|Dave and John by the Capital|
Saturday, May 18, 2013
On May 13-14, John Tremble and I went to Washington, DC to visit our legislative representatives. The goal for the visit was to raise concern related to two proposals that would impact Critical Access Hospitals (CAHs) in the President’s Fiscal 2014 - 2015 budget.
The budget targets both our Medicare reimbursement level and CAH designation for facilities within 10 miles of another hospital. The 10-mile proposal would be devastating to both Wisconsin and Minnesota—which have eight and four CAHs affected by this proposal respectively.
During the two day visit we were able to meet with the staff of both our Senate and House representatives from Wisconsin and Minnesota.
Senator Johnson (R-WI) Senator Klobuchar (D-MN)
Senator Baldwin (D-WI) Senator Franken (D-MN)
Representative Duffy (R-WI-07) Representative Nolan (D-MN-08)
Representative Kind (D-WI-03)
CAHs play a vital role in rural communities across the nation by providing access to health care, economic security, and jobs. Without CAHs, hundreds of thousands of Americans would likely lose or have limited access to essential care.
In retrospect, I am optimistic that we will be able to get support from all the Senators and Representatives that we visited. By Tuesday evening, we heard from Representative Duffy that he would take the lead in the effort opposing both proposals for the House Republicans.
Monday, March 11, 2013
Cesarean delivery is the most common surgery performed in the United States. There is enormous variation in C-section rates across the country according to a new study published in the journal "Health Affairs." The rates vary from 7.1 % to 69.9%, driven largely by differences in practices at individual institutions.
SCRMC is a leader when it comes to obstetrical care. We provide great value for our patients. We are a leader in quality, experience, and cost for obstetrical care. Regarding C-section rates, SCRMC is one of the lowest (lower is better) when compared to other hospitals in Wisconsin and Minnesota. Over the last three years our overall C-section rate has consistently stayed around 14%. Our primary rate (first time C-section) is approximately 5%. Of course there are other quality and safety factors that are monitored to track overall performance. I thought I would share this measure for comparison to the latest data.
Click here for additonal information related to the cesarean story on the Huff Post.
Attached is a link to the story in Twin Cities.com Pioneer Press
Monday, March 4, 2013
SCRMC and other health care providers will see payment reductions for services provided on or after April 1. It came very quietly, but the impact of the two percent across-the-board cuts will be felt across the country for all Medicare providers. With Congress’s failure to stop it, sequestration officially started at 11:59 pm March 1.
The U.S. Dept. of Health and Human Services (HHS) is expected to officially alert providers and insurers about the date that Medicare payment cuts will take effect, which is expected to be for services provided on or after April 1.
From my perspective, it is disappointing again that Congress is unable to work together to find common ground and work towards a long term solution to the country's fiscal crisis. It was even more troubling that there appeared in the weeks prior to the March 1st deadline no interest between the political parties to even attempt to work on a solution. To me this is irresponsible, we cannot run our organizations in this way, but I guess it is okay to run the Country in this manner.
For SCRMC, we did plan for the reduction due to our belief that no solution would be forthcoming. The two percent cut does have a negative impact to our financial health but true to our mission we will continue to put our patients first.
Source: Wisconsin Hospital Association
Dr. Lagus, who is a long time family practice physician at St. Croix Regional Medical Center participated once again in the American Birkebeiner Cross Country Ski Race. Dr. Lagus, who is 74, has been skiing in the race since 1978. The 88-kilometer Birkie Trail is located near Hayward and Cable, Wisconsin. He has participated in 34 of the races so far. He said he does it because he loves cross country skiing, and it keeps him motivated to stay healthy. During the off season he hikes, roller skis and bikes to stay in condition. He feels it really has kept him healthy. What a great example for all of us about the virtues of living an active and healthy lifestyle.
Incidentally, he has skied in 36 other cross country races in 15 other countries! Including Canada, Australia, New Zealand and Europe.
Saturday, January 26, 2013
You know you are getting old when you say, "Remember When." Unfortunately I do remember when X-country skiing was in my repertoire. It was a way for Jodi and I to enjoy the outdoors and get exercise at the same time. We had great hopes for this winter season with a major snowfall in December. We were so excited, we decided it was time to replace our skis from the mid 1980s and invest in new ones this winter and recommit to something we enjoyed from our earlier years. Since then, we have skied a few times but with the passing of time the snow keeps eluding us and what we have for snow is like ice. Skiing on that snow is like participating in the Red Bull Crashed Ice event happening this weekend. They use the tag, "The Ultimate Extreme Downhill Ice Racing Event." Try it on skis some time. As I head down to work out on the treadmill please join me in hoping for some good snow soon before this winter season is over.
|Skiing in Wild River State Park|
Wednesday, January 2, 2013
From the National Rural Health Association.
Hundreds of millions of dollars in rural health cuts were prevented by Congress as part of the last-minute “fiscal cliff” legislation passed last night. President Obama signed into law legislation that reinstates critical Medicare reimbursement payments to more than 850 rural hospitals, as well as prevented cuts to rural primary care physicians and rural ambulance providers.
The fiscal cliff bill, which included large tax provisions and an extension of unemployment compensation, also reinstated the Medicare-dependent hospital program and the low-volume hospital adjustment, both of which had expired Oct. 1. Had Congress not restored these payments, many rural fiscally fragile facilities likely would be forced to close their doors.
But we aren’t completely out of the woods. The 2 percent across-the-board sequestration cuts were delayed for two months, so the battle will begin again soon. Additionally, all rural payments were extended for a temporary period and additional calls for cuts are surely just around the corner.
Medicare physician payment update - This provision guarantees seniors have continued access to their doctors by fixing the sustainable growth rate (SGR) through the end of 2013. Medicare physician payment rates were scheduled to be reduced by 26.5 percent on Dec. 31. This provision would avoid that reduction and extend current Medicare payment rates through 2013.
Work Geographic Adjustment - Under current law, the Medicare fee schedule is adjusted geographically for three factors to reflect differences in the cost of resources needed to produce physician services: physician work, practice expense and medical malpractice insurance. This provision extends the existing 1.0 floor on the “physician work” index through 2013.
Payment for outpatient therapy services - Current law places annual per beneficiary payment limits of $1,880 for all outpatient therapy services provided by non-hospital providers but includes an exceptions process for cases in which the provision of additional therapy services is determined to be medically necessary. This provision extends the exception process through 2013. The provision also extends the cap to services received in hospital outpatient departments only through 2013.
Extension of Medicare inpatient hospital payment adjustment for low-volume hospitals - Qualifying low-volume hospitals receive add-on payments based on the number of Medicare discharges. To qualify, the hospital must have less than 1,600 Medicare discharges and be 15 miles or greater from the nearest like hospital. This provision extends the payment adjustment through 2013.
Extension of the Medicare-dependent hospital program - The Medicare-dependent hospital (MDH) program provides enhanced reimbursement to support rural health infrastructure and to support small rural hospitals for which Medicare patients make up a significant percentage of inpatient days or discharges. This greater dependence on Medicare may make these hospitals more financially vulnerable to prospective payment, and the MDH designation is designed to reduce this risk. This provision extends the MDH program until Oct. 1.
The bill passed the Senate by a vote of 89-9 and the House 257-167.National Rural Health Association
521 E. 63rd Street, Kansas City, MO 64110-3329
Phone - 816.756.3140 Fax - 816.756.3144
Thursday, November 22, 2012
Thanksgiving is our oldest national holiday. The origin of thanksgiving can be traced back to the 16th century. After a 66 day journey across the Atlantic Ocean, the pilgrims reached Plymouth (rock), Massachusetts on December 11th, 1620. Though accounts differ, 49 of the 102 pilgrims died that first winter due to the cold.
Fortunately for the pilgrims, the native Indians taught them to survive by growing food. It is said the Pilgrims learned to grow corn, beans and pumpkins. In the autumn of 1621, after a bountiful harvest, they held a 3 day celebration where 90 people were invited including the Indians. This communal dinner is popularly known as “The first thanksgiving feast.” However, there is no evidence to prove if the dinner actually took place. According to the firsthand account written by the leader of the colony, the food included ducks, geese, venison, fish, and berries. Turkey and pumpkin pie, a modern staple today, is unlikely to have been part of the feast.
After that first Thanksgiving, there were intermittent celebrations (1623, 1676, 1777, and 1795). In 1863, President Abraham Lincoln signed a proclamation declaring that there should be a national day of Thanksgiving on the last day of November. And although there was no law requiring a national day of Thanksgiving, every president since Lincoln declared a national day of Thanksgiving in the fall of the year. On Dec. 26 1941, a law passed by both houses of the United States Congress and signed by President Roosevelt. It set the fourth Thursday of November as a legal federal holiday of Thanksgiving to be observed annually from then on.
Wishing you, your family and friends a wonderful Thanksgiving.