Monthly Archives: July 2018

How Kennedy’s SCOTUS Replacement Could Open the Door to Medicaid Cuts

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http://www.thefiscaltimes.com/2018/07/03/How-Kennedy-s-SCOTUS-Replacement-Could-Open-Door-Medicaid-Cuts

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Axios’ Caitlin Owens says the next Supreme Court justice could give states more power to cut Medicaid. The legal issue in question is whether private health care providers can sue over Medicaid payment rates. The Supreme Court ruled in 1990 that they could, and Anthony Kennedy dissented in that case — but took less of a hard-line stance than other conservatives. He “was willing to leave the courthouse doors open in Medicaid cases, whereas the conservative majority is willing to shut it – I mean, really slam it,” Sara Rosenbaum, a George Washington University law professor, told Axios.

Kennedy’s replacement could provide a fifth vote to prevent private providers from suing, giving states plenty of leeway to make cuts to their Medicaid programs without the threat of legal action.

Owens notes that Kansas and Louisiana have asked the Supreme Court to consider whether they can exclude Planned Parenthood from their Medicaid programs, and whether the group can challenge that exclusion.

 

 

More Americans Paid for ACA Plans This Year — and More Are Getting Priced Out

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https://www.thefiscaltimes.com/2018/07/03/More-Americans-Paid-ACA-Plans-Year-and-More-Are-Getting-Priced-Out

 

President Trump has declared that Obamacare is finished, dead, gone, essentially repealed. And yet, despite the administration’s efforts to undermine the law’s marketplaces, the number of Americans who enrolled in and started paying for Affordable Care Act plans grew slightly this year, according to reports released Monday by the Centers for Medicare and Medicaid Services (CMS).

At the same time, rising premiums are taking a toll, forcing many middle-income Americans — individuals making more than about $48,000 a year, or families of four making more than about $100,000 — to drop coverage. “Taken together, these reports show that state markets are increasingly failing to cover people who do not qualify for federal subsidies even as the Exchanges remain relatively stable,” CMS said.

Here’s a look at what the new reports show:

* While the total number of people who picked a plan for 2018 fell, the number of people who paid for coverage rose from 10.3 million in February 2017 to 10.6 million this past February, an increase of about 3 percent. “The increase is striking because it happened even though federal health officials last year slashed ACA funding to grass-roots groups that help consumers sign up for coverage, cut advertising and other outreach activities by 90 percent, and shortened the enrollment period by half,” writes Amy Goldstein at The Washington Post.

* CMS argued that, based on historical trends, a “significant number” of people will wind up dropping coverage during the year even after making their initial payments. Of the 10.3 million who paid for their plans as of March 15, 2017, only 8.9 million were still in those plans by the end of the year. “This is likely caused by consumers struggling to pay premiums as costs continue to increase,” the CMS report said.

* A larger share of enrollees has been getting federal subsidies. In 2014, the first year Affordable Care Act plans became available, 55 percent of those enrolled in individual market plans on or off the new Obamacare exchanges got financial help, according to Bloomberg. Last year, 62 percent did. In all, more than 8 million people got subsidies last year, while 5 million bought individual plans without financial help. “When premiums rise a lot, a lot more people become eligible for subsidies,” Matthew Fiedler, a fellow at the U.S.C.-Brookings Schaeffer Initiative for Health Policy, told The New York Times.

* As insurance prices rose by an average of 21 percent last year, signups among people who did not qualify for subsidies fell by 1.3 million — a drop of 20 percent compared with 2016. Subsidized enrollees fell by just 3 percent. “These reports show that the high-price plans on the individual market are unaffordable and forcing unsubsidized middle-class consumers to drop coverage,” CMS Administrator Seema Verma said in a statement. Trump administration policies may have played a part in the decline, too, and some people may have stopped buying their own insurance because they found jobs with employer coverage. “But it’s reasonable to think that most of the attrition can be attributed to the spike in prices, as the Trump administration concludes,” writes Margot Sanger-Katz of The New York Times.

What it all means: “The individual health insurance market under the ACA is financially sustainable as subsidies rise to match premium increases,” Larry Levitt of the Kaiser Family Foundation tweeted. “However, the lack of affordable insurance for middle-class people ineligible for subsidies does not seem politically sustainable.”

 

 

 

 

 

 

Where is Dr. King now? A Civility Emergency

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Where is Dr. King now? A Civility Emergency

As the well-known, dramatic story unfolds, “Humpty Dumpty sat on the wall, Humpty Dumpty had a great fall. All the king’s horses, and all the king’s men, couldn’t put Humpty Dumpty together again.” Coincidentally, this nursery rhyme has me thinking about an important leadership issue.

During this Independence Day season, I’m concerned that our freedom is being threatened. Now is the time for honorable patriots to speak up and do our part on this issue. We must take a stand for civility in our culture, and it’s a basic responsibility as fellow colleagues and citizens.

What is Civility and why is it important?  

The word “civil” ties back to the Latin word for citizen, and the core meaning is the idea of people living together as a society under a government. The other well-known and related definition of the word civil is being courteous, respectful and considerate of others. To have and maintain freedom requires a degree of civility and tolerance for each other.

Just over fifty years ago Dr. Martin Luther King set the standard for civility when debating highly contested issues. Out of that era, our society learned a lot about respectful tolerance for others—it has been a foundational ethos over the past 30 years in the issues of race, gender, and religion, and it’s made us a better nation because of it. We had our differences in the past, but there was a general attitude of civility in debating them.

Today though, the tragic change is tolerance for being intolerant of others who have different ideas and views.

“When people reach a point of hate for each other because they have different perspectives, then you have a serious problem.”

Emotions are Contagious

From my past work in human behavior and performance, I know that emotions are contagious. Positive emotions give positive energy and make it easy to live and work together. Negative emotions bring negative energy and make it difficult to work together. We all know this principle from time spent with our work teams as well as relationships with family and friends. And the same thing applies to our culture.

Now we’re seeing intolerant and rude conversation on a mass scale. Some media outlets and politicians ignore the boundaries of civility, aggressively promoting disrespectful personal attacks on others who don’t share their views on politics or social issues. And social media has provided a layer of protection, allowing individuals to lash out in vicious ways at people they don’t even know. These actions aren’t illegal, but they are certainly anti-social and attack the civility needed to maintain a free society where we can live and work together.

Another Civil War?

A recent Rasmussen Poll showed that “thirty-one percent (31%) of U.S. voters say it’s ‘Likely’ that the United States will experience a second civil war sometime in the next five years, with 11 percent saying it’s ‘Very Likely.’[i]” This poll seems to confirm what I’m feeling—that we’re crashing over the boundaries needed in a civil society.

Underneath this breakdown in civility is the subtle mindset that “the ends justify the means”.

This is the bone-chilling Communist manifesto that we experienced in the POW camps, so I’m highly sensitive to this type of attack on freedom and independence. This abandonment of truth and civility can happen in our American culture, a business boardroom, a dysfunctional family relationship, or a dispute with a neighbor. No one can escape it, but we have an opportunity to do our part in arresting it.

What can we do?

If you’re agreeing with this article, then you’re part of the tribe that has decided to live and lead with honor! Regardless of your personal and professional perspectives or your allegiance to your like-minded group of people, you know that the true essence of influence and courage is taking a stand in a civil way regardless if that civility is returned in kind.  For more on this challenge, see my coaching video this month and hear my personal story.

Here are four things that we can do –

  1. Guard your own character first. Avoid using uncivil tactics to advance your arguments.
  2. Be direct and honest, but keep strong boundaries on your words and actions. Set an example of someone who can disagree politely and factually with those with whom you disagree.
  3. Speak up when you experience the intolerance of others, those who resort to negative name-calling that is hateful and viscous. Consider how we can respectfully not tolerate those who use incivility as a weapon to advance their ideology.
  4. Get a free copy of the Honor Code and share it with others. Pay special attention to Articles 2, 6, and 7.

If Humpty Dumpty takes a fall, it will be very difficult to put him back together again. Take a stand for our freedom and independence, stand and advocate for civility…in a civil way.

 

 

 

 

224 hospital benchmarks | 2018

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https://www.beckershospitalreview.com/lists/224-hospital-benchmarks-2018.html

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Hospitals across the nation compete in a number of ways, including on quality of care and price, and many use benchmarking to determine the top priorities for improvement. The continuous benchmarking process allows hospital executives to see how their organizations stack up against regional competitors as well as national leaders.

For the seventh year, Becker’s Hospital Review has collected benchmarks related to some of the most important day-to-day areas hospital executives oversee: quality, patient satisfaction, staffing, utilization, finance, affiliations, compensation and health IT.

 

St. Louis hospital offers nurses summers off to retain staff

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https://www.beckershospitalreview.com/compensation-issues/st-louis-hospital-offers-nurses-summers-off-to-retain-staff.html

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The pediatric unit at Mercy Children’s Hospital in St. Louis will give nurses summers off work in an effort to retain staff, KMOV reports.

The nurses who choose the seasonal staffing option would still work full-time — three shifts per week for the pediatric unit’s nine-month busy season (September through May). The nurses can take off from June through August, while keeping full-time benefits, and return to their jobs in September.

“It’s exciting to see what the nurses, coming back to the unit after having three months off and doing whatever they want to do, the excitement they are going to have, the rejuvenation for their practice, maybe having a new spark, interest [or] excitement for nursing,” Justin Travis, the nurse manager for pediatrics at Mercy Children’s, told KMOV.

Seasonal staff will receive a stipend every two weeks to cover insurance costs. They also can use accrued paid time off to pay themselves during the summer and work extra hospital shifts as needed, Mr. Travis said.

The hospital is recruiting pediatric nurses for the positions. The contract year would begin in September, meaning the nurses’ first summer off would be next year.

Hospital officials said they may expand seasonal staffing options to other departments if it works in pediatrics