State committee taps Springs health leader

Filed under: Health Care |

The Colorado Department of Health and Environment has appointed Rosemary Bakes-Martin, the director of the El Paso County Health Department, to a statewide, 16-member chronic disease committee.

According to the state health department, the purpose of the committee is “to set standards for and to review applications for $24 million in grants to be awarded for the prevention and treatment of cancer, cardiovascular disease and chronic pulmonary disease in the state.”

Other committee members include Sen. Deanna Hanna of Lakewood, Rep. Anne McGihon of Denver; Dr. Carl Bartecchi, an internal medicine specialist from Pueblo; Dr. John Westfall, a rural family practitioner also associated with the University of Colorado School of Medicine, other specialty and family practice doctors and doctor/professors in the Denver area.

Giant health care merger potential monopoly

The American Medical Association and the Colorado Medical Society are focusing their efforts on the merger of two giant health care groups.

According to a news release, the American Medical Association joined the Colorado Medical Society in “urging” Colorado’s insurance commissioner to “place conditions on the state’s approval” of the merger between UnitedHealth Group Inc. and PacifiCare Health Systems Inc.

According to a news release, AMA trustee Edward Langston told the insurance commissioner that patients do not benefit from health insurance consolidations.

“The AMA shares the outrage of many Americans that at a time of escalating health care costs and increasing numbers of uninsured, senior executives of PacifiCare stand to gain $315 million in buyouts if this merger is approved,” Langston said. “This acquisition highlights the potential danger that patients’ needs will take a back seat to the interests of shareholders.

“The proposed merger between two of Colorado’s largest health insurers is a prime example of the growing imbalance that allows giant health insurers to dictate terms to patients, physicians and employers. The state’s approval of the proposed merger must include a set of conditions to ensure that UnitedHealth commits significant funds to improving the infrastructure of the Colorado health care system.”

Colorado College hosts mock DUI emergency

On Dec. 9, the Colorado Springs Police Department, the Fountain Fire Department, Flight for Life and American Medical Response will respond to a staged accident on the Colorado College campus caused by a drunk driver.

The CC “emergency” is part of the new student-formed Colorado College Emergency Medical Services program, which consists of 80 members who have emergency medicine backgrounds. The program’s goal is community outreach emphasizing health and safety awareness, including education initiatives especially for youth. Emergency medical technician Christopher Collins is heading up the team.

“If this mock DUI influences a single person to think before getting behind the wheel drunk, the event will be considered a success,” Collins said.

The event is free and open to the public.

Update on physical therapy Medicare Part B caps

In October, we published an article about how private physical therapy centers might be affected if Congress were to lift a moratorium on caps for Medicare Part B outpatient rehabilitation services.

Well, Jim Hertel, the publisher of the Colorado Managed Care newsletter, alerted me to the Feds’ decision, announced Nov. 29. The private companies’ worst fears have come to fruition.

The decision summary from the department of health and human services reads: “Financial limitations of therapy services (therapy caps) are scheduled to be implemented on January 1, 2006, in the same manner that they were implemented in September 1, 2003, except the dollar amount.”

The initial cap requirement was part of the Balanced Budget Act of 1997. The most recent cap amount was $1,500.

Effective Jan. 1, the cap limits are “$1,740 for physical therapy and speech and language combined and $1,740 for occupational therapy.” According to the summary, the caps “don’t apply to therapy you get at hospital outpatient departments unless you are a resident of and occupy a Medicare-certified bed in a skilled nursing facility.”

As reported in October, “Medicare patients account for 18 to 35 percent of the clients at three privately owned local physical therapy clinics.”

The article also cited inconveniences, such as location and continuity of service plus the obvious financial limit the cap imposes on Medicare patients.

Lorne “Mac” MacDonald, the co-owner of Falcon Physical Therapy, mentioned that seniors living in rural areas will have to drive farther for treatments, which could prevent them from continuing, especially if they have established a comfort level with their therapist. When a Medicare recipient is a stroke victim or has a debilitating injury, a $1,740 cap on private physical and speech therapy won’t go very far, MacDonald said.

Maybe the legislators know something physical therapists don’t?

Marylou Doehrman covers health care for the Colorado Springs Business Journal.