Announcement

President's Report
by: Rod Betit (November 03, 2006)

Summary: Reports released new polling information that Alaska's gubernatorial race has grown more competitive. Republican Sarah Palin now leads Democrat Tony Knowles 42% to 40% . Twelve percent (12%) prefer "other," which in this poll would most likely be Independ

Full Story: el PRESIDENT’S REPORT November 3, 2006 Rasmussen Reports released new polling information that Alaska's gubernatorial race has grown more competitive. Republican Sarah Palin now leads Democrat Tony Knowles 42% to 40% . Twelve percent (12%) prefer "other," which in this poll would most likely be Independent candidate Andrew Halcro. With leaners added to the mix, it's Palin 45%, Knowles 44%. NOTE: ASHNHA’s Political Action Committee endorsed the Tony Knowles for Governor campaign on October 12, 2006. ________________________________________ AHA has provided the following estimate of the impact of final hospital payment rates released by CMS on September 29, 2006 under the Medicare Inpatient Prospective Payment System. The policy changes reflected in the 2007 rates include changes to adopt the new wage index, and the first phase of transition from “charge basis” to “cost based” weights to set rates. For 2007 the estimated Alaska percent impact of 3.2% compares favorably to the U.S. average of 3.0%. The range of impact was from a low of 0% for North Dakota to a high of 4.2% for Nevada (higher % denotes more favorable impact on a state). ASHNHA has provided facility specific financial impact information to the eight facilities impacted. # of Hospitals Affected Estimated Payment w/FYO6 Policies Estimated Payment w/FY07 Policies Dollar Impact Percent Impact U.S. 3,456 93,734,958,256 96,585,951,909 2,850,993,653 3.0% Alaska 8 102,947,268 106,223,471 3,276,204 3.2% ________________________________________ Medicare payments to physicians will decrease an average of 5% in 2007, according to a final version of rules made public on Wednesday, the AP/Seattle Post-Intelligencer reports. CMS in the draft version of the rules had projected a 5.1% reduction. Under the final version, payments to physicians will be cut by more than 5% for some services and by less than 5% for others. Acting CMS Deputy Administrator Herb Kuhn said payments will increase for most "evaluation and management" services, such as preventive care. For example, payments will increase by one-third for office visits, the most frequently billed physician service. Acting CMS Administrator Leslie Norwalk said the new rules "will encourage physicians to spend more time with their patients, assessing their health status and educating them about how to live longer, healthier lives." However, the AMA said almost half of physicians will face payment cuts from 6% to 20%. Cecil Wilson, chair of the AMA board of trustees, said the overall reductions "will negate any payment increases specific to physician office visit payments". The new payment rates are scheduled to take effect Jan. 1, 2007. ________________________________________ On October 1 the Massachusetts Connector began enrolling people at or below the federal poverty level into the new Commonwealth Care Health Insurance Program. Enrollment for those people above the federal poverty level is targeted to begin in January 2007. As of November 1, 2006, 15,326 people have been determined eligible for Commonwealth Care and 3,343 have been enrolled into a Commonwealth Care health plan. For those individuals whose incomes are at or below 100% of the federal poverty level, their health insurance plan will cover:  Inpatient services  Outpatient services and preventative care by participating providers  Prescription drugs  Inpatient and outpatient mental health and substance abuse services  Dental care, including preventive and restorative services  Vision care The benefits packages for individuals whose incomes are between 100% FPL and 300% FPL are still being finalized. ________________________________________ Wearing scrubs and slouching in their chairs, the emergency room staff members, assembled for a patient-safety seminar, largely ignored the hospital’s chief executive while she made her opening remarks. They talked on their cell phones and got up to freshen their coffee or snag another Danish. But the room became still and silent when an airline pilot who used to fly F-14 Tomcats for the Navy took the lectern. Handsome, upright and meticulously dressed, the pilot began by recounting how in 1977, a series of human errors caused two Boeing 747s to collide on a foggy runway in the Canary Islands, killing 583 people. Riveted, a surgeon gripped his pen with both hands as if he might break it, an anesthetist stopped maniacally chewing his gum, and a wide-eyed nurse bit her lip. An attention grabber, yes, but what does an airplane crash have to do with patient safety? After the Canary Islands accident, NASA convened a panel to address aviation safety and came up with a program called Cockpit or Crew Resource Management. The Federal Aviation Administration requires that all pilots for commercial airlines and the military undergo the training. They learn, among other things, to recognize human limitations and the impact of fatigue, to identify and effectively communicate problems, to support and listen to team members, resolve conflicts, develop contingency plans and use all available resources to make decisions. Recognizing the positive impact of the program on the aviation industry’s safety record, the Institute of Medicine in 2001 recommended similar training for health care workers. The National Academies, the Agency for Healthcare Research and Quality and the Institute for Healthcare Improvement also advocate the training, as well as the use of other aviation-inspired practices like pre- and post-operative briefings, simulator training, checklists, annual competency reviews and incident reporting systems. The British medical journal BMJ, The Journal of the American Medical Association and The Journal of Critical Care have also published research suggesting that hospitals that adopt these measures have fewer malpractice suits and post surgical infections. Patient recovery times tend to be lower, and employee satisfaction is higher. Some institutions, like Johns Hopkins, have created their own in-house training programs and safety structures based on aviation. “Aviation provided us with the ideas, which we then modified for health care as well as our particular situation,” said Dr. Peter Pronovost, the director of the Center of Innovation in Quality Patient Care at Johns Hopkins. The most recalcitrant tend to come around, however, when a safety check catches one of their mistakes, possibly saving a patient and preventing a malpractice suit. “I’m seeing errors caught virtually every day” in the operating room, said Dr. Timothy Dowd, the chairman of the anesthesiology department at Vassar Brothers, where critical-care staff members underwent aviation-based patient-safety training six months ago. “Even the most curmudgeonly surgeon has to admit this is a better way,” he said. (Excerpts of article from NY Times). ________________________________________ Upcoming Meetings of Interest: • ASHNHA 2007 Winter Meeting (Juneau) - March 8 & 9, 2007. A room block has been reserved at the Gold Belt Hotel for the nights of March 7 and 8. Rates are $104.00 Mountain View (weather permitting) and $109.00 Water view (there is always water). The phone numbers are - toll-free: 888-478-6909 or 907-586-6900. Meetings will be held at the Centennial Hall adjacent to the Hotel. The ASHNHA Board meeting will occur on March 9. • AHA Annual Meeting (D.C.) - May 5 through 9, 2007 in Washington, D.C. • National Rural Health Association Meeting (Anchorage) - May 14 through 17, 2007 in Anchorage, Alaska. • ASHNHA 2007 Annual Meeting (Petersburg) – to be held in conjunction with education sessions August 6 through August 9, 2007 in Petersburg. The ASHNHA meeting will take place on August 8 & 9. If there are other meetings you would like posted please let Rod know at rbetit@ashnha.com

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