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Medicare

Another important change in state benefit plan

Blue Cross and Blue Shield of Georgia is dropping its Medicare Advantage plan for next year for retirees in the State Health Benefit Plan.

That means UnitedHealthcare will be the sole provider of the Advantage plans for 2015. (Blue Cross is the sole provider for 2014.)

The Georgia Department of Community Health is informing retiree health plan members about the Blue Cross move through email and letter this month, letting them know that the decision won’t affect the coverage in effect for the current year.

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Medicare Advantage is a health plan offered by a private company that contracts with the federally administered Medicare program to provide benefits. The majority of the 54 million people on Medicare are in the traditional Medicare program, with about 30 percent enrolled in an Advantage plan, according to the Kaiser Family Foundation.

More than 102,000 people are in Medicare Advantage plans under Georgia’s State Health Benefit Plan, according to Community Health, which runs the health plan.

Blue Cross said Monday that its decision to discontinue its Advantage plan was made jointly with the SHBP.

Still, in a comparison of next year’s rates, Blue Cross had premiums that were much higher than United’s. full story

Freestanding ERs target suburbs, rural panel told

Freestanding emergency departments have been proposed in Georgia as a potential solution for struggling rural hospitals, or newly closed ones, that want to remain operational in downsized form to help patients in need.

Healthcare CostBut the trend toward such standalone emergency rooms nationally is totally different from that picture, members of the Georgia Rural Hospital Stabilization Committee were told Monday.

Freestanding EDs are actually proliferating in suburban areas, targeting high-income patients who have private insurance, said Charles Horne of accounting firm Draffin & Tucker. The prevailing emphasis is on patient convenience, not need, he told committee members at a meeting in Cordele.

Earlier this year, Gov. Nathan Deal backed a change in state licensing rules that would permit a stand-alone emergency department and some other services in rural areas that have a financially ailing – or closed – hospital.

But so far, no organization has applied to create such a facility in the state.

Meanwhile, four rural hospitals have closed in the past two years in Georgia, and others are having severe financial problems. full story

Experts on a roll … to help rural doctors

“Meaningful use.”

It’s another confounding term in the often opaque lexicon of health care. But it represents a concept that is important for health care providers’ bottom lines.

The basic idea is that Medicare and Medicaid will pay incentives for hospitals and doctors to demonstrate “meaningful use” of electronic health records (EHRs) to improve patient care.

And to help rural doctors get up to speed with education and technical assistance on meaningful use, a two-day bus tour swept through central and eastern Georgia last week.

Technical assistance is given at Taylor Regional Medical Center.

Technical assistance is given at Taylor Regional Medical Center.

Experts on board the bus came from GA-HITEC at Morehouse School of Medicine in Atlanta; the state Department of Community Health; HP Medicaid; the Georgia Health Information Network; the Medical Association of Georgia; and HomeTown Health. They visited Thomaston, Hawkinsville, Eastman, Fitzgerald, Baxley, Springfield and Swainsboro to provide hands-on help to physicians and others.

“There have not been many resources out in rural areas,’’ Kathy Whitmire of HomeTown Health, an organization of rural hospitals in the state, told GHN. She said the experts consulted with physician practices representing more than 120 eligible doctors, physician assistants and nurse practitioners. full story

Georgia sinks in state-by-state health care rankings

Georgia improved on several important health measures from 2007 to 2012, but its overall health care ranking among states fell from 35th to 45th in a newly released study.

unnamedThe Commonwealth Fund’s 2014 state health system scorecard, released Wednesday, found that all states saw meaningful improvement on at least seven of 34 indicators.

Georgia improved on 13, including child vaccinations, hospital admissions for pediatric asthma, Medicare 30-day readmission rates, and infant mortality.

But Georgia’s health statistics worsened in 12 areas, including its rates of uninsured adults; adults with a usual source of care; and adults without a dental visit in the past year. full story

The Personal Side: Looking into getting older

While recently sharing a seafood dinner, three of my old high school friends and I also shared an inventory of our medical conditions.

“Old’’ is a relative term. We’re in our early 60s. And our annual reunion is a golf vacation in Florida, so we’re mobile enough to get around the links (and send too many Titleists splashing into lagoons).

After some initial chitchat, our dinner conversation eventually got around to health.

Andy MillerWe’re members of the generation born in the aftermath of World War II — the so-called baby boomers. But we haven’t been babies for a long time. And the older we get, the more the talk among us friends veers into what’s ailing us. One of our foursome is a physician, so he can often fill in the blanks of our knowledge.

First off, none of us has a perfectly functioning body. Few people at our age have everything in good working order.

One of my friends is in the early stages of Parkinson’s disease. Another has atrial fibrillation, a heart condition he controls with medication. A third has high blood pressure. And I have occasional lower back problems, and take pills for cholesterol and thyroid conditions.

We’re all intent on maximizing our relative health for as long as we can. full story

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