State highlights: Medicaid pilot project costs $32B more than expected

Jul 24 2013

A selection of health policy stories from the District of Columbia, New York, Georgia, Minnesota, Illinois, North Carolina, Colorado and California.

Modern Healthcare: Reform Update: Medicaid Pilot Projects Cost $32 Billion More Than Expected, GAO Says
HHS has allowed states to spend billions more on Medicaid pilot projects in recent years than the agency's own rules allow, and the problem may grow in the future, according to a new federal audit. States regularly apply for approval of so-called demonstration projects that provide Medicaid coverage or services to populations beyond those required by federal rules (Daly, 7/23).

The Washington Post: D.C. Officials Agree To Plan To Settle D.C. Chartered Finances
District officials have agreed to pay $48 million to settle the accounts of D.C. Chartered Health Plan, the once-prominent Medicaid contractor that unraveled over the past year amid financial stress and allegations of its owner's involvement in political corruption (DeBonis, 7/23).

The New York Times: Ending Long Battle, Cuomo Agrees To Plan To House Mentally Ill
The administration of Gov. Andrew M. Cuomo agreed on Tuesday to give 4,000 mentally ill people who have been kept in institutional homes in New York City the opportunity to move into their own subsidized apartments, settling a contentious legal battle over the care for such patients that dragged on for a decade (Secret, 7/23).

Modern Healthcare: New Ga. Alliance Joins Wave Of Providers Seeking Common Benefits And Independence
The goals of population health management may be encouraging rampant consolidation across the health care industry, but some systems are pushing back and seeing whether they can achieve the same results with looser arrangements. Over the past two weeks, in markets 900 miles apart, two new non-equity alliances have been formed to pool resources, coordinate information and gain population health management expertise (Kutscher, 7/23).

Georgia Health News: Hospital Alliance Emerges In Middle, South Georgia
More than 20 hospitals in Middle and South Georgia, including nonprofit systems in Macon, Columbus, Valdosta and Tifton, have formed an alliance that aims to reduce costs, coordinate clinical information and improve the health of area residents. The alliance, called Stratus Healthcare, also includes about 1,500 physicians, along with 23 hospitals. It bills itself as the largest hospital alliance in the Southeast (Miller, 7/23).

MPR News: Psychiatric Emergency Room A 'Bottleneck' For Mental Health Care
One of the busiest entry points into Minnesota's mental health system is the psychiatric emergency room. Sometimes they walk in off the street or are brought in by police or EMS. Nearly always they are in need of treatment for mental illness. On a relatively serene Monday morning, MPR's Tom Crann spoke with Hennepin County Medical Center psychiatrist Dr. Kathleen Heaney, who described what it's like in a psychiatric emergency room that is an important place for mental health services, one that is often over burdened (Crann, 7/23).

MPR News: Bone Marrow Donor Campaign Targets College Students
Every year, thousand people with blood cancers fail to receive the bone marrow transplants they desperately need to survive. The shortage of bone marrow donors is so acute that last year only about half of the 12,000 patients requesting a donor received one. A key problem is that doctors find it hard to convince younger people -- whose blood cells are better able to fight cancer -- to join the registry of donors. With that in mind, nearly two dozen college students from across the nation came to Minneapolis this week to learn new strategies that could help persuade people their age to become bone marrow donors (Benson, 7/24).

Chicago Sun-Times: Condell Medical Plays Its Part In Charitable Care
Advocate Condell Medical Center played an integral role in Advocate Health Care's $614 million contribution in charitable care and services during 2012. The total is an increase of $43 million over the previous year (7/23).

North Carolina Health News: Hospitals Lose Clout, And With It, Dollars
In many areas of North Carolina, the local hospital is one of the biggest employers in town. And for years, hospitals have leveraged that local power into statewide political clout. But not this year. Lawmakers have made a series of moves during this legislative session that will force a trimming of hospital budgets across the state, as the once powerful hospital lobby has found itself increasingly in the crosshairs of budget writers (Hoban, 7/24).

The Denver Post: Colorado's Rural Health Services Bleeding Money In New, Old Ways
The hospital in Rangely is threatening to cut off ambulance service to the western half of a remote neighboring county. … A new round of crises and challenges in rural Colorado medicine has health experts and public officials on alert, scrambling to shore up services in far-flung areas (Booth, 7/24).

Health Policy Solutions (a Colo. news service): In Abrupt Reversal, Anthem Covers Transgender Care
One of Colorado's largest health insurance companies has reversed itself and is now covering care for transgender patients. Kelly Costello, 32, of Denver, received stunning news last week. One day after getting a formal notice that Anthem Blue Cross and Blue Shield of Colorado would not cover chest reconstruction surgery, the company abruptly overturned its decision. … In March, Colorado's Division of Insurance issued a bulletin barring health insurance companies from discriminating against people who are gay, lesbian, bisexual or transgender (Kerwin McCrimmon, 7/24).

California Healthline: Medi-Cal Children Having Trouble Getting Dental Care Services, Survey Says
California children aren't getting the dental care they need through Medi-Cal, according to a survey released yesterday by The Children's Partnership. By the end of this year, the survey pointed out, about five million children -- more than half of the state's kids -- will be Medi-Cal children. And those youngsters are having difficulty accessing dental care in California, the survey said. It also found one particularly troubling trend in access, according to Jenny Kattlove, director of strategic health initiatives for The Children's Partnership. The state posts a registry of those dentists in California who are accepting new Medi-Cal patients -- but 10% of those providers aren't actually taking on Medi-Cal children, Kattlove said (Gorn, 7/23).