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In November, the Food and Drug Administration announced plans to take artificial trans fats out of the food supply. / Getty Images More ADVERTISEMENT The U.S. began 2013 in the midst of a severe flu season. Then came renewed concern about mental health care in response to a mass shooting. And communities across the U.S. saw outbreaks of measles in areas with low vaccination rates. With no new blockbuster drugs or breakthroughs in cancer and heart disease, many experts say that public health issues such as these dominated health news in 2013. Influenza The flu hit early last year, killing 169 children and sickening an estimated 32 million Americans of all ages, according to the Centers for Disease Control and Prevention. More than 381,000 Americans were hospitalized during the 2012-13 flu season. The past year reminded us that flu really has unparalleled potential to do great harm, says CDC director Thomas Frieden. It reminded us that we are all connected by the air we breathe. New bird flu World health officials became alarmed in March by the emergence of a deadly new strain of bird flu in China, called H7N9. Most of those infections were related to infected poultry. And most cases were severe, with about one-third of patients dying. So far, the virus hasnt acquired the ability to spread easily from person to person, according to the World Health Organization. Although the Chinese developed vaccines, they arent great, Frieden says, because they require several doses and an adjuvant, or additional substance to boost immune response.
Stephen Hippler, OSF’s senior vice president for clinical excellence. The Catholic hospital system tapped into a charity program and made the repairs. The hospital has cared for about 10,000 Medicare ACO patients since July 2012. In November, UnityPoint acquired the 220-bed Procter Hospital, Peoria’s third-largest provider, giving it access to new addiction recovery services and skilled nursing care. The Procter deal follows Methodist’s decision in 2011 to join Iowa-based UnityPoint Health, the 13th-largest non-profit health system in the United States with annual revenue of $2.7 billion. The moves are part of a national consolidation trend among hospitals trying to fill out their menu of services and bring costs under centralized control. “There is a need for size and scale in the new environment,” said Terry Waters, vice president for strategy and development at UnityPoint Health. “You have to be able to diversify your financial risk over a larger patient population.” According to the Henry J. Kaiser Family Foundation, an estimated 14 percent of the U.S. population is covered by some form of accountable care organization, including 4 million Medicare beneficiaries. WILL IT WORK? OSF could not say whether it has saved money on Wright’s care in the two years since she has been in care management because the system does not release financial information about individual patients. But Canty said the system “has seen significant and sustained declines in the cost of care for patients in care management.” As for Wright, she appreciates the quick access she now has to her doctors, but she still needs a lot of care. In May, a hip implant had become infected and had to be replaced. While recovering, Wright developed a bothersome cough that turned out to be pulmonary fibrosis, a dangerous scarring of the lungs. “Between May 21 and July 19, I had been released and admitted five times.
To avoid the penalty, Freeport could cut back on the number of hours part-time and volunteer firefighters have to work. But that would mean finding more volunteers to make up the difference, something the department and others across the country already struggle to do, Fournier said. When he started in Freeport in 1972, there was a waiting list of 25 people. After three months actively recruiting in the community, Fournier said he’s lucky that he’ll soon be interviewing nine potential volunteer firefighters. “It’s pretty amazing how this law is touching different operations,” he said in an interview in Freeport’s brick firehouse, where yellow fire trucks and ambulances were lined up awaiting the next call. “I’m not sure everyone thought that through.” The question is expected to be answered when the Internal Revenue Service releases final regulations this year before the provision takes effect in 2015. A Treasury spokeswoman said the department is taking the concerns into account as it works toward the final regulations but wouldn’t comment on what they’re likely to include. In the meantime, Maine’s U.S. senators are backing a recently introduced bill aimed at ensuring volunteer firefighters and other emergency responders are exempt from the health care law requirement. Republicans point to the confusion as another example of the problems with the law, which has been plagued by a fumbled rollout and criticism over canceled health care plans. “This is yet another adverse and unanticipated impact of Obamacare,” said Maine Republican Susan Collins. City and town leaders are also discussing ways to keep their staff under 50 employees to dodge the costs, Maine Municipal Association officials said. School superintendents are making sure their substitute teachers aren’t working more than 30 hours a week to avoid having to cover them, Collins said. Others point to factors that they say show the concern is overblown. Many small towns only have about 20 to 30 volunteer firefighters, likely making them too small to be affected by the law’s mandate. And though Fournier described a busy winter with a lot of work for firefighters, they often fall short of working enough hours to be affected by the insurance requirement.