Maine gets health-reform exemption that Kentucky also wants

Maine has been granted an exemption that Kentucky is also seeking — one that will exclude it from being subject to the health reform's medical-care ratio rules.

The ratio requirement "mandates that at least 80 cents out of every premium dollar go toward patient care and quality improvement, rather than administrative costs and plan profits," Amednews.com's David Glendinning reports. Under the exemption, which has been granted until 2013, Maine insurers will only have to spend 65 percent of premiums on care.

The Department of Health and Human Services contends the Maine insurance market could not bear the impact of the new regulation. The state is only served by three major insurers, one of which threatened to pull out if the regulation stood. Kentucky, Florida, Nevada and New Hampshire have applied for similar exemptions. (Read more)

Forum on health-reform law to be held in Lexington March 21

In time for the one-year anniversary of the passage of the Patient Protection and Affordable Care Act, a forum will be held in Lexington to review the ins and outs of the law.

"This is not a debate about reform, but it is a chance for interested parties to get better educated by some of the top professionals in the field," said Mark Johnson, health equity team leader with the Lexington-Fayette County Health Department.

The forum will be held from 5 to 7 p.m. March 21 at the Lyric Theatre and Cultural Arts Center, 300 E. Third St. in Lexington. Speakers will include Jodi Mitchell, executive director of the Kentucky Voices for Health; the Rev. Marian M. Taylor, executive director of the Kentucky Council of Churches; and Anton J. Gunn, regional director of Region IV of the U.S. Department of Health and Human Services.

Other speakers will include Lexington Mayor Jim Gray; Councilman Chris Ford; the Rev. Troy Thomas, chair of the Black Church Coalition; and Dr. Rice Leach, acitng county health commissioner and former state health commissioner.

The event is sponsored by the health department, Kentucky Voices for Health and the Black Church Coalition. For more information, call Mark Johnson at 859-288-2391.

Madisonville hospital earns national award for program that helps pregnant women maintain, improve oral health

For its work in improving oral health in prenatal patients, the Center for Women's Health at Trover Health System in Madisonville has received a national award.

The William J. Gies Award for Outstanding Innovation is given to individuals and organizations dedicated to improving dental education, research and leadership. Trover Health System's program "Centering Pregnancy Smiles" focuses on educating women about the importance of maintaining their oral health while pregnant.

"Women may mistakenly think they can skip dental care when pregnant. However, now more than ever, regular oral health check-ups are very important," said LeAnn Todd-Langston, director of the Center for Women's Health. "Pregnancy causes hormonal changes that put women at increased risk of dental disease. Some studies even suggest that infections in the mouth, including gingivitis and cavities, may increase the risk of delivering early. Additionally, some studies have shown that the bacteria responsible for tooth decay are passed from the mother to the baby. By incorporating oral health education into the care our prenatal patients receive, we have been able to reduce the number of preterm and low birth-weight births at Trover." (Read more)

Judge rules Passport managed-care plan for Medicaid in Louisville region is subject to state Open Records Act

As Kentucky prepares to put more of its Medicaid program under a managed-care system to save money, a judge has ruled that the contractor running the program's only managed-care plan is a public agency subject to the state Open Records Act.

Ruling in a lawsuit filed by The Courier-Journal, Jefferson Circuit Judge Susan Schultz Gibson wrote, "Since Passport exists for the purpose of administering the Medicaid program on behalf of the Commonwealth, the sought records all appear to relate to Passport’s state-related operations."

Passport, which can appeal the ruling, declined to comment. A consortium of Louisville-area hospitals, physicians and other health care providers, it serves about 165,000 poor and disabled Medicaid patients in 16 counties in the Louisville region under a $740 million annual contract. The state administers the program but most of its money comes from the federal government.

"While it has been praised by lawmakers for providing good care and saving the state money, it came under fire last year after a critical audit by state Auditor Crit Luallen," Deborah Yetter writes for the Louisville newspaper. "The audit blasted Passport management for spending on meals, travel and lobbying, and it questioned the transfer of about $30 million in reserve funds to University Hospital and other physician groups and hospitals involved in Passport operations." (Read more)

Well-being index gives rankings for Kentucky's congressional districts and metropolitan areas; some are very bad

In keeping with its second-to-last state ranking in the 2010 Gallup-Healthways Well-Being Index, which assessed people's physical and emotional health across the country, one of Kentucky's congressional districts and its major metropolitan area have also ranked low.

Of 436 congressional districts nationwide, Kentucky's 5th District ranked 435th overall, and was dead last in the emotional-health and physical-health categories. The other districts' rankings were: 1st, 383rd; 2nd, 404th; 3rd, 312th; 4th, 415th and the 6th, 388th. Here's a table with breakouts and the 2009 rankings:

Of the 188 metropolitan areas assessed, Louisville ranked 170th, not much different from its 151st ranking in 2009. Lexington ranked 115th, way down from 15th. Among metro areas centered in other states, Cincinnati was 123rd; Clarksville, Tenn., was 162nd; Evansville was 172nd; and Huntington was 188th, dead last in the nation. It has scored poorly on several other health measurements.



The well-being index assessed respondents on their emotional health, physical health, life evaluation, work environment, healthy behaviors and basic access. Respondents answered a large spectrum of questions that pertained to their life now and how they expect it to be in five years. In the emotional-health category, for example, they were asked about how often they laugh, if they were treated with respect and if they experienced sadness, anger or depression. In the work-environment category, people were asked about how they are treated by their supervisor, if they are able to use their strengths while at work and if they're satisfied with their job.

Compared to the rest of the country, Kentucky as a whole ranked 49th, surpassing only West Virginia. Hawaii had the highest well-being index in the country.

It bears noting that the rankings are based on very narrow margins of difference, with many states' scores just a few tenths of 1 percentage point apart. While Kentucky's overall well-being index was 61.9 out of a possible 100 points, Hawaii, which ranked first in the country, had a score of 71. The 2010 score for the nation was 66.8. West Virginia's score was 61.7 points. Because the scores were so close together, precise rankings are uncertain. The ranges for congressional districts and cities are greater, but the error margins are larger.

The survey was based on random-digit dial telephone interviews with 352,840 adult Americans living in all 50 states and the District of Columbia. There were 5,881 Kentuckians who participated in the study. Of those, 1,046 live in the 5th Congressional District and 1,632 live in the Louisville area, which includes Jefferson County and the Indiana border. Interviews were conducted every day from January to December 2010.

The margin of sampling error for most states is plus or minus 1 to 2 percent, but is as high as plus or minus 4 percent for the smallest states. For results based on the total sample size, "one can say with 95 percent confidence that the maximum margin of sampling error is plus or minus 1 percentage point," says Elizabeth Mendes of Gallup.

Rogers, Florida colleague file measure to crack down on 'pill mills'

U.S. Rep. Harold "Hal" Rogers of Eastern Kentucky's 5th District continues to pressure the White House for more action to crack down on "crook doctors operating these pill mills," the Lexington Herald-Leader's Halimah Abdullah reports. (H-L photo by David Perry)

Along with U.S. Rep. Vern Buchanen, R-Fla., Rogers has filed a measure that would support state-based prescription drug monitoring efforts; use seized profits from the drug trade to support rehabilitation treatment; tighten prescription standards for some pain drugs; and make prison terms more lengthy and fines more expensive.

The Obama administration says it is doing its part and "is the first to publicly call the prescription abuse problem an epidemic," Abdullah reports. White House officials contend the administration has increased drug busts and has already poured millions into state-operated prescription monitoring programs. "We've been laser-focused on this issue since day one," said Rafael Lemaitre, a spokesman for the Office of National Drug Control Policy. (Read more)

Heavy smoking less common than 40 years ago

The percentage of people who smoked 20 or more cigarettes a day decreased significantly from 1965 to 2007 in the United States, according to a study in the March 16 issue of the Journal of the American Medical Association.

There was also a decline in the number of people who smoked 10 or more cigarettes a day. The declines were more significant in California than the rest of the country, in part due to the state's tough tobacco control programs, researchers concluded.

Before 1964, when the surgeon general first linked smoking and disease, Americans smoked an average of 1 pack — or 20 cigarettes — per day, the study shows. Researchers found that in 1965 "the prevalence of high intensity (20 or more cigarettes per day) of smoking among California adults did not differ from the remaining United States; prevalence of high-intensity smoking in California was 23.2 percent compared to 22.9 in the remaining United States, and these smokers represented 56 percent of all smokers," reports Newswise, a research-reporting service. By 2007, this prevalence was 2.6 percent in California and 7.2 percent in the rest of the country. As smoking rates have declined, so, too, have lung cancer death rates. (Read more)