Baptist Health is first stand-alone health provider to become founding partner of Shaping our Appalachian Region effort

Baptist Health has become the first stand-alone health-care provider to sign on as a founding partner in Shaping Our Appalachian Region, an initiative to improve the economy of Eastern Kentucky.

Baptist will work with SOAR to develop and implement health and education initiatives for residents of Appalachian Kentucky and has committed $150,000 to the initiative over the next three years, the organizations said in a press release.

“Baptist Health understands Eastern Kentucky because we have a proven and time-honored commitment to the health and well-being of our people,” Stephen C. Hanson, chief executive officer of Baptist Health, said in the press release. “Our participation in SOAR reflects this pledge. Besides Richmond, we’ve also got hospitals in Corbin and Lexington, along with outpatient facilities, doctors’ offices and other services all over Eastern Kentucky, the rest of the commonwealth and indeed throughout the region."

The University of Kentucky was the first founding sponsor of SOAR, pledging $300,000 over the next three years and winning the right to use the UK HealthCare brand on SOAR materials as well as the university's general logo.

Gov. Steve Beshear and Congressman Hal Rogers formed SOAR in the fall of 2013 to create strategic plans to improve Eastern Kentucky's economy and quality of life.

“Our primary objective is creating and maintaining jobs across eastern Kentucky, and in order to do that, we need a healthy and well-educated workforce,” Beshear said in the release. “I’m pleased that Baptist Health understands the key connections among our efforts and the critical role that health will play in the future of this region."

Study of poor but healthy Appalachian counties aims to find community-based approaches to improving the region's health

Though some people equate Appalachian areas with poverty, David Krol seeks to "shine a light" on a different picture—one that reflects "how health can flourish across Appalachia," despite data that confirms economic hardship, Krol writes for the Robert Wood Johnson Foundation.

While Krol was reviewing the Appalachian Regional Commission's county-based economic data, which compares economic indicators like poverty and unemployment rates with national averages and then ranks each county, it occurred to him to overlay this county index with the annual County Health Rankings.

For the most part, Krol said he found what he expected, "that the most economically distressed counties in Appalachia would also be in the lowest quartiles of health outcomes and factors for their state." But some counties that were economically distressed ranked in the top quarter of their state in health factors and outcomes.

"What was it about Wirt County, West Virginia; Pickett County, Tennessee; and Oktibbeha County, Mississippi, that helped them overcome significant economic challenges towards better health outcomes when similarly distressed counties in the same state did not?" he wrote.

The need to know why these "unexpected outliers" occurred has prompted Krol, with the help of the ARC and the Foundation for a Healthy Kentucky, to study how these counties have accomplished this and to look at whether this could be re-created in similar communities.

"This approach is rooted in the belief that communities have the best solutions to the problems they face—as opposed to solutions driven by outside experts," he wrote.

It’s an opportunity to “go beyond the data.. to community conversations about what’s important,” Susan Zepeda, CEO of the foundation, told Krol.

Krol wrote, "Quantitative data can get only get us so far—it’s up to us to ask those critical questions of “Why? How? What can be done? It’s up to us to turn data into action."

Reform law's backers say it boosts economy by freeing 'job lock;' foes cite estimate that it will make some drop out of job market

As the Patient Protection and Affordable Care Act's second enrollment period gets underway, supporters of the law say it boosts the economy by creating an affordable, accessible insurance market that's not dependent on employer-based insurance.

Travis Kalanick, co-founder of Uber, said the law has been "huge" for his personal-transportation business. Uber's drivers are independent contractors, so the company does not provide them with health insurance. But because the ACA creates a functioning individual market for health insurance, making it easier and more affordable for Uber drivers and others to buy coverage on their own, Americans don't have to stay in a job just to keep their health insurance.

"The democratization of those types of benefits allow people to have more flexible ways to make a living,” Kalanick said during dinner for reporters, according to Buzzfeed. “They don’t have to be working for The Man.”

This is why Uber loves Obamacare, reports Jason Millman of The Washington Post. For a company like Uber, it's about liberalizing the workforce so that people are able to take jobs they do like that don't provide health care, he writes.

Numerous sources cite the ability of individuals to obtain affordable coverage outside of the workplace as a boon to the labor market. A Congressional Budget Office analysis earlier this year said giving families more options for obtaining affordable health insurance outside the workplace, the PPACA removes a barrier to job mobility and boosts the economy.

Before the PPACA, many Americans’ only source of secure health-insurance coverage was through their jobs because without work-based plans, people often found coverage to be too expensive or impossible to obtain due to pre-existing conditions. This created a health-insurance obstacle to labor mobility, which is sometimes called "job lock", writes the Jason Furman in an online post from the White House Council of Economic Advisers.

Job lock can prevent individuals who want to look for a better job, change careers or start a new business from doing so for fear of not having health coverage, the CBO said. Now, because of both the PPACA’s patient protection measures and ban on discrimination against people with pre-existing conditions, Americans have reliable access to health insurance without having to count on employers to provide it, says the report. CBO also said many Americans will be able to start small businesses or take new positions where they can be more productive because they don't have to worry about health insurance.

Opponents of the law argue that it shrinks the labor market. For example, in a Forbes article, Avik Roy writes that the law hampers job growth by imposing one of the largest tax hikes in U.S. history, increasing the cost of employing workers and establishing exchange subsidies that encourage workers to drop out of the job market. They cite a CBO estimated that by 2024, 2.5 million full-time-equivalent workers will drop out of the job market. Jay Carney, then White House press secretary, celebrated the findings, arguing that they mean that Americans would no longer be “trapped in a job,” Roy writes.

Claims that health-reform law is putting Kentuckians out of work don't hold up to scrutiny, economic experts say

"Key Republicans running for election Nov. 4 say the federal Affordable Care Act is putting Kentuckians out of work, but employment data and interviews with Kentucky-based economists suggest otherwise," John Cheves reports for the Lexington Herald-Leader.

The objects of Cheves's scrutiny are a television commercial for U.S. Rep. Andy Barr, R-Lexington, saying Democratic challenger Elisabeth Jensen "supports Obamacare, which has decimated Kentucky jobs," and an opinion piece, by Sen. Mitch McConnell saying "There are so many stories about businesses holding back from expanding or hiring — or even cutting back on their workforces — it's hard to even count."

McConnell's anecdotal assertion proves nothing, and Barr's appears to be false. Cheves notes that Kentucky has gained 3,600 health-care jobs during the last year and quotes experts: Manoj Shanker, an economist at the state Office of Employment and Training, who said the law "is expected to be a net gain for the economy . . . and not just for doctors and nurses. It will mean the creation of jobs in other areas, including clerical staff for processing claims, more receptionists, more pharmacy technicians and clerks, more janitors, orderlies and ambulance drivers."

Glen Mays, a University of Kentucky public-health professor who studies health economics, told Cheves, "I think the law is definitely going to stimulate the health-care segment of our local economies, especially where we've seen substantial drops in the numbers of people who are uninsured. People who were forgoing medical care because they did not have insurance now can access it."

Grimes and McConnell lay out differences on health reform

By Al Cross and Megan Ingros
Kentucky Health News

U.S. Sen. Mitch McConnell kept attacking federal health-care reform and challenger Alison Lundergan Grimes gave her strongest defense of it yet as the candidates held the closest thing to a debate Wednesday, Aug. 20, at Kentucky Farm Bureau headquarters in Louisville.

Grimes was the most detailed she has been in a public discussion about health-care reform. Grimes indicated that she supports Kynect, the state health-insurance exchange, created by Gov. Steve Beshear and funded by Obamacare, where people sign up for Medicaid or buy insurance.

“For the first time ever, because of our governor, 500,000 Kentuckians are able to go to the doctor, their kids get checkups before school, and many of them are farm families in rural Kentucky,” she said. “The law isn’t perfect but we have to work to fix it. . . . We have to work to streamline the Affordable Care Act, to make sure there aren’t over-burdensome regulations on our businesses, especially our small businesses.”

Grimes endorsed President Obama’s delay in the law’s employer mandate and suggested that he should also live up to his promise that “If you like your doctor, you can keep it.”

She actually appeared to be referring to keeping old insurance policies, because her next words were, “We should be working to extend that grandfathering clause so we live up to that promise that Washington politicians made to Kentuckians. . . . It requires a senator, though, who doesn’t want to repeal root and branch the access to health care that Kentuckians just got for the first time.”

McConnell answered, “She won’t use the words, but she supports Obamacare, he single worst piece of legislation that’s been passed in the last half-century.”  He said Obamacare is going to cost jobs and it “ought to be pulled out root and branch and we ought to start over.”

McConnell said what should have been done is “truly national competition among health-insurance companies to keep prices down and quality up,” as well as “a national medical malpractice standard to bring some sanity to the litigation lottery that’s confronting every health-care provider in America; and thirdly, we need to allow small businesses to form groups for the purpose of more purchasing power on the open market.”

Citing a study by the Congressional Budget Office, McConnell said the law will only cover 10 million of the 40 million people who were uninsured, and will “cost 2.5 million jobs.” The study says the predicted reduction, through 2024, will come “almost entirely because workers will choose to provide less labor,” not because jobs will be eliminated.

McConnell said Kentucky will not be able to afford its expansion of the Medicaid program, which covers about three-fourths of the newly insured. “She applauds it,” he said. “It’s fine for the governor because the first three years the federal government will pick up 100 percent of the tab, but after that, the state’s going to be in serious financial problems.”

Beshear has cited studies showing that the Medicaid expansion will pay for itself by expanding the health-care industry and creating jobs, but Republicans say they are skeptical of that.

A video of the debate is available on the Farm Bureau website, www.kyfb.com, until Sept 20. The specific site is http://new.livestream.com/accounts/7542430/events/3309694.

'Hard times' help 13 more schools in Paducah area join about 20 in federal program that gives free meals to all students

Thirteen more schools in the Paducah area will offer free breakfasts and lunches to all students under a provision of the federal school-lunch program, joining about 20 others in the region, reports Genevieve Postelthwait of The Paducah Sun.

"Schools that are new to the program include Hendron-Lone Oak, Calvert City, Lowes, Wingo, Graves Central and North Livingston elementary schools; Fulton County elementary and middle school; South Marshall, Livingston and Ballard County middle schools, and Ballard Memorial, Fulton County and Graves County's Gateway Academy high schools," Postlethwait writes.

"They will join a group of about 20 other area schools that have qualified for and opted into the Community Eligibility Provision (CEP), a component of the Healthy, Hunger-Free Kids Act of 2010 that allows high-poverty schools to provide two square meals a day for all students at no cost to parents. . . . CEP schools must have 40 percent or more of their students "direct certified" as at-risk for food insecurity through state data. Direct-certified students include those whose households participate in the Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families Cash Assistance (TANF) or Medicaid, as well as those who are in foster care, a Head Start program, or are homeless or migrant children."

In Ballard County, where all schools now have free meals, Food Service Director Amber Hayes told Postlethwait that CEP has made a difference has been critical for parents on "the bubble" because of layoffs at a paper mill, the U.S. Enrichment Corp. plant and the Honeywell Inc. plant in Metropolis, Ill., across the Ohio River from Paducah. "Good-paying jobs are hard to find," she said. "Some parents are making too much to qualify for most assistance programs, but it's still not enough." (Read more; subscription required)