March 27, 2013

Presence Health is New Name for Provena and Resurrection

The two Provena hospitals in Urbana and Danville are now officially operating as Presence hospitals. It is the end result of the 2011 merger of two Catholic healthcare chains --- Provena Health and Resurrection Healthcare.

The new Presence Health is the largest Catholic health facility in Illinois. It has facilities in Chicago and suburbs, Joliet, Kankakee, the Fox River Valley region and east-central Illinois.

Presence Health describes itself as a non-for-profit health system, encompassing 12 hospitals, 27 senior care locations, more than 500 employed physicians and 90 primary and specialty care clinics, extensive home health services, and a fully accredited non-for-profit specialty school for health sciences (Resurrection University in Oak Park).

Mike Brown is the regional president and CEO for what is now Presence Covenant Medical Center in Urbana and Presence United Samaritans Medical Center in Danville. The signs on the two hospitals still say Provena, but Brown said new signs are coming soon.

With the new name, Presence Health is launching a new care model, which Brown describes as patient-centered --- similar to the Patient-Centered Medical Home model -- instead of disease-centered. Brown said at Presence Health, patients are active participants in their own care ---- receiving services meant to focus on their specific needs.

“I would give you a for-instance, to say that if you’ve ever been a patient in a hospital, that when the nurses change, you notice the change in nurses,” said Brown. “But you really weren’t present as they talked about your care from shift to shift. Today, we do those things by your bed. “

As part of the new patient-centered care model, Presence Health is also launching one of the first Medicare Accountable Care Organizations --- or A-C-O’s --- in Illinois.  They are included in the federal Affordable Care Act as a way to better coordinate care for Medicare patients.

Brown said Presence Health will be launching a marketing campaign in April to introduce their new brand. Their new website is at


March 26, 2013

Report: Medical Claim Costs to Rise in Illinois

A new report says the national health law will lead to a nearly 51 percent increase by 2017 in the cost of medical claims paid by insurers selling policies to individuals in Illinois.

The report from the Society of Actuaries says costs will rise largely because of spending on sicker people and other high-cost groups who will gain coverage under the Affordable Care Act.

Medical claims are considered the biggest driver of the cost of health insurance premiums.

The report does not make similar estimates for employer plans, which cover workers and their families.

The White House questions the design of the study, saying it focuses only on one piece of the puzzle and ignores cost relief strategies in the law such as tax credits to help people afford premiums.

March 20, 2013

Health Care Law Turns Three, Public Still Confused

As the Affordable Care Act nears its third birthday this Saturday, a poll finds the public actually knows less about the law now than when it passed in 2010. Oh, and a lot of what people think they know just isn't so.

Those are the central findings of this month's tracking poll just released by the Kaiser Family Foundation.

As has been the case all along, the poll found the central elements of the law remain popular across partly lines. In case you've forgotten, those are things like providing tax credits to small businesses to help employees afford insurance, closing the Medicare prescription drug "doughnut hole," and creating health insurance marketplaces where individuals and small businesses can buy coverage.

Support for those three provisions polled above 70 percent among Democrats, Independents, and Republicans.

"It is dying hard, but the political fight about the ACA is winding down, and the challenge of introducing the law to the public for real is just beginning," Drew Altman, president and CEO of the Kaiser Family Foundation, tells Shots.

Still, the law as a whole remains controversial, with only 37 percent saying they view it favorably. Forty percent view it unfavorably, and 23 percent declined to offer any opinion.

Maybe some of the folks in the last group just weren't sure enough about what they wanted to say. The poll tested people's knowledge of what the law does and doesn't do. The results weren't pretty.

Three-quarters of those polled correctly identified the most controversial elements of the measure, like the "individual mandate" that will require most people to either have health insurance or pay a penalty starting next year. And most people (69 percent) identified popular aspects that have already taken effect, like the provision allowing young adults up to age 26 to remain on their parents' health plans.

But it's clear that misleading statements made by opponents of the law have made a mark.

Nearly half (47 percent) of respondents incorrectly said the law allows undocumented immigrants to receive subsidies to help pay for insurance, while 40 percent still say the law included a government panel that will make decision about end-of-life care for people on Medicare.

Respondents who said the law has already affected them in a negative way (22 percent) were also allowed to provide their own examples of how that has happened. And some of those responses seemed not to actually square with the law's impact.

One person, for example, said "My doctor will no longer take Medicare patients like he did before. Now he limits the time he will see Medicare patients and they don't pay as well as they did before."

There are issues with doctors and Medicare payment. But they predate the health law.

Meanwhile, one of the few bright spots on the health front — historically slow health spending — is something that seems to be going largely unappreciated.

Nearly 60 percent of respondents incorrectly said that health spending has been going up faster than usual over the past few years. Only 4 percent correctly said health inflation has slowed.

February 28, 2013

Illinois Senate Approves Medicaid Expansion

An expansion of Medicaid under President Barack Obama's health care overhaul is one step closer in Illinois. The state Senate passed the expansion 40-19 on Thursday, sending the bill to the House.

Nearly 2.8 million Illinois residents are currently covered by Medicaid, the government health program for the poor and disabled.

Gov. Pat Quinn says he's grateful to Senate President John Cullerton, bill sponsor Sen. Heather Steans and everyone who voted for the bill.  The vote came along party lines.

The governor says that access to quality health care "is a fundamental right.'' He's urging the state House to approve the bill, which he says will improve the health of hundreds of thousands of Illinois residents and create thousands of health care jobs.

Starting in 2014, an estimated 500,000 to 600,000 uninsured Illinois residentswould be newly eligible for coverage. The expansion would mainly benefit low-income adults who don't have children at home.

People making up to 138 percent of the federal poverty line, or about $15,400 for an individual, would be eligible for Medicaid under the expansion.

The federal government would pay the entire cost of expanding Medicaid the first three years.

February 13, 2013

Feds Approve Illinois Health Exchange with Conditions

Illinois has received conditional federal approval for its plan to provide a health insurance marketplace where thousands of state residents will shop for insurance beginning Oct. 1.

U.S. Department of Health and Human Services Secretary Kathleen Sebelius issued a conditional approval letter Wednesday to Gov. Pat Quinn with a list of six conditions.

Conditions include signing a memorandum of understanding with the federal government for how the state will monitor and approve health plans sold on the exchange by March 1 and a separate memorandum of understanding for how the state will run consumer outreach activities by April 1.

Sebelius’ letter acknowledges that “Illinois is working under intense timelines.’’

The state is partnering with the federal government to offer the online marketplace.

November 05, 2012

Illinois Moves Ahead on Health Insurance Exchange

Illinois is considering proposals from five companies to build a health insurance exchange that would meet requirements of President Barack Obama's health law. An official from one of those companies says whoever wins Tuesday's presidential election many states will continue their plans for these marketplaces.

Exchanges are a cornerstone of Obama's health law, and Mitt Romney has expressed support for states setting up their own exchanges with more flexibility. That means many states will move forward with plans. That's the view of Brian Patt of Infosys Public Services.

Infosys is one of five companies bidding to design an Illinois exchange, a website where consumers would comparison shop for health insurance.

Spokeswoman Brooke Anderson says Gov. Pat Quinn plans to proceed with plans no matter who wins the election.

Democrat David Gill, Republican Rodney Davis, Independent candidate John Hartman
October 29, 2012

13th District Candidates Differ on Health Care

The three men vying for Illinois’ 13th Congressional have very different views about the future of health care in America. Democrat David Gill, Republican Rodney Davis, and Independent John Hartman all think very differently about the Affordable Care Act.

Gill said he would not have voted for it, had he been in Congress in 2010, because of its private health insurance mandate. 

“The most important part of the bill, in my opinion, is that it maintains the need to purchase private health insurance,” Gill said. “It brings 32 million more customers into the clutches of the private health insurance industry.”

But Gill, who has touted his experience as a family practice physician and emergency room doctor throughout the campaign, stresses he does not think the health insurance industry is evil.

“They simply have a different mission than the mission should be of health care providers and of governmental leaders,” Gill said. “My mission as a health care provider is to make sure that people are healthy.”

Dr. Gill does believe some elements of the Affordable Care Act do serve that purpose, including provisions that keep insurers from denying coverage to those with pre-existing conditions, keep young adults under 26 insured through their parents’ coverage, and address the so-called Medicare “donut hole.”

He would have liked something else though.

“I would have put a public option in there,” Gill said. “If nothing else as a demonstration project. I believe that the preservation and protection and ultimately the expansion of Medicare will pave the way toward us being healthier, and also being substantially wealthier in this country.”

Rodney Davis agrees with Gill about the benefits of the Affordable Care Act covering pre-existing conditions, and younger adults staying on their parents’ plan. He also likes that it lifts lifetime caps.

Nevertheless, Davis has consistently stated that, if elected, he would work in Congress to repeal and replace the legislation with what he calls a “market-based solution.” 

It is a conclusion he attributes to his wife’s successful battle with colon cancer.

“My wife was misdiagnosed for months before she was correctly diagnosed, after being told it was in her head that she had colon cancer,” Davis recalled. “And the only reason why we were able to get that diagnosis was because we had the ability to move beyond our primary care physician and go to a specialist, who thought he would find Crohn’s disease and unfortunately found a colon cancer tumor.”

Shannon Davis recently celebrated 13 years since her last chemotherapy treatment.

Rodney Davis said that experience has solidified his view that patients need to be able to choose where and when to seek medical treatment.

“My health care plan talks about putting forth an opportunity to where we can do some simple changes in the country by allowing insurance to be sold across state lines, by allowing larger pools to be able to be put together to reduce rates,” Davis said. “That’s going to be the solution that’s still going to make paramount that doctor-patient relationship.”

John Hartman, meanwhile, is generally satisfied with the legislation passed in 2010, and wants to see it preserved.

“The Affordable Care Act is projected to cover 32 million more Americans, and we certainly should not repeal that because if we do, we’ll go back to arguing with each other, we won’t have anything,” Hartman argued. “And those 32 million Americans won’t have insurance. So, it’s ethically responsible for us to maintain that.”

Yet, Hartman notes controlling health care costs has to be a priority. He points to the Mayo Clinic as an example of how quality care can also be economical.

“What they do is they pay their doctors on a salary,” Hartman said. “They don’t pay them on a, the more tests, the procedures you perform, the more money you make. You get to make the same amount of money. Then, that takes that out of the equation – you just concentrate on what’s best for the patient.”

All three candidates believe there’s more than can be done to ensure the nation’s health and well-being. ‘

David Gill believes the best path to a healthier country lies in his concept of “Medicare for everyone.”

According to Gill, “we’ve got a lot of American ingenuity and creativity in this country, and we can design a Medicare that allows for appropriate counseling, and whether it be dietary counseling or sitting down with a physician to talk for 30 minutes about options to stop smoking – those types of things. To push forward before these things mount up and become a crisis ultimately.”

Rodney Davis believes we should expand the use of community health care centers nationwide, as a more cost-effective health care safety net.

“We can do it, and provide those who are uninsured, underinsured and underserved the ability to get that primary care access that they need, to be able to have a doctor that walks them through the wellness process and through any health issues that they may or may not have,” Davis said.

John Hartman, meanwhile, emphasizes the importance of education as means to a healthier nation.

“We’ve got great advances in technology and science…but we have problems in disseminating that knowledge,” Hartman said. “And what we need to do, probably starting with our public schools, have a re-invigorated understanding of how our behavior affects our health, and make that part of our approach to health throughout our lifetimes, including our doctors, and our doctors doing a better job of listening to us as patients, and taking in consideration our values and where we’re coming from and what we want in health care.”

David Gill, Rodney Davis, and John Hartman offer three sets of ideas, three very different philosophies. They would also likely debate and ultimately vote in different ways in Congress, on behalf of Illinois’ 13th district.


September 17, 2012

GOP Congressional Candidate Davis Unveils Health Care Plan

Congressional candidate Rodney Davis says he’ll work to repeal the Affordable Care Act, and replace it with a plan to that keeps the doctor-patient relationship in place.

The 13th District Republican from Taylorville announced his own strategy for health care Monday.  He says the market-based approach will give individuals control of their insurance, and portability of their plan.

Under what Davis calls a ‘common sense, market-based approach’, he says nothing will change for current Medicare recipients.

“But we also have to look at the solvency of Medicare, and the fact that our kindergartener entering school this year – by the time he or she graduates from high school, Medicare will be insolvent," he said.  "So we have to make some decisions to ensure that we have a Medicare system that many seniors are happy with now.  Make sure that it’s there for generations to come.”

Davis says he also wants to reign in the cost of liability insurance, noting the ‘judicial hellhole’ of Madison County falls in the 13th District.

“Medical malpractice suits where doctors then begin practicing defensive medicine, which adds to the cost of delivery of health care and adds to the overall cost of getting access to health care," he said.  "Common sense tort reform needs to be part of any health care delivery system. I find it somewhat offense that it wasn’t addressed at all in Obamacare.”

Davis says he’ll also advocate for more rural community health centers, giving uninsured people access to primary care physicians outside emergency rooms. Davis spoke in a conference call Monday morning.

Democratic opponent and Bloomington physician David Gill ripped the Davis plan in a press release.

"Rodney Davis' rollout of a supposed 'market-based' health plan is little more than a payback for his insurance company sponsors," he said.  "Clearly, when Aetna Insurance paid for a barrage of false and deceptive ads against me, they extracted a promise from Davis.  The promise is Davis' support for a return to the bad old days, when health insurers could freely deny coverage and impose lifetime caps.  Those so-called 'market-based' tactics insure only one thing - the death of patients."

Gill campaign manager Tom Alte says Davis wants to put health insurance profits ahead of patient care.

Davis and Gill face independent candidate John Hartman in the November 6th election.

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