Indiana reports jump in new HIV cases in rural outbreak

From Reuters:

An HIV outbreak in southeastern Indiana related to abuse of intravenous prescription drugs has jumped by 24 cases in the past week, an increase attributed to offering more testing resources, state health officials said on Friday.

The outbreak centered in rural Scott County near the border with Kentucky has reached 130 cases, including 10 preliminary positive tests, up from 106 a week ago, health officials said.

Scott County, about 30 miles north of Louisville, Kentucky, has been the center of the outbreak, the biggest in the state’s history.

Google Glass bridges gap in ER

From the News Telegram:

To all of the tools and instruments that physicians use when treating patients, add this: a wearable computer.

Researchers in Rhode Island reported this week that they found it possible to use Google Glass, a computer headset worn like eyeglasses, while treating patients in an emergency room for skin problems. One of the physicians involved in that study is now working on a similar project in Worcester by studying the use of Google Glass when treating patients who seek hospital care after a poisoning.

Both studies concern the quest to get more information into the hands of doctors, some of whom might be far from the patient, when a call for help comes in.

Iowa: Candor Becomes Law

From the Iowa Medical Society:

Governor Branstad held a public signing ceremony on Tuesday for IMS’s priority Candorlegislation; the law goes into effect on July 1, 2015. IMS is now in the process of developing educational toolkits to assist physicians and their practices in implementing Candor programs. The toolkits will include information on the new law, steps practices will need to take to develop their own programs, and information on training available to prepare staff to have meaningful and effective early disclosure conversations with patients. IMS has developed an initial fact sheet detailing the protections of the new law, available here.

In addition, IMS is working to identify pilot sites to test the Candor concept in Iowa and to collect in-state data demonstrating the effectiveness of the approach. The pilot sites will either implement a new Candor program or modify an existing early disclosure program and avail themselves of the new legal protections. Practices will be asked to document issues with implementation as well as successes made possible by the new approach. IMS will use this information to assist with larger-scale implementation and, if needed, look to additional legislation to ensure all Iowa practices are able to make use of this concept should they so choose. For more information about these resources or to discuss your practice becoming a pilot site, please contact Kate Strickler, JD, LLM, with IMS.

Mayor O’Neal Walks to Washington to Save Rural Hospitals & Call for Medicaid Expansion

From Save Our Hospital (hat tip: AJ):

On Monday “Walking Mayor” Adam O’Neal (R) will complete his 273-mile march from his home town of Belhaven, NC to the U.S. Capitol Building in the name of Medicaid expansion, endangered rural hospitals, and the Pungo District Hospital, which closed on July 1 endangering over 20K people in his community.

Vidant Health, Inc., which had built a near monopoly in eastern North Carolina, pulling in over $100 million a year with $550 million in the bank, purchased and closed Belhaven’s Pungo District Hospital as part of a regional business model that involves transporting Medicare patients to their profit center in Greenville, NC, while avoiding the costs of operating hospitals with emergency rooms. O’Neal calls this business model immoral, and points out in the United States, more rural hospitals have closed in the past 2 years than in the previous 15.

Telehealth dropped from 21st Century Cures bill?

From Modern Healthcare:

More Medicare pay for telehealth services will not be a part of the 21st Century Cures bill, according to industry sources informed of the decision by the House committee drafting the legislation.

The telehealth industry had been hoping the legislative package would include a separate Medicare billing code for remote patient-monitoring.

The package, expected to be unveiled in the coming weeks, will include a variety of initiatives intended to stimulate treatment and therapy innovation. The telehealth provision appeared in early drafts but has been dropped. Difficulties posed by the Congressional Budget Office’s scoring system were cited as a factor in the decision.

Minimum-Distance Requirements Could Harm High-Performing Critical-Access Hospitals And Rural Communities

From Health Affairs:

Since the inception of the Medicare Rural Hospital Flexibility Program in 1997, over 1,300 rural hospitals have converted to critical-access hospitals, which entitles them to Medicare cost-based reimbursement instead of reimbursement based on the hospital prospective payment system (PPS). Several changes to eligibility for critical-access status have recently been proposed. Most of the changes focus on mandating that hospitals be located a certain minimum distance from the nearest hospital. Our study found that critical-access hospitals located within fifteen miles of another hospital generally are larger, provide better quality, and are financially stronger compared to critical-access hospitals located farther from another hospital. Returning to the PPS would have considerable negative impacts on critical-access hospitals that are located near another hospital. We conclude that establishing a minimum-distance requirement would generate modest cost savings for Medicare but would likely be disruptive to the communities that depend on these hospitals for their health care.

Senate appears poised to pass doc-pay reform plan

From Modern Healthcare:

The Senate is expected to pass a bill late Tuesday night repealing and replacingMedicare’s sustainable growth-rate formula for paying physicians.

If it passes without amendments as expected, President Barack Obama has indicated he will sign it. If amendments are added, that would introduce delays because the bill would have to be reconciled with the House version.

Passage of the bill Tuesday would stave off a 21.2% cut in payments to doctors one day before the CMS is set to begin processing claims at the reduced rate. The legislation would end a cycle of 17 consecutive short-term fixes that have spanned more than a decade.


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