Health reform means ER use jumps in Colo.; Calif. insurance premiums rise; Ore. waits to see who wants in on coordinated care

Apr 3 2012

A selection of state health policy stories from Colorado, California, Oregon, South Carolina, New Hampshire, Minnesota, Connecticut and Massachusetts.

Denver Post: Health Reform Means Huge Rise In ER Use, CU School of Medicine Says
Even people who just got health insurance use the emergency departments to access their care, according to a new study by University of Colorado School of Medicine researchers. It's not just people who lost insurance or people living long without it, the researchers note -- any change in health insurance status, whether positive or negative, tends to send people to the ER because they don't know where else to go. The study has huge implications if SCOTUS leaves health care reform intact this summer. With 32 million Americans getting new health insurance under the Affordable Care Act, and at least half of those coming through Medicaid, Colorado and national ER use will spike to unmanageable levels, the authors say (Booth, 3/30).

San Francisco Chronicle: Health Insurance Premiums To Rise Soon For Many
More than a million California small-business owners and individual policyholders face a wave of health insurance premium increases in the coming months that range from single digits to as high as 20 percent. Starting Sunday, about 101,000 Anthem Blue Cross small-group customers will see their premiums go up an average of 13.8 percent but as high as 20.5 percent. At the same time, more than 16,000 small businesses covered by Aetna will receive hikes averaging 3.7 percent. While a few will see decreases, others will get hit with increases of more than 20 percent (Colliver, 3/31).

Healthy Cal: Scribes: Helping Overworked Primary Care Physicians
Doctors and patients alike have experienced rising frustration as physicians using electronic health records bury their heads in computer screens, rarely making eye contact while listening to highly personal tales of sickness and woe. But a Northern California community clinic has found a solution to this technological glitch that calms frustrated patients, frees overworked physicians, and improves the clinic's bottom line. Shasta Community Health Center (SCHC) in October completed a successful pilot program that paired "scribes" with physicians at its six clinics (Perry, 4/1).

The Associated Press/Modern Healthcare: Oregon Waits To See How Many Providers Want To Try Coordinated Care
The Oregon Legislature has bought into Gov. John Kitzhaber's ideas for redesigning the state's health care system for low-income patients. Now, it's about to become plain how many Oregon doctors, hospitals and other care providers are ready to put his vision into practice. Organizations that want a piece of the redesigned Oregon Health Plan must declare their intentions to the state by the end of the day April 2 or miss their chance until next year. Letters to state health officials will reveal which care providers are planning to participate, what areas of the state they want to cover and how quickly they're hoping to get their plans off the ground (4/1).

The Lund Report: Committee Creating Community Health Worker Standards Plans To Continue Meeting
The Non-Traditional Healthcare Workforce Committee, which has been designing standards for community health workers in Oregon, believes it's important to continue its work to oversee the development of that work force. It intends to ask the Oregon Health Policy Board for permission to become a formal advisory body. … Last year, the committee began developing training and education standards for community health workers, and make recommendations to the Policy Board about how the work force should be incorporated into coordinated care organizations (CCOs). The CCOs are part of a major overhaul to the Oregon Health Plan's delivery system, and are expected to integrate physical and mental healthcare for 650,000 Oregon Health Plan patients in August (Waldroupe, 3/30).

Modern Healthcare: Appeals Court Overturns Order For S.C. Hospital To Pay $45 million In Stark Case
A federal appeals court overturned a district judge's unusual 2010 order for Tuomey Healthcare System to pay more than $45 million for alleged Stark law violations. The 4th U.S. Circuit Court of Appeals concluded that the outcome denied the Sumter, S.C., hospital its constitutional right to a jury trial. In False Claims Act complaints filed in U.S. District Court in Columbia, S.C., a whistle-blower and the U.S. Justice Department alleged that Tuomey entered contracts with specialists that illegally rewarded the physicians for the amount of money they generated for Tuomey (Blesch, 4/1).

New Hampshire Public Radio: DOJ: N.H.'s Mental Health System In Crisis
Earlier this week, the U.S. Department of Justice moved to join a federal lawsuit suing New Hampshire over its mental health system. Government lawyers allege without adequate community-based services, the state is violating the American with Disabilities Act. NHPR's Dan Gorenstein spoke with Department of Justice Attorney Alison Barkoff (Gorenstein, 3/30).

Minnesota Public Radio: State Failed To Review Troubled Past Of Ousted Minn. Security Hospital Administrator
It was April Fool's Day and David Proffitt was a man with a problem. … But just two weeks later, on April 14, 2011, he sent an email to a state agency more than 1,000 miles away to inquire about a job opening at a facility for the mentally ill and dangerous. The agency had just asked the program's long-time administrator to resign. It needed someone who could correct years of problems with staff morale and patient care. The facility in question was the Minnesota Security Hospital in rural St. Peter, Minn., about 70 miles southwest of the Twin Cities. This was Proffitt's chance to redeem himself -; if Minnesota did not look too deeply into his past (Baran, 3/30).

CT Mirror: A Judge's Frustrations Lead To Proposal, Outcry From Advocates
Probate Court Judge Robert Killian wants Connecticut to follow the lead of the majority of other states by allowing for people with psychiatric disabilities to be medicated, even if they object, while they're in the community -- if remaining unmedicated would leave them or others at risk of harm. The concept, part of a bill pending before the legislature's Judiciary Committee, is vehemently opposed by advocates for people with mental illness (Levin Becker, 3/30).

Boston Globe: Patients Risk Addiction Relapse With Closure Of Doctors' Clinics
At least 21 doctors who prescribed substance abuse medications in the state have closed their clinics unexpectedly since 2004, leaving more than 1,000 recovering drug addicts looking for urgently needed care. In all but two cases, the doctors faced legal trouble or disciplinary actions, often for fraud, over-prescribing, or their own drug use. The exodus of such providers has strained the limited resources available for substance abuse treatment in the state and, in many cases, put patients in danger of relapse, said Colleen LaBelle, who tracks the closures and runs a state-funded program at Boston Medical Center to connect patients affected by them with new providers (Conaboy, 4/1).