State roundup: Examining health issues on state ballots

A selection of health policy stories from Massachusetts, Texas, Oregon, California, Colorado and Kansas.

Kaiser Health News: Health Issues On The Ballot In The States;
Sprinkled throughout ballots across the country are state initiatives that run the gamut from education to animal rights to marriage. And health care is well-represented, too. The National Conference of State Legislatures labels health a "key issue" in this cycle's roundup of state ballot questions (Girshman, 11/5).

Medscape: Will Physician-Assisted Suicide Spread To Massachusetts
A Massachusetts ballot proposition before voters next Tuesday pits traditional medical ethics against another creed anchored by a phrase that Hippocrates probably never uttered -- patient autonomy. The ballot proposition in question would legalize physician-assisted suicide, although supporters prefer the expressions "physician-assisted death" or "death with dignity." Regardless of the name, the proposed law would permit physicians to prescribe a lethal dose of oral narcotic to terminally ill patients who request it to end their suffering. Patients would swallow the medicine on their own, unlike the euthanasia that Dr. Jack Kevorkian illegally administered on occasion to willing patients. If the proposition passes, and polls suggest it could, Massachusetts would become the fourth state in which physician-assisted suicide is legal (Lowes, 11/4).

The Boston Globe: Hospitals Look To Lower Readmission Rates
Beth Israel Deaconess is one of hundreds of hospitals in the country that will lose money under a new federal program meant to force improvement in the overall care of some of the sickest seniors. Created under the Affordable Care Act, the program docks Medicare payments to hospitals whose patients are most likely to be readmitted within 30 days of treatment for pneumonia, heart failure, or heart attacks. Government officials say readmissions drive up health costs and can be a sign of inadequate care (Conaboy, 11/5).

The Oregonian: Hospital Charity Care In Oregon Sinks As Debate Over Standards Grows
In 2009 the recession was in full swing, and as the number of unemployed and uninsured shot up, Legacy Health System ratcheted free care to the needy in the Portland area to a new high. Legacy wrote off $67 million in area patients' bills last year, a nearly 25 percent jump since 2009, more than 6 percent of revenue. That may not have been a smart business move, but "we have a mission" to help others, says Dave Eager, chief financial officer of the nonprofit. Other tax-exempt hospitals in the state did not follow suit, according to newly released state records. From 2009 to 2011, 31 of Oregon's tax-exempt hospitals cut free care to the poor as a percent of revenue (Budnick, 11/3).

The Oregonian: Oregon's County Assessors Challenge Hospital Acquisitions' New Tax Breaks, Murky Law
Nonprofit hospitals in Oregon are increasingly pushing to take newly acquired property off public tax rolls, and assessors in cash-strapped counties are pushing back. Nationwide, hospitals are swallowing private practices, hiring their practitioners, absorbing their patients, and buying or leasing buildings and equipment. Counties have long granted charitable tax exemptions to nonprofit hospitals in exchange for their care for the poor. But health reform's coordinated care model along with changes to Medicare are driving mergers between hospitals and private practices to an all-time high. In Oregon, county assessors are fighting the trend. Douglas County recently denied Roseburg's Mercy Medical Center's request to extend its exemption to four properties worth $18 million. Hood River and Josephine counties, currently gathering information, may follow suit on similar requests, assessors there say (Budnick, 11/3).

The Texas Tribune (Video): Where The State Women's Health Program Stands
Women's health providers in Texas have had Nov. 1 marked on their calendars for months. It was supposed to be the day the state-funded Women's Health Program would launch. But it hasn't. And it won't until, according to Texas Health and Human Services Commission officials, the federal government stops funding it or a final court decision is rendered (Rocha, 11/2).

Kaiser Health News: As California Prepares To Expand Medicaid, Only The Poorest Will Benefit In Sacramento
Midday on a Monday outside the Primary Care Center on Broadway and Stockton Boulevard in Sacramento, patients linger outside, waiting for services. Asked about their experiences at the clinic, they are eager to share -- and many offer complaints (Bartolone, 11/4).

Health Policy Solutions (a Colo. news service): New Data Tool Finds Health Costs Vary Wildly
An MRI on your knee in Colorado could cost as little as $297 or as much as $1,261 depending on where you get it, according to the first release of health data from a powerful new tool aimed at improving health, bringing down costs and improving the quality of care. On Thursday, Colorado became the 12th state in the nation to unveil an All Payer Claims Database (APCD) with the debut of cohealthdata.org managed by the Center for Improving Value in Health Care (CIVHC). So far, the database includes about 40 percent of health data from 2009 to 2011, representing about 2 million people (all under 65) who were covered through both private and public health insurance programs in Colorado. By 2014, CIVHC managers hope to add data from Medicare patients along with claims from self-insured private employers to reflect about 90 percent of insured Coloradans (Kerwin McCrimmon, 11/1).

California Healthline: Healthy Families Notices Sent, Now Federal Approval Needed
The state late last week sent 415,000 notices to inform Healthy Families participants they will need to switch to Medi-Cal managed care plans on Jan. 1. At the same time, almost two dozen organizations, including the California Medical Association, sent a letter to lawmakers and state health officials asking for a delay in the conversion for 880,000 children in California. The 60-day notices went out on Thursday and Friday last week, according to officials at the Department of Health Care Services. That officially starts the clock ticking on the Healthy Families transition (Gorn, 11/5).

California Healthline: New Name, New Website For Exchange
California consumers will be able to get a strong picture of California Covered, the newly named package of health insurance offerings from the Health Benefit Exchange when the state launches a new website next month, according to exchange officials. "We've been targeting the new website by the end of this year, but I'm optimistic we're looking at Dec. 1 for the launch of that," said Oscar Hidalgo, director of communication and public affairs at the exchange. … The exchange eventually plans to launch a bigger web portal that can actually start people through the enrollment process, but that won't happen till the middle of next year, Hidalgo said (Gorn, 11/2).

Health Policy Solutions (a Colo. news service): Better Primary Care Saves Colorado $20 Million
An experiment to ensure that complex Medicaid patients have a regular doctor and care coordinators who can help them stay healthy has saved Colorado an estimated $20 million in its first year, according to a new report from Colorado's Medicaid managers (Kerwin McCrimmon, 11/2).

Kansas Health Institute News: Officials Gather To Evaluate State's Public Health System
Sixty officials from a variety of disciplines and from around the state gathered here today to grade Kansas' public health system by collectively answering a battery of 600 questions as part of the National Public Health Performance Standards Program. Kansas is one of 23 states to conduct the evaluation and first did so in 2008, a year after the program was started by the federal Centers for Disease Control and Prevention. Four years ago, however, only officials from the Kansas Department of Health and Environment participated, said Brenda Nickel, director of KDHE's Center for Performance Management (Cauthon, 11/2).