RUSTHOVEN: An Indiana Obamacare snapshot
Obamacare’s calamitous launch, including the widening gap between promise and reality, continues to consume political discourse. Here’s a quick summary of Indiana’s status:
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Why insurers want to limit your choice of doctor
In spite of President Obama’s promises that if you like your doctor, you can keep your doctor, the president’s health reform law is spurring health insurers to make him a liar on that point too.
Company news
Franciscan Alliance, which operates three hospitals in the Indianapolis area, has signed an affiliation agreement with the University of Chicago Medicine that will affect its facilities in northwest Indiana. Both institutions said they plan to work together to develop new models for delivering health care services, such as accountable care organizations. Franciscan, based in Mishawaka, operates 13 hospitals in Indiana and Illinois. The partnership with the University of Chicago’s Pritzker School of Medicine will involve the Franciscan facilities in Crown Point, Dyer, Hammond, Michigan City and Munster.
Indiana will not allow health insurers to reinstate customers’ policies that were canceled due to new requirements of Obamacare, the state Insurance Department announced Nov. 20, saying that would “create logistical chaos” and “destabilize” Indiana’s individual insurance market. The announcement, which affects an estimated 108,000 Hoosiers who have had their policies canceled, came in response to President Obama’s request Nov. 14 that state insurance commissioners let insurers reinstate policies that they had decided to cancel for 2014. Indiana is the eighth state that has announced it will not allow insurers to reinstate canceled policies. According to the Atlantic Information Services, another five states have said they have allowed insurers to do so. However, some Hoosiers still have the option of renewing their canceled policies for 2014, as long as they do so before Dec. 31. The state's ruling announced on Wednesday would apply to customers whose policies had been canceled, and who waited until 2014 to buy coverage for that year.
The Hoosier Healthcare Innovation Challenge helped launch three young health information technology companies. CreateIT won the entire competition by developing an application for sending educational articles, event alerts and baby updates to the mobile phones of low-income pregnant moms. The goal is to help reduce infant mortality, which has surged to high levels in Indiana. Other companies that received awards during the competition were DeDupIt, which created a way to merge electronic medical records about a patient into a single report; and MedDiary, which created a new system of care that tracks all medications, over the-counter and prescriptions, being taken by a single patient. Each company received cash prizes and free professional services.
IU Health gears up to take on insurers
Indiana University Health, already the state’s largest hospital system, is now ramping up to compete against Anthem, UnitedHealthcare and other health insurers.
IU Health could fall out of network for UnitedHealthcare
IU Health, the state’s largest hospital system, and UnitedHealthcare, the state’s second-largest health insurer, have been unable to come to terms on a new set of reimbursement contracts.
Hospital cuts create uncertain future for nurses
The new climate is a seismic change for many who got into nursing because for generations it had been a recession-proof career.
Community Health CFO makes sudden exit
Tom Fischer, the chief financial and chief operating officer of Community Health Network, departed suddenly this month. Sources with knowledge of the situation described Fischer’s exit as a firing. But a Community spokeswoman said Fischer resigned in a private meeting with Community CEO Bryan Mills.
Ascension hospitals pledge 549 more service center jobs
Even though St. Louis-based Ascension Health cut nearly 900 jobs this year from its Indianapolis-based hospital subsidiary, St. Vincent Health, it wants to add 549 more to its service center here by 2016.
People
Beth A. Keultjes has been named vice president and chief operating officer of home health and hospice for Franciscan VNS. She replaces John Pipas, who will retire as president of Franciscan VNS, which partnered with Franciscan St. Francis Health in 2011. For the past three years, Keultjes worked at the Cassopolis Family Clinic in Michigan. Before that, she had worked for Saint Joseph Regional Medical Center in South Bend. Keultjes has a bachelor’s in business administration from Indiana University and a master’s in administration from the University of Notre Dame.
Company news
Even though St. Louis-based Ascension Health cut nearly 900 jobs this year from its Indianapolis-based hospital subsidiary, St. Vincent Health, it wants to add 549 more to its service center here by 2016. Ascension, the largest Catholic hospital chain in the nation, opened a service center in Indianapolis in June 2011, and has hired 500 people since then. The service center workers perform human resources, purchasing, bill payment and supply chain management for all of Ascension’s hospitals and hundreds of its other health care facilities. As part of the expansion over the next three years, the service center will provide support services to the entire Ascension chain, which includes 150,000 employees at more than 1,900 locations spread over 24 states and Washington, D.C. St. Vincent cut 865 workers at the end of June. The staff cuts, which represented 5 percent of St. Vincent’s total Indiana employment of 17,300, were brought on by lower-than-expected patient volumes, congressional budget cuts and slower-than-expected growth in reimbursement rates. St. Vincent’s announcement was the first of several by Indiana’s largest hospital systems. In October, Indiana University Health eliminated 935 positions. And in October, Franciscan Alliance cut 925 positions. The Indiana Economic Development Corp. offered Ascension up to $4.8 million in conditional tax credits and up to $200,000 in training grants, if Ascension adds all 549 jobs it has promised.
Anthem Blue Cross and Blue Shield, along with most other major insurers, will allow consumers who enroll in health plans through the new Obamacare exchanges 10 extra days to pay their first premiums and still gain coverage effective Jan. 1. That means consumers can wait to make their first payment until as late as Jan. 10. According to Bloomberg News, the Obama administration had asked insurers on Dec. 12 to give customers more time to pay and grant retroactive coverage. A few days of retroactive coverage is common in the health insurance industry. Anthem’s parent company, Indianapolis-based WellPoint Inc., will also let current members buy a new plan in the off-exchange individual market as late as Jan. 10 and still be covered retroactive to the first of the year. Many WellPoint and Anthem customers whose individual policies were canceled because the policies did not comply with Obamacare’s new rules, were automatically enrolled in a similar Obamacare-compliant plan off of the exchange. But now Anthem is allowing such customers to choose a different plan by the 10th of each month in either January, February or March.
Eli Lilly and Co., Pfizer Inc. and other large drugmakers will keep paying doctors to give talks about their products, leaving GlaxoSmithKline Plc alone for now in its decision to halt such compensation. According to Bloomberg News, United Kingdom-based Glaxo changed its policy after Chinese authorities accused the company of using cash and sexual favors to bribe doctors and health officials to promote product sales. But Lilly and other drugmakers say physicians are still in most cases the best source of information for their colleagues. “Few products in the world are as complex as an innovative medicine,” said Scott MacGregor, a spokesman for Indianapolis-based Lilly. He added that Glaxo’s move won’t change how Lilly does business. New York-based Pfizer, the world’s biggest drugmaker, is “committed to fairly compensating health-care professionals, clinical investigators and institutions for the work they do,” Dean Mastrojohn, a spokesman for the company, told Bloomberg.
Employers prep for Obamacare
The pace of rule-making and decision-making was feverish in the year leading up to the Jan. 1, 2014, implementation of Obamacare.
Fox Sports Indiana cashing in on Pacers’ success
The Indiana Pacers are the hottest team in the National Basketball Association, and their winning ways are paying off for the team and its broadcast partner.
Company news
Encore Health Network, a network of health care providers owned by Community Health Network, Indiana University Health and Deaconess Health, has added St. Vincent Health to its fold. The Indianapolis-based network will offer discounted access to St. Vincent doctors and hospitals in the Anderson, Carmel, Fishers, Indianapolis and Kokomo markets. Insurance companies, third-party administrators and employers contract with Encore and its Encircle network products to obtain discounts on medical services.
Indiana University Health and UnitedHealthcare entered the new year without a contract. That would normally mean UnitedHealthcare’s customers would pay higher prices at IU Health’s hospitals and physician offices. But IU Health has decided to still give patients the same "in network" co-pays and deductibles that UnitedHealthcare had negotiated under the expiring contracts, keeping patients’ costs the same until a new deal is reached. IU Health said in a press release it would apply the "in network" discounts only to the patient portions of its bills, not to the portions paid by UnitedHealthcare. The Minnesota-based health insurer first notified its customers on Dec. 2 that its contracts with IU Health could expire at year end. Such contracts typically shave 30 percent or more off the list prices of a hospital system’s services. The contract dispute could affect the roughly 400,000 Hoosiers that have employer-based or individually purchased insurance with UnitedHealthcare. That represents about 12 percent of the Indiana commercial market, according to data from Tennessee-based market research firm HealthLeaders-InterStudy. IU Health operates 20 hospitals and employs nearly 1,500 physicians around Indiana.
The U.S. Supreme Court has temporarily blocked an Obamacare requirement that religiously affiliated employers provide health insurance that includes birth control. The decision gives temporarily relief to Catholic plaintiffs that said Obamacare’s requirement to provide contraception coverage violated their religious freedom. In a related case, Indiana-based Franciscan Alliance and other Catholic organizations won a temporary injunction from a federal judge in Indiana, to allow the Supreme Court challenge to play out before Franciscan would be required to provide contraception coverage to its workers via its health insurance plan. "We simply asked that the government not impose its values and policies on plaintiffs, in direct violation of our religious beliefs," said Kevin Leahy, CEO of Franciscan Alliance, which operates three hospitals in the Indianapolis area. The Affordable Care Act required all health insurers to cover contraception at no cost to its health plan members and required all employers with 50 or more workers to provide health insurance to their workers. Both provisions were set to take effect Jan. 1.
New St. Vincent CEO will inherit financially solid system
It’s a challenging time to be a hospital CEO, but when Jonathan Nalli takes the helm of St. Vincent Health, he’ll have about as strong a financial hand as anybody to play.
OK, I’m convinced: Hospitals actually are transforming
There are clear signs that hospitals nationally, and even here in Indianapolis, are actually starting to make good on their promises to keep patients healthier and out of the hospital.
People
Dr. Anthony Sorkin, an orthopedic trauma surgeon, has been named system medical director of Indiana University Health Orthopedics and Sports Medicine. Sorkin joined IU Health Physicians a year ago to treat patients with traumatic injuries at IU Health Methodist Hospital. Prior to IU Health, Sorkin served as director of orthopedic traumatology for Rockford Orthopedics in Illinois. Sorkin earned his bachelor’s degree in biology from the University of Miami and his medical degree from the University of Maryland School of Medicine.
Dr. Sachin Mehta, a rehabilitation and physical medicine doctor, has joined Franciscan Physician Network Rehabilitation Specialists in Indianapolis. He most recently served as medical director of the brain injury and rehabilitation programs at Marianjoy Medical Group, Wheaton, Ill. He received a bachelor’s degree in biology at Lehigh University and a medical degree from the Indiana University School of Medicine.
Central Indiana hospitals limit visitors over flu
A swine flu outbreak has prompted several central Indiana hospitals to restrict visitors to protect patients, families and staff from unnecessary potential exposure.
New tiered network trips up IU Health, UnitedHealthcare talks
In spite of offers to strike a short-term extension, UnitedHealthcare and Indiana University Health are still hung up in contract negotiations on one key point: Minnesota-based UnitedHealthcare wants to create a multi-tiered network of providers and services that would offer the lowest co-pays and deductibles for favored hospital systems—which IU Health is not.