The ECHO Act aims to make the University of New Mexico's groundbreaking Project ECHO telemedicine program a national model for healthcare collaboration.
By Eric Wicklund on November 29, 2016 | mHealth News
A telemedicine program born at the University of New Mexico is set to become a national model for pushing healthcare into remote and underserved regions.
The Senate on Tuesday approved by a 97-0 vote S. 2873, the Expanding Capacity for Health Outcomes (ECHO) Act. The bill places UNM’s five-year-old groundbreaking Project ECHO (Extension for Community Healthcare Outcomes) on a national stage, setting the wheels in motion for a national network of hub-and-spoke telemedicine platforms to provide education and collaboration opportunities for healthcare providers in hard-to-reach areas.
The Republican surgeon from Georgia, tapped to head the Department of Health and Human Services, espouses a more privatized approach to healthcare.
Francine Kiefer, Staff writer | NOVEMBER 29, 2016
WASHINGTON — Donald Trump is indeed serious about repealing and replacing the Affordable Care Act. And to show just how serious he is, on Tuesday he chose conservative Rep. Tom Price to lead the Department of Health and Human Services.
Rep. Price, a Republican doctor from Georgia, not only stridently opposes Obamacare. He has also put forward legislation to replace it in every Congress since the bill was passed in 2010.
President-elect Trump’s other healthcare nominee, Seema Verma, would play a particularly important role. Ms. Verma was nominated Tuesday to head the Centers for Medicare and Medicaid Services, a division of HHS.
Increasing the income threshold to qualify for Medicaid has been the ACA’s main tool to get more poor people health coverage. The Supreme Court made that expansion of Medicaid optional for states, and many red states have decided against Medicaid expansion.
But some went ahead, on their own terms. Verma worked with Vice President-elect Mike Pence when he was governor of Indiana to design a Medicaid expansion in keeping with his Republican principles. To some, her appointment signaled pragmatism. “To me, the Verma announcement was reassuring. It’s not just ‘let’s throw a couple hundred thousand people off Medicaid rolls and let them fend for themselves,’ ” says Daniel Derksen, director of the Center for Rural Health at the University of Arizona in Tucson.
Dr. Derksen, who once practiced medicine as a family physician, says that Medicaid expansion has greatly helped to cover more people and directly eased the bottom line of hospitals that treat uninsured patients – “charity” cases. States have been able to somewhat customize the expansion and that has helped it gain acceptance in some Republican states such as his own. He says he appreciates the “personal responsibility” aspect of Indiana’s program, where residents have to contribute to the cost of their coverage. Those above a certain income level who fail to make their payments are dropped and not allowed back for six months.
Repeal first, then find a replacement - Critics – and not just Democrats – point to weaknesses in the Better Way plan. Medicaid grants to the states run the risk of failing as a safety net during times of recession, for instance. States are required to balance their budgets, yet the number of poor people who would need Medicaid increases during hard times.
Also, high-risk pools were tried before the ACA fully took effect, and didn’t work particularly well, says Derksen, who is a Republican. “It’s hard to make insurance work when you’re only covering sick people,” he says. He also worries about insurers and Big Pharma having too much sway if the marketplace exchanges are eliminated. He prefers to see the exchanges modeled along the lines of Tricare, the military plan that goes out to bid among insurers.
WASHINGTON – Diabetes, hypertension and depression are the biggest problems facing Arizona counties, according to a new nationwide health index map that also scored counties on whether they tend to be more healthy or less. The report Tuesday by the Blue Cross Blue Shield Association looked at every county where the insurer has clients and was issued, sponsors said, to help local governments focus health improvement efforts where they can do the most good.
…the director of the University of Arizona’s Center for Rural Health said he was not surprised by its findings on the biggest challenges facing counties in the state. Dr. Daniel Derksen said it is not unusual for the state’s rural counties to have health issues related to diabetes, noting that counties with large numbers of Latino or Native American residents “tend to have higher rates of diabetes.” He pointed to two counties in the report where diabetes is the No. 1 problem, Yuma and Navajo, that have high numbers of Latinos and Native Americans respectively.
But he also said that many counties in the state face a combination of problems that include diabetes, hypertension and hypercholesterolemia that “contribute significantly to poorer health outcomes and much higher costs of care. Focusing public and population health interventions in these higher-risk populations and areas … would improve outcomes and control cost growth” in medical spending, he said.
To provide University of Arizona graduate health sciences/health professions students, medical interns and residents with an opportunity to gain experience in rural and urban medically underserved Arizona communities through research and/or scholarly projects;
To address community needs specific to the five Arizona AHEC regional centers through health promotion and disease prevention research and relevant projects;
To demonstrate interprofessional education or practice models.
Eligibility: University of Arizona graduate health sciences/health professions students, interns, residents, and faculty, as well as AzAHEC regional centers may apply. Projects should demonstrate interprofessional education or practice models and address community needs specific to one or more of the AzAHEC regional centers.
Funding period: One year, beginning in March 2017
Available grants: Up to five projects will be funded in amounts up to $5,000.
Please see the attached RFA for full details.
Please direct questions to:
Arizona AHEC Staff RFA@azahec.org
2017 AzAHEC Research and Project Small Grant Program RFA
By Stephanie Innes | Arizona Daily Star | November 12, 2016
Nov. 12--The election results will not change anything about open enrollment in Obamacare health insurance for 2017 coverage, local, state and federal officials say. The Affordable Care Act is still the law of the land and until it’s not, consumers are being urged to continue enrolling on the government-run marketplace as usual. Open enrollment on the marketplace, created by the 2010 Affordable Care Act, began Nov. 1 and goes through Jan. 31. The enrollment is for coverage in 2017. People who want coverage by Jan. 1 should enroll by Dec. 15. Last enrollment season, 11 million Americans got their insurance through the federal and state marketplaces.
On Wednesday, the day after the election, more than 100,000 Americans signed up for health insurance via the marketplace, which is also known as the health exchange. U.S. Department of Health and Human Services director Sylvia Burwell tweeted that it was the highest number of plan selections since this season's open enrollment began.
“Consumers want affordable coverage, and are naturally apprehensive about the unknown,” said Dr. Daniel Derksen, a professor in the public health policy and management program at University of Arizona's Mel and Enid Zuckerman College of Public Health. “Until things are sorted out by the new administration and Congress, many want to be sure they have coverage.”
“For now, the prudent path would be for consumers to understand their current options, and do what is best for their own coverage and for their families," Derksen said. “It would be very difficult, for many reasons, to leave 11 million without a viable alternative.”
Open enrollment for the Affordable Care Act (ACA) health insurance marketplace starts Tuesday, Nov. 1, and the University of Arizona Center for Rural Health Navigator Consortium says it has two “navigators” in Santa Cruz County ready to help.
“The Arizona Center for Rural Health Navigators in Santa Cruz County are trained to provide impartial and unbiased assistance to help review your health insurance options and eligibility, and enroll in coverage,” the center said in a news release. “They provide assistance in English and Spanish and their services are free of charge.”
Sep 12, 2016 -- Exploration of the lack of access to dental healthcare in the U.S. due to both geographic and financial causes. The issue of access is notably worse in rural areas, where there are fewer dentists, dentists are less likely to accept Medicaid, residents tend to be poorer, and are less likely to have dental health insurance or fluoridated water. Focuses on dental clinics in Wisconsin which have been opened to serve the rural poor and the success they have had in securing financing to maintain their services.
By Logan Whiteside | CNNMoney Reports | CNN Money October 25, 2016 | Video 3:00 minutes
Many healthcare providers say that at the very least, Obamacare needs improving. It won’t be easy given the political gridlock in Washington. “We have to stick with it and improve what we have, rather than just throw everything out. You don’t save money by not insuring people. All you do is shift the cost of care to hospitals, nurses, and physicians that are willing to take care of people regardless of ability to pay.” Daniel Derksen, Director, University of Arizona Center for Rural Health.
Health insurance premiums under Obamacare are spiking and Donald Trump claims it's proof that the Democrats' signature healthcare reform is blowing up. Guest host Barbara Bogaev looks at how healthcare is shaping the campaign in the last two weeks before the election.
By Francine Kiefer, Staff writer OCTOBER 25, 2016 | Christian Science Monitor
SEARCH FOR SOLUTIONS Daniel Derksen, who drafted part of Obamacare, has had a front seat to the implosion of Arizona's private insurance marketplace. But as a rural health expert, he also sees how it's helped.
Daniel Derksen knows only too well how polarizing Obamacare can be.
In 2012, he was leading an effort to build a health insurance marketplace for New Mexico under the new law. The state’s Republican governor, Susana Martinez, and Dr. Derksen – also a Republican – were committed to standing up a robust, competitive marketplace that would be run by the state, not the federal government.
Initially, things went pretty smoothly for this family physician and health-policy expert. Derksen, who had actually drafted part of the Affordable Care Act, had secured a first round of federal funding for the state’s marketplace exchange. He was readying his proposal for a second round of funding.
After more than six years' hiatus, KidsCare is now finally available as a health coverage choice for working families. This is exciting news for Arizonans who have been waiting for an affordable option for medical insurance for their children.
Now, families across Arizona who earn too much to qualify for the Arizona Health Care Cost Containment System (AHCCCS), yet find the cost of private health insurance unaffordable, will be able to apply for low-cost coverage through KidsCare. KidsCare is tailored specifically to the needs of Arizona children, some 30,000 of whom may be eligible, according to AHCCCS.
There are no enrollment deadlines, but the sooner families apply, the sooner coverage for qualified applicants will begin. Computer-savvy parents can either apply through AHCCCS at www.HealthEArizonaPlus.gov if they are comfortable doing so on their own, or get free, professional help close to home by scheduling an appointment. They can either call 1-800-377-3536 or visit http://www.CoverAZ.org/connectorto book a convenient time and location online.
Phoenix native Patrick Kishi ventured to Yuma last summer as part of the Rural Health Professions Program Certificate of Distinction, which was created by The University of Arizona College of Medicine-Phoenix to address the shortage of physicians in rural and underserved areas.
Three students from the class of 2017 will be the first cohort of students who will graduate with the Certificate of Distinction in Rural Health. Among them will be Kishi, who spent 15 weeks in Yuma during his third year.
As part of the certificate’s requirements, students must attend a seminar series, complete a scholarly project on a subject relevant to rural health, participate in a four-week summer rural pre-clinical experience and a 19-week rural clerkship that exposes them to internal medicine, family medicine, pediatrics and surgery.
Rural areas in which students may be sent to complete their clerkship include Yuma, Lake Havasu, Prescott, Sedona, Flagstaff, Page, Williams, Show Low, Lakeside, Snowflake, Florence, Morenci, Silver City, NM and Deming, NM.
The U.S. Environmental Protection Agency has invited rural communities to apply for planning assistance to develop strategies that help grow the economy and revitalize downtown neighborhoods. EPA is offering this assistance as part of Rural Advantage, a suite of federal economic development planning assistance programs for rural communities.
“Rural Advantage is helping communities reinvent themselves in ways that are good for the economy and the environment,” said EPA Administrator Gina McCarthy. “We are excited to partner with communities that want to use their unique rural assets to create a brighter, healthier future.
WASHINGTON – Arizona communities need to do more to combat and treat drug addictions or face potentially devastating long-term consequences, Coconino County’s chief health officer said during a national conference call this week.
Dr. Marie Peoples said cities and towns in Arizona are “behind the eight ball” in terms of providing treatment for opioid addicts. Among possible solutions, she said, are implementing a prescription monitoring system and tracking data from medical examiners and emergency rooms.
If local officials do not fix the problem, Peoples said during a call on what local communities can do to fight the drug epidemic, they could face long-term consequences, including rising child care and emergency room costs.
“These are real-world problems facing us today,” Peoples said during the International City/County Management Association call. “It’ll be even more difficult to deal with in the upcoming years.”
Peoples said Arizona “fortunately hasn’t faced an intense epidemic,” compared to states with high overdose death rates like New Mexico and Ohio, but is not exempt in terms of an opioid addiction crisis.
The latest figures from the Centers for Disease Control and Prevention reported that 1,211 people in Arizona died from opioid overdoses in 2014. Opioids include illegal drugs like heroin as well as prescription drugs, such as Oxycontin and Vicodin.
An additional 1,052 people in the state required emergency room treatment for drug overdoses that year, the CDC found.
“The issue is on our radar,” Peoples said. “We look at arrest data, but we can’t arrest our way out of this problem.”
The Arizona Department of Health Services found an increase in the number of deaths in 2014 for both prescription and heroin overdoses. Heroin overdoses accounted for 605 deaths in 2014, up from 521 in 2013. Prescription drug overdoses claimed, on average, one person per day in 2014, the state data showed.
Dr. Daniel Derksen, director of the University of Arizona’s Center for Rural Health, said a viable option for combating opioid overdoses is enacting local prescription drug monitoring programs. They let doctors and pharmacies check for potential abuse by tracking how often a patient is being prescribed highly addictive medication.
“One of the areas we can work on is educating health providers and pharmacies on the appropriate use of controlled substances,” he said. “States with these programs have done well (in terms of combating opioid addiction).”
Marty Harding, director of training and consultation at the Hazelden Betty Ford Foundation, said although community intervention is essential to fighting the drug epidemic, regional officials need to work together to protect their cities from being exposed to an influx of opioids.
“This issue does not stop at your border,” she said. “State leaders need to have a regional conversation and have an effective strategy for prevention with treatment and law enforcement.”
Derksen acknowledged that Arizona has made progress in addressing the problem with opioid addiction in the state, but said local communities need to start addressing the issue independent of state and national governments.
“It’s a fairly accurate description to call this an epidemic,” he said. “As communities understand better how devastating this problem really is, they can approach it from a public health perspective, where they are dealing with different tools to improve on health outcomes.”
Law enforcement agencies and fire departments in Santa Cruz County and along the border frequently work together. But they can’t always communicate with each other, because more than 80 percent of their service area has “dead spots” unreachable by their shared radio channel.
“Santa Cruz County has a longstanding history of communication problems based on the terrain we have,” said Santa Cruz County Emergency Services Director Ray Sayre.
“We have rolling hills and it’s difficult to get coverage in the shadow areas,” he added. “Can’t hear you. Can’t see you.”
Sayre said the equipment upgrades will cost $330,000, which will be covered by two already approved grants. After federally mandated environmental and historic preservation reviews are completed, construction will begin in 2017.
For now, radio transmissions are frequently garbled in low-lying areas along Interstate 19, said Al Flores, a battalion chief in the Rio Rico Medical and Fire District. Other trouble spots are in Nogales, Rio Rico and Tubac.
“Without communication you’re basically playing hide and go seek,” he said. “Nobody knows where anybody’s at.”
The Arizona Interagency Radio System – commonly known as AIRS – is operated by the Arizona Department of Public Safety. In theory, it enables departments that work on different radio frequencies to all talk together.
Two Homeland Security grants will enable the county to add or upgrade three radio-signal repeater sites for a shared emergency services channel, and connect them via microwave linkages.
“We need more repeaters, higher towers that can actually be seen from over the hills,” Flores said. “Technology for this is always changing.”
Currently, firefighters, customs agents, highway patrol officers and others have to call their separate dispatch centers to relay information, or lend each other matching radios, or communicate face-to-face. None of those tactics is easy at a large wildfire or other chaotic emergency scene.
“The public in Santa Cruz County deserves the same quality of dispatch as the rest of the state – and anywhere in the country,” said Rio Rico Medical and Fire District Chief Les Caid.