The Pulse

Time of change — and crisis — in the hospital world

The financial turmoil rocking Georgia’s hospitals shows no signs of fading.

Just this week, Emory-Adventist Hospital announced it would close by the end of October. By doing so, the Smyrna hospital would become the fifth Georgia hospital to close within the past two years. And unlike the previous four, it is in the affluent Atlanta suburbs, not a struggling rural area.

Emory-Adventist Hospital

Emory-Adventist Hospital

Emory-Adventist officials said Wednesday that the hospital “is no longer sustainable in today’s dramatically changed health care environment.’’

Other hospitals in better financial shape are seeking to position themselves for tough times ahead. Some are partnering with other health systems, seeking to broaden their services and increase their scale.

Why all the activity?

Hospitals across the state and nation are being squeezed by several major factors, including lower reimbursements from insurers, fewer inpatient visits, and more pressure to update their technology, including information technology, said Tom Sims, a health care consultant with Stroudwater Associates.

“For health care executives, it is a perfect storm of margin pressures, additional regulatory oversight and reductions in inpatient demand,’’ added Chris Kane, an Atlanta-based health care consultant. full story

Emory-Adventist Hospital plans to close

Emory-Adventist Hospital announced Wednesday that it will close its doors by the end of October.

The 88-bed hospital, in the suburb of Smyrna just northwest of the city of Atlanta, “is no longer sustainable in today’s dramatically changed health care environment,’’ officials said in a press release. The hospital’s board approved the closure decision Monday.

Emory-Adventist Hospital

The nonprofit facility, a joint venture between Atlanta-based Emory Healthcare and the Florida-based Adventist Health System, employs 400 to 500 people. The employees were notified of the impending closure on Wednesday, said a hospital spokeswoman, Tonya Long.

Emory-Adventist has been losing money, Long said. “Like many hospitals, we’ve faced a lot of financial challenges.” full story

Cutting coal power will save many lives, EPA says

While opponents say the Environmental Protection Agency’s plan to reduce carbon emissions will cost jobs and bring higher electric bills, supporters of the proposal have a counter-argument: beneficial health effects.

Dr. LeRoy Graham

Dr. LeRoy Graham

The EPA is holding hearings in Atlanta and three other cities this week on its plan for reducing power plants’ carbon emissions.

Those in favor of the changes say that as coal plants shut down or are replaced with cleaner natural gas, there will be fewer conventional pollutants in the air. Specifically, that means fewer lung-damaging particulates and less ground-level ozone, or smog.

The EPA expects that the resulting cleaner air will mean fewer asthma attacks and hospitalizations, and 2,700 to 6,600 fewer premature deaths per year by 2030.

Dr. LeRoy Graham, a pediatric pulmonologist who practices in the Atlanta area, said Tuesday in a GHN interview that as the carbon “footprint” in the air increases, “people with lung problems are suffering more. The health threats are increasing.’’ full story

State says it’s hard at work on Medicaid backlog

A state health agency says it’s working though the application backlog for Medicaid that recently provoked federal scrutiny.

clipboardThe Department of Community Health has made decisions on eligibility for up to 70 percent of the 88,854 “account transfers” from Georgia’s insurance exchange, the agency said Friday.

The backlog in Georgia is linked to the thousands of people expected to join Medicaid and PeachCare this year as a result of the Affordable Care Act.

These new enrollees are not coming in because of expansion of Medicaid, as is happening in some states, because Georgia has declined to pursue expansion. But Georgia is reported to have tens of thousands of people who are already eligible for Medicaid or PeachCare but have not been getting it. Their names have emerged through the enrollment process in the ACA’s insurance exchange.

“We have been in the process of comparing the information in the account transfers to our various eligibility databases for several weeks,’’ said Pam Keene, Community Health spokeswoman, in an email to GHN. “Those who were found eligible are already receiving benefits. Those who were deemed ineligible have been notified and referred to the [exchange] where appropriate.”

An estimated 18,000 of the transfer files processed have been enrolled in Medicaid or PeachCare, Community Health said. But because the account transfers represent families with possibly more than one person eligible, the number enrolled would be higher. full story

Insurers to pay $11 million in Georgia rebates

A federal rule on health insurers’ spending will bring $11 million in rebates to Georgia individuals and employers this summer.

Federal figures released Thursday show that 304,000 Georgians will benefit from the refunds, with an average rebate of $53 per family, as a result of the “Medical Loss Ratio” (MLR) rule on 2013 insurance plans.

1088819262-1249Created by the Affordable Care Act, the MLR standard generally requires health insurers to spend at least 80 percent of the premium dollars they collect on medical care or activities to improve the quality of health care.

In Georgia, $5.5 million will go to refunds to 180,000 individual consumers, while $5.4 million will go to employers in the small-group market. In both these sectors, the required threshold is 80 percent.

The large employer market, where the minimum requirement is 85 percent, accounts for just $270,000 in refunds in Georgia for last year’s health plans.

Humana plans in Georgia will have to pay the highest amount in rebates — $4.5 million combined in the small-group and large employer market. full story

Consumer Corner

Big jump in doctor visits for diabetes

By 2010, one in every 10 visits Americans made to their doctor’s office involved diabetes.

Around the State

Macon: TB testing

Children attending east Macon’s Neighborhood Academy will be tested for tuberculosis after a 9-month-old boy was diagnosed with the deadly disease last week.

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Macon Telegraph

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Savannah: Obesity grant

Healthy Savannah has received a $150,000 grant from the Healthcare Georgia Foundation as part of a three-year program to combat childhood obesity.

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Savannah Morning News

Containing Ebola

WABE reports on what the Atlanta-based Centers for Disease Control and Prevention is now doing to help contain the Ebola virus.

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West Nile virus found

Mosquito samples from four Fulton County communities have tested positive for West Nile virus, health officials announce.

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Decatur: Fraud case

The owner of Brighter Futures Learning Center in Decatur is accused of billing fraudulently $355,000 from Georgia Medicaid.

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Atlanta Business Chronicle


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