State highlights: Missouri gives green light to med-school graduates to treat patients as assistant physicians; Georgia hospitals brace for broader gun-carry law

A selection of health policy stories from Washington, Illinois, Minnesota, Missouri and Florida.

The Wall Street Journal: Missouri To Allow Med-School Grads To Work As Assistant Physicians
Missouri will allow medical-school graduates to work as "assistant physicians" and treat patients in underserved rural areas, though they haven't trained in residency programs, despite strong opposition from some doctors' groups. At least one year of residency is usually required to practice medicine independently in the U.S.; most young doctors spend at least three years in such programs, which include intense on-the-job training and supervision (Beck, 7/16).

Seattle Times: Plenty Of Room To Improve, Says Report Rating Health Plans
Group Health Cooperative was the overall top-scoring health plan among five graded by the Washington Health Alliance, a collaborative of employers and others working to improve health-care transparency through measurement. What does the Alliance measure in its eValue8 report? For an insurance plan, it looks at processes aimed at ensuring patient safety, closing gaps in care, and improving consumers' health and the health care they get. It also measures how well a plan controls costs, reduces waste, and whether it educates and encourages consumers to manage their own health well. The five plans that have volunteered to be measured -; and have their results displayed publicly -; also provide details on how they measure performance of medical providers, and how they pay them (Ostrom, 7/16).

The Wall Street Journal's Washington Wire: Despite Challenges, Union Seeks To Win Over Home Health Workers
But a more important number might actually be a smaller one in AFSCME's quest to convert these workers who had been resistant to joining their workplace union: A significant subset of them – more than 21,000-; are home health care workers, the very kinds the U.S. Supreme Court recently said can't be forced to pay dues to unions they don't want to join. The union, said AFSCME President Lee Saunders, was dealt a "serious blow" last month by the court, which ruled that home care workers in Illinois – and possibly other states -; aren't full-fledged public employees, and therefore can't be forced to pay dues to a public-sector union that represents them but that they don't want to join. The ruling set the stage for more legal challenges to these dues, known as agency fees, down the road. It will also make it harder for AFSCME to represent home care workers, Mr. Saunders said (Trottman, 7/16).

Georgia Health News: How Will Broader Gun-Carry Law Affect Hospitals?
Now that Georgia's controversial gun-carry legislation has taken effect, hospitals across the state are trying to figure out how to respond to it. The new law means different things for different hospitals. Generally speaking, hospitals that are considered government buildings have to comply with it, while those that are privately owned do not. And there are other exceptions, including one that pertains to Grady Memorial Hospital in Atlanta (Miller, 7/16).

The Star Tribune: For Mental Health Patients, An Unmarked Ride To Psychiatric Care
In Minnesota, as in many other states, a patient who suffers a mental-health crisis often faces the added indignity of being taken to the emergency room in an ambulance or the back of a police car -; even when there is no public safety risk. The experience can aggravate the patient's trauma by alerting neighbors and friends to a mental illness they would rather keep private. Now, a number of hospitals and local officials across Minnesota are experimenting with ways to transport mental health patients in a more dignified manner, such as unmarked vehicles with plainclothes paramedics. They aim to reduce the stigma associated with a psychiatric crisis while also reducing the enormous cost of sending ambulances long distances (Serres, 7/16).

The Associated Press: Minnesota Hospitals Test Mental Health Transports
Minnesota hospitals are considering ways to transport mental health patients in unmarked vehicles instead of ambulances. The Star Tribune reports hospitals and local officials across the state are experimenting with ways of responding to a psychiatric crisis if there's no public safety risk. Changes could cut down on ambulance costs and the time police and fire departments spend transporting psychiatric patients (7/17).

Modern Healthcare: Halifax Ruling Supports Hospitals' Defense in False-Claims Cases
A federal judge in Orlando, Fla., gave hospitals a reason to cheer when he ruled that violating Medicare's conditions of participation doesn't automatically expose providers to the potentially crippling triple-damages available under the False Claims Act. U.S. District Judge Gregory Presnell's recent ruling in the closely watched case of Elin Baklid-Kunz v. Halifax Hospital Medical Center bolstered a growing body of law around the False Claims Act that requires whistle-blowers to prove more than just violations of Medicare administrative rules. Though the ruling was consistent with recent law, the whistle-blower had urged him to decide otherwise (Carlson, 7/16).