State highlights: Mo. drops many from Medicaid; Mich. Medicaid shift savings

A selection of health policy stories from Texas, Missouri, Illinois, Michigan, Florida, Pennsylvania, North Carolina and Minnesota.

The Associated Press: Texas Sees Little Change Despite Insurance Gains
Harris Health System -- like other programs across the state -- hasn't enjoyed the expected savings from the Affordable Care Act because most of its 48,000 patients eligible for subsidized insurance instead chose to remain enrolled in the county's cheaper taxpayer-funded medical care. Now, public entities from Houston to El Paso are scrambling to tweak rules to make those who qualify for subsidized insurance ineligible for the local programs (8/9).

The Associated Press: Missouri Led Nation in Medicaid Roll Reductions
Missouri's Medicaid program is leading the nation in the number of people dropped from its rolls. New figures from the U.S. Department of Health and Human Services show that Missouri's Medicaid enrollment dropped by 37,260 people in June, compared with its average enrollment from July through September of last year. That was the largest numerical decrease of any state, though it ranked second behind Nebraska in terms of the percentage decline (8/11).

Detroit News: Medicaid Shift Could Save Michigan Prisons $19M
The Michigan Department of Corrections expects to save at least $19 million on health care next year by enrolling inmates and parolees in the state's expanded Medicaid health care program. Corrections officials and experts argue that providing uninsured ex-cons with treatment for the mental illness, substance abuse and chronic health conditions that otherwise can lead them to commit crimes again could reap future savings in the state's $2 billion-a-year corrections budget (Bouffard, 8/11).

USA Today: What Ails Appalachia Ails The Nation
Diabetes is slowly ravaging Alisha Blankenbeckler's body -- stealing her eyesight, impairing her kidneys and damaging her nerves so severely she can barely walk across a parking lot without help. And she's only 48. ... This week, U.S. Centers for Disease Control and Prevention Director Tom Frieden made a "house call" to find out more about the underlying causes of the region's ills and how to treat them -; and in the process gain traction against the rising burden of chronic disease that ails the nation. … Appalachia, like some blighted urban areas and Native American reservations, mixes several ingredients of poor health: doctor shortages and access-to-care problems; stressful, unhealthy lifestyles; low education levels; and insidious poverty (Ungar, 8/8).

Chicago Tribune: Illinois Prison Hospice Offers Care, Redemption
Ralph Pollock, in the ninth year of a 25-year sentence for a drunken driving crash that killed two children, bent forward in his chair, rested the book on the bed in front of him and quietly read to a man lying under a blanket. Propped up against a pillow, his eyes closed, the man listened as Pollock read from "The Purpose Driven Life." Pollock, 55, is a volunteer in the hospice program for prisoners at Dixon Correctional Center, one of only about 20 prison hospices nationwide where the caregivers are inmates. Both patients and caregivers have been convicted of grievous crimes. But the hospice program is based on the belief that everyone deserves compassion as they are dying. And the program's supporters say inmates who extend that compassion as volunteers can be transformed. The infirmary where the dying receive hospice care is in the prison's health care unit (Brotman, 8/11).

Health News Florida: No Documents? No Problem Here
The dirt road and lush tree canopy leading to the Catholic Charities medical clinic is in stark contrast to the bright lights surrounding the nearest hospital. Here, sirens would be drowned out by choruses of crickets and katydids. But this refurbished double-wide trailer off a rural highway in Dover is a medical refuge for some agricultural workers and their families. Dozens show up at the San Jose Mission medical clinic every Monday night, knowing Sister Sara Proctor and her team of volunteers won't ask for what they don't have: money or documentation. The Pew Research Center estimates that 825,000 immigrants in Florida today live here illegally. And regardless of any government policy or ongoing political debate, they sometimes get sick (Shedden, 8/8).

Philadelphia Inquirer: Health System Forms Preferred Provider Network For Nursing Homes To Decrease Readmissions
The handoff of patients from hospitals to nursing homes has taken on increased significance now that Medicare penalizes hospitals if too many patients are readmitted unnecessarily within 30 days of discharge. To help prevent a breakdown in that transition and to generally improve care for its patients, Virtua, which bills itself as South Jersey's biggest health system, has formed a preferred provider network for nursing homes and rehabilitation centers. The plan is part of an effort at Virtua to cast a wider net of care in the community it serves in preparation for a time when insurers will pay health systems for keeping people out of the hospital, not just for procedures and stays in the hospital. Starting about five months ago, Virtua signed contracts with 36 nursing-home operators in Burlington, Camden, Gloucester, and Mercer Counties. It's not meant to be an exclusive list. It includes 29 of the 46 nursing homes in Burlington, Camden, and Gloucester Counties, which is where most of Virtua's operations are located (Brubaker, 8/11).

Raleigh News & Observer: DHHS Doubles Money Paid In No-Bid Medicaid Contract 
In doubling a no-bid contract to $6.8 million, the state Department of Health and Human Services has turned over the financial management of North Carolina's $13 billion Medicaid program to a Washington-area consulting firm. Recently released contract documents spell out how Alvarez & Marsal is running the day-to-day financial operations of Medicaid, developing budgets, managing cash and contracts, and preparing reports for the legislature and governor. In addition, the department has tapped the consulting firm to reorganize the entire Medicaid division (Neff, 8/9).

Minnesota Public Radio: Pharmacists Ready, Worry Over New Role: Medical Pot Dispenser
When medical cannabis becomes available next July, a pharmacist -- not your doctor -- will help you figure out your exact dosage. And that pharmacist will be one employed by the companies selected to manufacture the drug. Minnesota will be just the second state to use pharmacists to dispense medical cannabis. While some pharmacists say it makes sense to tap their expertise in handling medications, they also see many challenges in dispensing a drug that has a lot of variability and limited research to guide them (Benson, 8/10).