Florida Officials Say It Would Be A Struggle To Meet Medicaid Costs Of Health Reform

News outlets report on a variety of health care issues at the state level including the cost of health care reform in Florida, widespread budget cuts in Nebraska, a hand-washing initiative in Maryland as well as some hospital and VA-related developments.

The Sun-Sentinel reports: "Federal health care overhaul proposals in Congress would cost Florida taxpayers between $600 million and $1 billion a year starting in 2015, as uninsured residents are added to the Medicaid program, state officials said Tuesday. Democratic plans in the U.S. Senate and House would expand the number of people on the Florida Medicaid program from 2.7 million to more than 4 million, a new report by the Agency for Health Care Administration says. The federal-state program provides health coverage to the disabled and poor. The federal government would pick up most of the tab, but lawmakers presented with the figures Tuesday say the state would struggle to pick up its share, given the tight finances in Tallahassee" (Hafenbrack, 11/3).

The Associated Press reports: "Most Nebraska agencies will feel some pain over the next year and a half if lawmakers adopt the widespread spending cuts Gov. Dave Heineman proposed on Monday. Heineman's plan relies on a combination of reducing future spending, past savings and some one-time transfers of money from other state accounts. Heineman said he would oppose any plan to increase taxes to deal with the projected $334 million shortfall in the state's two-year budget. ... Lawmakers will be forced to make some tough decisions about where to cut the budget. But spending on education and the Department of Health and Human Services' programs are almost certain to be scrutinized because together they represent more than 80 percent of the budget." There may be cuts to keep payments level for health care providers and adjust Medicaid payments (Funk, 11/3).

The Baltimore Sun reports: "A state panel charged with health care unveiled its first major initiative Tuesday: an effort to improve hand-washing at Maryland hospitals. Called the Maryland Hospital Hand Hygiene Collaborative, it's funded by $100,000 in federal stimulus money provided through the U.S. Centers for Disease Control and Prevention. It's voluntary, but state officials expect almost all of the 47 acute-care hospitals in Maryland to participate because they want to reduce potentially avoidable infections that have large human and financial costs" (Cohn, 11/4).

The Boston Globe reports: "Children's Hospital Boston has agreed to limit increases in fees it charges the state's major health insurers next year as part of a larger push to control the rise in pediatric health care costs." The three health plans, along with the state's Medicaid program, will then "contribute a portion of their savings, about $10 million in total, to a fund that will enable Children's Hospital to accelerate pilot programs aimed at providing better care at lower costs. One program gives doctors immediate feedback on the success of treatments. Another explores ways to expand the range of services provided by primary care physicians, potentially enabling them to handle ailments like headaches and asthma without having to refer patients to specialists. A third is pioneering new payment models for pediatric care as state lawmakers consider revamping the current payment system" (Weisman, 11/4).

NPR reports that an inspector general report from the Department of Veterans Affairs continues to find problems at a VA Medical Center in Marion, Ill., two years after officials noticed a spike in the number of patient deaths there. "A 2008 investigation found that at least nine patients died because of surgical mistakes and poor post-surgical care at the VA hospital in Marion, which is in southern Illinois. That report made recommendations to improve conditions at the facility. The new report finds poor quality management oversight, inconsistencies in the way patient deaths are reported and continuing problems with ensuring patient safety - including the discovery that surgeons were performing procedures they were not authorized to handle." Members of the Illinois congressional delegation "sent a sharply worded letter to Veterans Affairs Secretary Eric Shinseki in which they demanded that VA management be held accountable for the problems at the Marion facility" (Schaper, 11/3).