January 16, 2013 in Health

The Spokesman-Review

Kathy Plonka photo

Kootenai Health recruiter Brittany Stockstill decided to wear a mask instead of getting a flu shot while working in the business services department at Kootenai Medical Center in Coeur dAlene. Six percent of hospital staff chose a mask over thevaccination. (Full-size photo)

Hospitals, clinics and nursing homes increasingly are requiring their employees to get a flu shot, but some health care workers are refusing, putting their jobs on theline.

A Newman Lake woman said she felt she had no choice but to resign from Kootenai Behavioral Health because she would not comply with a new policy directing employees to get vaccinated for influenza or wear a mask at work during fluseason.

Sarah Peterson, a mental health specialist, resigned Dec. 7 after more than 17 years at Kootenai Behavioral Health, which is part of KootenaiHealth.

They have every right to make it mandatory, and I have every right to stay or quit, said Peterson, adding she didnt want to befired.

Two other workers at Kootenai Health have resigned for the same reason rather than face discipline that could lead to their dismissal, spokeswoman Kim Andersonsaid.

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Some in health care refusing flu vaccine - Wed, 16 Jan 2013 PST

With major implementation of the Affordable Care Act about a year away, local health officials are publicly unveiling a study aimed at analyzing the county's health care safety net, including its current capabilities and its capacity for expanding to meet the demands of national health care reform.

The study, dubbed the "Phase I Report: Preliminary Profile of Health Care Needs & Safety Net Providers that serve Residents of Monterey County," will be presented at five public meetings set for the next week and a half at various locations throughout the county. The meetings, which begin Monday with a two-hour session at 6 p.m. at the Castroville Library, will also offer attendees an opportunity to ask questions and offer comments.

Subsequent sessions will be held from 6 to 8 p.m. at Seaside's Oldemeyer Center on Tuesday, the county Health Department in Salinas on Wednesday, the Big Sur Grange Hall on Jan. 21, and St. John the Baptist Catholic Church in King City on Jan. 24.

The first phase of the study, which was completed in June by Cal State University faculty researchers under contract with the county health department, is a collaboration between county health officials, the university's Institute for Community Collaborative Studies, and the county's safety net providers, including local hospitals, clinics, physicians and other health care organizations.

The health care safety net is described as organizations that offer care to uninsured, underinsured and

Meanwhile, on Tuesday, the Board of Supervisors is scheduled to hear a report on how the county is planning to implement the Affordable Care Act by the beginning of next year.

The supervisors are also set to receive updates from county health officials on a pair of proposed health care programs Via Care and Access Point aimed at offering temporary health coverage or improved access to care for hundreds of poor and uninsured county residents as a precursor to national reform.

Last fall, county health officials backed off plans to implement the Via Care pilot program that would have provided temporary health coverage to up to 1,500 poor and uninsured residents.

The officials argued that putting the long-planned program into place even on a short-term basis would have endangered local health care funding from state and federal sources. Instead, they proposed expanded access to care without insurance under an alternative program they called Access Point.

According to an executive summary of the safety net analysis, the first phase of the study focused on providing an initial profile of the region's population, including demographics and socioeconomic variables, and current safety net providers, including location and available services.

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Study analyzes health care safety net in Monterey County

Transforming Health Care in the US
Optum and Mayo Clinic today jointly launched Optum Labs, an open, collaborative research and development facility with a singular goal: improving patient care. Based in Cambridge, Mass., Optum Labs provides an environment where the health care industry can come together to combine information and ideas that benefit patients today while also driving long-term improvements in the delivery and quality of care. John Noseworthy, MD, president and chief executive officer of Mayo Clinic discusses the joint venture.

By: mayoclinic

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Transforming Health Care in the US - Video

The medical spending pie is growing; but the consumer slice is, unexpectedly, getting smaller.

Consumer-driven medical spending may be the second-biggest story in health care, after the Affordable Care Act. As employers give workers more skin in the game through higher costs from purse and paycheck, the thinking goes, they'll seek more efficient treatment and hold down overall spending.

But consumers may not be as invested as experts thought, new government figures show. Despite rapid growth in high-deductible health plans and rising employee contributions for insurance premiums, consumers' share of national health spending continued to fall in 2011, slipping to its lowest level in decades.

"I'm surprised," says Jonathan Gruber, a health economist at the Massachusetts Institute of Technology. "All the news is about the move to high-deductible health plans. Based on that logic ... I would have expected it to go up."

True, medical costs are still pressuring families. Household health expense has outpaced sluggish income growth in recent years, says Micah Hartman, a statistician with the Department of Health and Human Services, which calculates the spending data.

But from a wider perspective, consumer health costs continued a trend of at least a quarter-century of taking up smaller and smaller parts of the health-spending pie. Household expense did go up. But other medical spending rose faster, especially for the government Medicare and Medicaid programs.

Economists measure three kinds of consumer health costs: insurance premiums paid through payroll deductions or for individual policies; out-of-pocket costs for deductibles and co-pays; and Medicare payroll taxes. Such outlays fell to 27.7 percent of the health care economy in 2011, down from 28 percent in 2010 and from 32 percent in 2000, according to the national health expenditures report issued by HHS last week.

That's despite the fact that one in three workers is covered by a plan with a deductible of at least $1,000 -- up from one in 10 in 2006 --according to the Kaiser Family Foundation. Among small firms, half the workers are now in high-deductible plans.

One factor holding down costs even for families with consumer plans has been patent expirations for expensive, commonly used medicines such as Prevacid and Flomax.

"People these days are spending a lot less out-of-pocket on prescription drugs," said Peter Cunningham, director of quantitative research at the Center for Studying Health System Change. "A lot of that has to do with the shift from brand name to generics."

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Patients' Share of Health Care Costs Is Actually Shrinking

NEWTOWN, Conn., Jan. 15, 2013 /PRNewswire/ -- To shed light on one of the toughest issues facing the country, fiscally and socially, a new eBook is asking the critical questions about why patients often don't get the right care, why America spends twice as much per person as the next biggest spender, and why the rules that apply to every other industry don't apply to health care? More importantly, "The Incentive Cure: The Real Relief for Health Care," also provides answers to many of the questions around why the U.S. health industry fails and highlights some of the most promising ideas for change.

"It's tough to do right when you're encouraged to do wrong," said Francois de Brantes, eBook author and executive director of the non-profit Health Care Incentives Improvement Institute (HCI3). "We must change the incentives of our health care delivery system those impacting patients, physicians, hospitals, insurers, and policy makers alike. Real and lasting change won't happen until the incentives change and we begin to pay for value instead of volume to encourage physicians to do right; change health insurance benefit designs to encourage patients to do right; make all price and quality information easy to get and act upon in order to create a real health care market; and remove regulatory and legislative barriers that impede payers and providers from innovating."

The Affordable Care Act addresses some of the imbalances of our U.S. health care system (for example, hospitals are starting to be penalized when they have excessive rates of readmission or patient safety failures; and Medicare is starting to experiment with payment models that move away from fee-for-service), however, far more needs to be done far faster. Change needs to come not only by the Administration, but ordinary Americans need to take action.

In addition to helping consumers understand the forces at work (both for us and against us) in the U.S. health care system, the eBook also provides information to help all Americans make smarter decisions about their care:

Co-authored with business writer Bob Conte, and illustrated by artist Kriss Wittmann, the eBook is available in various formats and can be found on the Amazon Book Store, Smashwords, and forthcoming on iTunes.

About the Authors

Francois de Brantes is executive director of the Health Care Incentives Improvement Institute where he leads the organization's efforts to accelerate the transformation of the health care industry into delivering greater value. Francois has been published in a number of journals including the New England Journal of Medicine, Health Affairs, the American Journal of Managed Care, and his work has been featured in articles in The New York Times and the Wall Street Journal. He can be reached at francois.debrantes@hci3.org.

Bob Conte is a business writer, editor, and communications consultant. He works with a broad range of local, national and global clients, and has received many industry awards for his work across the communications spectrum. Bob is also the author of a textbook on American music. He can be reached at bob@bobconte.com.

Available Topic Expert: For information on the listed expert, click appropriate link.

Francois de Brantes

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New eBook Shines Light on What's Wrong with U.S. Health Care and Offers Ways to Fix It

IRVINE, Calif., Jan. 15, 2013 (GLOBE NEWSWIRE) -- Sabra Health Care REIT, Inc. ("Sabra," the "Company" or "we") (SBRA) is pleased to announce its hiring of Peter W. Nyland, who will join Sabra's team as Senior Vice President of Asset Management, effective immediately.

Within this role, Nyland will oversee Sabra's asset management function. Nyland's proven background as SVP of Purchasing, Asset Development and Real Estate for Sun Healthcare Group, Inc. will support Sabra's continued growth, allowing the company to further its position within the healthcare REIT industry. "I've known and worked with Pete for ten years. Pete has an operating background and in his years at Sun Healthcare Group headed up construction, development, and capital expenditures," said Rick Matros, Chief Executive Officer of Sabra. Matros added, "That background makes him a perfect fit for the culture we have developed at Sabra and we believe he will bring great value to our operating partners."

Nyland comes to Sabra with over 29 years of experience in the health care/nursing industry. He graduated Summa Cum Laude with a Bachelor of Science degree in Health Care Administration from State University of New York at Utica. Nyland resides in New Mexico.

ABOUT SABRA

Sabra Health Care REIT, Inc. (SBRA), a Maryland corporation, operates as a self-administered, self-managed real estate investment trust (a "REIT") that, through its subsidiaries, owns and invests in real estate serving the healthcare industry. Sabra leases properties to tenants and operators throughout the United States. As of January 15, 2013, Sabra's investment portfolio included 120 properties leased to operators/tenants under triple-net lease agreements (consisting of (i) 97 skilled nursing/post-acute facilities, (ii) 22 senior housing facilities, and (iii) one acute care hospital) and two mortgage loan investments. As of January 15, 2013, Sabra's properties were located in 27 states and included 12,552 licensed beds/units.

The Sabra Health Care REIT, Inc. logo is available at http://www.globenewswire.com/newsroom/prs/?pkgid=8563

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Sabra Health Care REIT, Inc., Hires Peter W. Nyland as Senior Vice President of Asset Management

A Collin County husband and wife have been arrested and charged with health care fraud violations in the Eastern District of Texas, announced U.S. Attorney John M. Bales today.

John Mitchell Rutoskey, 59, and Gwenice Rutoskey , 54, were arrested early this morning at their McKinney home without incident. On Dec. 12, 2012, the Rutoskey's were named in an indictment returned by a federal grand jury charging them with conspiracy to commit health care fraud, six counts of health care fraud, causing false representations in relation to federal health care programs, and two counts of money laundering. The Rutoskey's will make an initial appearance today before U.S. Magistrate Judge Amos Mazzant.

If convicted of these charges, the Rutoskey's face up to 10 years in federal prison for each health care fraud and money laundering charge. They face up to five years in federal prison for the charge of causing false representations in relation to federal health care fraud programs.

Any individuals with knowledge of these or other health care fraud violations are encouraged to contact the Department of Health and Human Services' fraud hotline at 1-800-HHS-TIPS (447-8477)

A grand jury indictment is not evidence of guilt. All defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.

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Businessman David Goldhill's father died of a hospital-related infection. His book Catastrophic Care argues that the American health care system needs to become more consumer-driven.

Businessman David Goldhill's father died of a hospital-related infection. His book Catastrophic Care argues that the American health care system needs to become more consumer-driven.

In 2007, David Goldhill's father, in good overall health, checked into the hospital with a minor case of pneumonia. Within a few days, he developed sepsis, then a wave of secondary infections. A few weeks after entering the hospital and the day after his 83rd birthday, he died.

Shortly after, Goldhill read an article that changed the course of his life. He learned just how common hospital infection deaths like his father's are: An estimated 100,000 happen in the U.S. each year. Goldhill also learned just how simple it can be to prevent them in some cases as simple as regulating physician hand-washing.

So Goldhill set out to learn as much as he could about our convoluted, insurance-based health care system. And he found that much of it is broken.

His new book is called Catastrophic Care: How American Health Care Killed My Father and How We Can Fix it. Goldhill first wrote about the experience in a 2009 Atlantic cover story.

As president of the Game Show Network, Goldhill approaches the topic from a business perspective. He believes patients should take on more of a consumer role.

"It seemed strange that any industry could have a relatively low-cost way of significantly improving its customer experience," he tells weekends on All Things Considered host Jacki Lyden, "and it would be hard to get the industry to adopt it."

Goldhill says the true cost of our health care is massive and it is hidden.

He looks at a typical entry-level employee earning about $35,000 a year. He finds that over the course of her lifetime she will pay more than $1 million to support her and her family's health care. And that's if there is zero growth in costs and if she avoids major illness.

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Father's Death Spurs Son To Tackle Health Care

Employee gets flu shot from nurse

Bill Staples, a Mississippi Department of Health employee, is given a flu vaccine shot by registered nurse Rosemary Jones, also with the health department, in this October file photo taken in Jackson, Miss. A survey by Centers for Disease Control and Prevention researchers found that in 2011, more than 400 U.S. hospitals required flu vaccinations for their employees and 29 hospitals fired employees who were not vaccinated against the virus. Associated Press

Should health care workers have the right to refuse getting a flu shot?

CHICAGO - Patients can refuse a flu shot. Should doctors and nurses have that right, too? That is the thorny question surfacing as U.S. hospitals increasingly crack down on employees who wont get flu shots, with some workers losing their jobs over their refusal.

Where does it say that I am no longer a patient if Im a nurse, wondered Carrie Calhoun, a longtime critical care nurse in suburban Chicago who was fired last month after she refused a flu shot.

Hospitals get-tougher measures coincide with an earlier-than-usual flu season hitting harder than in recent mild seasons. Flu is widespread in most states, and at least 20 children have died.

Most doctors and nurses do get flu shots. But in the past two months, at least 15 nurses and other hospital staffers in four states have been fired for refusing, and several others have resigned, according to affected workers, hospital authorities and published reports.

In Rhode Island, one of three states with tough penalties behind a mandatory vaccine policy for health care workers, more than 1,000 workers recently signed a petition opposing the policy, according to a labor union that has filed suit to end the regulation.

Why would people whose job is to protect sick patients refuse a flu shot? The reasons vary from allergies to flu vaccine, which are rare, to religious objections and skepticism about whether vaccinating health workers will prevent flu in patients.

Dr. Carolyn Bridges, associate director for adult immunization at the federal Centers for Disease Control and Prevention, says the strongest evidence is from studies in nursing homes, linking flu vaccination among health care workers with fewer patient deaths from all causes.

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Health care workers who refuse flu shot thorny issue

Accomplished Health Care Executive to Help Further Castlights Engagement with Leading Employers and Health Plans.

San Francisco, CA (PRWEB) January 10, 2013

With a wealth of experience in the health care industry, Tracy brings a strong vision and key relationships to Castlight, said John Driscoll, Castlight Health president. As a special advisor, Tracy will help us evolve how we engage and partner with health plans and employers, making access to critical health care cost and quality information a reality for more Americans.

Bahl has a proven track record of success advising and leading health care companies. Bahl currently serves as a special advisor to global growth equity firm General Atlantic where he focuses on health care-related activities. Previously, Bahl served as CEO for Uniprise, a UnitedHealth Group Company, where he advanced the companys position as the leading provider of health care solutions to large employers and led the companys technology, service and consumer health care operations. He also has served as Executive Chairman of Emdeon and held senior executive positions at CIGNA HealthCare.

Health Care Transparency is changing the way we experience and consume health care for the better, said Bahl. Castlight has already made an indelible impact on the industry, and Im excited to be working with the Castlight team to further expand its business and partnerships.

Based on increasing demand for Health Care Transparency solutions, Castlight continues to experience incredible growth. In 2012, Castlight added significant new leaders to its management team. Over the past year, Castlight also secured $100 million in funding and was named one of the top emerging health care companies by the Wall Street Journal.

About Castlight Health

Castlight Health enables employers, their employees, and health plans to take control of health care costs and improve care. Named #1 on The Wall Street Journals list of The Top 50 Venture-Backed Companies for 2011 and one of Dow Jones 50 Most Investment-Worthy Technology Start-Ups, Castlight Health helps the countrys self-insured employers and health plans empower consumers to shop for health care. Castlight Health is headquartered in San Francisco and backed by prominent investors including Allen & Company, Cleveland Clinic, Maverick Capital, Morgan Stanley Investment Management, Oak Investment Partners, Redmile Group, T. Rowe Price, U.S. Venture Partners, Venrock, Wellcome Trust and two unnamed mutual funds. For more information, please visit our web site at http://www.castlighthealth.com or call (415) 829-1400.

Drew Smith Blanc & Otus 415-856-5127 Email Information

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Health Care Industry Veteran Tracy Bahl Joins Castlight Health as a Special Advisor

MVP and employees partner with American Red Cross to help families recover from Hurricane Sandy.

Schenectady, NY (PRWEB) January 10, 2013

I am so proud of how Team MVP came together to help with this effort, said Denise V. Gonick, MVPs President and CEO. Seeing so much devastation on the news and knowing our members, friends and neighbors were affected by the storm inspired our coworkers to give generously.

MVP partnered with the American Red Cross in November on an online donation program for MVP coworkers and pledged to match employee donations up to $10,000. In the first two weeks, MVP employees donated $6,781.

By early December, it was clear the situation in the hurricane zone was far from resolved. Denise Landi, a MVP Clinical Review Coordinator who lives on Long Island, shared her experience of the storm with her coworkers.

This wasnt just a power outage, this was brutal. It was a nightmare, Landi said. Trees lifted up entire front lawns and crashed into houses. I have friends who watched their oil heater go floating down the street. Though Landis home was spared from flooding, she knew many people who lost everything to the powerful storm.

Employee donations continued to come in during December, totaling $11,531. With MVPs match, the grand total donated to the American Red Cross was $21,531.

###

About MVP Health Care

Founded in 1983, MVP Health Care is a community-focused, not-for-profit health insurer serving members in the states of New York, Vermont and New Hampshire. Through its operating subsidiaries, MVP Health Care provides fully-insured and self-funded employer health benefits plans, dental insurance, and ancillary products, such as flexible-spending accounts, to more than 650,000 members. For more information, visit http://www.mvphealthcare.com.

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MVP Health Care and Employees Raise $21,531 for Hurricane Sandy Relief

By Brian Orelli | More Articles January 11, 2013 |

JPMorgan's health care conference is a treasure-trove of information about health care companies. From basic information to fourth quarter sales, even a few deals are signed, sealed, and announced at JPMorgan.

But the most interesting -- both entertaining and educational -- part of the meeting happened virtually when attendees and remote observers of the conference piled onto a Twitter hashtag, #jpmpickuplines, scientifically mocking what an attendee might say to pick up someone at the hotel bar.

"Best set of data points I've seen all year," tweeted San Francisco Business Times reporter Ron Leuty who started the meme.

The top one -- as measured by retweets -- came from Roche's official Genentech Twitter account that tweeted, "Nice antibody. Wanna conjugate?"

Educational? The meme is clearly entertaining -- well at least most of them, some got a little raunchy -- and it highlights that investors and companies can have a little fun. Investing may be serious, but it doesn't have to be stuffy.

But the list of pickup lines also serves as a nice glossary of terms that every biotech investor should know. Genentech's tweet, for example, refers to the process of adding drugs to antibodies so the drug can be targeted to specific cells. Seattle Genetics (NASDAQ: SGEN) and ImmunoGen (NASDAQ: IMGN) have both developed technologies to produce antibody-drug candidates; Roche's T-DM1 was developed using ImmunoGen's technology.

Here are a few more that contain terms you should know:

There are plenty more, have a look and if you find any that you just don't get, it might be time for a little education to make you a better biotech investor. Just don't try using them at the bar.

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The Most Interesting Thing at JPMorgan's Health Care Conference

BOSTON (AP) -- Massachusetts Gov. Deval Patrick plans to propose legislation calling for sweeping changes in future retiree health care benefits for state and municipal employees that officials estimate will save up to $20 billion over the next 30 years.

The changes would include raising the number of years an employee needs to be vested in the retiree health care system, cut the state's contribution to health care premiums for many workers, and raise the eligibility age for health benefits from 55 to 60 for most employees, according to an administration official knowledgeable about the report. The official spoke on condition of anonymity because the report had not yet been made public.

The recommendations are to be included in a report due for release Friday by a special commission studying what many in government view as unsustainable costs for retiree health care.

The proposed changes would not affect any of the current 75,000 retired state employees, spouses or survivors who receive health care benefits, or about twice that number of retired municipal workers.

But current state and municipal employees would be affected with some exceptions, such as a worker who currently has completed at least 20 years of service and is within five years of retirement.

According to the commission, Massachusetts faces an unfunded liability for retiree health care and other non-pension benefits totaling more than $46 billion approximately $16.7 billion for the state and $30 billion for cities and towns. The liability exceeds the state's unfunded pension obligations, and according to the report the state and most cities and towns have not set aside adequate resources to cover health care liabilities.

Among the key recommendations that will be included in the legislation, according to the administration official, is raising the minimum years of service an employee must have before being vested in the retiree health care system from the current 10 years to 20 years.

The state currently contributes 80 percent of the health care premium for all vested retirees, but that too would change for many workers in the future. Retirees with 20 years of service would be eligible for a 50 percent premium contribution from the state, rising on a prorated basis for each year of service up to 30 years, when a retiree would become eligible for the full state contribution.

The same proposed changes would apply for municipalities, though some currently pay a lower share of the premiums for retirees.

The minimum age for eligibility to receive retiree health care benefits would also rise from 55 to 60, though it would be lower for some workers, such as police and firefighters, who can retire at younger ages.

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Massachusetts to revamp retiree health care

CORPUS CHRISTI Coastal Bend residents could get better access to primary care doctors, specialty care doctors and mental health services, as well as more comprehensive care for the chronically ill, under a new federal financing system the state is implementing.

Area health care providers have submitted proposals for $312 million worth of projects aimed at transforming the way they care for uninsured and other uncompensated patients.

The projects were submitted as part of the Medicaid waiver the state received, which could draw $29 billion for statewide health care providers during the next five years.

The waiver replaces the old financing system in which health care providers received reimbursements for the amount of uncompensated care they provided. Under the new system, some federal dollars will continue to reimburse for uncompensated care but other dollars will go toward projects that cut the cost of health care and improve the quality.

Driscoll Children's Hospital, for example, has proposed expanding some already successful programs, including the Oral Health Project, which provides low-income children with preventive dental care.

"For some of these young kids, it helps reduce incidents of oral health disease that, if you didn't take care of, would have to be treated with surgery," said Eric Hamon, the hospital's vice president and chief financial officer.

Hamon said the new financing system, which will tie money to good patient outcomes and cost efficiency, give health care providers more flexibility in how they treat their patients.

"You tailor the care to the population you serve," he said. "This allows us to specifically carve out, not only what's best for our region, but for the children of South Texas."

Local health care providers picked their projects based on the community's health needs.

The Coastal Bend has an inadequate number of primary and specialty care providers, high numbers of uninsured, inadequate access to behavioral health services and high prevalence of chronic diseases, including heart disease and diabetes, according to the region's plan.

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Area health care providers propose projects to improve care, cut costs with new federal financing system

A Texas Health Care Story What Is Health Insurance
http://www.lientx.AwisCard.com 281-948-9863 Just Call today!

By: Nguyen FamilyCare

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A Texas Health Care Story What Is Health Insurance - Video

Family Chiropractic Spinal Health Care Center
Family Chiropractic

By: Don Robinson

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Family Chiropractic

LITTLE ROCK, Ark. (AP) -- Wal-Mart Stores Inc. said Thursday it will add its Arkansas employees' insurance plan to a state effort aimed at lowering health care costs by changing the way private insurers and Medicaid pay for services, and it committed $670,000 to create a tracking system that would measure the initiative's success.

The world's largest retailer announced that it would participate in the state's payment improvement initiative, which moves away from a fee-for-service model to one where insurers pay for "episodes" of care rather than each individual treatment.

The Bentonville-based retailer said its insurance plan in Arkansas, which covers about 57,000 workers, will be a part of the initiative. Besides paying for the tracking system, the $670,000 commitment over the next four years also will help distribute information about the reforms and Wal-Mart will serve on an employer advisory council for the state.

Officials with the company said they believed Wal-Mart and other private companies would save money with the payment reforms and that the program aligns with its discount philosophy.

"We believe if we can apply that mindset of saving people money so they can live better to the health care system, then we will all come out ahead," Sally Welborn, Wal-Mart's senior vice president of benefits, said at a news conference at the state Capitol.

Welborn said Wal-Mart, which self-insures its health program, has not estimated how much money it hoped to save in health care costs by joining the payment initiative.

"The goal is for the average Arkansan, and in particular the patients that are administered through Wal-Mart's plans, that we would see better quality care and lower costs over time," she said.

Gov. Mike Beebe and state health officials called the move an important step in its plan, billed as the first in the nation of its kind to change the way health care pays for services.

"The old way of paying for health care is unsustainable," Beebe said. "The old fee for service model is unsustainable."

Under the initiative, the average cost of services provided by doctors and other health care providers will be measured once a year and compared against an established threshold. The providers will either receive a share of the savings, if the costs come in less than the established threshold, or pay for any costs that go above that level.

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Wal-Mart to join Arkansas health care program

LITTLE ROCK, Ark., Jan. 10, 2013 /PRNewswire/ -- Arkansas Governor Mike Beebe announced today that Wal-Mart Stores, Inc. (WMT) is joining a groundbreaking effort to create a more patient-centered and cost-efficient health payment system through the Arkansas Payment Improvement Initiative (APII). Walmart has committed $670,000 to underwrite the ongoing work of the new program, the first of its kind in the United States.

"We have worked for the past two years to bring the public and private sectors together in order to provide better health care in more cost-efficient ways," Governor Mike Beebe said. "It's critical that large, self-insured companies like Walmart be involved in this complex work that has the potential to serve as a model for the rest of the nation. With more than one million people on its health plan, Walmart's willingness to step forward and lead in this effort shows the company's continued pursuit of innovation and the initiative's potential for the future of health care."

Now in the first phase of implementation, the Arkansas Payment Improvement Initiative is designed to reward physicians, hospitals and other providers who give patients high-quality care at an appropriate cost. The long-term goal is to build a new and sustainable system that provides the best possible health care for Arkansans through team-based approaches and cost containment. For example, when primary care providers actively encourage patients to use preventive services, patients can manage chronic diseases and reduce future serious illnesses and costly treatments. And, when people receive appropriate follow-up care after hospitalizations, the likelihood of hospital readmissions can be dramatically reduced, which results in better health and lower costs.

As part of the agreement, Walmart will serve on the newly created APII Employer Advisory Council, fund the development and distribution of information to the public that explains how payments are being restructured, and help underwrite an annual statewide tracking report that will evaluate the impact and effectiveness of the project.

"We are very supportive of this work that will reward doctors, hospitals and other providers who offer great care at an appropriate cost," said Sally Welborn, Walmart senior vice president of benefits. "Governor Beebe is leading a first-of-a-kind payment-reform effort in Arkansas that health experts elsewhere are following closely. We respect the work being done in Arkansas, and we are excited about the opportunity to offer real support to such a meaningful project in our home state."

Health care costs in the United States are projected to increase 6.3 percent in 2013. The average deductible for an individual on health plans in the U.S. increased nearly 9 percent last year.

"Our health care system is at a tipping point brought on by rising costs, an increasingly unhealthy population and a fragmented system of care," said Arkansas Surgeon General Dr. Joe Thompson. "We need all hands on deck if we are to restructure the health care system to better meet the needs of our citizens. Private companies pay for a large portion of our health care costs. So, it is very encouraging to have an organization of Walmart's stature join this important effort."

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Walmart Joins Arkansas Health Care Payment Improvement Initiative

By MARY SHEDDEN | The Tampa Tribune Published: January 10, 2013 Updated: January 10, 2013 - 6:34 PM

Gov. Rick Scott's controversial projections about expanding health care for the poor are a sign of the uncertainty behind the looming federal overhaul, conservative lawmakers and health care executives said today.

Scott has been criticized for releasing an analysis this week that predicted adding nearly 900,000 Floridians to Medicaid would cost the state $26 billion over the next 10 years. His Agency for Health Care Administration revised that estimate to $3 billion after complaints.

Sen. Joe Negron, R-Stuart, chairman of a committee guiding the state's health care expansion, backed Scott's initial decision to calculate possible costs without considering contributions from the federal government. There's no guarantee that contribution will last, Negron said at the Florida Health Care Affordability Summit in Orlando.

"I think the governor is reasonable in questioning the cost," Negron said during a panel discussion sponsored by the business advocacy group Associated Industries of Florida.

Regardless of the final costs, several state hospital leaders and health policy experts said Florida must come up with some way to provide insurance for those who are poor enough to qualify for an expanded form of Medicaid. The federal Affordable Care Act requires that all Americans be insured by Jan. 1, 2014.

"I just want to see people in the hospital show up with a (health insurance) card," said Daniel Waldmann, senior vice president of public affairs for the South-Florida's Tenet Healthcare Corp.

Negron questioned the value of handing over Medicaid cards to residents and making them "wards of the state" if they don't want to or can't get to a doctor. Negron backs Scott's proposal that these uninsured residents buy subsidized insurance plans on a privately-run health care exchange.

"I'm leery of people telling other people that don't have something that they need it," he said.

But even leaders who back a private market expansion acknowledged that Medicaid is better than nothing. Hospitals absorb millions in unpaid hospital bills every year, and indirectly pass those costs onto small businesses and people with insurance, said Alan Levine, Florida group president for the Health Management Associate hospital chain, which includes Pasco Regional Medical Center.

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Lawmakers, executives debate health care overhaul at Orlando summit

Posted: Jan. 9, 2013 | 2:04 a.m.

Scores of people from around the world are coming to Las Vegas to see the future of technology at the annual Consumer Electronics Show, the world's largest consumer technology trade show. What might surprise people is that the next cutting-edge technologies may not be a smart TV or a tablet - they are health-related innovations that are already in their hands.

A majority of Americans - 53 percent, according to a recent national survey - don't use consumer electronics to access important health care information, options and services. However, more than 60 percent of survey respondents anticipate increasing their use of consumer technology for just these purposes during the next year. This suggests the public is starting to realize how technology and consumer electronics can help them learn more about health, empower them to take better control of their individual health, and even simplify the entire health care system.

So what innovations at CES will help shape tomorrow's health care system?

Here are a few examples of how consumer technology already intersects with personal health:

Exergaming: Studies are showing that "exergaming," which refers to video games that also serve as a form of exercise, are becoming an increasingly popular and effective way to reduce the growing obesity epidemic among children and adults. Driven by interactive video game consoles that incorporate movement into game play, exergaming represents a new, fun way to get in shape, at home and in other settings. For example, UnitedHealthcare and Konami have teamed up to install DanceDanceRevolution Classroom Edition, the latest iteration of the popular dance game, in three schools. The participating schools, in Florida, Georgia and Texas, will track the impact the gaming system has on the students' health, well-being and exercise habits.

Health care pricing tools: Historically, patients often don't know how much their medical care actually costs, with the bill arriving months after treatment. That is starting to change as new online tools enable consumers to comparison shop for health care services, based on quality as well as cost. Some of these tools enable people to create side-by-side quality comparisons, ensuring consumers place just as much emphasis on quality as they do price.

Mobile applications: The growing prevalence of smartphones has started to empower consumers to take charge of their health like never before. The possibilities are almost limitless, with a range of apps already improving the health and well-being of people nationwide. Recently introduced apps enable friends, colleagues and families to participate together in health challenges of their own design, while other apps enable people to find in-network doctors, check benefit information and review the status of a specific claim.

CES is the place where America gets a sneak peek at the entertainment, information and education technologies of the future.

But we don't need to look too far ahead to see the future of health care in America; the answer is already in front of us. Just look down at the remote control, game console or smartphone that's already in your hand.

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Health Care Technology At Your Fingertips