Kentucky hospitals gave $1.96 billion to communities in 2011, including $576.7 million cover of Medicare, Medicaid shortfalls

In 2011, despite economic and financial obstacles, Kentucky hospitals' estimated value of benefits to their communities up 17 percent from the year before, to $1.96 billion. So says the Kentucky Hospital Associated 2011 Community Benefits Report, compiled by the Kentucky Hospital Association with data submitted by hospitals. (Chart gives a breakdown of hospitals' total community benefits and services expenditures in 2011.)

Kentucky hospitals say they absorbed $576.7 million in 2011 shortfalls from Medicaid and Medicare, which cover 19 and 55 percent of Kentucky hospital patients; those losses were 26 percent larger than 2010, and may nearly double under federal health reform, to an estimated $852 million by 2019.

Bridging gaps created by Medicaid and Medicare underpayment is only one example of how the 131 Kentucky hospitals demonstrate their commitment to local communities by investing in community needs, the report says. In addition to covering government shortfalls, community benefits include providing charity care, forgiving bad debt and supporting medical research.

In 2011, the reports says, Kentucky hospitals financed $451 million in charity care, which means they cared for the sick and injured even if those patients could not afford care.

In Glasgow, T.J. Sampson Community Hospital and Dr. Bharat Mody (left), a general surgeon, have teamed up to fulfill the unmet health care needs of low-income, working, uninsured or under-insured adults of Barren County through a charity program called Community Medical Care. The program provides assistance with basic coverage for those who qualify, in addition to helping cover the cost of medications, glasses or hearing aids.

In 2011, Kentucky hospitals absorbed $426.5 million in bad debts, losses due to patient non-payment that often occur in hospital emergency rooms. Dennis Manners, who had a $500,000 medical bill and sometimes visited the ER 25 times a month, is one patient out of the total 22 percent of University of Louisville patients who cannot afford care and often cannot even afford their $15 co-pay. Highlighting its efforts to give back to the community, the reports says U of L developed a new treatment plan for Manners, which included sending him to a treatment center outside of Cincinnati.

Many health-improvement services in Kentucky communities, such as health fairs, screening programs, immunization clinics, health needs assessments and community planning, are financed by Kentucky hospitals. According to the report, $43.7 million was spent by these hospitals on such outreach programs that serve all ages and a number of special needs populations. For example, Northern Kentucky's St. Elizabeth Healthcare is fighting against cardiovascular disease, diabetes and stroke with its Cardiovascular Mobile Health Unit that brings vascular services to the community for easy access, screenings, risk appraisals and education.

Hospitals also spend a lot of money, an estimated $127.5 million in 2011, to ensure health professionals are properly educated -- a great need in Kentucky, where 59 of the 120 counties are designated as health professional shortage areas. One effort, the Rural Physician Leadership Program on the campus of St. Claire Regional Medical Center in Morehead, addresses this shortage by training physicians to serve in rural areas of Kentucky and the nation.

Other community benefits include subsidized health services, estimated at $32.3 million, to support programs like Highlands Regional Medical Center's Highlands Center for Autism in Prestonsburg (left). The center is the first of its type in the state and was created in 2009 to address autism in Kentucky, which is estimated by the Center for Disease Control to be diagnosed in one out of every 88 children, says the report. Each child at the Highlands center has a customized treatments plan involving psychologists, educators, behavior analysts, speech pathologists, pediatricians and neurologists, who collaborate to help children with autism reach their full potential.

The annual KHA report reminds people what hospitals do for the state and provides education about ongoing efforts. A more recognizable contribution is that Kentucky hospitals had a combined spending of $6.4 billion in 2011 on staff salaries, purchases or supplies and services that create a‘ripple effect” in the overall economy to generate state businesses, jobs, and tax revenue. The reports says St. Joseph Mount Sterling, for example, provided 213 jobs and generated about $12 million in annual local payroll in 2011. Kentucky hospitals' compensation comprises 5.8 percent of all wages and salaries in the state.

The reports says hospitals are more important than ever to the overall economic health of Kentucky communities. This is the fourth year for the report, generated by the voluntary KHA survey and other data sources, including the annual survey by the American Hospital Association; Kentucky Hospital Statistics, 2013; and Kentucky Hospitals’ Economic Importance to Their Communities, 2011. The KHA report covers community benefit expenditures made in 2011, which is the most recent year for which statewide data is available.

Louisville dental school to mark Women's History Month with women's art and oral-health fair and reception

The University of Louisville School of Dentistry will kick off its Women's History Month celebration March 18 with "Chew Art," an all-women's art and oral-health fair and reception.

In an effort to better engage with the community on issues related to oral health, increase oral health literacy and celebrate Women's History Month, the fair will focus on specific oral health care needs of women. The school will provide oral health information, and in some cases, limited screenings for women who live with diabetes, hypertension, who are pregnant or undergoing various treatments for cancer.

But the school says this event will not be like an ordinary trip to the dentist or health fair; it will be much more exciting! It is teaming up with Kristen Hughes, Arts in Healing manager at the Kentucky Center for the Performing Arts, to employ an innovative Arts in Health Care approach. Unlike the normal clinical environment, original works of art, created by a group of local female artists, will be on display at the fair.

The "Chew Art" event will take place Monday, March 18, from 5 to 7 p.m. on the second floor of the newly renovated dental building at 501 S. Preston St. and will feature tapas, wine, sangria and live music in addition to the art displays.  To RSVP, email Deborah Wade at D0wade01@louisville.edu.

New U of L public-health dean has rural health background

Craig H. Blakely, dean at the School of Rural Public Health at Texas A&M University, has been named dean of the University of Louisville School of Public Health and Information Sciences. U of L has a role in rural health in Western Kentucky, overseeing the Area Health Education Centers in the region.

Blakely, who has a Ph.D. and a master's in public health, has researched and published extensively regarding access to care and rural health. His research has focused on under-served expectant mothers and juvenile delinquents, and includes substance-abuse prevention and community-based change. Blakely has also evaluated major initiatives such as a school-based prevention program targeting at-risk youth.

Blakely’s expertise will be invaluable in tackling issues like obesity, access to care, disease management and much more, said Dr. David L. Dunn, U of L's executive vice president for health affairs. Blakely’s appointment is effective April 1 and is subject to approval by the U of L Board of Trustees. He replaces Richard Clover, who has led the school for 10 years.

UK has its pediatric heart program under review; chief is on leave, and patients are being referred to other hospitals

Kentucky Children's Hospital at the University of Kentucky is reviewing its cardio-thoracic surgery program and referring surgical patients to other hospitals, "but the reasons why are unclear," Brenna Angel reported Dec. 21 for WUKY-FM, the university-owned station.

Angel did identify "the surgeon at the center of the review," Dr. Mark Plunkett, left, who is on a leave of absence but "remains on staff at UK with a $700,000 annual salary," as chief of cardio-thoracic surgery. "UK denied an open-records request for the date of his most recent surgery and his patient mortality rate," citing privacy rules in the federal Health Insurance Portability and Accountability Act. It was unclear how release of such statistics, without any personally identifying information, would compromise privacy. Plunkett and officials of the medical center refused to be interviewed.

"It's been pretty hush-hush," Tabitha Rainey of Lexington, the mother of a Plunkett patient, told Angel, who reported: "Plunkett and his assistant Dr. Deborah Kozik operated on Waylon seven days after he was born. Tabitha was later told that Dr. Plunkett was taking a leave of absence." Rainey told Angel, "Months went past and they lost another patient, who was a dear friend of mine, and it was pretty heavy in the unit at the time. Then soon after I guess they decided to stop doing the surgeries and review the entire program."

Angle was able to get some records from UK and reported they showed that "The number of children Dr. Plunkett operated on this year is down around 43 percent from two years ago." UK Trustee Dr. Charles Sachatello, a surgeon who sits on the Board of Trustees' health-care committee, told Angel, "I was not aware of that, and that was never announced at the Board of Trustees meeting." Sachatello told Angel that UK should merge its pediatric heart program with the one at the University of Louisville because of the high operational costs of such programs. (Read more)

Experimental concentrated breast cancer radiation therapy offers new options for women who live far away from treatment facilities

A study at the University of Louisville James Graham Brown Cancer Center designed to make  radiation treatment more accessible to women who face obstacles such as distance, transportation problems and time constraints is proving promising. The idea is to cut daily trips to the cancer center to once a week, says Dr. Anthony Dragon, a radiation oncologist at U of L. It also has the added benefit of cutting treatment costs by better than half.

Laura Ungar of The Courier-Journal in Louisville reports that Dragun led a previous study that found that "about a third of Kentucky women with early-stage breast cancer didn’t get recommended radiation treatments after lumpectomy surgery. Among those least likely to get radiation were rural Kentuckians, the elderly, African Americans and women in the Appalachian region of the state. Women who did not get recommended radiation were 60 percent more likely to die during the time they were studied."

Dragun told Ungar that the folks at U of L were not satisfied with just gathering those numbers, they wanted solutions to the problem. Dragun said the new experimental regimen is yielding good results, with women who get weekly radiation reporting similar levels of side effects as those getting radiation every day. Ungar notes that some outside experts say the approach does seems promising, but one critic was concerned about breast appearance results after the once-a-week treatments.

According the National Cancer Institute, more than 3,070 new cases of breast cancer were diagnosed in Kentucky in 2009 and was responsible for 614 deaths.  (Read more) 

U of L doctor tells American Heart Association that cardiac stem-cell research shows a lot of promise

Dr. Roberto Bolli

Promising results are coming from research that uses patients’ own cardiac stem cells to heal their hearts, a Louisville doctor told colleagues this week at an American Heart Association meeting in Los Angeles.

Laura Ungar of The Courier-Journal reports that Dr. Roberto Bolli, lead author of the clinical trial and chief of cardiovascular medicine and director of the Institute of Molecular Cardiology at the University of Louisville, said cardiac stems cells may someday be used to treat heart failure caused by muscle scarring after a heart attack.

Bolli, who partnered with Dr. Piero Anversa of Brigham and Women’s Hospital in Boston on the research, explained that their research showed that hearts in patients treated with their stem cells had greater pumping power, and benefits continued to increase as long as two years after receiving the cells.  Heart failure afflicts about 6.6 million Americans. (Read more)

U of L researcher gets $3.4 million to replicate studies of stem cells for heart treatment

Dr. Roberto Bolli of the University of Louisville has received a $3.4 million grant from the National Institutes of Health to test the validity of several recent studies by replicating them. The studies examine whether certain types of stem cells are safe and effective in treating heart failure, heart attacks and other cardiovascular disorders.

"Replicating studies in several locations with a large number of patients is necessary for researchers to ultimately determine which ones can be submitted to the Food and Drug Administration for approval," Jill Scoggins reports in a U of L press release.

Bolli has received more than $100 million in grants for basic research for NIH. This is the first grant he has been awarded for clinical research. (Read more)

Dean of U of L medical school resigns to take New York job

The dean of the University of Louisville School of Medicine, Edward C. Halperin, is stepping down from his post to become chief executive officer and chancellor for health affairs of New York Medical College and provost for biomedical affairs at Touro College and University System.

His new job starts May 1. During his tenure at U of L, which started in 2006, he recruited nine department chairs; applications for admissions rose 67 percent; research funding in the school of medicine increased 28.3 percent to $111.4 million; a post-baccalaureate program was established; and three dual-degree programs were created.

"Dr. Halperin has been instrumental in moving our School of Medicine to a different level in terms of our missions of education, research and clinical care," said Dr. James R. Ramsey, U of L president. "He has raised the standards we now hold ourselves to in terms of the students we accept and graduate from the School of Medicine, as well as the faculty we recruit."

U of L said it will name an interim dean and start a national search to replace Halperin in the coming weeks. (Read more)

Smile Kentucky! celebrates 10 years and more than 100,000 children helped

Smile Kentucky! celebrates its 10-year anniversary tomorrow, representing $1 million in free dentistry and benefiting more than 100,000 students.

"It's a wonderful program," said Arleta Watkins of Bullitt County Schools. "I've had children who've never had a dental exam before. They get that service for free."

The program serves children in Louisville and nearby counties. Since it began, more than 127,000 students in 143 schools and 11 counties have received classroom dental education, 35,000 kids have gotten free dental screenings at school and nearly 3,000 children have received free treatment.

Smile Kentucky! works with 30 elementary schools in Jefferson and surrounding counties each fall. Students receive dental education, and children in grades 3 to 6 get a free dental screening. Children without dental insurance or medical care get free treatments by going to the University of Louisville's School of Dentistry or private dental offices in February.

"Dental pain and infection is one of the leading causes of missed days at school and affects a child's ability to concentrate," said John Sauk, dean of U of L's School of Dentistry.

U of L is one of 30 agencies on the steering committee. Other founding partners include the Louisville Water Co.,  the Louisville Dental Society, Colgate, Sullivan Schein Dental, Northwest Area Health Education Center and the Bullitt County Health Department.

For more information about Smile Kentucky!, click here.

Republican leader and former U of L trustee says university made poor argument that hospital isn't public

The University of Louisville made a “terribly flawed argument” when it claimed that University Hospital was not a public entity, former U of L Trustee Bill Stone told cable channel cn|2's "Pure Politics" program yesterday. "That argument has been central as university leaders try to finalize a merger with two private hospital groups, Jewish Hospital and Catholic Health Initiatives," Ryan Alessi notes.

Stone, a former Jefferson County Republican chairman, said he agreed with Democratic Attorney General Jack Conway's ruling in an open-records case that the hospital is a public entity, and “I don’t know of any lawyer of merit who wouldn’t agree with Jack Conway’s assessment. That has been the weakness in U of L’s selling point. The University of Louisville Hospital is part of the university.”

Alessi reports, "Stone said the university should be highlighting the positives of the merger." Stone told him, “I think this merger can be sold to the public on the basis of how much it will mean to this community economically, what it will mean from a prestige point of view, where it will be an incubator for Nobel Prize-winning scientists.” For the story and video, click here; for the video only, on the image above.

State senator says U of L doctors used Medicaid funds to pay themselves $4.8 million in bonuses, seeks more oversight

State Sen. Tim Shaughnessy has questioned a $30 million transfer of surplus Medicaid funds to Passport Health Plan board members in 2008 and 2009. Shaughnessy, a Louisville Democrat, says doctors at the University of Louisville medical school paid bonuses to themselves using about $4.8 million intended for indigent care and used another $5.2 million to purchase an electronic records system, making them eligible for more bonuses from the federal government, Deborah Yetter of The Courier-Journal reported.

Since Attorney General Jack Conway ruled the transfer illegal, some groups have elected to repay. University Physicians Associates will repay $9 million over five years; U of L, University Medical Center and local hospitals that provided capital to start Passport have agreed to repay, but on different terms. Conway did not indicate whether the $4.8 million in compensation was bonuses or salaries, Conway spokeswoman Shelley Johnson told Yetter.

Shaughnessy said repayment is not sufficient to address the real problem — "that U of L's board wasn't involved in major financial transactions involving groups with which it is affiliated, including Passport, University Physicians Associates and the U of L medical center," Yetter reports. "We need to know how this happened, and we need to make sure it doesn't happen again," Shaughnessy said in an interview.

Shaughnessy is working on legislation for the 2012 General Assembly requiring public university boards to apply more oversight to groups like Passport. He has also written letters to Passport chairman Dr. Gerard Rabalais and U of L President James Ramsey. (Read more) To read Shaughnessy's letter to The Courier-Journal, click here.

Is University Hospital public? Attorney general will decide; merger proposal raises question of church-state separation

Attorney General Jack Conway has been asked to decide "whether University Hospital is a public institution — an issue in the controversial plan to merge the University of Louisville’s main teaching hospital with two other health-care systems," Patrick Howington of The Courier-Journal reports.

ACLU of Kentucky and The Courier-Journal have appealed denials of of open-records requests they made to University Medical Center Inc., which does business as University Hospital. "UMC turned down both requests on grounds that it is a nonprofit corporation rather than a public agency and therefore isn’t subject to the act," Howington writes. An attorney general’s opinion on open records or open meetings has the force of law unless overturned in court.

Meanwhile, Howington also writes that "Some legal advocates and constitutional scholars say," citing court cases, that the hospital's "plan to follow Catholic health-care directives under a pending merger could violate the U.S. Constitution’s provision to keep state and religious matters separate." (Read more)

U of L scientist wins $9.5 million for heart research

A University of Louisville scientist has received more than $9.5 million from the National Heart, Lung and Blood Institute to conduct promising new cardiovascular research.

Dr. Roberto Bolli, right, aims to find a drug that would reduce heart damage during a heart attack, The Courier-Journal's Laura Ungar reports.

Bolli will also work with scientists at John Hopkins University in Baltimore, Emory University in Atlanta and Virginia Commonwealth University in Richmond to conduct the research.

Kentucky Department for Public Health numbers show 10,000 Kentuckians died from heart disease in 2005. (Read more)