BCBS exit leaves an “Unhealthy” void

Blue Cross and Blue Shield (BCBS) of Kansas City recently announced that they are withdrawing participation in the 2018 individual marketplace. Unless another insurer enters the individual marketplace, 25 western counties in Missouri will be left without any insurers. Thirty counties in Missouri and two counties in Kansas City, amounting to 67,000 Blue KC members, will be affected.  The graphic above provides details about counties affected.

Of the 25 counties that will be left without an insurance option through the individual marketplace, several counties that are part of GVMH’s service area will be affected.  Johnson, Henry, Pettis, Benton, St. Clair and Bates are among those affected.  The vast majority of residents served by GVMH will not have a marketplace option as of January 1, 2018.

BCBS of Kansas City is leaving the marketplace because they have experienced financial losses since they began offering the plan as a result of the Affordable Care Act in 2014.  Here’s a statement I found on the BCBS website explaining their decision;  “Since 2014, we’ve expended significant resources to offer individual ACA plans to increase access to quality healthcare coverage for the Kansas City community,” said Danette Wilson, President and CEO of Blue KC. “Like many other health insurers across the country, we have been faced with challenges in this market. Through 2016, we have lost more than $100 million. This is unsustainable for our company. We have a responsibility to our members and the greater community to remain stable and secure, and the uncertain direction of this market is a barrier to our continued participation.”

This situation is not unique to Missouri.  Several states have limited or no individual marketplace option because insurers have lost money by participating.  There are several reasons the model hasn’t worked but two stand out.  One, many young, healthy adults have chosen not to pursue coverage through the marketplace.  Insurance requires as many low utilizers as high utilizers to work out.  Two, the subsidy provided by the federal government to help cover the cost of marketplace plans is not enough to cover the insurers loss.

GVMH is committed to providing high quality care to anyone in need regardless of coverage or ability to pay.  Thousands of people within our service area will have no affordable insurance option beginning in 2018 and BCBS’s decision to exit the marketplace puts them at risk.  It’s well documented that individuals without coverage tend to put off health care causing acute problems to become chronic.  Treating chronic illness is more difficult and costly than catching a problem early on and resolving it.

I can understand BCBS’s decision and I appreciate they were willing to take a financial loss as long as they did so I don’t blame them.  Our great country has a health care system problem and there are no easy solutions.  The best we can hope, for residents of Henry and surrounding counties, is that another insurer enters the marketplace by January 1, 2018.  But why would they?

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Ransomware: GVMH keeping you, and your information, safe

One of the largest cyber security incidents ever to occur happened just over a week ago.  On Friday, May 12, hundreds of hospitals in Europe were affected by a malware known as WannaCry ransomware.

Ransomware is a computer virus that takes over a user’s computer and requires the user to pay a fee, or ransom, to recover access to the computer.  Ransomware has been around for a while but what made last week’s attack alarming was the rate at which it spread.  The attack crippled several European hospitals forcing them to divert patients to other facilities and it spread fear that US hospitals would be affected.

The infection began as a phishing email with an attachment that was opened by some unsuspecting person.  Once the attachment was opened the virus spread throughout the system the computer was connected to.  A phishing email is an email that looks legitimate and usually has an attachment or a link.  The recipient of the email is instructed to open the attachment or click on the link, once they do, the computer is infected.

Hospital computers and information systems are high value targets for cyber criminals.  Health care data is high value for a number of reasons.  If a cyber criminal were to gain access to billing information they could illegally bill Medicare or other payers for services and would likely not be discovered until long after they received payment.  An individuals health care information is protected by HIPAA and hospitals go to great lengths protect health information.  If a cyber criminal were to gain access to a hospital’s information system the hospital could face civil and criminal penalty.  Most importantly, hospitals rely upon electronic health records to assist in the provision of care.  Patient’s care plans, allergies and medication lists all reside within the electronic medical if the system isn’t available, or corrupt, it can slow care to patients and a delay in care can negatively affect outcomes.

Cyber attacks are an ongoing threat.   At work and home, each of us can protect our computers by not opening emails, especially attachments, if they’re not from a trusted source.

GVMH’s IT Department works diligently every day to protect our patients and to protect our systems.  I can’t share all they do because that would create more risk.  It would be like the jailer sharing the location of the keys to the inmates.  I can provide a general overview of steps GVMH takes to keep our Information Systems and our patient’s information safe.

GVMH has a cyber security awareness and training program. GVMH has effective technical measures to protect computer networks, such as:

 

  • GVMH utilizes spam filters to prevent phishing emails from reaching the end users and implement technologies to prevent email spoofing.
  • Incoming and outgoing emails are scanned to detect threats and filter executable files from reaching end users.
  • Firewalls are configured to block access to known malicious IP addresses.
  • Antivirus and antimalware programs are set to automatically conduct regular scans.
  • GVMH continuously backs up data.
  • GVMH conducts an annual cybersecurity assessment—with network penetration testing—to identify vulnerabilities

Our highest calling is patient safety.  Protecting patient information and having strong systems to protect our information systems is just one way we promote patient safety.

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Construction update – lots to share

Surgery

Back Corridor

Endoscopy Procedure Room

Pharmacy

Sleep Lab

I’ve been a little delinquent in a blog post on current construction activity and that’s partially because construction activity has consumed a lot of my time.  Below I will provide an update on current construction and provide details about next steps.  For an abbreviated version skip to the bulleted pointed list below.

We are approaching crunch time for completion of new Endoscopy Department space and the second phase of Surgery renovation.  The first phase of Surgery consisted of all new construction and provided for our 6 new operating rooms.   Four of the six rooms are in service and once the next phase of surgery is complete we will be able to utilize all six OR’s.  Once this phase of Surgery renovation is complete, the final phase of Surgery renovation will begin.  The third, and final, phase includes renovation of the Surgery Waiting area and pre-op.  During this phase, the Surgery Waiting Room will be temporarily be located in the old Emergency Department, the same space that was temporarily occupied by Lab.

The new Sleep Lab is on the home stretch as well and will be located in space that used to be occupied by the Emergency Department, near the new Outpatient Treatment Center and adjacent to Pulmonary Services on the first floor.

Renovation of the Pharmacy is almost complete.  The Pharmacy includes a “clean area” that houses hoods for mixing chemotherapy and IV’s.  The space requires very technical air exchanges to keep staff in the area safe and we are awaiting certification of the area.  A company will come in and test air exchange, positive and negative pressure areas, and filtration.  Once the certification is complete Pharmacy will be able to return to their space.

Work continues on the Right In / Right Out onto 7/13 highways as does work on the Outpatient Parking Island.  The island is being modified to eliminate curbs and to add walkways to make the island safer for patients and visitors who are accessing our outpatient services.  Both of these outside projects need a few days of sunny weather.  The Right In / Right Out is scheduled to be complete by May 25 and the island modification should be finished by then as well.  Both of these projects are weather dependent and the weather hasn’t cooperated as of late.

Sometime this summer work will begin on second floor in the space that was vacated by Endoscopy, Nuclear Medicine and Ultrasound.  Eventually that area will house Information Technology and Education Departments.

Work will also begin on the first floor to provide additional space to Auxiliary just off the main hospital lobby.  New space for the Development & Communications Department (the departments formerly known as Foundation and Marketing).  Their new space will be located just outside of the new Human Resources space.

Here’s a bullet pointed list to summarize the above:

  • Pharmacy returning to their permanent home within the next two weeks
  • May 24, state inspection of new Endoscopy and Post Anesthesia / Recovery on first floor, plus re-opening of back corridor on first floor and opening of two additional OR’s.
  • May 24, state inspection of new Sleep Lab on first floor.
  • May 25, Right In / Right Out and Outpatient Parking Island completion (weather dependent)
  • Early to Mid Summer work begins on second floor to accommodate new IT and Education space
  • Early to Mid Summer work begins on first floor to accommodate additional space for Auxiliary and to create new space for Development & Communications

 

 

 

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Dreams do come true

GVMH provides great care to our patients every day, and that’s because our staff cares for – and about – our patients.

Along the way we all need a little help.  Mary Darling, a social worker in the Oncology Department at GVMH, took it upon herself to help make a dream come true for one of our patients.

Sandra Lacount, pictured holding flowers alongside her son, was diagnosed with cancer in January 2014. Dr. Lara Kenney managed Sandra’s care, which involved surgery, chemotherapy and radiation.  Sandra improved but as is too often the case, she experienced a recurrence of her cancer that required additional chemotherapy and radiation in late 2015 through June 2016.  Sandra’s cancer is currently in remission.  As you can imagine, the past couple of years have been tough on her, and her family, and her need for treatment has required her to stay close to home.

Along the way Sandra shared with Mary that she moved to Missouri from California 29 years ago and she has not been able to visit family in California for a number of years.  Mary took it upon herself to submit a dream request to the Dream Foundation on Sandra’s behalf.

Last week Sandra’s dream came true.  Representatives of the Dream Foundation traveled to GVMH to present Sandra with roundtrip airfare and spending money for a two-week trip to California where she’ll spend time with family and friends.  While in California, Sandra plans to travel the state, investigate her family heritage and update family records.  Sandra’s grandson, who lives in California, recently graduated from basic training in the Marine Corps, and Sandra looks forward to celebrating his achievement with him.

The Dream Foundation serves terminally ill adults and their families by providing end-of-life dreams that offer inspiration, comfort and closure.  Sandra’s dream was the first granted to a GVMH patient by the Dream Foundation.  Now that staff understand the process they will be able to assist other patients in applying.

I was honored to be present when Sandra’s dream was granted.  Sandra and her family were touched and emotional, as were GVMH staff who have been involved in Sandra’s care for almost two years.  I’d like to offer a special thank you to Mary Darling for all she did to help make Sandra’s dream come true.

For more information on the Dream Foundation, you can visit http://www.DreamFoundation.org

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Every Child Deserves a Champion

Last week, Golden Valley Memorial Healthcare had the honor of receiving the Mary Strack Partner of the Year Award at the national Bright Futures conference. We’re equally proud of the Clinton School District, which received the national Spotlight Award.

We partner with Henry Elementary through Clinton Bright Futures so we can make a difference in the lives of children who need champions. Our staff members are in the building nearly every day. They read to and with kids, each lunch with them, go to recess with them, present skits and awards and do what they can to support the teachers and staff who are helping the children grow to become productive citizens.

Our vision focuses on making a difference in each life we touch. And while our vision and our mission specifically mention healthcare, we believe we have a role to play in the vitality of our schools and, consequently, the overall health of the communities we serve. We recognize that we, along with the public education system, are part of our community’s landscape. We work collaboratively because our children are our future.

Bright Futures elevates our involvement in our schools. We are more committed as an organization collectively and as employees individually. We also treasure the children and teachers whose faces are now familiar to us.

We find that the dividends from our involvement in Bright Futures far exceed our investment. Yes, we put dollars to work each month providing supplies, rewards and matching funds as requested. We encourage our staff to leverage their interest in helping others with time away from work to volunteer regularly. We also actively seek learning opportunities for students that bring them from their campus to ours. Those outings allow them to brighten the lives of patients or discover how interesting healthcare can be and the variety of jobs available right here in their hometown.

Making an investment in the life of a child is a privilege. Becoming a champion for children is priceless. We have received many times more than the time, talent and treasure we have shared.  The return on our investment takes many forms – smiles, laughter, warm clothes, nourishing snacks, watching a child grow confident in a skill like reading.  We have discovered that the journey is equally as important as the destination.  As a partner, we have the ability to empower the children we meet and encourage the teachers who guide them.

In our community we are one of the largest employers, but size does not matter when it comes to involvement. All of us have enough to share. And children aren’t impressed, at least not for long, by big checks and grand programs and all the other stuff that money makes possible. What matters to a student is that someone cared. That someone took the time to show up and keep showing up. That someone said, “You are worth it.” That’s an investment any of us can make.

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Medicaid Block Grants – cup half full or half empty

cuphalffullMissouri Senate Bill 28 has not yet been assigned a formal hearing date on the Senate calendar but it’s already caused a lot of discussion.

Senate Bill 28 would allow Missouri to ask the federal government for a block grant to pay for its Medicaid program, MO HealthNet, each year.  The way things work now, the federal government picks up a portion of the cost of care for all of the services provided to Missouri citizens enrolled in the state’s Medicaid program.  Advocates for Senate Bill 28 say that the block grant, which delivers a set amount of money each year, would help to reduce health care costs to the state and give the state more control over how, and where, the program uses the money.  Proponents argue that a block grant could end up restricting care for those who need it most because once funds are used, or as covered services are eliminated, access to vital care is eliminated.

The bill does not outline how much money Missouri would request in a block grant or how much it would increase over time.  It’s estimated that it would cost the state more than $400,000 annually to apply for the grant.

There are almost 1,000,000 low income Missourians covered through MO HealtNet.  Income eligibility is the primary coverage determination and almost two thirds of those covered are children.

It seems logical that a block grant approach will require the state to reduce Medicaid coverage because funding is capped.  Cuts in funding will lead to reductions in access to care.  As access to care decreases it could drive more Medicaid patients to seek care in the Emergency Department setting which could drive cost to the state and place an undue burden on hospitals.

Funding Medicaid at the state level is a challenge and consumes a significant portion of the state budget.  A block grant will guarantee funding from year to year but at what cost?

When it comes to health care, cost can’t simply be measured in dollars and cents, cost is measured in lives and quality of life.

Block grant to fund Missouri Medicaid, cup half full or half empty?

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Improving access to health care services

riro2 riro1

GVMH recently completed a large facility expansion to make access to health care services easier and more efficient for those we serve.  The recent expansion was close to 100,000 square feet and was focused on Outpatient Services as well as a new Emergency Department and new Surgical Suites.

We’ve seen a lot of growth in outpatient activity over the past few years and we were beginning to run out of space to meet patient demand.  The expansion helped us locate all of our outpatient services to one main corridor.  Hospital services have changed over time and more and more things are being done on an outpatient basis.  The addition has had an impact on how patients access our campus.  Prior to the expansion patients coming for outpatient services entered through the admitting entrance which was also shared by the Emergency Department.  Now the Emergency Department and Outpatient entrances are separate but both on the same side of the building and served by the same parking lot.

The Missouri Department of Transportation (MoDOT) recently announced a 50/50 cost share program.  The City of Clinton and GVMH partnered on an application and were awarded a grant to add a Right In / Right Out from 7/13 highway to the hospital campus.

You can see from the picture above the new entrance from the highway will cross Gaines Drive and enter the campus at the service road that runs between the Life Flight Eagle hangar and the new outpatient parking area.

The new highway access will make access to campus easier and more efficient for patients and visitors traveling to GVMH from the South and East and will make exiting campus for vehicles heading to the West and North easier and safer as well.

The 50% cost share opportunity offered by MoDOT made the decision to improve the access easy.  Without the cost share program the only way GVMH could have improved highway access would have been to pay for the project our on own.  The cost share opportunity will provide a very cost effective approach and we will essentially get $1.00 of improvement for every $0.50 invested.  The City of Clinton will oversee and sponsor the project while GVMH and MoDOT will split the cost evenly.

The work will begin soon and is currently out to bid.  Bids to do the work are due to the City by February 28 and work should begin mid-March with the intent of construction being complete by May 25.  We all recognize how much traffic through our community changes over the summer months and project completion by May 25 will allow for work to be complete prior to the Memorial Day Weekend or the official kick off to summer.

GVMH devoted a lot of resources to improve our physical facility to improve access for our patients, their families and visitors.  The new highway access will provide improved and efficient access to our campus for not only patients, their families and visitors but also to emergency vehicles.

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