HEALTH PROMOTION: Website Aims To Track, Promote Health in Louisville

Louisville officials have developed a website to help track and promote health throughout the community over the next six years.  HealthyLouisvilleMetro.org will help to track the city's progress on its Healthy Louisville 2020 comprehensive plan to improve residents' health. Louisville Mayor Greg Fischer (D) said the site "can be a valuable tool for meeting the health challenges [the city] face[s], because it allows everyone to see and to contribute to our progress in achieving the goals." In addition to tracking the initiative, the site will host best practices, news clips and information about community events. Metro Director of Public Health LaQuandra Nesbitt said, "The site will also prove useful for those seeking to get involved in health initiatives but don't know where to begin" (Shafer, Louisville Courier-Journal, 10/7). Click here for the Louisville Courier-Journal article. Click here for the HealthyLouisvilleMetro.org site.

MENTAL HEALTH: Ind. Communities Experience Shortage of Mental Health Care Providers

A shortage of mental health care professionals in rural southern and central Indiana communities is causing an increase in patient wait times as providers are forced to triage patients according to their need for care. The shortage can be attributed in part to an aging population of psychiatrists and fewer medical students pursuing the profession because of lower salaries than other medical professions. In addition, the Affordable Care Act increased the number of consumers with mental health care coverage, while a reduction in the stigma associated with mental health issues has encouraged more people to seek care. As a result, many patients must wait an average of between one and three months for an appointment, according to Bob Siegmann, vice president of health care integration at the Centerstone behavioral health center. Meanwhile, Scott Branam -- executive director of behavioral health at Indiana University Health's Bloomington Hospital -- said, "The number of mental health providers we have in Bloomington is being overtaxed" (AP/Evansville Courier & Press). Click here for the AP/Evansville Courier & Press article.

HEALTH CARE REFORM: Many Uninsured Unaware of Second Enrollment Period

About nine of 10 uninsured individuals did not know that the Affordable Care Act's next open enrollment period begins in November, according to a Kaiser Family Foundation survey released last week (Sanger-Katz, "The Upshot," New York Times, 10/21). The finding comes from the most recent Kaiser Health Tracking Poll, for which researchers surveyed 1,503 U.S. adults between Oct. 8 and Oct. 14 (KFF poll, 10/21). In addition, the survey found that two-thirds of uninsured respondents said they know "only a little" or "nothing at all" about the ACA's insurance exchanges, while more than half said they knew that they might qualify for financial assistance to purchase exchange coverage. According to "The Upshot," spreading awareness among uninsured U.S. residents will be difficult compared with last fall, because the first uninsured residents to enroll in coverage likely were more motivated. The upcoming enrollment period begins Nov. 15 and ends Feb. 15, 2015 ("The Upshot," New York Times, 10/21). Click here for the New York Times' "The Upshot" article. Click here for the KFF poll.

HEALTH CARE REFORM: Ind. Efforts To Cut ED Use See Mixed Results

While the Affordable Care Act was intended in part to reduce unnecessary patient visits to emergency departments with its coverage expansion and financial incentives for providers, some Indiana hospitals are experiencing increases in ED admissions. For example, ED admissions at Community Hospital East in Indianapolis are on pace to increase by nearly 5% this year and have grown by 6% on average over the past five years. In an attempt to reduce ED admissions, Community East has established a Patient Resource Center to help visiting patients sign up for coverage and educate them about other provider options, like community medical facilities. Meanwhile, ED visits at Indianapolis-based Eskenazi Hospital are on pace to decrease by 6% this year after a 7% decrease in 2013, while ED visits at Indiana University Health's Methodist Hospital are on pace to decline by 3.8% this year after a 6.9% decrease in 2013. Eskenazi Health CEO Lisa Harris said that while some attribute ED admission increases to "pent-up demand" and decreases to"high-deductible plans ... it's all purely a matter of speculation at this point." (AP/Evansville Courier & Press, 10/18). Click here for the AP/Evansville Courier & Press article.

MEDICAID: Change in Ind. Medicaid Eligibility Affects Thousands

A change in how Indiana residents are determined eligible for Medicaid could mean thousands more state residents are eligible for Medicaid while other residents lose coverage.  As of June 1, Indiana replaced its Medicaid disability eligibility determination process with one in which any residents that are deemed eligible for supplemental security income also are eligible for Medicaid. Before the change, about 18,000 state residents were eligible for supplemental security income but were not enrolled in Medicaid. According to the state Family and Social Services Administration, those residents now are Medicaid beneficiaries. However, other state residents could lose coverage because of the change. About 68,400 state residents qualify for Medicaid disability but do not receive supplemental security income. More than 13,000 state residents lost disability benefits when the rule change went into effect.  Other residents lost Medicaid disability benefits because the change ended a program that allowed older disabled residents who were medically eligible but had incomes above the maximum limit to "spend down" to qualify for the program (AP/Indianapolis Business Journal, 10/20). Click here for the AP/Indianapolis Business Journal article.

MEDICAID: Ohio Legislature Could End State's Medicaid Expansion in 2015

Ohio's Medicaid expansion could be at the whim of state legislators next summer, according to some stakeholders. Gov. John Kasich (R) moved last year to expand the program under the Affordable Care Act after the state Legislature declined to approve the expansion. The expansion was funded by $2.5 billion in federal funding included in the state's budget. However, Medicaid spending must be re-authorized by state lawmakers as part of the state's two-year budget, which ends in June 2015. As a result, the state Legislature might be able to rescind the expansion. Former Ohio Health Director Ted Wymyslo said that groups on both sides of Ohio's expansion debate are working on strategies, adding that the issue is "bringing people together like wars do quite often and you could look at this almost like that kind of a battle" (Tribble, WCPN/Kaiser Health News, 10/14). Click here for the WCPN/Kaiser Health News article.

MEDICARE: Part B Premiums, Deductibles To Remain Unchanged in 2015

The Obama administration earlier this month announced that Medicare Part B monthly premiums and deductibles will remain unchanged for 2015. Next year, premiums for beneficiaries with annual incomes below $85,000 will stay at $104.90 -- the same rate as the previous two years -- and deductibles will be unchanged at $147 (Radnofsky, Wall Street Journal, 10/9). Medicare Part B covers doctor's appointments, outpatient care and other services. Those with annual incomes of more than $85,000 pay more, but their premiums also will remain unchanged (Demko, Modern Healthcare, 10/9). Meanwhile, the administration announced that costs for hospital and skilled-nursing facility stays will increase slightly. Specifically, Medicare Part B beneficiaries in a skilled-nursing facility next year will pay $157.50 daily after 20 days, compared with $152 per day this year (Wall Street Journal, 10/9). Further, deductibles for hospital admissions under Part A of the Medicare program will increase by $44 in 2015, to $1,260 (AP/U-T San Diego, 10/9). Click here for the Wall Street Journal article (subscription required). Click here for the Modern Healthcare article (subscription required). Click here for the AP/U-T San Diego article.

Rx DRUGS: Lawmakers Press Obama Administration To Address Rising Generic Rx Costs

Rep. Elijah Cummings (D-Md.) and Sen. Bernie Sanders (I-Vt.) in a letter sent Oct. 16 to HHS Secretary Sylvia Mathews Burwell urged the Obama administration to address the rising costs of generic prescription drugs. In the letter, Cummings and Sanders wrote that the "federal government must act immediately and aggressively to address the increasing costs of these drugs." The lawmakers included examples of rising generic costs, such as an asthma treatment that increased from $11 to $424 in one year. They noted that the increases affect both consumers and the federal government, particularly budgets for the Department of Defense, Veterans Affairs, Medicaid and Medicare (Cox, "Floor Action," The Hill, 10/17). Click here for The Hill's "Floor Action" article. Click here to read the letter.

SUBSTANCE USE DISORDERS: Ind. State Police Receive $567K To Combat Methamphetamines

The Indiana State Police department has been awarded a $567,000 grant to stem methamphetamine use and distribution in the state. According to Sen. Joe Donnelly (D), Indiana is one of 10 states to receive the Department of Justice's Office of Community Oriented Policing Services funding. The grants allow law enforcement agencies to investigate illicit methamphetamine-related activity (AP/Fort Wayne News-Sentinel, 10/8). Click here for the AP/Fort Wayne News-Sentinel article.

ACCESS TO CARE: Cleveland Clinic Launches Health Kiosks in Local Stores

The Cleveland Clinic has begun offering telemedicine appointments via health kiosks for minor, common ailments at two retail store locations. The HealthSpot kiosks will allow patients at Marc's Garfield Heights and Mentor locations to remotely discuss illnesses such as coughs, fevers and sore throats with physicians and nurse practitioners, who also will be able to write prescriptions. The kiosks will be staffed by Cleveland Clinic medical attendants, who will assist patients with the kiosks' built-in devices -- including its blood pressure cuff, scale, stethoscope and thermometer -- as well as sanitize the stations between patient visits. The telemedicine sessions, which are available during certain hours when many physicians' offices are closed, cost $49 and are covered by many insurers as a typical office visit (Zeltner, Cleveland Plain Dealer, 10/13). Click here for the Cleveland Plain Dealer article.