Appeals court rules against Arizona's mandatory co-pays for Medicaid recipients

A 9th U.S. Circuit Court of Appeals has ruled against Arizona's assessment of mandatory co-pays for some Medicaid recipients. The Arizona state legislature originally began the implementation of mandatory co-pays in 2003 for some patients, with payments that ranged from $4-$30. According to the policy, if the patient could not pay the co-pay, the medical provider could refuse to provide health services to the patient.

In November 2010, the state started to assess co-pays again and a class-action lawsuit was initiated. The lawsuit claimed that the medically needy shouldn't be required to make co-payments for health services, that the co-pays violated the Medicaid Act cost-sharing restrictions and that notices patients received about changes in their health coverage was inadequate.

Greater lack of healthcare access for rural Americans

A recent Reuters article describes findings in a new report published by the UnitedHealth Center for Health and Reform Modernization. The report found that those in rural areas faced greater rates of diabetes, heart problems and cancer, but received lower quality healthcare.

Patients at Small, Rural Hospitals in U.S. More Likely to Receive Lower Quality of Care Compared With Other Hospitals

A recent release from the Harvard School of Public Health details a national study that showed that patients at small, isolated, rural hospitals had a lower quality of care and poor patient outcomes when compared to other hospitals. The study found that patients admitted to critical access hospitals in rural areas for a heart attack, congestive heart failure or pneumonia were at a greater risk of dying within 30 days than at other hospitals.

Read more here.

Stereotyping Patients

There was an interesting article published in the New York Times a few days ago that focused on the stereotyping of patients. One of the patients described in the article served time in prison at Rikers during the 90's. He was taken in for a battery of tests and told that he had HIV. He was put on drugs for the disease but continue to show a normal T-cell range. When released, he made his way to an H.I.V. clinic to continue his care for his disease and several others like diabetes, hypertension, and Hepatitis C. But his T-cell range continued to be normal and was thought to have been a lucky "non-progressor". One of the nurse practitioners had a hunch and ran another H.I.V. test on him and found that the previous test conducted while in prison was actually a false positive.

The author of the story then asks the readers - why did the patient have to carry a false diagnosis for the last 8 years? When everything pointed to him not having H.I.V., why did medical professionals continue to think that his normal T-cell range was only an indicator that he was a non-progressor? Was it because he seemed to fit a certain picture - prisoner, tattoos infected with Hepatitis C and a drug user to boot?

What are your thoughts on this article? In your opinion, how do stereotypes affect the kind of medical attention one should expect to receive?

A Doctor’s Push for Single-Payer Health Care in Vermont

A recent article in the New York Times tells of how Dr. Deb Richter came to Vermont to achieve a tough goal - a single-payer healthcare system ran and paid for by the government. Thanks to her persistence, the governor of Vermont is signing a bill that puts Vermont on the road to the system she has fought for over the last 12 years. All 620,000 of the state's residents would be eligible for the coverage and a 5-member board (appointed by the governor), will determine pay rates for doctors, what should be covered, etc.

Partnership for Patients

According to a recent article in the WCF Courier, the new national Partnership for Patients will help hospitals adopt proven safety strategies to improve hospital safety and save money at the same time. The hope is that this program will help save 60,000 lives and reduce hospital re-admissions by 20% over the next three years.

You can read more about this program by visiting HealthCare.gov.

6 health care systems team up on cost/care project

According to a recent article published in the Washington Post, six health care systems serving more than ten million patients around the country will begin to share data in hopes of helping other providers improve quality while reducing costs. The group plans to focus on conditions and treatments for which there are wide variations in quality and outcomes.

Friday Roundup

Here is a listing of articles of interest published within the last 7-10 days:

Health
1. Embracing incentives for efficient health care, WSJ.com, 11/28/2010
Brief Intro: "Spurred by incentives in the federal health-overhaul law, hospitals and doctors around the country are beginning to create new entities that aim to provide more efficient health care. But these efforts are already raising questions about whether they can truly save money, or if they might actually drive costs higher."

2. Hospital train heals Argentina's poor, Yahoo News, 11/28/2010
Brief Intro: "Children from this desperately poor village in northern Argentina rushed to welcome a special hospital train rolling into town, their only chance to receive specialized care for a year."

Vulnerable Populations
1. Putting down textbooks to provide for triplets, NYT.com, 11/27/2010
Brief Intro: A young teenage mother becomes pregnant with triplets and has to forgo finishing her Associate's degree to care for her children.

Education
1. NAACP educational summit to look at return of segregation, CNN.com, 11/29/2010
Brief Intro: "The nation's oldest and largest civil rights organization wants to sound the alarm on school resegregation, and is hoping a national educational summit will bring attention to what its members consider a huge problem, according to a news release from the NAACP."

Employers may win U.S. health law exemption

According to an article on Bloomberg, employers may be allowed to switch health insurers and still be shielded from costly coverage changes called for in recent health care legislation. Under the health law passed in March, companies who change plans must provide added services like preventive care. Talks are taking place to determine whether employers should be able to avoid the new requirements, even with a new insurer, as long as benefit levels stay the same.

Emergency care becoming the new primary care?

On CNN's On The Chart blog, the author focuses on the possibility that emergency care has become the new primary care center in America. Citing September's issue of Health Affairs, it appears that less than half of the 345 million annual visits for acute-care problems take place with one's personal physician. Nearly a third of these visits occur in the E.R., with an enormous chunk of these occurrences not really fitting a true definition of the word "emergency".

The author believes that providing health insurance for a country's people is a basic tenet of a civilized society and questions the priorities of those who are looking to chip at the recently passed health care legislation.

Documentary of Interest: Uninsured in the Mississippi Delta

This short Media That Matters documentary takes a look at the uninsured in the Mississippi Delta. The Delta region is one of the most impoverished and uninsured areas in the nation. The film focuses on those people who are working but are making too much for Medicare, but too little to buy their own insurance. Greenville, MS, has the highest rate of uninsured households in the country with 34% of households lacking coverage. Those who lack coverage usually wait until the condition becomes serious before seeking aid as they can't afford the doctor's visit to resolve the issue at the very beginning.

This film is highly recommended for those who want to learn more about the obstacles to health care that the working poor face today.