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Initiative Gives Health Care Dose of Transparency

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By giving patients access to their doctors’ notes, the OpenNotes initiative seeks to improve health and health care.  Danville-based Geisinger Medical Center was one of three health systems to participate in a national study, and officials there were so pleased with the results they’ve already expanded the program.

“Patients really seem to love this and physicians – for the most part – really don’t seem to mind all that much,” explains Dr. Jonathan Darer, Geisinger’s Chief Innovation Officer. 

82% of the patients participating in the trial actually opened their notes, and 77 – 87% of them reported that access to their doctors’ notes made them feel more in control of their health care. 

“Here we have an innovation where all we did is share information and patients feel like they’re getting better care,” Dr. Darer tells Radio PA.  “How cool is that?”

In light of the study’s findings, Geisinger has expanded the OpenNotes program to more than 500-doctors and roughly 130,000 patients. 

Darer envisions the day when the initiative will be ubiquitous, not only at Geisinger, but throughout the health care industry.  Adaption will be even faster, Darer says, if future studies can confirm that this sort of information sharing improves clinical outcomes in addition to getting patients more involved in their care.

RadioPA Roundtable

Radio PA Roundtable 05.24.13

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On this week’s Radio PA Roundtable, Matt Paul discusses new legislation that would create letter grades (A – F) for all of the state’s public schools, and examines a new law designed to expand community health clinics in the state.  Also, have you ever wanted to actually see your doctor’s notes?  Many Geisinger patients are alreading doing it.

Please have a happy & safe Memorial Day weekend, and remember to take some time to consider the true meaning of the holiday.

Radio PA Roundtable is a 30-minute program featuring in-depth reporting on the top news stories of the week.

Click the audio player below to hear the full broadcast:

[audio:https://s3.amazonaws.com/witfaudio/radiopa/Roundtable05-24-13.mp3]
health care, prescription

Report: Fewer Pennsylvanians Getting Health Insurance via Employer

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The Robert Wood Johnson Foundation has been tracking a decade-long decline in the number of Pennsylvania residents who receive health insurance through their jobs.  Back in 2001 78% of Pennsylvania residents received health insurance via their employers.  In 2011; 67%. 

A new report indicates the reduction is due to a combination of fewer employers offering insurance and fewer employees selecting insurance.  “And we think that part of this has to do with the costs,” RWJF senior vice president John Lumpkin tells Radio PA.  “Over the last ten years we’ve seen that the cost of buying insurance in Pennsylvania has more than doubled, and this makes it difficult for companies to try to purchase insurance for their employees.” 

Pennsylvania’s average employer-sponsored insurance premium for individuals now stands at $5,100.  Family premiums increased from $6,400 – $14,300 over the time period covered in the study.

In all, 47-states saw a statistically significant decline in employer-sponsored insurance over the past decade.  Pennsylvania was one of 22-states to see a drop-off of ten percentage points or more, but Lumpkin says it still ranks in the middle of the pack.

Starting in 2014, Lumpkin believes the health insurance exchange, offered via the Affordable Care Act, will provide alternatives for the 33% of Pennsylvanians who do not receive health insurance through their employers. 

But will states like Pennsylvania experience a further decline in employer-sponsored insurance once the federal health care overhaul is fully implemented?  According to Lumpkin, no.  “Seven years ago Massachusetts passed a law that was very similar to what we see with the ACA, and in their experience employer-sponsored insurance – insurance through the job – has stayed exactly flat.” 

Pennsylvania has elected to allow the federal government to operate its health insurance exchange, or marketplace, but could still opt to assume control at a later date.

Supporters Push Nurse-to-Patient Ratio Bills

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Pennsylvania hospitals would be required to meet minimum nurse-to-patient ratios under bills introduced in the state House and Senate.  The ratios would vary depending on the care setting, but supporters say they could both improve patient safety and save money in the long run. 

Inadequate staffing is the ultimate concern for Pennsylvania Association of Staff Nurses and Allied Professionals (PASNAP) president Patty Eakin.  “Patients can suffer,” she tells Radio PA, “and suffering is not just dying but you might have medication errors made, you might have medications missed, treatments missed.”    

Eakin points to a 2010 study out of the University of Pennsylvania that indicates California’s mandatory minimum nurse-to-patient ratios are helping to save lives. 

But California is the only state to go down this road to date, and Pennsylvania hospitals have long opposed similar bills that have been introduced in the General Assembly. 

The Hospital & Health System Association of Pennsylvania says a one-size-fits-all policy ignores the many variables involved in determining safe staffing levels.  HAP also contends there’s no consensus on what nurse staffing levels should be or how to set them. 

This year SB 637 has been introduced by Sen. Daylin Leach (D-Montgomery) and HB 923 has been introduced by Rep. Phyllis Mundy (D-Luzerne).  While similar bills have gone nowhere in Harrisburg, Eakin says giving up the fight is not an option. 

(photo credit: CDC / Judy Schmidt)

Grassroots Movement Behind Bills to Expand FMLA

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The federal Family Medical Leave Act was enacted 20-years ago this month.  While the anniversary is considered a milestone, and millions have used the FMLA, many believe it’s time for an update. 

The law allows employees to take unpaid leave to care for a child, parent or spouse.  But Anne Marie Pearson of Chester County was thrust in the role of caregiver for her sister, who had nobody else to help her battle late-stage gynecologic cancer.  “Our father is deceased and our mother is elderly with medical conditions of her own,” Pearson explains of the situation in 2008.  “Joanne was not married and she did not have any children, so there really wasn’t anyone to help take care of Joanne, and get her back-and-forth to those chemotherapy appointments, radiation appointments and so many doctor visits.” 

Pearson was immediately turned down through the Family Medical Leave Act because it does not cover siblings, and her attempts to obtain a special exemption went nowhere.  Ultimately she had to quit her job of 16-years; a decision Pearson says she’d make 100-times over. 

Joanne has since passed away, but Anne Marie Pearson has taken up a grassroots movement to expand the FMLA in Pennsylvania for others in similar situations.  “I figured no one law out there can dictate who’s considered family anymore.  There’s death, divorce, separation, single people – they all play a role in everybody’s family unit.” 

While the FMLA is a federal law, the best chance for action is the state-level, and Pearson’s local legislators have taken up the cause.  State Rep. Dan Truitt (R-Chester) and State Senator Andy Dinniman (D-Chester) have introduced companion bills in Harrisburg, which would – under special circumstances – provide up to six weeks of unpaid leave for an employee to care for a sibling, grandparent or grandchild. 

Such individuals would only be eligible if the person being cared for has no living spouse, child (over 17-years-old) or parent (under 65-years-old).  The bills would mirror the federal law, which means that small businesses would be exempt. 

Truitt’s bill has been assigned to the Aging & Older Adult Services Committee.  Dinniman’s co-sponsorship memo is currently being circulated.

Report: Insurance Costs Outpace Income Growth

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The story is the same in all 50-states; the rising cost of employer-sponsored health insurance has dwarfed income growth over the past eight years.  A new study from the Commonwealth Fund crunches the numbers from 2003 – 2011. 

In Pennsylvania, the report pegs the combined cost for a family plan at $15,000, which is right at the national average.  “It’s an increase of 65% in just eight years,” explains Senior Vice President Cathy Schoen, who says Pennsylvanians’ median income increased only 13% over that same period.   

If trends continue at this rate the report indicates that Pennsylvania is on its way to a nearly $25,000 a year family premium by the year 2020. 

Schoen, however, believes the Affordable Care Act will slow the growth of health insurance and health care costs.  “Taking even 1% off the trend makes a real difference,” Schoen says, “By 2020 it would mean – in Pennsylvania — $2,000 more on the table for families in terms of wages or employers investing in jobs.”        

The Commonwealth Fund report is being released as governors across the nation are deciding whether to create state-based health insurance exchanges for individuals and small businesses to purchase insurance.  Pennsylvania, like 27 other states, will rely on the federal government to run its marketplace.

RadioPA Roundtable

Radio PA Roundtable 12.14.12

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On this week’s Radio PA Roundtable, Brad Christman and Matt Paul break down Governor Tom Corbett’s big decision on a health care exchange and look ahead to possible Medicaid expansion under the Affordable Care Act.  Also, Matt speaks with US Seantor Bob Casey about the gift card regulations he’s pushing this holiday season.

Radio PA Roundtable is a 30-minute program featuring in-depth reporting on the top news stories of the week.

Click the audio player below to hear the full broadcast:

[audio:https://s3.amazonaws.com/witfaudio/radiopa/Roundtable12-14-12.mp3]

Will PA Take Medicaid Expansion Option?

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Governor Tom Corbett has already decided against a state-based insurance exchange under the Affordable Care Act, but he’s still mulling whether to take an option to expand Medicaid.  The federal health care law expanded Medicaid to cover people up to 138% of the federal poverty line, but the courts have since made in optional for the states.

The federal government would pick up the vast majority of the tab, and state Senate Democratic Appropriations Chair Vincent Hughes (D-Philadelphia) is urging the governor to opt-in.  “That is a $4-billion dollar windfall for the people of Pennsylvania.  That’s $4-billion dollars of new investment in our health care network across the Commonwealth,” Hughes tells reporters.

Supporters say it will ensure health care coverage for hundreds of thousands of Pennsylvanians, save on uncompensated care costs and stimulate the economy.  Critics say it will financially burden the Commonwealth, and question how the federal government can truly fund its share of such a massive Medicaid expansion when it’s $16-trillion dollars in debt. 

In a statement, Governor Tom Corbett said he will continue to seek guidance from the US Department of Health and Human Services on the costs, impacts and flexibility involved in the state’s options.