Health

Brought to you in part by: Dartmouth-Hitchcock

The state’s University System says it saved $10 million last year by switching how it provides health insurance for employees.

Rather than paying an insurance company a fixed amount per employee for health coverage, the University System now uses a self-insured plan, where it pays out of pocket as health bills come in.

Self-insured plans put more risk on the employer, but Todd Leach, Chancellor of the University Stem, says the model made economic sense for his institution.

After a $0.10 cut two years ago, smokers in New Hampshire will again pay an extra dime in tobacco taxes starting today. 

Republicans in the statehouse lowered the tobacco tax in 2011, saying the cut would spur cross-border sales and boost state revenues. But tax receipts have come in $56 million lower in the past two years than the prior biennium.

Lawmakers included an automatic trigger to reset the tax if revenues fell, so today, the tax goes back up to $1.78 per pack.

Todd Bookman / NHPR

The New Hampshire Insurance Department took an overwhelmingly positive view on expansion during its presentation to the Medicaid Expansion Study Commission, the body that will decide if the state grows the health care program for the poor under so-called Obamacare.

Department officials told the nine-member body that expansion would benefit a wide range of groups, including insurance companies, hospitals and employers with low-paid workers.

Tyler Brannen, a health policy analyst with the Department, testified that people who buy their own insurance also stand to gain.

Todd Bookman / NHPR

    Infants who suffer from malnutrition are more likely to have poorer physical health when they grow up.

Research also finds more emotional problems, including anxiety and attention deficit disorder.

But even as the negative long-term impacts of infant malnutrition become clearer to scientists, Dr. Janina Galler is working to push the field of study even further.

When An Emergency Room Closes Its Doors

Jul 22, 2013
Todd Bookman / NHPR

Back in December 2008, with the town of Lyndeborough still frozen from an ice storm, Sue Carita and her husband went to check on a neighbor. Good deed done, they would both slip and fall on the return trip.

“We went home and called our doctors and of course, it was 4:30pm, 5:00pm on a Saturday afternoon, and there was no one there,” she recalls.

In pain, the Caritas sought care at the nearby Milford Medical Center, where x-rays showed she had a broken wrist, her husband a cracked hip.

One key aspect of the federal health overhaul law is a transition away from a fee-for-service system, where hospitals and doctors get paid, for example, per lab test or re-admission. To help test new models under so-called Obamacare, 32 hospitals nationwide launched an alternative system called an Accountable Care Organization (ACO).

Results released today looking at the first year of the program show Dartmouth-Hitchcock as one of 18 hospitals that succeeded in lowering costs compared to a control group of Medicare patients.

Todd Bookman / NHPR

As head of Dartmouth’s mission control center for Medivac flights, Mark Pippy spends a lot of time grappling with New England weather.

“Oh, wait ten minutes: it is going to change,” Pippy jokes. “It is always partly cloudy to partly sunny, with a chance of showers, and there will be darkness. And you got it 100% of the time.”

Pippy has spent the past 19 years dispatching copters from Dartmouth’s Lebanon campus and a unit based in Manchester. Together, they fly around 1,400 calls each year. Now, he’s a got a new GPS tool to help.

Special Medicaid Commission Gets To Work

Jul 8, 2013

A special commission looking into a possible expansion of the state’s Medicaid program met Monday for the first time.

The body consists of nine voting members, including five Democratic appointees and four by Republicans.

They put partisanship aside during the first meeting, unanimously selecting Jim Varnum to chair the group. He was tapped to serve by Governor Hassan after leading Mary Hitchcock Memorial Hospital for nearly three decades.

“I appreciate the opportunity and the confidence you have,” says Varnum. “This is such an important task for all of us.”

Some New Hampshire businesses say they welcome news of a recent delay in a key part of the Affordable Care Act. 

On Tuesday, the Obama Administration announced it is postponing the so-called employer mandate by a year, citing a need for more time to simplify regulations. 

It was this provision that Senator Kelly Ayotte, speaking at the Republican National Convention last summer, offered  as a reason why she thinks Obamacare won’t work.

The final four members have been named to the state's Medicaid Expansion study committee.

Dartmouth-Hitchcock is agreeing to join the Medicaid managed care program.  The state's largest health care system had been a key hold out in the new effort.

A transition from traditional Medicaid to so-called managed care is already a year behind schedule, costing the state an estimated $15 million in expected savings. One problem has been a lack of participation from hospitals. They’ve voiced concerned that the arrangement could pay them less for treating Medicaid patients.

Quirk In Health Law Creates 'Coverage Canyon'

Jun 25, 2013
istock photo

At 60-years old, Wendy Rogers considers herself lucky. She’s healthy, her kids are grown. There’s just one thing that gets her down: health insurance.

“I really don’t let myself think about it, because it overwhelms me.”

Rogers lives in Franklin, in a tidy apartment decorated with framed photos of friends and family. She lost her insurance three years ago, after getting laid off from a local school district  where she was a kindergarten aide. Now she works part time at a child-care center.

Rogers says she relies on family for medical expenses.

State public health officials today released their final report looking into the outbreak of Hepatitis C at Exeter Hospital. The document provides new information into just what took place inside the hospital’s cardiac catheterization lab, where a former employee stands accused of stealing narcotics and returning tainted needles. 

NHPR’s Todd Bookman tells All Things Considered Host Brady Carlson about the important new information in the case.

Medicaid Expansion Left Out Of Next State Budget

Jun 20, 2013
Todd Bookman / NHPR

    

The heavy lifting on the state’s next two year budget wrapped up a little past 3 a.m. Thursday. So when the two sides gathered less than twelve hours later to make it official, House budget leader Mary Jane Wallner was happy to call it a day.

“That’s it. I think we’re done. We’re adjourned!”

But despite that celebratory flourish, lawmakers are far from done when it comes to Medicaid.

Leaders in the Democratically-controlled New Hampshire House are seeking to cut a deal with Senate Republicans that would expand the state’s Medicaid program.  But hours after receiving the proposal Tuesday, members of the upper chamber said they can’t move forward with the plan, and offered their own course of action.

Medicaid expansion remains a key sticking point as lawmakers seek to finalize the state’s next budget by Thursday’s deadline.

New Hampshire can withdraw from an expanded Medicaid program at any time, according to a letter received Thursday from the Centers for Medicare and Medicaid Services, or CMS.

The letter comes as legislative negotiators are poised to meet to finalize the state’s budget.

A point of impasse between the Democratically-held house and Republican-controlled Senate has been an expansion of the state’s Medicaid program.

Todd Bookman / NHPR

 Women’s health advocates took to the statehouse today, calling for an expansion of the state’s Medicaid program under the Affordable Care Act. The issue remains a sticking point as lawmakers work to finalize the state’s budget.

Planned Parenthood’s Jennifer Frizzell estimates that 61% of those able to sign up for an expanded Medicaid program are women, and she accuses GOP lawmakers of being oblivious to what they want.

Governor Hassan today announced the reopening of 12 psychiatric beds at New Hampshire Hospital. They'll be used to treat adults over the age of 55 in need of both psychiatric help and medical attention, and are meant to shore up a mental health system that the Governor calls deeply strained.

New Hampshire's Health Exchange Monopoly

Jun 10, 2013
via WUKY

It wasn’t exactly a victory lap, but the president was in California last week praising an early success of the Affordable Care Act.

Speaking in San Jose on Friday, Obama touted the California health insurance exchange--one of the new online marketplaces where individuals and small business employers can shop for coverage and apply for subsidies starting October 1.

California's exchange will have 13 companies competing for business and rates far below what experts predicted.

State public health officials say another person has tested positive for Hepatitis C stemming from last year’s outbreak at Exeter Hospital. 

That brings the total number to 33.

A former hospital employee was arrested last July in connection with the spread of the virus inside the cardiac catheterization lab. Prosecutors say David Kwiatkowski reused syringes on patients after injecting himself with powerful pain killers.

Dr. Jose Montero, the state’s public health director, says it appears this latest case, though, is from sexual contact.

Todd Bookman / NHPR

Supporters of Medicaid expansion filled the lobby of the Legislative Office Building in Concord for a mid-morning press conference. The show of force comes in advance of Thursday’s budget vote in the Senate.

Flanked by reform advocates, hospitals administrators and doctors, Governor Hassan pressed lawmakers to take advantage of the federal government’s promise to pay 100% of the costs of expansion for the first three years.

She quoted New Jersey Republican Governor Chris Christie, who supports expansion and says it will save money for taxpayers in his state.

One of the biggest and most contentious issues of this spring’s budgeting process remains whether or not the state should expand Medicaid. When the Supreme Court ruled last summer on the Affordable Care Act, it said the Federal government can’t force states to expand. Instead, states must be given a choice about growing the health care program for the poor.

Governor Hassan and the Democratically controlled House favor expansion, and the House included it in its proposed spending plan.

Group Prenatal Care Takes Root In New Hampshire

May 29, 2013

Just off from a circle of cushioned chairs, behind a privacy screen, Jessica Densmore greets patients inside a Cheshire Medical Center conference room, in Keene.

“Let’s take a listen and see if we can hear this baby today,” she says, positioning a fetal heart monitor.

Today’s mothers, ten in total,  are all between 22 and 29 weeks pregnant. They come once a month, and then every two weeks as due dates approach, for their Centering Pregnancy appointment: basically a group check-up.

GOP Budget Writers Vote Down Medicaid Expansion

May 22, 2013

Saying there’s simply too much uncertainty, top Senate budget writers voted 4-2 against expanding the state’s Medicaid program on Wednesday.

Senate President Peter Bragdon (R-Milford) says he has concerns the Federal government won’t be able to meets its promises to fund the expansion long-term.

And he says it’s unclear if the program would even improve care for the uninsured.

State Hears Ideas For Launching Health Exchange

May 17, 2013

Health providers, small business owners and reform advocates attended a brainstorming session in Concord on Friday. State Insurance Department officials organized the event, seeking input on how best to implement the new health exchange in New Hampshire.

A range of ideas were offered, from social media campaigns to informational events at hardware stores to old-fashioned word of mouth. Participants stressed a need to reach all communities, including minority and non-English speaking groups, and to do so quickly.

State officials continue to press for action on $340,000 in federal money meant to help implement the health exchange in New Hampshire. 

Speaking to the Joint Health Care Reform Oversight Committee, Insurance Commissioner Roger Sevigny repeated the need for quick acceptance of the grant money. Last month, a different legislative body, the Joint Fiscal Committee, delayed the funds, citing concerns over a lack of information.

Sevigny says the money would help "put flesh on the bones" of his Department's effort to help consumers understand the new health law.

N.H. Panel Urges Action On Health Overhaul Funding

May 11, 2013

A committee advising New Hampshire on implementing the federal health overhaul law is urging state lawmakers to move quickly in accepting federal money intended for consumer assistance and outreach.

The Health Exchange Advisory Board, whose members represent consumers, health care providers, insurers and businesses, drafted a letter Friday saying that timely, effective outreach will be impossible unless the Legislature accepts the money.

Michael Brindley / NHPR

About 100 people gathered at the State House Plaza on Thursday to highlight children’s mental health awareness.

Many there said more funding is needed to make sure children have access to proper mental health care.

Francine Gagne with the Greater Nashua Mental Health Center says children are often overlooked in the discussion about funding for mental health programs.

New Hampshire Not Alone In Health Exchange Setbacks

May 6, 2013
via WUKY

The new health exchanges are often described as something akin to Orbitz or Travelocity. A central place--a website--where insurance can be researched, compared, and purchased.

“Competition in markets, of course, is the way in this country we try to make reasonable prices and good quality available to people and so that is one of their roles,” says Professor Timothy Jost with Washington and Lee University in Virginia.

Jost says another key role of the exchanges is subsidies.

robson / Flickr/Creative Commons

As part of the Affordable Care Act, pharmaceutical company payments to doctors will become public information starting in 2014. But a slice of those disclosures is already available, and the impact of transparency is being felt across New Hampshire.

In the last four years, New Hampshire doctors and nurse practitioners have taken in $5.8 million in money from drug companies.

But in 2012, for the highest earning doctors, there was a noticeable decline. In fact, every one of the top 10 recipients in the state saw his or her total compensation go down or hold flat last year.

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