Jewish Hospital cuts 155 jobs, reflecting national trend of patients deferring treatment for economic reasons

In the face of a bad economy and people putting off health care to save money, Jewish Hospital is cutting 155 positions at its downtown Louisville facility. The move is part of a national trend, experts say."People are looking very carefully at any financial expenditure," healthcare consultant Peter Young told The Courier-Journal. (C-J Photo by Matt Stone)

Jewish Hospital & St. Mary's HealthCare, which owns the downtown facility, saw a 15 percent drop in in cardiology procedures in 2010 compared to the year before. That translates to 7,000 less cases. In total, surgeries fell almost 9 percent, The C-J's Patrick Howington and Laura Ungar report.

This is the second big cut by Jewish & St. Mary's. In March 2010, it eliminated 500 positions. The latest round of eliminations show why Jewish plans to merge with University Medical Center and Saint Joseph Health System is so important. "Health care is changing, and volumes are dropping while bad debt increases," Jewish Hospital officials said in a statement. "To be effective, growing organizations, we must be flexible and adapt." (Read more)

Judge to decide if health board's smoking ban will stand in Bullitt County, as one did in Hopkins County

Whether the Bullitt County Board of Health had the authority to pass a countywide smoking ban is in the hands of Bullitt Circuit Judge Rodney Burress, who heard from the board and representatives of the Fiscal Court objecting to the move Thursday.

In March, the Board of Health passed a ban that would prohibit smoking in bars, restaurants and all public places, including some that are outside. It was supposed to go into effect in September.

But attorneys representing the Bullitt Fiscal Court said the health board has "overstepped its authority by enacting a policy that should have been handed down by a legislative body, such as a city council or Fiscal Court," The Courier-Journal's Charlie White reports.

Margaret Miller, who is helping to represent the board of health, cited the Kentucky statute, which gives boards of health the authority to adopt, implement and enforce regulations to protect people's health.

The Bullitt County Board of Health is not the first in Kentucky to enact such a ban. Health boards in Woodford, Hopkins, Madison and Clark counties did likewise. The move in Hopkins County did result in a legal battle, but the judge sided with the health department and the ruling was not appealed. (Read more)

Weekly newspaper in Adair County does a special section on health and sends it to everyone in the county

Special sections on health are good for community newspapers and their readers. Health-care providers have money for advertising in such sections, and a section focused on health can have more impact on readers than individual, occasional stories.

Based on a pilot project it oversaw in 2007, the Institute for Rural Journalism and Community Issues began recommending to rural newspapers that they schedule health sections as part of editions that are mailed to every postal customer in a paper's home county, a standard circulation-building technique. If a newspaper wants to help improve the health of its community, why not reach everyone in the community?

Last week, one Kentucky newspaper did that. The Adair County Community Voice of Columbia included a 10-page broadsheet section on health in an edition that was mailed to everyone in the county. And though it got no advertising from the local public hospital, with which it has been embroiled in an open-meetings dispute, it did get ads from hospitals in other counties.

Newspapers can mail up to 10 percent of their annual circulation to non-subscribers in their home county at subscriber rates, and can sell "sponsored circulation" to pay the extra cost of printing and postage for the extra copies. The 2007 pilot project with another Kentucky weekly, The Berea Citizen, found that non-subscribers said they were more likely to subscribe if the paper regularly included health information. For a copy of the report on the project, click here. The health section is not online, but PDFs of its pages are posted on the Institute website in a 4.4 MB file, here.

Ky., Ohio, Tenn. and W.Va. join forces to fight prescription-drug abuse amid questions about use of Ky. system

Kentucky has formed a partnership with Ohio, Tennessee and West Virginia to help fight prescription drug abuse, "even as questions linger over how well the state has used its own electronic monitoring resources," reports Mike Wynn of The Courier-Journal.

The Interstate Prescription Drug Task Force will comprise about 30 experts from law enforcement and drug agencies. They are charged to come up with ways to lessen prescription drug abuse and sales. "We do a good job from a law enforcement standpoint, but by working together, we can better identify prescribers, dispensers and patients who are exploiting our borders," Gov. Steve Beshear said in announcing the task force Wednesday.

Task force members will share drug information the state collects on who receives and prescribes certain medications. Kentucky's system is known as KASPER, short for Kentucky's All Schedule Prescription Electronic Recording system. How well the data compiled by the system are being used came into question last week when House Speaker Greg Stumbo, D-Prestonburg, pressed the Kentucky Board of Medical Licensure to explain why it wasn't analyzing the numbers, which it had asked for permission to obtain, Wynn notes.

Rural hospitals to get federal help for recruiting physicians

Critical-access hospitals will get help recruiting physicians to their rural areas through an expanded loan repayment program that is part of President Obama's new jobs initiative for rural America.

The initiative is called the National Health Service Corps, Alexandra Wilson Pecci of HealthLeaders Media reports. The 1,300 critical-access hospitals can use federal loans to recruit new physicians. A press release from the White House states the addition of one primary care physician in a rural community generates about $1.5 million in annual revenue and creates 23 jobs annually.

Kentucky has 30 critical-access hospitals, which must be in rural areas, 35 miles from another hospital or 15 miles from another hospital in mountainous terrain, according to the Rural Assistance Center. The average CAH creates 107 jobs and generates $4.8 million in payroll annually, the White House says.

The jobs program also includes an agreement that will "link rural hospitals and clinicians to existing capital loan programs to help them buy health IT software and hardware and jump the typical rural hospital hurdle of limited access to capital and lower financial operating margins," HealthLeaders Media reports.

A few days before announcing the jobs program, the White House Rural Council released a report that outlined recent investments in rural healthcare access. Those include placing more than 2,600 clinicians in rural communities and providing distance learning and telemedicine services to more than 2,500 rural healthcare and educational facilities. It also highlighted an investment of 500 projects across the U.S. Department of Veterans Affairs health care system that support rural health care. That includes 404 community-based outpatient clinics and 48 outreach clinics in rural areas.

On average, rural counties had 62 primary care doctors for every 100,000 residents in 2008, compared to 79.5 primary care doctors in urban areas, the Rural Council report said. (Read more)

U of L physicians' group drops open-records appeal, but C-J may still not get records

An organization representing University of Louisville doctors who were trying to keep their financial records private dropped its lawsuit appealing an adverse open-records decision Tuesday. In April, Attorney General Jack Conway ruled that University of Louisville Physicians Inc. is a public agency and, as such, is subject to the Kentucky Open Records Act. Conway's opinion was requested by The Courier-Journal.



Last November, state auditor Crit Luallen released a scathing audit against Passport, which provides managed care for 165,000 Medicaid patients in Jefferson and 15 surrounding counties. The audit accused the organization of "wasteful spending, conflicts of interest and the questionable transfer of $30 million in Medicaid funds to organizations represented on Passport's board, including University Physician Associates," The Courier-Journal's Tom Loftus reports. Because of the audit, the newspaper asked for financial records from University Physicians Associates and University of Louisville Physicians Inc., which is the successor to University Physicians Associates. They refused to hand over the records, and Conway's decision followed.



Though the attorney general determined the organization should be subject to the open-records law, and the doctors' lawsuit has been dismissed, giving Conway's opinion the force of law, The Courier-Journal may not receive the records it has asked for. In its notice of dismissal, University of Louisville Physicians stated it could change "its structure and function in the future which it believes may alter its status as a public agency."



"We are still forming our final structure and function," Diane Patridge, ULP's vice president for marketing and communications, told Loftus. "Once we're up and fully established we may appeal this current determination." Curiously, "Partridge also said that ULP has no records to release to the newspaper as a result of the dismissal of the case," because it has no employees -- even though it was incorporated in March 2010. "She said University Physicians Associates . . . has handled all financial matters and paperwork for ULP to date," Loftus reports.



“This case is another piece of a puzzle,” Courier-Journal attorney Jon Fleischaker said. “It’s another step to try to make sure there’s more transparency at the University of Louisville School of Medicine and University Medical Center.” (Read more) "Sounds like a shell game with shell corporations," said Al Cross, director of the Institute for Rural Journalism and Community Issues and associate extension professor of journalism at the University of Kentucky.

Data leaks are a risk with electronic health records; state says it has safeguards to protect privacy

As hospitals and other health-care providers in Kentucky and across the country are adopting electronic health records to save money and improve care, they do so at some risk. The medical files containing insurance forms, Social Security numbers and doctors' notes of about 300,000 Californians were posted recently on the Internet, available to anyone who might stumble across them or know how to search for them. "At a time of mounting computer hacking threats, the incident offers an alarming glimpse at privacy risks as the nation moves steadily into an era in which every American's sensitive medical information will be digitized," The Associated Press reports.

"When things go wrong, they can really go wrong," said Beth Givens, director of Privacy Rights Clearinghouse, a nonprofit that tracks data breaches. "Even the most well-designed systems are not safe ... This case is a good example of how the human element is the weakest link."

Generally, data breaches are the result of hackers who break into computers or thieves who steal the actual equipment. Sometimes they can just be be caused by human error. Leaks can also happen as data passes through health industry networks. "Dozens of companies can be authorized to handle a single person's medical records," the AP reports. "The further away from the health care provider the records get, the flimsier the enforcement mechanisms for ensuring the data are protected."

One of the biggest breaches was in 2006 when a laptop containing data for 26.5 million veterans was stolen from the home of a government employee. The computer was recovered. This year, hard drives containing personal information of 1.9 million Health Net insurance customers were taken. They contained health histories, financial information and Social Security numbers. The matter is still under investigation.

In the wrong hands, "health records can be used for blackmail and public humiliation," AP notes. "The information can also be used by insurance companies to inflate rates, or by employers to deny job applicants."

Preventing data leaks is on the minds of Kentucky officials setting up the Kentucky Health Information Exchange, the state clearinghouse for EHRs. Participating providers have to sign several agreements in which they attest the information they obtain will be used responsibly. "The golden rule is this data will only be viewed by a provider who is providing care to a patient," said Jeff Brady, executive director of the Governor's Office of Electronic Health Information. To make sure that is happening, Brady said the software has an audit function, in which administrators are able to see who looks at a patient's data, when they did, from what computer and what piece of data was examined. (Read more)