AUSTIN, Texas – Funcionarios federales concedieron a Texas una prórroga de 15 meses sobre su programa de condonación “Sección 1115”, el cual aporta fondos para reembolsos a los hospitales por la atención que brindan sin cargo para los pacientes. Pero este programa está siendo suspendido, y los funcionarios electos de Texas –quienes hasta ahora se han negado a expandir el programa Medicare bajo la “Affordable Care Act” (Ley de Atención Asequible)– podrían tener que reconsiderar esos costos.

La Legislatura de Texas se ha negado hasta ahora a expandir su programa Madicaid bajo la Ley de Atención Asequible (ACA, por sus siglas en inglés), pero el estado todavía recibe del gobierno federal billones de dólares para atención de la salud.

Los funcionarios federales recién extendieron la condonación de la “Sección 11-15” del Estado, la cual reembolsa a los hospitales por la atención que brindan sin compensación, pero el dinero de ese programa pronto desaparecerá a menos que el estado lo sustituya con Medicaid.

Joan Alker, directora del “Georgetown University Center for Children and Families” (Centro de la Universidad Georgetown para los Niños y las Familias), dice que las estadísticas muestran que los hospitales tienen muchos más pacientes que pagan cuando los estados amplían la cobertura de Medicaid.

“Así que ya hay mucha información que muestra que los estados que han ampliado Medicaid están viendo reducciones mucho, mucho mayores en la estadía de pacientes hospitalarios no asegurados.”

Las condonaciones de la Sección 1115 consisten en programas temporales para ayudar a los estados a pagar por atención no remunerada y para impulsar la innovación en la prestación de servicios de salud.

Bajo esta figura, Texas ha recibido unos seis billones de dólares anuales durante los últimos cinco años.

Pero sin la ampliación de Medicaid, cerca de un millón de tejanos siguen estando en un “vacío de cobertura”, sin poder tener un seguro médico accesible a sus bolsillos.

La condonación fue programada para expirar en septiembre, pero esta semana los funcionarios federales otorgaron a Texas una prórroga de 15 meses.

Anne Dunkelberg, directora asociada del “Center for Public Policy Priorities” (Centro de Prioridades de Políticas Públicas), afirma que los funcionarios federales están en proceso de programar los pagos por la atención no remunerada (conocida como “UC”, siglas de “uncompensated care”), cuando un paciente es elegible para Medicaid o alguna otra cobertura de salud.

“Ese dinero de atención no remunerada se irá a partir de 2018 de cualquier manera, y la pregunta es si tenemos o no listo un plan de cobertura con fondos federales diseñado para Texas que reduzca el número de no asegurados y traiga unos 6 billones de dólares."

Bajo la Ley de Atención Asequible (ACA), el gobierno federal aporta fondos para la expansión de Medicaid. De cualquier manera, los estados comenzarán a pagar una pequeña fracción a partir de 2017, y pagarán no más del 10 por ciento al entrar el año 2020.


get more stories like this via email

Toughing it out during spring allergy season is not in your best interest if you want to avoid asthma later in life.

New Mexico has plenty of grass and weed pollens carried by the wind which contribute to itchy, watery eyes, a stuffy nose and sneezing fits this time of year.

Dr. Osman Dokmeci, associate professor of internal medicine at the University of New Mexico, suggested for those who suffer acutely, seek an allergy test and possibly medication to prevent asthma from taking hold.

"One out of 10 has asthma in America," Dokmeci pointed out. "Having seasonal allergies increases your chance of developing asthma at least fivefold."

He recommended treating allergies early and as aggressively as possible. May is "Asthma Awareness Month," which aims to bring attention to the health issue and highlight improvements in care and quality of life. Nationwide, asthma affects more than 25 million Americans, including 4 million children, and disproportionately affects certain racial and ethnic groups.

Allergies do not "cause" asthma but people who have allergies, or have family members who have allergies, are more likely to get asthma than those who do not. Research shows allergy season is starting earlier and lasting longer. A 2022 study from the University of Michigan found pollen count could increase by 200% by the end of the century due to climate change, which is why Dokmeci stressed it is important not to ignore the problem.

"There's no treatment that actually makes your asthma not happen," Dokmeci explained. "But once you develop asthma, there are good treatment options."

The estimated economic impact of asthma is more than $80 billion per year from direct and indirect costs, such as missed school and workdays.

Recent research shows approximately half of people who die by suicide had contact with a health care professional within the month prior to their death.

However, a recent study shows only 8% of hospitals are currently implementing all four recommended suicide prevention practices: safety planning, warm handoffs to outpatient care, patient follow-up and lethal means counseling.

Melissa Tolstyka, director of Behavioral Health Services for Trinity Health Ann Arbor, said a seamless transition from inpatient to outpatient care is critical. At Ann Arbor, she saw a 46% increase in compliance with comprehensive suicide risk assessments and patients discharged on the suicide care pathway now receive a safety plan, which she sees as progress.

"We continue to see a need for really robust programming," Tolstyka explained. "Not just within the behavioral health world, but in the medical world as well. Our organization really wanted to focus on bringing the behavioral health and the medical services together to enhance our safer suicide care practices for our patients."

The initiative is being piloted across various units at Trinity Hospitals in Ann Arbor and Grand Rapids including the emergency department, psychiatric medical and inpatient nursing units. If you or anyone you know is struggling or in crisis, help is available 24 hours a day, seven days a week, by calling or texting 988, the Suicide and Crisis Lifeline.

Casie Sultana, clinical nurse leader for Trinity Health Grand Rapids, prioritizes patient well-being, emphasizing support and improvement over solely managing risks within the facility.

"We want to be someplace that people feel welcome to come to who are dealing with suicide," Sultana emphasized. "You feel so alone. It's a very lonely journey and we want people to come seek help and feel welcomed when they do that."

Susan Burchardt, clinical services manager at Trinity Grand Rapids, advised other hospitals considering a similar program to learn from organizations already using it.

Support for this reporting was provided by The Pew Charitable Trusts.


get more stories like this via email

Access to reduced-price medication is a necessity for many rural Missourians with low income.

Rep. Cindy O'Laughlin, R-Shelbina, the Senate Floor Leader, said Big Pharma is trying to confuse legislators with unrelated hot-button topics such as abortion access and illegal immigration in a last-ditch effort to stop the state from joining a program to force drugmakers to sell medicines at a discount.

"Appealing to nuclear topics, which really do not apply in this situation, is a disingenuous way to try to defeat a bill that is actually good for Missouri," O'Laughlin asserted.

O'Laughlin pointed out the program is transparent, and uses the tax money saved to help low-income families deal with chronic conditions such as diabetes.

The drugmakers object to the government forcing them to give significant discounts, arguing hospitals' and for-profit pharmacies' bottom lines, particularly those owned by pharmacy benefits managers, are being exploited. Nationally, 46% of contract pharmacy agreements involve pharmacies linked to the three largest benefits managers.

Rep. Tara Peters, R-Rolla, introduced the 340B contract pharmacy access billand said the lobbying is absurd.

"Federally, 340B program does not allow for abortion drugs," Peters stressed. "Why would any legislation that we're trying to pass in the state allow for that? I mean, the thought of that even being in existence is absolutely ludicrous."

The Missouri Senate passed the bill 27-3 on Monday and it now goes to the House.


get more stories like this via email