance reforms and insight to whether Kentucky companies can truly afford it. The seminar is part of a statewide partnership that includes Commerce Lexington, Greater Louisville Inc., the Kentucky Society for Human Resource Management and the Northern Kentucky Chamber of Commerce (Click here for more details or to advance register)

Princess Health and Death rates for heart and pneumonia patients at critical-access hospitals are rising nationally, study finds.Princessiccia

Princess Health and Death rates for heart and pneumonia patients at critical-access hospitals are rising nationally, study finds.Princessiccia

critical access hospitals Medicaid Medicare research rural health

Gusty 11:12 Add Comment

Death rates are rising at rural critical-access hospitals for Medicare patients who have heart attacks, heart failure and pneumonia, according to a study published in the Journal of the American Medical Association.

Hospitals designated as critical-access get slightly higher Medicsare and Medicaid reimbursements in exchange for limiting their size, procedures and patient stays. In 2002, they had a death rate of 12.8 percent for such ailments, under the 13 percent rate at other hospitals. But from 2002 to 2010, mortality rates at critical-access hospitals increased 0.1 percent each year, to 13.3 percent, while the rates at other hospitals fell 0.2 percent each year, to 11.4 percent.

There are 1,331 hospitals in the critical access program, Jordan Rau reports for USA Today. "Congress started the critical access program in 1997 to stave off hospital closures in places where patients had no good alternative because the next hospital was at least 35 miles away by regular roads or 15 miles by secondary roads. To qualify hospitals need 25 or fewer beds."
 
The authors of the study "suggested that the hospitals' care may suffer because they don't have the latest sophisticated technology or specialists to treat the increasingly elderly and frail rural populations," Rau reports. "Since hospitals are not required to submit performance evaluations to Medicare, the government may not realize that facilities could need additional assistance in caring for sicker patients."

Brock Slabach of the National Rural Health Association told Rau that the statistics don't always tell the complete story and that "The association's own research has found that rural hospitals do better in patient satisfaction surveys than do urban hospitals," Rau writes.

Princess Health and It's Autism Awareness Month; do you know the warning signs?.Princessiccia

Princess Health and It's Autism Awareness Month; do you know the warning signs?.Princessiccia

autism children children's health public health

Gusty 19:27 Add Comment

The University of Kentucky hosted the state's first Light It Up Blue event by illuminating Memorial Hall with blue lights on April 2nd, and this event is a unique global initiative that kicks-off Autism Awareness Month and helps raise awareness about autism.

This is the sixth year for Light It Up Blue, but the Autism Society has been celebrating National Autism Awareness Month since the 1970's in order to highlight the need for awareness about autism. Autism is increasing in prevalence, and according to a recent report by the Centers for Disease Control and Prevention, 1 in 50 school-age children in the United States has autism; that number increased from 1 in 88 in 2012.

Autism is defined by a certain set of behaviors and is a spectrum disorder that affects individuals differently. Typically, autism appears during the first three years of life and affects a person�s ability to communicate and interact with others, says the CDC. While there is no known single cause of autism, it is treatable, and studies show that early diagnosis and intervention lead to significantly improved outcomes for families.

With individualized interventions, says the CDC, parents can minimize challenges their child faces. From birth to 5 years, children should reach certain milestones in how he or she plays, learns, speaks and acts, and delays in any of these areas could be a sign of a developmental problem. Therefore, it is important to talk to a doctor as soon as possible children display some of the warning signs below.

From the CDC's Learn the Signs, Act Early campaign

Kentucky is one of 12 states with existing autism care insurance requirements, meaning that private insurance must cover autism treatment. Fortunately, there are many treatment options for autism in Kentucky that can generally be divided into four categories: behavioral and communication approaches, dietary approaches, medication and alternative medicine approaches. Click here for a full list of treatment resources or here for more Autism signs and symptoms.

In addition to when a parent is concerned, the American Academy of Pediatrics recommends that children be screened for general development using standardized, validated tools at 9, 18, and 24 or 30 months and for autism at 18 and 24 months. While autism spectrum disorders occur in all racial, ethnic and socioeconomic groups, they are almost five times more common among boys than girls, says the CDC.

In order to make sure your child reaches his or her full potential, it is very important to get help as soon as possible if your child shows concerning symptoms, according to the CDC's Learn the Signs, Act Early campaign.

Princess Health and UK Healthcare says it must get even bigger, and expand its market area, to provide needed services to Kentucky.Princessiccia

Princess Health and UK Healthcare says it must get even bigger, and expand its market area, to provide needed services to Kentucky.Princessiccia

cardiac care health care health care access health reform heart transplant liver transplant lung transplant neurosurgery surgery

Gusty 08:15 Add Comment

By Molly Burchett and Al Cross
Kentucky Health News

The University of Kentucky's health-care system has grown by leaps and bounds in the last decade, becoming one of the state's largest businesses, but its boss says it must expand its geographical reach to maintain its newly raised national status and to ensure access to quality care for Kentuckians.
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Over the last decade, UK HealthCare�s caseload has increased 85 percent, and its annual hospital budget has increased from $300 million to $922 million, Dr. Michael Karpf, executive vice president for health affairs, said in an interview.

This explosive growth, in addition to the growth of the UK medical school, has jacked up the enterprise's national ranking. It has grown from about the 85th largest academic hospital in the U.S. to approaching the 35th largest in terms of total discharges, the benchmark it uses. That means it has jumped from the bottom third to the top third in less than a decade. (For a more precise measurement over time, based on a Council of Teaching Hospitals standard, see chart.)

The push for growth and development began in 2003, after UK's caseload hit a plateau even though the 1998 General Assembly had mandated it to become a top 20 public research institution. Karpf came aboard and combined the Chandler Medical Center, clinics, faculty practice plans and the College of Medicine into a single integrated system of care -- branded as UK HealthCare -- which he commands. Good Samaritan Hospital in Lexington was added in 2007.

"Ten years ago people viewed this a safety-net hospital," Karpf said of the Chandler facility. "We've had to redo the brand." Now more people are choosing the hospital, as suggested by who's paying the bills. Medicare now covers a plurality of the patients; a decade ago, it trailed Medicaid, the program for the poor and disabled. In that time, the total caseload grew 7.2 percent; Medicare cases rose 10.9 percent.

But despite the huge growth in the last decade, the enterprise is still not big enough, Karpf said.

"We want the hospital to be the first choice when it comes to complex care,� he said. �We must advance to better serve the health-care needs of Kentucky.� To do this, he said, UK HealthCare is rejuvenating its brand as "Kentucky's Best Hospital," with a broad range of advanced specialties to keep Kentuckians from leaving the state for care, and is moving to expand its geographic reach to Western Kentucky and out-of-state markets.

Karpf said UK must expand because its traditional market, approximately the eastern half of the state, is not large enough to provide the number of cases that UK will need to receive certification as a federal �Center of Excellence� for complex services like brain surgery and heart, liver, kidney and lung transplantation. He said such a designation will be necessary to get enough referrals from doctors and smaller hospitals to maintain these services and to guarantee that Kentuckians can get the care they need inside the state. "What we make money on is the complex stuff," he said.

Unless UK secures half the available business from out-of-state competitive areas over the next 10 years, Karpf said, "It becomes an issue of access for Kentuckians."

He said the out-of-state institutions that are large and advanced enough to effectively compete with UK as a major referral center include Vanderbilt University, Washington University in St. Louis, Indiana University, Ohio State University, Cleveland Clinic, the University of Pittsburgh Medical Center and the University of Virginia. Vanderbilt is the nation's 10th largest academic medical center and gets many patients from Western and Southern Kentucky. ???

UK HealthCare map shows out-of-state markets and institutions it targets for its expansion.

What about Louisville, Cincinnati, Knoxville and other cities? Karpf said the University of Louisville, the University of Tennessee, the University of Cincinnati and West Virginia University are too small and too far behind to be Centers of Excellence. U of L's hospital ranks 88th in total discharges among academic medical centers.

All hospitals are facing challenges from federal health-care reform, but Karpf said at UK it has prompted a culture change centered on quality of care, which the reform law is designed to reward. As UK tries to expand its market, he said, it is critical to stay focused on, safety, service and patient satisfaction. One issue Karpf is dealing with now is the hospital's cardiothoracic surgery program for children, which has been suspended pending an internal review.

As UK seeks more referrals, Karpf said, it is building better relationships with smaller hospitals. "in the past, academic medical centers have been seen as predatory," he said. "We concluded that we need to be seen as in another line of business. . . . We have very strong relationships with community hospitals in Western Kentucky."

For example, UK is  training a cardiologist who is dedicated to practicing in Paducah once his training is complete, and kidney specialists from the area are in its transplant network. The specialists evaluate patients, send them to Lexington for transplants, and provide follow-up care upon their return. Such coordination helps community hospitals keep patients and recruit professional staff, and helps UK capture the cases it might lose to Vanderbilt and other out-of-state hospitals.

Baptist Hospitals Inc. has a large facility in Paducah and recently bought the Trover Health System hospital in Madisonville, making Baptist the largest hospital system in Kentucky, but Karpf said UK has a strong relationships with Baptist and the Norton Healthcare hospitals in Louisville. "They do not compete with us for complex care," he said. "We don't go after the bread-and-butter cases."

Complex care, for which insurance companies pay well, accounts for 5 to 7 percent of UK's cases but almost all its profits. Karpf said UK loses money on another 5 to 7 percent and breaks about even on the rest. He said the profits are invested in buildings, technological equipment and attracting nationally recognized specialists.

The most visible evidence of that is the hospital's new bed tower, part of $1.4 billion UK Healthcare has spent revitalizing itself, mostly with its own profits. But the larger impact is probably in expansion of good-paying jobs.

Dr. Michael Karpf

"We've been the most important growth engine in this region," said Karpf. UK HealthCare went from paying $350 million in salaries and benefits in 2004 to more than $700 million last year. The College of Medicine went from 1,810 employees in 2004 to 2,337 in 2012. The hospital grew from 2,562 full time employees in 2004 to 5,544 in 2012, a 116 percent increase.

The medical school's full-time faculty has expanded from 443 a decade ago to 625 now. "We know the stronger you are clinically, the better your research profile," Karpf said. UK Healthcare hopes to achieve National Cancer Institute designation for the Markey Cancer Center, and it must continue to evolve in its clinical, education and research missions, Karpf said.

If UK HealthCare can do that, it will continue to be a major economic driver for Kentucky while ensuring that all Kentuckians have access to quality care.

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.