healthcare

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As national confusion over the future of health care continues, an organization in Wyoming is pressing hospitals to be more transparent.

Twelve hospitals across the state participated in a survey by the Leapfrog Group, which works with the Wyoming Business Coalition on Health to evaluate providers in the state. 

Bob Beck / Wyoming Public Radio

Blue Cross Blue Shield of Wyoming is proposing to raise health insurance rates by 48 percent in the coming year. That would mainly impact the 28,000 Wyomingites who get their coverage via the Federal Health Insurance Exchange.  

Those off the exchange and who get group insurance through Blue Cross Blue Shield could also see a substantial increase. Spokeswoman Wendy Curran explained that Blue Cross Blue Shield is nervous about proposed changes in the current health care law. She said they are particularly concerned about threats to remove cost shared reduction subsidies.

Bob Beck

As the Senate health insurance reform effort remains on life support, Wyoming’s two senators are pushing their Republican colleagues to get on board with the effort.

Senator John Barrasso literally burned the midnight oil on Wednesday when he invited a large group of Republican senators into his office for last minute negotiations on their party’s health insurance reform plan. Barrasso emerged late and was the last to address the thirty or so reporters who huddled outside for hours.  

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Wyoming’s two U.S. Senators have been at the center of their party’s effort to overhaul the nation’s healthcare system, and they’re still optimistic they can pass a bill when they return to Washington after their July Fourth recess. Some have been critical of their work, mostly because Republicans have been negotiating their health insurance bill behind closed doors after holding no hearings on it this year. 

More healthcare providers around Wyoming are expressing worry over the Senate’s healthcare bill released last week.

The Downtown Clinic in Laramie provides primary care and emergency dental services to people without any healthcare coverage.

Pete Gosar, the clinic’s executive director, said the bill may make it more difficult to provide coverage there. The clinic recently had to extend its operating hours, staying open two days a week instead of one, to accommodate all 700 patients.

Wyoming Medical Center

The U.S. Senate released its version of a healthcare bill Thursday. Wyoming Senators Mike Enzi and John Barrasso helped craft the legislation, and they say it will be an improvement over the Affordable Care Act. But the head of the state's largest hospital is worried.

Vickie Diamond, CEO of the Wyoming Medical Center in Casper, said ultimately the bill would hurt hospitals in Wyoming. She said the biggest impact would be from the bill’s significant decrease in federal Medicaid funding, starting in 2021.

Following the adoption of the Affordable Care Act, Wyoming’s Northern Arapahoe tribal members signed up in high numbers for fully subsidized health insurance, many of whom had never received any before.

Now, a federal judge in Casper says it’s not the responsibility of the federal government to pay for tribal health care. It’s the responsibly of the tribe. U.S. District Judge Scott Skavdahl ruled against the tribe in its lawsuit with the IRS, arguing that under the ACA the Northern Arapaho tribe qualifies as a large employer.

Melodie Edwards

This year, while Wyoming lawmakers were voting down Medicaid Expansion in the state, they also approved a Medicaid Waiver for the state’s two tribes, potentially pumping some $16 million of aid into the reservation’s health system. The health crisis on the Wind River Reservation is now at critical levels, but tripling the amount that the tribe’s receive for health care could help.

In March, Northern Arapaho member Cherokee Brown’s daughter brought her a tooth. She didn’t think much about it. Kids lose teeth.

Melodie Edwards

In the recent legislative session, lawmakers approved a Medicaid Waiver for tribes on the Wind River Indian Reservation that could give the tribes federal money to expand healthcare.  But there’s still one more hurdle: approval by the Center for Medicaid Services, a federal agency.

Representative Lloyd Larsen of Lander says he expects the process to go smoothly. “We don’t expect the application process to take too long because they’re working closely with CMS.”

While a Medicaid Expansion bill has its skeptics in the State Senate this week, a waiver to expand it for Native Americans is getting warmer reception.

The Joint Appropriations Committee has included a waiver in the state supplemental budget that would provide health care to some 3,500 low-income Northern Arapaho and Eastern Shoshone on the Wind River Indian Reservation. Representative Lloyd Larsen from Lander says just last year about 40,000 health care visits went uncompensated. Larsen says Wyoming has a legal obligation to pay up.

A bill that would use federal money to help poor people buy insurance was soundly defeated in the Wyoming Senate.

The so-called Arkansas Plan would use federal Medicaid expansion money to help those who need insurance to buy it through the state.  Instead of people being on Medicaid, they would have actual insurance. 

The Senate Labor, Health, and Social Services Committee recommended passing the bill last month, but Senator Charles Scott who chairs the committee voted against the bill because he says it's a long way from being workable for Wyoming.

In an effort to increase medical services to rural communities, the Centers for Medicare and Medicaid Services (CMS) are now accepting applications for the Frontier Community Health Integration Project (F-CHIP).

Bob Beck / Wyoming Public Radio

The Wyoming Board of Medicine says a record number of physicians received licenses to practice in Wyoming last year.  The Board of Medicine’s Kevin Bohnenblust says 35 more physicians were licensed when compared to 2012 numbers, and overall they saw 15-percent more doctors compared to 2009.  He says that’s due to a new, simplified licensing process and the fact that many doctors include non-traditional approaches, such as telemedicine, in their practices.

Bob Beck / Wyoming Public Radio

Cheyenne Regional Medical Center is heading a statewide effort called Enroll Wyoming to help people get health insurance through the new online marketplace. The program has trained navigators across the state, including in Jackson where St. John's Medical Center and Teton County Library have teamed up to offer individualized sessions, designed to guide community members through healthcare.gov. Wyoming Public Radio's Rebecca Huntington has more. 

JULIE: I don't have Internet service myself, and so I was concerned about how I'm going to, you know, fill out this Obamacare insurance.

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A central mandate of the Affordable Care Act is getting health care professionals to communicate across disciplines.  A conference Thursday at the University of Wyoming brought health care leaders together to talk about how to better train students for doing that.

Brenda Zierler with the Center for Health Sciences at the University of Washington was one of the conference leaders.  She says it’s time to move past the old paradigm in which nurses, social workers and psychologists all learn their crafts in isolation. 

A study by the Government Accountability Office – or GAO - shows that it takes over one year for the Indian Health Service to process payments to contractors in 8-percent of claims.

The Indian Health Service provides limited medical services to tribal members and outsources other treatments through the contract health services program. The GAO’s Kathleen King says some payments are delayed because decisions about whether IHS will pay for a service are made on a case-by-case basis. 

The nonprofit organization Wyoming Dementia Care received a five thousand dollar grant from the Alzheimer’s Foundation of America last week.

Wyoming Dementia Care provides cost-free social support and information to dementia sufferers, their families, and their caregivers.

Carol Crump with WDC says that the organization’s most popular service is a series of support groups for caregivers, who are often the dementia sufferer’s family.

Wyoming residents will get to choose from roughly 16 health insurance plans as the new federal health insurance marketplace opens up today.  While Wyoming premiums will be higher than the rest of the country,  Mike Fierberg of the Centers for Medicare and Medicaid says that tax credits will help offset the cost.  He says credits will be available to low-income people, all the way up to salaries that are four-times the federal poverty level. 

St. John's Medical Center

St. John's Medical Center CEO Lou Hochheiser is presenting a series of public forums to help Teton County residents understand health care reform.

Wyoming Department of Health

The Wyoming Department of Health is trying to improve healthcare in rural communities by providing grant money for rural health centers.

The agency’s Keri Wagner says the money can be used to open new clinics, or to allow existing facilities to expand.

“Priority will be given to … applicants for new clinics in areas where access does not already exist,” Wagner said.

She added that while many areas in Wyoming don’t have access to good healthcare, money is not the only problem; it’s also hard to find doctors who are willing to live in rural areas.

Governor Matt Mead is urging legislators not to dismiss health care issues, but to study them and craft a Wyoming response to the Affordable Care Act.  During his state of the state message today, Mead asked legislators to study both the health insurance exchange and Medicaid expansion. 

The Supreme Court, in a five-four decision, upheld the individual mandate in the Affordable Care Act. The justices ruled that the individual mandate is unconstitutional under the commerce clause, but can go ahead as a tax.

The individual mandate requires that all people must buy health insurance. For insurance companies, that means they’ll be getting a large, new pool of customers. In Wyoming, 17-percent of the population is currently uninsured, compared to a nationwide average of 16-percent.  

The Wyoming Chapter of the American Civil Liberties Union says that most complaints surrounding state prisons and jails involves improper medical of mental health care.  Much of that has to do with inmates not getting their necessary medication.