VA hospital officials, it is reported, understand that noise can delay recovery and healing. Look for signs in the hospital that state “Quite please Patients healing.”

In a San Franscio CBS TV news interview,”Ruth Gay, director of public policy and advocacy with the Alzheimer’s Association in Northern California and Nevada said wandering can have terrible consequences. “Wandering in fact is a very big safety issue. We do know that if people aren’t found within 24 hours, the risk of death goes up substantially. They don’t always know how to protect themselves from the elements or find a safe location,” she said.

The Shoes are available for purchase online at After purchase of the shoes there is a monthly charge (between 35 to 40 dollars) for location alerts. I think this is very cool, because with dementia patients long term memory is the last to go and those actions of long term habit are likely to continue. The act of putting on ones shoe may be an effect habitual tool that Geo-tags your loved one.

For more information

Bloomberg reports

The industry that was the loudest, most persistent critic of this law, the industry whose analysts and executives predicted it would suffer immensely because of the law, has thrived,” Gosselin said. “There is a shift to government work under way that is going to represent a fundamental change in their business model.

Federal officials agreed in December to extend the pilot through June 2014 but placed strings on how $50 million of the LIP money could be used. Those strings call for taking money that otherwise could go toward hospital services and requiring that it be spent on new or beefed-up programs to improve quality of care.”

http://www.sunshinestatenews.com/story/panel-wrestles-federal-rules-health-funding

JACKSONVILLE, Fla., Jan. 5, 2012 /PRNewswire via COMTEX/ — Blue Cross Blue Shield of Florida (BCBSF) and the AmeriHealth Mercy Family of Companies (AMFC) today announced an agreement to enter into a joint venture to bring best-in-class Medicaid managed care and services to Florida beginning in mid-2012.

The joint venture, called Florida True Health, Inc., will be an equal partnership between BCBSF and AMFC. Both companies will share in the startup costs, financial risk and risk-based capital, among other business practices. Florida True Health will be responsible for Medicaid member enrollment, claims processing, provider network development, utilization management, quality management, customer service, community outreach, marketing, finance, actuarial and public affairs.

“This joint venture with AmeriHealth Mercy enables us to enter the Florida market with competitive capabilities from day one,” said Steve Booma, executive vice president of strategy and diversified business. “AmeriHealth’s exceptional operations and strong history in serving Medicaid members, combined with BCBSF’s 67-year history serving the health care needs of all Floridians, creates a unique organization dedicated to serve the state’s Medicaid population.”

Michael A. Rashid, President and Chief Executive Officer of the AmeriHealth Mercy Family of Companies said, “It is a privilege to bring our proven care management expertise to Florida. Our medical management and outreach programs have improved the health of our members for nearly 30 years. We look forward to working with the providers, community partners, the state and our BCBSF partner to make a positive difference in the lives of Floridians in need.”

Florida True Health will be headquartered in Florida, although the specific location of its offices has yet to be determined. Florida True Health will enter Medicaid as soon as state approvals are obtained.

About Blue Cross and Blue Shield of Florida

Blue Cross and Blue Shield of Florida (BCBSF) is a leader in Florida’s health industry. Since 1944, the company has been dedicated to meeting the diverse needs of all those it serves by offering an array of choices. BCBSF is a not-for-profit, policyholder-owned, tax-paying mutual company. Headquartered in Jacksonville, FL, BCBSF is an independent licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield companies. For more information concerning BCBSF, please see its website at www.bcbsfl.com .

About AmeriHealth Mercy

The AmeriHealth Mercy Family of Companies is one of the nation’s leaders in health care solutions for the underserved. AmeriHealth operates in 11 states and serves more than 4 million Medicaid, Medicare and SCHIP members through its Medicaid managed care products, pharmaceutical benefit management services, behavioral health services, and other administrative services. Headquartered in Philadelphia, AmeriHealth Mercy is a mission-driven company with more than 25 years of experience serving low-income and chronically ill populations. AmeriHealth Mercy’s divisions include:

Keystone Mercy Health Plan, a Medicaid managed care health plan servicing over 321,000 members in five southeastern Pennsylvania counties;

AmeriHealth Mercy Health Plan, a Medicaid managed care health plan servicing 108,000 members in 15 Pennsylvania counties;

Select Health, a Medicaid managed care health plan serving 214,000 members throughout the State of South Carolina;

MDwise Hoosier Alliance, a Medicaid managed care health plan serving 133,000 members throughout the State of Indiana;

PerformCare/CBHNP Behavioral Health Services, servicing almost 1.1 million members in Pennsylvania, New Jersey, Indiana, and South Carolina;

Perform Rx, a pharmacy benefits manager servicing over 1.8 million members.

The AmeriHealth Mercy Family of Companies also provides other administrative services in New Jersey and Kentucky.

SOURCE Blue Cross Blue Shield of Florida

Copyright (C) 2012 PR Newswire. All rights reserved

Whoever provides medical care or pays the costs of illness stands to gain the good will of the sick and their families. The prospect of these good-will returns to investment in health care creates a powerful motive for governments to intervene in the economics of medicine. Political leaders since Bismarck . . . have used insurance against the costs of sickness as a means of turning benevolence to power. Similarly, employers often furnish medical care to recruit new workers and instill loyalty to the firm. Unions have used the same means to strengthen solidarity. To be the intermediary in the costs of sickness is a strategic role that confers social and political as well as strictly economic gains. Paul Starr, The Social Transformation of Medicine

The quote above is a bit stale in today’s marketplace of medicine. Health Care services will always follow the streams of payment from whatever sources are available. With state governments unable to afford federal matching funds for entitlement programs the infrastructure of our community’s health care structure is truly at risk.

As the true cost of this health care infrastructure becomes more of a local government issue, limited funding may cause consolidation at the Hospital Level. Special Taxing Districts may increase to fund Hospitals. As the debate becomes more local a closer look a medical outcomes and cost of care will be fought at our doorsteps. We need to be watchful of this issue.

Michael Porter a Harvard professor on strategy looked at Health Care financial waste and suggested that only a few centers of excellence exist and redundant facilities of care be closed.  There are more choices in the public debate, but we need to keep our eyes on this one.

The Commissions draft report does highlight how concerned hospitals are over the medicaid reform approach the state is taking. The report did not suggest that public hospitals are not in Florida’s best interest. Here is the pull quote from the report. It

The Legislature has also established timeframes for the Medicaid program to move to managed care for the vast majority of its recipients. This is to be completed for the individuals receiving Medicaid long term care services beginning July 1, 2012 and completed by October 1, 2013; and for Medical services by October 1, 2014—Implementation begins January 1, 2013.

In a managed care environment, health plans and hospitals will negotiate a rate. They are not tied to the Medicaid rate, but the Medicaid rate is normally used in the negotiations as a reference or starting point. Sometimes, it ends up being the negotiated rate. If the state moves to DRGs, questions will occur as to how this may affect the health plans/hospital negotiation and establishment of a rate, as well as how local contributions may be affected.

Health plans will be required to contract with “essential providers” that offer services that are not available from any other provider within a reasonable access standard. Statutory teaching hospitals, hospitals that are trauma centers, hospitals located at least 25 miles from any other hospital will be included in this group.
It will be essential that managed care companies selected by AHCA in the competitive procurement process for the new managed care programs receive a fair portion in the capitation payment for the cells that represent the hospital component for each individual. Providing a system where managed care companies and hospitals receive fair compensation is a major challenge that will need continued monitoring and development by the Agency and the Legislature. It has been a somewhat contentious battle between hospitals and managed care companies surrounding the rate issues. Hospital rate increases should not be implemented without coordination of the managed care rate for the new program to be a success.

Taking both reports together, it would seem likely that property taxes may increase to fund local indigent care in the public hospitals. Keep an eye on this issue.