Tag Archives: Ohio

Ohio Medicaid program demands new payment strategy after journalists explain how PBMs use ‘spread pricing’

Photo: afagen via Flickr

Over the past six months, journalists for the Columbus Dispatch have written more than 40 articles about the murky world of pharmacy benefit managers (PBMs) in Ohio. This week, they wrote one of the most important stories in this ongoing series, “Ohio firing pharmacy middlemen that cost taxpayers millions.”

In this article, they explained that the Ohio Department of Medicaid was changing the way it pays for prescription drugs by, “giving the boot to all pharmacy middlemen” because the Medicaid program wants to shift away from what’s called the “spread pricing” practice. Continue reading

Reporting should include questions about demographics, state plans on aging

It’s hard to imagine a better statistical portrait of a state’s aging population than one available at a new website created by the Scripps Gerontology Center at Miami University.

It’s a fascinating look at Ohio’s demographic present and recent past and a provocative peek into its potential future.

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One section documents the accelerating graying of this Rust Belt state over the past 20 years: It features comprehensive data about residents 65 and older for each of Ohio’s 88 counties for 1990, 2000, and 2010. (Click on the 65+ bar beneath the banner on the top.)

As expected, there’s considerable variability among the counties, with some reporting significant gains in their senior population over the 20-year period (as high as 83 percent) and others reporting declines of up to 10 percent.

Leading the latter group is Cuyahoga county (home to Cleveland), which has seen a reduction in its total population and elderly residents over the past several decades. But look at the data and an exception becomes apparent – the number of people 85 and older is rising in the area (from 20,510 in 1990 to 33,421 in 2010).

This detail is significant because this oldest-of-the-old group is most likely to be frail, in poor health and in need of services such as caregiving, home health, nursing home, or home and community-based care.

Turn to another section of the Scripps website, and you’ll find the future coming into focus with projections for Ohio’s 60-plus population for 2020, 2030, 2040 and 2050. (Click on the option on the home page for the site called “County maps.” The data is displayed on a state map, county by county.)

There, data suggests that older adults will account for at least one-third of the population in 16 Ohio counties by 2050. In 2010, no counties met that threshold. That’s news and, when Scripps launched the site earlier this week, predictably it received some coverage. (See a brief story from the Associated Press here and another from the Dayton Daily News here.)

Shahla Mehdizadeh, director of research for the Ohio Long-Term Care Research Project at Scripps, told the Dayton paper that as jobs become hard to find, older adults put off retirement and young people leave the state in search of economic opportunities elsewhere, a vicious cycle comes into play.

“The state is in the position where its revenue is shrinking, but its obligation to the (elderly) population is going to gradually increase.”

Fine and well, you may be thinking, but I don’t live in Ohio, I don’t report about Ohio, and why should I care?
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Ohio’s hospital transparency law under fire

Thanks are due to blogger and one-time hospital executive Paul Levy for drawing our attention to the Ohio hospital industry’s recent push to overturn much of the state’s recently passed transparency legislation.

The law required hospitals to post performance data, such as infection rates and patient satisfaction, on the Ohio Hospital Compare site.

According to Brandon Glenn’s report in the MedCity News, the hospital industry opposes the site, online since Jan. 1, 2010, because it serves the same purpose as the federal Hospital Compare site.

The OHA supports the new legislation… because it wants to remove “duplicative” reporting requirements on the state’s hospitals. Ohio hospitals already report the same data to a federal Hospital Compare website maintained for the public by the Centers for Medicare & Medicaid Services, said OHA spokeswoman Tiffany Himmelreich.

The new legislation “doesn’t reduce reporting. It just eliminates reporting the same information to two different places,” she said. “We don’t want the public to feel that this is taking a step backwards in terms of data availability.”

For their part, consumer advocates say website maintenance is not an onerous burden, and that the hospital association’s push is part of a larger, statewide antitransparency trend.

As an interesting side note, Glenn found the Ohio Hospital Compare site to be rendered inoperable by apparent bugs on an initial visit but discovered that, after his inquiries to the state health department, the site was put into working order.

Journalist-turned-doctor combats high lab prices

On CNN’s Health page, Jim Kavanagh profiled Dr. Doug Lefton, a man who has gone from newspaper reporter to physician to entrepreneur on the front lines of the war against high medical bills.

Frustrated that high costs were keeping his patients from following through with basic blood tests, Lefton brought attention to the issue with the help of the Akron Beacon Journal, then teamed up with online marketer called PrePaidLab, a lab test provider named LabCorp and other physicians to create a cheap, national source of lab tests. Thanks to the site, a lipid panel that might cost a patient $148 at a hospital can be had for $18 online. Patients take their sample to a local outlet, then often get the results in less than 24 hours.

LabCorp agreed to accept the lower charges in exchange for the increased volume it expected to gain, PrePaid’s Patton said.
“The only subsidy is out of our end,” he said. “We just gave them a lower fee schedule. Believe me, the margins are very, very low. But it’s for a good cause.”
Lefton was adamant that the program be set up strictly for the benefit of patients.
“Doug’s kind of a different guy,” Patton said. “He made it a point this was going to be his program, no doctors were going to make any money off of it, and that’s it.”

NLM workshop in Ohio tests waters for possible chapter

This post was contributed by AHCJ member Eileen Beal.

On Oct. 9, health care journalists, a couple of journalism professors, a couple of local medical librarians – a total of 15 – turned out for the free National Library of Medicine Workshop that NLM senior staffer Robert Logan presented at the Cleveland Heights Library on Cleveland’s east side. Logan was formerly a journalist and professor of journalism at the University of Missouri-Colombia. Currently, he is with NLM’ s Office of Communications and Public Liaison and chair of NLM’s Consumer Health Informatics Research Interest Group.

The 2 ½-hour workshop accomplished two goals. It taught attendees how to access several of the National Library of Medicine’s on-line databases (PubMed, Clinical Trials.gov, and Medline Plus) and it provided hands-on training on how use the MeSH feature on NLM’s website to better-target research and databases searches. Feedback indicated that the workshop was, as one person put it, “well worth giving up a sunny Saturday morning for.” (A few copies of the workshop handout are still available.)

In addition, the workshop tested the waters in the health-writer-rich Cleveland-Akron area (home to several large newspapers, Advanstar Communications, Penton Media, Inc., MedCity News and a host of health care institutions) about interest in forming a local chapter of AHCJ to provide opportunities for more education/training events and networking.

Feedback on this was also good, so, if you live in Northeast Ohio, contact AHCJ member Eileen Beal (eojb@visn.net) for more information about forming a local chapter.