By Dr. Madelyn E. Butler, special to the Times

As a practicing OB-GYN in Tampa and Florida Medical Association president, I was dismayed to read the recent St. Petersburg Times editorial, “Devaluing the lives of poor, elderly.” The FMA finds the editorial’s references to medical liability reform passed during the 2011 legislative session to be misleading.

The FMA, which represents more 20,000 physicians, across the state, worked hard this session to pass medical liability reform, including a provision addressing expert witness testimony — a measure we’ve been working to pass for over a decade. We’ve prioritized the passage of these reforms to increase access to care for all patients and ensure that there are enough physicians to treat them.

Unfortunately, the Times‘ editorial specifically targets HB 479, saying it forces “additional state regulation on medical expert witnesses. … The goal is to make it harder for personal injury lawyers to bring cases by intimidating and harassing the pool of medical professionals willing to testify.”

To read more go to http://www.tampabay.com/opinion/columns/bill-aims-to-make-florida-a-friendlier-place-to-practice-medicine/1170370

Reductions less severe at nursing homes

By Gary Pinnell

SEBRING – Hospitals plan to absorb a 12 percent Medicaid reimbursement cut without reducing health care services or laying off nurses and caregivers.

To reconcile a $4.6 billion revenue shortfall in the state budget, the Legislature agreed to reduce $510 million in Medicaid payments to hospitals.

“The Medicaid cuts include both state and federal funds,” said State Rep. Denise Grimsley, R-Sebring.

Nursing homes lost 6.5 percent of their Medicaid dollars. As a result, each nursing home resident is expected to receive 3.6 hours of care from nursing assistants and nurses, down from 3.9 percent, the Florida Health Care Association estimated.

“However, we also provided for staffing relief, which was worth about 2.5 percent of the 6.5 percent, bringing the total reduction closer to only 4 percent,” said Grimsley, who is also a registered nurse at Florida Hospital Heartland.

To read more about these reductions, visit

http://www2.highlandstoday.com/content/2011/may/15/hospitals-12-medicaid-cut-wont-cause-layoffs/

By: Liz Freeman

NAPLES — Some seniors are caught between their past and their futures.

Legislation passed by Florida lawmakers during the recent session could offer some remedy.

The legislation addresses continuing care retirement communities and would allow these retirement communities to offer “memberships” to seniors for various services while they still live in their private residences.

State Rep. Kathleen Passidomo, R-Naples, was one of the House sponsors.

“This gives the (continuing care retirement community) the ability to provide services to people who want to live off-campus,” she said. “A lot of people can’t sell their home and they are stuck.”

The legislation enables seniors to become part of a retirement community before they have the need to move on the campus, she said. The membership can involve such services as use of wellness programs, the dining room and at-home health care, she said.

For more information about this new law visit http://www.naplesnews.com/news/2011/may/14/continuing-care-retirement-community-florida-law/

By Michael Peltier

(Reuters) – Florida lawmakers passed a sweeping Medicaid reform package that places most recipients into managed care in a closely watched debate over how to curb costs and provide health benefits to the poor.

Following hours of debate and back-room negotiations over the past several weeks, the Republican-dominated Legislature late on Friday sent a package to Governor Rick Scott that backers say will save the state $1.1 billion next year.

Savings would be realized by shifting Medicaid from a traditional fee for service program to one that caps payments to providers and more closely mirrors private sector health insurance plans.

The bill would split the state into 11 regions and allow managed care companies to compete for business within those geographic boundaries

For more information go to

http://www.reuters.com/article/2011/05/07/us-medicaid-florida-idUSTRE7461IU20110507

Republicans have partisan control of both chambers of the Legislature and a shared intention to move Medicaid patients to managed care plans, yet the state Senate and House of Representatives have significant differences over how to implement those strategies.

Medicaid is expected to cost $22 billion next year (as part of a state budget near $68 billion), a huge sum. The program will cover about 3 million Floridians, so that many lives and more will be affected by the Legislature’s decisions concerning Medicaid.

Despite Medicaid’s notoriously low provider reimbursement rates, many corporate managed care plans and health maintenance organizations see opportunities for expanding market share — thus the substantial private-sector support for moving Medicaid patients to managed care from the traditional fee-for-service payment model.

Medicaid provides insurance for among the following Floridians with low family incomes or few financial assets: children who need basic dental care and medical services; adults with chronic ailments, such as diabetes, that often require hospitalization; people of all ages with developmental disabilities; nursing-home residents with long-term ailments such as dementia.

Funding and providing care to such a wide range of patients are, at best, complex tasks that don’t lend themselves to one-size-fits-all measures.

For more information go to http://www.heraldtribune.com/article/20110420/OPINION/110419426/-1/sports?Title=Medicaid-reform-s-huge-stakes

By Jim Saunders
04/15/11 © Health News Florida

The Senate Budget Committee approved a massive Medicaid overhaul Thursday that would try to slam the brakes on health-care spending.

The bill includes a controversial proposal that would cap the amount of money the state spends each year on Medicaid and force mid-year cuts if costs go up. The proposal could be a key issue as House and Senate negotiators work out differences in the coming weeks.

Senate Health and Human Services Appropriations Chairman Joe Negron, R-Stuart, has made the cap a priority and says it would offer “budget predictability.” In recent years, the state has faced steadily increasing costs as the bad economy has pushed more people into Medicaid.

“We as a legislature will decide, ‘This is how much we’re going to spend on Medicaid,’ ” Negron said before the Senate Budget Committee voted 17-4 to approve the overhaul bill and send it to the full Senate.

For the full article go to http://www.healthnewsflorida.org/top_story/read/sen._medicaid_bill_headed_to_floor

Written by Lindsey Dunn

Coral Gables, Fla.-based Baptist Health South Florida will open the new West Kendall Baptist Hospital in Miami on April 27, according to a news release by the health system.

The hospital will be the first new, non-replacement hospital in Miami in more than 35 years, according to the report.

The hospital will feature surgical, emergency, maternity and diagnostic units. Its campus will include a freestanding, 63,000-square-foot physician office building.

The hospital will also be home to an accredited family practice residency program through an affiliation with Florida International University’s Herbert Wertheim College of Medicine.

Read the report on http://www.baptisthealth.net/en/facilities/West-Kendall-Baptist-Hospital/Pages/default.aspx

Patient numbers are expected to double by mid-century, report finds

TUESDAY, March 15 (HealthDay News) — Nearly 15 million Americans are caring for someone with Alzheimer’s or another form of dementia, and the number is rising, according to a report released Tuesday.

“People with Alzheimer’s who are otherwise healthy may live as long as 20 or 25 years,” said William H. Thies, chief medical and scientific officer at the Alzheimer’s Association, which is publishing the report in the March issue of its journal, Alzheimer’s & Dementia. “These are individuals who need increasing levels of care over time, and that can be very difficult for families.

About 5.4 million people in the United States have Alzheimer’s disease, and their 14.9 million caregivers provided a total of 17 billion hours of unpaid care, valued at more than $200 billion, according to the report, which also highlights the physical and emotional burdens that caregivers face every day.

“There’s a real lack of understanding among families about the toll that this disease is ultimately going to take,” said Beth Kallmyer, senior director of constituent services at the Alzheimer’s Association.

“Too many people wait until they’re in a middle of a crisis to seek help, which is why we encourage people to start the care-planning process as soon as someone gets the diagnosis,” she said.

For more about this article visit: http://consumer.healthday.com/Article.asp?AID=650818

It’s no secret that all hospitals are not equal. The special quality shared by the 152 that made it into the new 2010-11 Best Hospitals rankings (out of nearly 5,000 that were considered), and even more so by the 14 in this year’s Honor Roll, is their ability to take on and meet the most difficult challenges. Their operating rooms showcase delicate, demanding procedures—excising a cancerous portion of a pancreas without destroying the rest of the fragile organ, say, or restoring function to an arthritis-ravaged hand through a creative blend of fusing joints and splicing tendons. They are referral centers for ill patients with multiple risks—advanced age plus heart failure plus diabetes, perhaps.

Patients at these centers are not exempt from picking up hospital-based infections, getting the wrong drugs, or becoming victims of other medical errors. No matter how skilled or deep their expertise, even “best hospitals” don’t do everything right. But when high stakes call for unusual capabilities, they are hospitals that can save lives that might be lost or preserve quality of life that might be sacrificed. That is why U.S. News has published the Best Hospitals rankings for 21 years: to help guide patients who need high-stakes care because of the complexity or difficulty of their condition or procedure. For 2010-11 we analyzed 4,852 hospitals, virtually every one in the United States, in 16 specialties from cancer and heart disease to respiratory disorders and urology. Only 152 centers appear in even one of the 16 specialty rankings. Fourteen ultra-elite Honor Roll hospitals had very high scores in six or more specialties.

In 12 of the 16 specialties, the quality of hospital care can determine life or death. Therefore the largest part of each hospital’s score in those 12 specialties came from death rates and other hard data on patient safety, volume, and various care-related factors such as nursing and patient services. The rest of the score was derived from a reputational survey of specialists. The 50 highest scorers were ranked. Scores and complete data for another 1,740 unranked hospitals are also available. In the four other specialties—ophthalmology, psychiatry, rehabilitation, and rheumatology—hospitals were ranked on reputation alone. The number of deaths in these specialties is so low that mortality data and certain other categories of data are not relevant factors.

A detailed description of the analysis in the 12 specialties is available. In brief, death rate, care-related factors, and patient safety added up to slightly more than two-thirds of each hospital’s score. The reputation portion of the score used responses from nearly 10,000 physicians, who were surveyed in 2008, 2009, and 2010 and asked to name five hospitals they consider among the best in their specialty for difficult cases, ignoring cost or location.

The Honor Roll requirements were so stiff that 99.7 percent of all centers in the nation were excluded. A hospital had to be ranked in at least six specialties, but ranking alone was insufficient for inclusion. It also had to have an extremely high score (in statisticians’ terms, at least 3 standard deviations above the mean). That earned 1 point per specialty. Reaching the top of the Honor Roll called for even higher scores (4 or more standard deviations above the mean), earning 2 points, in far more specialties. The highest-ranked hospitals on the Honor Roll, which is ordered by points, had high scores in 15 of the 16 specialty rankings. Johns Hopkins stands at No. 1—as it has for the last 20 years.

To view photos of the hospitals go to http://health.usnews.com/health-news/best-hospitals/photos/a-tour-of-americas-best-hospitals-2010-11?s_cid=related-links:TOP

WASHINGTON — Codifying recommendations made at a meeting last month, the Medicare Payment Advisory Commission (MedPAC) has officially recommended that physician reimbursement under the Medicare program be increased by 1% in 2012.

MedPAC — an independent agency of 17 trustees that provides Congress with advice on Medicare — sends a report to Congress each March on Medicare’s fee-for-service payment system and recommends payment updates for the following year.

In its report to Congress last year, MedPAC also recommended a 1% pay increase, justifying the size by explaining that most Medicare patients have access to physicians and there doesn’t appear to be any doctor shortage.

This year, they said it’s just as easy for a Medicare beneficiary to access a doctor as it is for someone with private insurance, adding a caveat that a “small share” of people with Medicare do report difficulty in finding a primary care doctor.

In addition, they noted, contrary to threats that doctors will stop accepting new Medicare patients, the vast majority of physicians are not shutting their doors.

“In light of these positive indicators and the modest expected growth in physicians’ and other health professionals’ costs, the Commission recommends an update of 1% for physician fee-schedule services in 2012,” the trustees wrote.

To read more visit http://www.medpagetoday.com/PublicHealthPolicy/Medicare/25354