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Questions surround Certificate of Need laws and their impact on Mississippi healthcare

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1 year ago

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Opinions split on whether or not changing Mississippi’s CON laws could be a positive for healthcare providers, patients, and the marketplace.

Across America, Certificate of Need programs (CON) have been used to regulate resources within the healthcare industry. These laws or programs are tools by which states require hospitals and healthcare system providers to prove a community need before opening a new facility or expanding in an area.

Mississippi is one of those 35 states that utilize CON programs. Statutes in the state oversee facilities such as hospitals, long-term care facilities, ambulance services, rehabilitation facilities, and home health agencies. The CON laws also can be triggered when providing services like clinical health, medical equipment supply, relocation of a healthcare facility, change of ownership of facilities or equipment, and expenditures such as the purchase of a building or land.

The Mississippi State Department of Health (MSDH) is responsible for review and approval of CON applications. In Fiscal Year 2022, MSDH reported reviewing 20 applications within the CON program, authorizing $160 million in capital expenditures.

According to the 2022 State Health Plan, CON policies aim to improve the health of residents, increase accessibility, acceptability, continuity and quality of health services, prevent unnecessary duplication of health resources, and provide cost containment.

However, opinions are split as to whether or not the current CON laws actually increase accessibility and lower prices.

State Rep. Lee Yancey says reforming Mississippi’s CON laws could increase doctors and healthcare providers. However, MHA President Tim Moore worries new healthcare companies will absorb the majority of insured patients, leaving large hospitals to treat only Medicare and Medicaid patients.

Efforts to reform CON laws

“It is anti-competitive,” said State Representative Lee Yancey (R).

Rep. Yancey has attempted to pass legislation over the last several years to reform CON laws or do away with them altogether. The effort, he says, has barely made it past committee.

Originally passed in 1974 by Congress, the National Health Planning and Resources Development Act required states to implement CON requirements. This was done to control federal funding. At the time, Louisiana was the only state that did not implement the program.

The decision from Congress came after efforts were made in New York during 1964 to regulate healthcare costs. But in 1986, after nearly every state had implemented a version of a CON program, the federal government repealed the mandate. Through the 1990’s, many states including California, Colorado, Idaho, Texas, Utah and Wyoming began to do away with the programs.

Research conducted by the Mercatus Center at George Mason University in 2016 suggested that CON laws have not provided better healthcare services. GMU professor Thomas Stratmann and his co-author Jake Russ, found that CON programs are associated with a more limited supply of hospital beds and medical imaging equipment.

In 2020, the National Library of Medicine (NLM) reviewed 90 articles to determine the effectiveness of CON programs. The results were mixed.

“The literature provides mixed results, on average finding that CON increases health expenditures and overall elderly mortality while reducing heart surgery mortality. Our cost-effectiveness analysis estimates that the costs of CON laws somewhat exceed their benefits, although our estimates are quite uncertain,” the review stated.

While there was no definitive conclusion reached, the NLM said their review showed that the cost of CON exceeded its benefits and when it comes to hospitals, it also had no impact on health costs overall.

Mississippi still heavily regulates its healthcare industry even as other states have begun to pull back on their CON laws.

“I’ve been trying to find a way to crack the ice to get some more competition in healthcare. We have a paradigm in healthcare that seems to be failing across the state,” said Rep. Yancey.

He said CON programs prevent the availability the patient to have more choices. At time times this forces residents in rural communities to travel great distances for care. He said Mississippi’s need for outpatient type facilities is continuing to grow.

Rep. Yancey believes it is ultimately the market and the consumer who should decide where they receive care. He says allowing more competition will provide a better product and more competitive market pricing.

“My job is not to make sure that hospitals have no competition; it is to make sure that my constituents and those around the state are going to have the best quality healthcare they can get that is close to them and affordable,” said Rep. Yancey.

If Mississippi were to make adjustments to current CON laws, Yancey said there could be an increase in local doctors in rural towns as well as partnerships among physicians in smaller communities.

“We have to look at things differently than we have in the past,” Yancey said. “Doing them the same old way is not going to work. We’ve seen that.”

Mississippi Hospital Association supports CON laws

While Tim Moore, President of the Mississippi Hospital Association, echoed the sentiment that the healthcare system has to change, his perspective on CON programs differed from Rep. Yancey.

The major concern for hospitals regarding an unregulated market of healthcare facilities, is revenue to keep them all operational. Moore said there are worries among established hospitals that if these private health companies begin to pop up across the state, they will absorb the majority of insured patients. This could leave many large public hospitals, with heavy administrative overhead, to treat only Medicare and Medicaid patients.

Hospitals seeing patients on Medicare or Medicaid receive reimbursements largely provided by federal funding. The Medicaid rate is roughly 88 cents on the dollar. Moore said if hospitals are not being reimbursed proportionately to the care being provided, this could lead to devastating impacts for the public as a whole.

“When federal funding makes up a large portion of a hospitals funding, any disrupter to that system can be a big deal. It could mean the difference in staying open or closing,” said Moore.

Moore did voice support for some efforts to revise these programs so that established hospitals and facilities could grow or expand without the risk of loosing certification.

States like Louisiana have recently made agreements with the Centers for Medicare and Medicaid (CMS) for a new payment model. This returned roughly $900 million to their hospitals. The new model, which went into effect in 2022, increased hospital supplemental payments. It also prioritizes maintaining adequate funding for safety-net hospitals without additional state funds.

Moore said when Mississippi officials went down this path to try and bring the same relief to the state’s hospitals, they found that the commercial rates were actually lower than the Medicaid and Medicare reimbursement rates. This number matters because of how reimbursement rates are set.

In a conversation with Commissioner of Insurance Mike Chaney, he explained that in Louisiana’s decision they chose to take an average of Medicare and Commercial rates as their reimbursement for Medicaid. He added that the commercial insurance rate in Louisiana is roughly 25 percent higher than Mississippi’s. This prevented Mississippi from moving in the same direction, because those averages did not compare to Medicare, which is considered the “gold standard” of reimbursements. Therefore, Mississippi continues to use Medicare as the benchmark.

What’s to come?

Rep. Yancey and others who support rolling back CON laws could make another run at offering reforms in the 2024 legislative session. Hospitals and healthcare will likely be front and center when lawmakers return to the Capitol in January as more facilities are announcing plans to restructure and various systems consider layoffs.

Lawmakers did provide $103 million in grant funding during the 2023 session to support hospitals. That program has been under scrutiny as some systems have complained that the appropriated funds have not been as accessible as intended. Lt. Governor Delbert Hosemann has said that lawmakers will take a look at the program when they return.

The post Questions surround Certificate of Need laws and their impact on Mississippi healthcare appeared first on Magnolia Tribune.

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By: Sarah Ulmer
Title: Questions surround Certificate of Need laws and their impact on Mississippi healthcare
Sourced From: magnoliatribune.com/2023/07/24/questions-surround-certificate-of-need-laws-and-their-impact-on-mississippi-healthcare/?utm_source=rss&utm_medium=rss&utm_campaign=questions-surround-certificate-of-need-laws-and-their-impact-on-mississippi-healthcare
Published Date: Mon, 24 Jul 2023 15:00:54 +0000

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Staring mortality in the face at Christmas

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1 year ago

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December 16, 2023

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My friend Jarrod is dying after an eight year battle with cancer. He’s lived a life worth celebrating, one that has drawn people to Christ.

I was going about my business this week when I received a text that stopped me in my tracks. A college friend was being moved to hospice care.

Jarrod Egley was diagnosed with colorectal cancer in early 2017. In the fall of 2018, tests revealed the cancer had spread to his lungs and Jarrod’s cancer was classified as Stage IV.

For almost eight years from the date of the original diagnosis, he’s fought. Through surgeries, radiation, endless rounds and cycles of chemotherapy, and experimental immunotherapies, he’s fought.

Last year, I flew out to California and spent some time with Jarrod and his wife, Emily. We sat outside one night. He acknowledged to me that it was not a question of ‘if’, but ‘when’ the cancer would claim his life. I told him I was sorry, because what else is there to say?

We talked about our faith, about the trials of Job, about Jacob wrestling with God, about Paul’s affliction. But mostly we reflected on our time together in school, on the good things, and the mundane things, that happened since.

Jarrod and I met at Tulane University. One Sunday morning in the Spring of my freshman year, I rose from my dorm room bed, dressed, and began walking down Saint Charles Avenue in New Orleans with no particular agenda. I walked until I came across First Baptist Church and the thought flickered in the vacuous recesses of my brain to enter.

Some would say it was a lark. The Calvinist in me says providence. The walk that morning changed the trajectory of my time at Tulane and my life on the whole. Intervarsity Christian Fellowship and the Baptist Collegiate Ministry became central to my life and put me in regular league with Jarrod. I met him first at the BCM and we ultimately ended up attending church together.

Jarrod was a faithful servant on and off campus. He helped organize a group of us that would weekly make our way down to the Esplanade seawall on the backside of the French Quarter to feed the homeless. On Friday nights, he could be found at chapel with a small cadre of students foregoing Bourbon Street for early 2000s worship music.

Jarrod was a loyal friend in those years. Never rude or biting. Not prone to an insult for an easy laugh. Persistently encouraging. An engineering student, his mind worked linearly and was oriented to problem solving. There were never a lot of wasted words — always a lot of deliberative questions when he disagreed or did not understand a point. He exhibited intelligence, empathy, and the kind of moral conviction that sets someone apart.

He also had a wry and dry sense of humor and a penchant for beating people at Madden football. He was fair-to-midland on the ultimate frisbee pitch. Along the way, there were crawfish boils, Mardi Gras outtings, poorly attended Tulane football games, and more than a decent amount of wing eating.

After college, I lost touch with Jarrod. He moved back to his home state of California. He got married to his college sweetheart, who could not have anticipated her husband’s journey, but has been a steady and constant helpmate throughout. Jarrod became a very successful engineer and a bourbon connoisseur. One of his bucket list trips took him to Kentucky, where he got to meet and became friends with bourbon “Hall of Famer” Freddie Johnson of Buffalo Trace acclaim.

Jarrod at Buffalo Trace Distillery (Spring 2022).

Sitting in his backyard nearly 20 years after graduating from Tulane, I saw many of the same qualities I had grown to admire when we were students together. I saw a husband who doted on and supported Emily’s passions. But I also saw someone whose body had been beaten to hell and back, who was tired, and who, like Jacob, had been wrestling with God. We quickly fell back into friendship, which perhaps is the mark of good friendship.

We all have aspirations in our youth — for the kind of spouse or parent we might be, for what we might accomplish, for what we might experience. Along the way, dreams are satisfied, modified, or they die on the vine. The clock inevitably works against all of us. That night in Oceanside, California, Jarrod, a numbers guy, saw that time was not on his side. He believed, as we all would, that he still had more to give, more impact to be made, and more things to see and experience.

After that trip, Jarrod and I stayed in touch, most frequently triggered by news of his cancer. It has been mostly the bad variety in recent months. Now spread throughout his body, down to his bones, he has lived in constant pain for months. Not even a steady diet of morphine and an implanted pain pump solve for it. Jarrod’s been hospitalized twelve times just in 2023.

But his matter of fact sense of humor and way of seeing the world remains in tact. So too does his faith that despite these trials, he has always been safe in the hands of Christ.

There are people in the world who believe that life is random, disordered, and without reason. I am not among them. I think my friend is staring mortality in the face at Christmas for a reason.

For thousands of years before Christ came, there was darkness and despair. Sin and shame gripped the hearts of men. Until one holy night, God, in His infinite love, mercy and wisdom, sent His son to save. Jesus is the light of the world and the hope of man. He has won victory over death and Jarrod’s will not be the exception. Jesus came for Jarrod, and for you.

For thousands of years since Jesus’s death, burial, and resurrection, His disciples have been used as divine instruments to point the way to God. Jarrod is among them. If life expectancies were the measure, Jarrod would be at the midway point for most people. He’s made a lifetime of impact for the Kingdom and on other people.

So, to my friend Jarrod, you were placed here with a purpose. You have run your race. You are loved. And when this chapter closes, you will hear “well done, my good and faithful servant.” There is no greater evidence of a life well lived.

While Jarrod and Emily have been fortunate to have health insurance, their portion of the medical bills so far in 2023 have eclipsed $30,000, and Emily is facing additional uncovered expenses during Jarrod’s hospice care, including a night nurse that costs over $400 a night. If you would like to help defray the cost, a contribution can be made at their Go Fund Me page.

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By: Russ Latino
Title: Staring mortality in the face at Christmas
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Published Date: Sat, 16 Dec 2023 15:05:22 +0000

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Magnolia Mornings: December 15, 2023

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December 15, 2023

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Important state and national stories, market and business news, sports and entertainment, delivered in quick-hit fashion to start your day informed.

In Mississippi

1. Laurin St. Pe’ named CEO of Singing River Health System

Laurin St. Pe

The Board of Trustees of Singing River Health System announced the immediate appointment of Laurin St. Pe’ as the Chief Executive Officer on Thursday.

“We are thrilled to announce Laurin St. Pe as the new CEO of Singing River,” said Steve Ates, Board President in a statement. “His wealth of healthcare experience and proven track record make him the ideal leader to steer our health system toward its next phase of growth and success.”

St. Pe’, who has been serving as Interim CEO since July 2023, said he is honored to assume the role of CEO at Singing River. He has worked at Singing River as Administrator of Singing River Health System’s Pascagoula Hospital and Gulfport Hospital, in addition to overseeing program service lines throughout the entire system to his subsequent appointment as Chief Operating Officer of Singing River.

The health system says St. Pe played a crucial role in the financial revitalization of Singing River Health System while steering the organization toward financial stability.

2. Gulfport-Biloxi airport, Stennis evacuated after threats

The Gulfport-Biloxi International Airport was evacuated on Thursday morning “out of an abundance of caution,” airport officials said, after receiving an emailed threat to certain transportation entities across the state.

The airport was thoroughly security swept, cleared and reopened in just over two hours. Gulfport-Biloxi is now operating regularly.

The threat was also sent to Stennis International Airport. Their staff and personnel were also evacuated until the facilities could be swept and cleared.

Any passenger whose travel was affected by the evacuation is encouraged to contact their respective air carrier.

3. Cassidy arrested in Iowa for beheading Satanic Temple statue

Former Mississippi congressional and legislative candidate Michael Cassidy was arrested this week in Iowa for beheading a statue at the state’s Capitol erected by The Satanic Temple.

Cassidy reportedly decapitated the statue and turned himself to police on Thursday. He was charged with fourth degree criminal mischief. He then started an online legal defense fund where he’s raised upwards of $20,000 as of Thursday night, according to his X account.

4. “Serial fraudster” ordered to cease offering investments into companies

According to the Mississippi Secretary of State’s office, on October 26, 2023, Secretary Michael Watson and the Securities Division issued an order against Stephone N. Patton. The SOS says Patton is a serial fraudster with multiple criminal convictions in Mississippi and Florida.

Through business filings with the SEC and Mississippi, Patton has held himself to be the CEO of various companies, including Star Oil and Gas Company, Inc., North Gulf Energy Corporation, Inc., Patton Oilfield Services, Inc., and Patton Farms, LLC.

The SOS says using these business filings and company websites, Patton claimed to have raised hundreds of billions of dollars through investment opportunities. Through investigative efforts and collaboration with the SEC, the SOS discovered none of Patton’s companies are operational, have any assets, or generate any revenues. Account records show Patton spent investors’ funds almost as soon as he received them on personal expenses. The total amount of known investments made to Patton’s fraudulent companies is over $80,000. Further, none of Patton’s investment offerings have been registered or notice filed with the Mississippi Secretary of State’s Office.

The SOS order requires Patton to cease and desist from offering investments with his companies, requiring Patton to permanently deactivate his companies’ websites to prevent any further dissemination of his false or misleading information. Patton is also ordered to pay an administrative penalty of $25,000 to the Mississippi Secretary of State’s Office for these violations, in addition to restitution owed to all his Mississippi investors.

National News & Foreign Policy

1. Congressional retirements mounting as 2024 election cycle nears

Retirement and departure announcements are piling up ahead of the start to the 2024 election cycle. The New York Times has developed a Retirement Tracker that currently shows 22 Democrats and 11 Republicans who are in Congress now will not be seeking re-election next year.

“Dozens of members of Congress have announced plans to leave their seats in the House of Representatives, setting a rapid pace for congressional departures, with more expected as the 2024 election draws closer,” the NY Times reports. “Given Republicans’ razor-thin House majority, the wave of exits has the potential to lead to a significant shake-up next year.”

You can find the tracker here.

2. Texas, Daily Wire, The Federalist sue U.S. State Department over media censorship

The U.S. State Department’s Global Engagement Center has come under fire as Texas Attorney General Ken Paxton along with The Daily Wire and The Federalist have filed a federal lawsuit alleging that the department funded technology that could “render disfavored press outlets unprofitable.” They claim that the department has helped social media – Facebook, YouTube and X (formerly Twitter) – to censor free speech while funding technologies used to censor right-leaning news outlets such as theirs.

New Civil Liberties Alliance is representing The Daily Wire and The Federalist. Paxton and the outlets claim the Global Disinformation Index (GDI), a British think tank, received a $100,000 grant from the State Department in 2021, and NewsGuard, which rates the “misinformation” levels of news outlets, received $25,000 from the State Department in 2020, according to the lawsuit.

According to the State Department’s website, the Global Engagement Center’s mission is to direct, lead, synchronize, integrate, and coordinate U.S. Federal Government efforts to recognize, understand, expose, and counter foreign state and non-state propaganda and disinformation efforts aimed at undermining or influencing the policies, security, or stability of the United States, its allies, and partner nations.

As reported by Reuters, the lawsuit cited a GDI-produced list from December 2022 that ranked The Daily Wire and The Federalist as among the 10 “riskiest sites” for news while the least-risky included The New York Times, Associated Press and NPR. Reuters notes that the lawsuit alleges such “blacklists” are reducing revenues to The Daily Wire and The Federalist along with their visibility on social media and ranking results from browser searches.

Sports & Entertainment

1. SEC releases 2024 schedules

Wednesday evening, the Southeastern Conference released the 2024 football schedules for its member schools, including of interest in the Magnolia State the schedules for Ole Miss and Mississippi State.

It is the first schedule that includes new conference members University of Oklahoma and University of Texas, bringing the conference to 16 schools. Each SEC team will play eight conference football games plus at least one required opponent from the ACC, Big Ten, Big 12, Pac 12 or major independent, each team will have two open dates.

The 2024 season will be the first year the SEC will play a schedule without divisional competition since 1991. The top two teams in the league standings based on winning percentage will play in the 33rd SEC Football Championship Game in Mercedes-Benz Stadium in Atlanta on Saturday, December 7.

2. White, Jesiolowski, Jones honored by MAIS

John White

The Midsouth Association of Independent Schools (MAIS) in Mississippi, comprised of non-public schools, announced this week that Madison-Ridgeland Academy’s senior quarterback John White was named the 6A Player of the Year while Hartfield’s Reed Jesiolowski and Hartfield Chris Jones were named the MAIS 6A Offensive and Defensive Players of the Year, respectively.

All three have committed to play college football at the University of Mississippi.

White is Mississippi’s all-time leader in career passing yards with 15,259 yards, a record he broke during the 2023 season.

MAIS, like the Mississippi High School Activities Association (MHSAA) for public schools, is broken down into classifications, from 1A to 6A. However, MHSAA added a 7A this season.

Markets & Business

1. Consumer retail sales up as energy, gas prices move down

The U.S. Bureau of Labor Statistics reported this week that the Consumer Price Index rose 0.1% in November after being unchanged in October. Retail sales rose 0.3% in November after rising 0.2% in October, meaning consumers continue to spend at the start of the holiday season.

The CPI or inflation rate is 3.1%, higher than the Federal Reserve target of 2% but below the 9% peak in 2022 which reached a 40-year high.

As for the energy index, BLS reported that it fell 2.3% in November after decreasing 2.5% in October. The gasoline index decreased 6% in November, following a 5% decrease in the previous month.

The index for fuel oil fell in November, decreasing 2.7%. However, the natural gas index rose 2.8% over the month after rising 1.2% the previous month. The index for electricity also rose 1.4% in November, after increasing 0.3% in October.

The energy index fell 5.4% over the past 12 months. The gasoline index decreased 8.9%, the natural gas index declined 10.4%, and the fuel oil index fell 24.8% over this 12-month span.

2. Week’s market rally continues into Friday

At close of trading on Thursday, the U.S. markets continued the week’s rally, pushing the Dow up 158 points to 37,248 while the Nasdaq and S&P also made gains, 27 points and 12 points, respectively, to close at 14,761 and 4,719.

The record high for the Dow on Thursday moved futures up 102 points.

According to CNBC, the major averages are headed for their seventh straight positive week. As of Thursday, the Dow is higher on the week by 2.8%. The S&P 500 is up by 2.5%, while the Nasdaq Composite rose 2.5% this week.

Stocks rallied after the Federal Reserve left rates unchanged this week while members look towards cuts in the new year and beyond.

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By: Magnolia Tribune
Title: Magnolia Mornings: December 15, 2023
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Published Date: Fri, 15 Dec 2023 13:00:00 +0000

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New water rates expected in Jackson come 2024; those who don’t pay face shut off

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1 year ago

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December 15, 2023

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Interim Third-Party Director Ted Henifin said this week that only about 59% of the City of Jackson’s water customers are paying their bills.

JXN Water has announced new rates and fees coming in 2024. Those who are not paying will be at risk of shut offs.

The company, which was established by federal appointed interim Third-Party Director Ted Henifin, has been overseeing the city’s water system for the better part of a year.

Officials estimated that the average cost for water in the city was $76 per month for residents. Henifin clarified that JXN water will not attempt to recoup any charges prior to November 29, 2022, and will work with those who have failed to pay since that time.

He said only about 59 percent of the city’s water customers are paying their bills.

“You can’t forgive bills, so we have to be creative in how we part that,” said Henifin in reference to Mississippi’s laws that prevent giving away water.

According to a release by JXN Water announcing the rate changes, residents in single family households with small meters that use up to 748 gallons daily would see a bill increase of roughly .30 cents per day. Research indicates that the average U.S. family uses 300 gallons per day.

SNAP customers will have a new rate tier that could lower their bill by up to .69 cents per day, on average.

“Those who need to save the most benefit from saving money by drinking tap water. This new rate structure makes water affordability possible for 12,500 JXN Water customers who receive SNAP benefits,” said Henifin in the release.

Read more about the anticipated rate changes here.

New fees will also be implemented, including a new service fee of $50, service deposit of $100, returned check fee of $25, service restoration fee of $100, and meter tampering charge of $500. 

JXN Water has continued to encourage residents to use the water, with Henifin going on the record in a federal status hearing saying that the water “was safe to drink.”

More conversation regarding the billing process is expected to come at next week’s Jackson City Council meeting.

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By: Sarah Ulmer
Title: New water rates expected in Jackson come 2024; those who don’t pay face shut off
Sourced From: magnoliatribune.com/2023/12/15/new-water-rates-expected-in-jackson-come-2024-those-who-dont-pay-face-shut-off/?utm_source=rss&utm_medium=rss&utm_campaign=new-water-rates-expected-in-jackson-come-2024-those-who-dont-pay-face-shut-off
Published Date: Fri, 15 Dec 2023 20:00:00 +0000

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