Significant management improvements at Passport Health Plan, audit finds

Passport Health Plan has improved significantly since a 2010 audit uncovered wasteful spending and other problems, a new audit has concluded.

The managed care organization that cares for Medicaid recipients in Jefferson and 15 surrounding counties "has made significant improvements in accountability and financial record-keeping," a press release from Audrey Tayse Haynes, the new secretary of the Cabinet for Health and Family Services. "Patient satisfaction with the health care provider remains high," she states.

"The audit is a follow-up to former State Auditor Crit Luallen's scathing report of November 2010 in which Luallen found lavish spending by Passport's former executives on travel, meals and other expenses," reports Tom Loftus for The Courier-Journal. "It also questioned transfers of about $30 million of reserve funds to the major health-care organizations represented on Passport's board of directors."

Gov. Steve Beshear ordered a plan to correct the problem, which involved replacing Passport's executives, among other changes. Though there has been improvement, "after having exclusive rights to the region for about 14 years, Passport will have to bid against other managed care organizations if it wants to be among those that will serve it in 2013," Loftus reports.

Still, since the state has switched to managed care for the rest of the state and severe problems have surfaced with the three companies that have been hired to serve those recipients, Passport's reputation has improved substantially. State Auditor Adam Edelen said in February the state was unprepared for the quick transition to managed care in the rest of the state. (Read more)

U of L profs get $6.3 million to continue spinal cord research

Susan Harkema, a University of Louisville professor, talks
about epidural spinal stimulation. Courier-Journal photo.

Two University of Louisville professors have received a $6.3 million grant to continue their work helping paralyzed patients restore movement by using electrical stimulation.

The grant was awarded to Susan Harkema and Dr. Jonathan Hodes from the Leona M. and Harry B. Helmsley Charitable Trust.

Last year, they received much acclaim when they published a study in the journal The Lancet "showing that the use of continual, direct, electrical stimulation of a patient's lower spinal cord using technology designed for pain relief can allow a person using a wheelchair to stand and bear weight," reports Laura Ungar for The Courier-Journal.

With these new grant funds, Harkema said they will "be able to built a stimulator that will allow the individual to take advantage of these advances in their homes and communities."

One of the initial case studies involved Rob Summers, a former baseball player from Oregon who was paralyzed below the chest after a car accident. After the therapy, he was able to get to a standing position and stand as long as four minutes. "He was also able to take steps with help and move his toes, ankles, knees and hips." Harkema said he continues to improve.

Nationwide, more than 5 million Americans live with some type of paralysis, and more than 1.3 million have spinal-cord injuries. (Read more)

Complaints of bed bugs made in 34 of 64 Northern Ky. hotels; Cincinnati area ranked worst in country for problem

Bed bug, up close. (Photo from Northern Ky. Health Dept.)

Nearly half of Northern Kentucky hotels have had at least one complaint of bed bugs since May 2010. In the region, 34 of 64 hotels have had an issue.

The soon-to-be-sold Drawbridge Inn in Fort Mitchell has had the most complaints, with 12 findings of bed bugs from 20 complaints. The Super 8 Motel, also in Fort Mitchell, had 12 findings and 17 complaints since May 2010.

"It's not just the mom and pop hotels on the side of the road," said Steve Divine, of the Northern Kentucky Health Department. "It's those all the way up to expensive hotels with big operations that can have the issue. It can happen to any hotel or facility, but it's how they handle it that seems to make the difference."

In one circumstance, hotel officials had the room in question "inspected by a pest control company and was scheduled to be shut down for a month," reports Mark Hansel for The Kentucky Enquirer. "For the most part, they don't want to have them either because it's bad for business," Divine said. "They usually have been very receptive of what we are requiring them to do. They know that's just part of doing business, unfortunately, at this point."

The problem is not entirely a surprise. Orkin Pest Control ranked Cincinnati, just across the Ohio River, as the worst bed bug city in the United States. Bed bugs feed on human blood and can cause skin rashes and allergic symptoms. They are notoriously difficult to exterminate, in part because they can live for very long periods without eating and are adept at squeezing themselves into very small spaces. (Read more)

Federal panel says PSA screening for prostate cancer does more harm than good, but no better test is available

Prostate cancer cells. Getty Images photo by Abbey Michael.

An influential federal panel says testing healthy men's prostate-specific antigen levels to detect prostate cancer does more harm than good.

The PSA test can lead to unnecessary biopsies for men who turn out to be cancer-free. Those biopsies can also lead to men being treated for cancers that are so slow-growing (a characteristic of most prostate cancers) that they didn't need to be detected.

An estimated 1,000 to 1,300 men die annually from complications associated with treatments that are initiated because of PSA screening, reports Alice Park for Time magazine. Moreover, treating harmless prostate tumors increases the chances of making men impotent or incontinent.

The U.S. Preventive Services Task Force published the recommendation in the Annals of Internal Medicine. In 2009, the panel also recommended that women delay routine mammograms until the age of 50. That was controversial, and "The task force's recommendation goes against two decades of widespread use of the PSA test, a $35 blood test," Park reports.

"The recommendation is not just counter to what the lay public has been taught about cancer prevention but what physicians have been taught as well," said Dr. Michael LeFevre, co-vice chair of the USPSTF and a professor of family and community medicine at University of Missouri. "We've been told for decades to be afraid of cancer and that the only hope is early detection and treatment. So it's hard for physicians and patients alike to accept that not all cancers need to be detected or need to be treated and that there are harms associated with screening, not just benefits."

Through PSA testing, physicians "were finding the cancer earlier, so the time from diagnosis to death was longer, but the patient wasn't actually living longer," explained Dr. Otis Brawley, chief medical officer of the American Cancer Society.

But there isn't a better test to replace the PSA, and Ian Thompson, chairman of urology at the University of Texas Health Science Center, said to reject it completely is unwise. He said U.S. death rates from prostate cancer dropped between 30 and 50 percent since the screening became commonplace in the early 1990s, though those numbers could also have been influenced by more effective treatments. Thompson said he didn't want to go back to the "bad old days" when doctors only found prostate cancer when it was already unable to be cured, reports Liz Szabo for USA Today.  (Read more)

Louisville comes in third to last in fitness and health ranking of 50 largest cities

Rowing under California's Bay Bridge (Photo by City Kayak)

In a fitness ranking of the country's 50 largest cities, Louisville ranked an abysmal 48th, sitting just above Detroit and Oklahoma City.

These were some of the results of the American College of Sports Medicine's 2012 Fitness Index. Cities were assessed on preventive health behaviors; levels of chronic disease; health care access; and community resources and policies that support physical activity such as bike lanes and parks.

Minneapolis-St. Paul was ranked first for the second year in a row, scoring 77.2 out of a possible 100 points. Louisville got just 32.1 points, but it did climb up one ranking slot over 2011's assessment.

The index is gaining notoriety and "might well become the scorecard for cities looking to attract health-conscious companies and people to settle in for a spell," reports Melissa Healy for the Los Angeles Times. "It draws on parks and recreation data from the Trust for Public Land, on nutrition and health behavior collected by the Centers for Disease Control and Prevention, and on federally tallied school report cards to learn about school policies that promote fitness." (Read more)

Nursing home chain says it will lease its Kentucky facilities because legislature didn't pass bill to filter lawsuits

A major nursing-home chain says it will lease all of its Kentucky properties to a Texas company because a bill to insulate nursing homes from lawsuits did not pass the General Assembly this year,

Extendicare Health Services owns Pembroke Nursing and Rehabilitation Center, Shady Lawn Nursing Home in Cadiz and 19 other facilities in Kentucky, reports Nick Tabor of the Kentucky New Era in Hopkinsville. The company has been riddled with problems. A 2009 study ranked three of its Kentucky facilities among the country's worst nursing homes.

"The combination of a worsening litigation environment and the lack of any likelihood of tort reform in the state of Kentucky has made this the prudent decision for our company and its unitholders," said Tim Lukenda, president and CEO of Extendicare.

In this year's legislative session, nursing homes lobbied for a law that would have created medical review panels to evaluate potential lawsuits against nursing homes, personal-care homes and some facilities for the intellectually and developmentally disabled. The goal of the panel was to help eliminate frivolous lawsuits against the long-term care industry.

The Pembroke facility has been sued 20 times in Christian Circuit Court since 2002, and seven of the suits are still pending, Tabor reports. The others were dismissed, most with confidential settlements. (Read more)

Care in rural hospitals is just as good as that in urban hospitals, study concludes

While rural Americans have less access to primary care and have worse health outcomes, the care at rural hospitals is equal to, if not better, than that at urban hospitals, a National Rural Health Association report says.

The study also found rural health care is not more expensive than urban care. "However, urban residents rarely out-migrate to rural settings for either routine or advanced treatments or care yet many rural patients are referred to or voluntarily travel to urban providers based on the myth of better care," a summary of the study says.

The study was compiled by iVantage Health Analysis, a private health-care research company. It collected data on Medicare costs and health outcomes for doctors and hospitals for 12 months and divided the results into rural and urban groups based on zip codes, to give a picture of the state-by-state importance of rural hospitals.

In Kentucky, nearly half of its Medicare beneficiaries lived in rural counties in 2010. Nationwide, just 21 percent of them do, though there were western states with much higher percentages. In Wyoming, for example, 69 percent of Medicare beneficiaries live in rural places. Spending per Medicare beneficiary in Kentucky was nearly $8,000 in both urban ($7,851) and rural ($7,879) settings in 2010. That spending is high compared to the rest of the country, however; only nine other states had higher spending.
The study could have wider wider ramifications given changes in the federal health-care reform law and the move toward accountable care organizations, in which doctors and other providers are encouraged to team up to give coordinated care for a population of people and be paid financial incentives to do so.

"Value in health care is created by doing a few things well and not by trying to do everything," the summary reads. "The rural findings may just suggest that by national selection, rural has figured out what it does well and has optimized those services for the patient's benefit." (Read more)

University Hospital's trust to pay for indigent care lacks oversight, state auditor finds

An audit of the trust that disburses more than $30 million in state and local funding to provide indigent care at University Hospital has found there is a lack of oversight. There is no evidence taxpayer dollars were abused, however.

"The audit, released by state Auditor Adam Edelen, found that the board structure wasn't suited for proper oversight and the agreement between University Medical Center, which runs the hospital, and state and local governments to administer the money is outdated," reports Laura Ungar of The Courier-Journal.

The audit also found there is insufficient record keeping. "The responsibility for providing a safety net for our most vulnerable is a critical one shared by the university, city and commonwealth," Edelen said. "While this audit underscores the need for modernization and reform of the governing structure, it does not provide justification for those who desire a retreat from that mission." (Read more)

Agriculture commissioner visits six counties to promote local food, better nutrition in school lunches

State Sen. David Givens, R-Greensburg, watches
as Commissioner James Comer speaks at Green
County High School.(Greensburg Record-Herald)

To encourage child nutrition and healthier school lunches, state Agriculture Commissioner James Comer visited six Kentucky school districts earlier this week. He met with school boards in Owsley, Jackson, Knox, Marion and Metcalfe counties, and visited Green County High School, according to a news release from his office.

Many Kentucky children consume more than half of their daily calories at schools. During a typical school day, 4 in 10 American students buy and eat snack foods and drinks, the Pew Health Group found. More than 23 million children and teens in the U.S. are overweight or obese.

"Children who are overweight and obese are at greater risk of chronic ailments that can damage their quality of life and even shorten their lives," Comer said. "Schools can help students eat better, but many schools simply don't have the resources, the equipment or the training necessary to serve healthy meals on a consistent basis. I want to talk to local leaders about how the Kentucky Department of Agriculture can help."

"Just a small amount of money would enable many school districts to make healthy and nutritious foods available to their students," he said. "The KDA can help these schools wade through federal bureaucracy and find the necessary funding. We can also help with our Farm-to-School Program, which connects schools with local producers who can provide fresh Kentucky Proud foods. That's food for our kids, and it helps local farmers make a living." (Read more)

Obama administration spent $25 million on health-care law publicity campaign, part of it exaggerating, McConnell complains

The Obama administration spent nearly $20 million on mailings to seniors touting the federal health-care reform law and another $5 million on postcards to small business owners informing them of a tax credit under the law, Senate Minority Leader Mitch McConnell, R-Ky., said in a floor speech today. He said the Government Accountability Office found that the mailing to seniors "overstated the law’s benefits."

"These are just a few of the way the administration is quietly promoting its own failed policies; how it's trying to change people's minds about the president's policies with their own money," McConnell said. "The larger point is the fact that we've got a nearly $16 trillion debt, the largest tax hike in history right around the corner, chronic unemployment, and sky-high gas prices, and this President things it's a good idea to spend $20 million to promote Obamacare."

McConnell's remarks can be heard in their entirety by clicking on the video above.