Healthcare

Sara Plourde for NHPR

A committee of New Hampshire House lawmakers is calling for the repeal of the state's Medicaid work requirement.

Disparities in healthcare quality and outcomes for gender (including people who are transgender) and race are receiving more attention: for example, recent reports show black women have much higher mortality rates during and after pregnancy, and women and people of color receive less medical intervention for pain management and cardiovascular care. We discuss the history, systems, and personal biases that contribute, in a multitude of ways, to these disparities. 

Original air date: September 16, 2019 at 9 a.m. 

Disparities in healthcare quality and outcomes for gender (including people who are transgender) and race are receiving more attention: for example, recent reports show black women have much higher mortality rates during and after pregnancy, and women and people of color receive less medical intervention for pain management and cardiovascular care. We discuss the history, systems, and personal biases that contribute, in a multitude of ways, to these disparities. 

Original air date: September 16, 2019 at 9 a.m. 

Courtesy Photo, MCC

River Valley Community College is developing a new program to train licensed practical nurses.

The LPN program would be offered at the Lebanon and Keene campuses, starting in January, if approved by the state’s Board of Nursing.

In 2018, there were about 1,200 openings for LPNs, according to the New Hampshire Department of Employment Security.  

Licensed practical nurses work under the supervision of physicians and registered nurses. They can collect patient data and provide some treatment. 

Sara Plourde / NHPR

As a new work requirement for beneficiaries of New Hampshire’s expanded Medicaid program takes effect this month, some in the healthcare industry say early signs are pointing to a bumpy road ahead.

Senator Maggie Hassan was one of a group of bipartisan lawmakers who introduced a bill on Thursday designed to stop surprise medical billing.

The plan would set up an arbitration process where medical providers and insurers could work out who pays for an out-of-network visit without involving the patient.

“That's really the key part of our legislation,” said Hassan at a press conference in Washington, D.C., “taking the patient out of these payment disputes between plans and providers.”

Ali Oshinskie for NHPR

U.S. Sen. Maggie Hassan said the ripple effects of opioid addiction will be felt for generations. 

She joined NHPR's The Exchange Monday to discuss the federal and state responses to the crisis, as well as the role the FDA may have played in either "wittingly or unwittingly" encouraging overprescribing of opioids. 

Listen to the full interview here, or watch a video of the program below

Hassan also addressed climate change -- she prefers a series of steps, rather than the sweeping Green New Deal. And she's concerned about the possible impact of  Medicare for all proposals now under discussion.

"As you transition people from one system to the next, it can be very disruptive...especially if you're somebody with complex medical needs," she said.

NHPR Staff

A battle is brewing over the state's new Medicaid "community engagement requirement," which requires certain beneficiaries of Medicaid to engage in various activities, including attending school or holding a job in order to receive coverage.  

New Hampshire is one of a handful of states with this type of arrangement, often called a "work requirement."

Sara Plourde For NHPR

New Hampshire has joined a handful of states that mandate some Medicaid recipients to engage in certain activities: for example, a job, school, or community services. But recent federal changes tightening certain aspects of the program, as well as proposed legislation, have renewed debate over the Granite State's approach. 

Garrett Vonk

A number of affiliated North Country hospitals are pledging to continue working together despite a recent decision by the group's largest member, Littleton Regional Healthcare, to go its own way.

The hospitals include Androscoggin Valley in Berlin, Weeks Medical Center in Lancaster, and Upper Connecticut Valley in Colebrook.

They came together less than four years ago in an attempt to cut costs and keep care accessible to the largely rural communities they serve.

North Country Hospital Group Loses Largest Member

Feb 21, 2019
Allison Quantz | NHPR

Littleton Regional Healthcare has announced plans to pull out of an affiliation agreement with three Coos County medical centers.

The hospitals formally joined together less than four years ago under a non-profit umbrella organization, North Country Healthcare, in an attempt to cut costs and improve accessibility of care for patients.  

A New National Strategy for Managing Pain

Feb 4, 2019
U.S. Air Force photo/ Senior Airman Mariah Haddenham)

In the midst of the opioid epidemic, the U.S. Department of Health and Human Services is addressing the need for alternative pain management. The department recently released a draft federal report on best practices — and opened a public comment period. Pain specialists recommend an interdisciplinary approach, combining physical treatments, pharmacology and mental health therapy. Many Granite Staters encounter hurdles with insurance coverage, access to health care providers, and stigma in treating their pain holistically.

We talk to physicians about the best approaches to acute and chronic pain. We also hear how health insurance companies are adjusting coverage to meet changing trends in pain management.

  

The six-week window for people who buy their own health insurance through the Affordable Care Act begins Thursday.

Three insurance companies—Anthem, Harvard Pilgrim and Ambetter—are offering a total of 17 different plans in New Hampshire.

Even if you like your current plan, consumers are encouraged to shop around as prices and policies tend to shift from year to year. Overall, premiums for 2019 are down slightly from current rates.

The open enrollment window runs through December 15th.

Dan Tuohy / NHPR

 

Chris Pappas, Democratic candidate in the 1st Congressional District, says we bipartisan legislation is needed to bring down insurance costs, and that patient protections will rein in profit-driven insurance companies.

All Things Considered host Peter Biello spoke with Pappas on health care policy in our final interview for this series. In the past two weeks, All Things Considered spoke with all of New Hampshire's gubernatorial and Congressional candidates.

[This transcript has been lightly edited for clarity.]

Allegra Boverman for NHPR

The Republican candidate in New Hampshire's 1st Congressional District Eddie Edwards says he supports the repeal of the Affordable Care Act. For people who currently rely on expanded Medicaid, he says, increasing access to insurers across the country would bring down costs.

All Things Considered Host Peter Biello spoke with Edwards about healthcare policy. All Things Considered is speaking with all congressional candidates this week.

(This transcript has been edited lightly for clarity.)

 

Allegra Boverman / NHPR

Democratic Congresswoman Annie Kuster says if she is re-elected, her proposals for healthcare in New Hampshire, including a plan for Medicare expansion, will increase access and stabilize health insurance markets.

All Things Considered Host Peter Biello spoke with Kuster, incumbent in the 2nd Congressional District, on healthcare policy. All Things Considered is speaking with all Congressional candidates this week.

(This transcript has been edited lightly for clarity.)

 

Dan Tuohy / NHPR

The Republican candidate in New Hampshire's 2nd Congressional District Steve Negron says he does not think the government should be in the business of healthcare, although he supports federal funding for Medicaid to help needy populations. 

NHPR's Peter Biello spoke with Negron about healthcare policy. All Things Considered is speaking will all congressional candidates in the New Hampshire this week.

(This transcript has been edited lightly for clarity.)

If you are elected to Congress how would you tackle the state's opioid crisis?

Sarah Gibson for NHPR

Governor Sununu unveiled a $24 million plan on Tuesday to tackle New Hampshire's nursing shortage.

The Governor says he expects a major surplus in state funds this year and that the majority of it should go to expanding college nursing programs.

Allegra Boverman

Gov. Chris Sununu says he has a model for paid family and medical leave that's voluntary, citing his opposition to the mandatory proposal that passed the House during the last legislative session.

Britta Greene / NHPR

Dr. Anna Konopka, a physician in New London, surrendered her medical license in October to settle allegations from the New Hampshire Board of Medicine. Months later, she’s still fighting to reopen her doors.

As her battle plays out in the courts, many of her patients are struggling to find a new primary care doctor. Many of them are low income and reliant on pain medication day-to-day.

The Single-Payer Healthcare Debate Revisited

Dec 13, 2017
Reese Brown; U.S. Army

With uncertainty over the Affordable Care Act's future, and Congressional inaction on an alternative, some lawmakers in D.C. and New Hampshire are re-branding an old idea: government-financed universal healthcare.  We look at the pros and cons from a medical and budgetary perspective.

GUESTS:

Britta Greene / New Hampshire Public Radio

Dr. Anna Konopka, a New London doctor who's been fighting in the courts to reopen her practice, was dealt another disappointment this week. In a decision released Wednesday, a judge in Merrimack County Superior Court denied her motion to have her case reconsidered.

The news comes after Konopka learned just last week that she's under investigation by her local police department. The details of that investigation remain unclear. 

Britta Greene / New Hampshire Public Radio

A judge in Merrimack County Superior Court has dismissed a case brought by a New London doctor who said she was forced to close her practice under pressure from the state.

Dr. Anna Konopka agreed to surrender her license this fall to settle allegations from the New Hampshire Board of Medicine. The details of those allegations are sealed, but Konopka admits she failed to use an online database required for doctors prescribing opioids. In her mid-80s, Konopka does not use a computer.

In the past few months, the Manchester VA Medical Center met with scandal, disaster, and a full helping of public outcry. Today on Word of Mouth, NHPR's Peter Biello looks back on the summer's news and tells the story of one woman's effort to improve hospital facilities for survivors of military sexual trauma. 

Britta Greene / New Hampshire Public Radio

Dr. Anna Konopka’s medical office sits just across the driveway from her house, tucked along the shore of Pleasant Lake in New London. There’s no cell service, no wifi. Her phone rings off the hook.

At 85, she’s set to close her practice Friday, but the move is not voluntary. She says she’s being forced to shut down by a system that no longer values the type of patient-centered medicine that she practices.  

The New Hampshire Board of Medicine has a different take. They’re challenging her medical decision-making and other fundamental aspects of her work.

Franchise Opportunities; Flickr

After the Graham-Cassidy Bill proposed by Republicans -- their latest Repeal and Replace effort -- failed to garner enough votes recently, patients, healthcare providers, and insurers still face plenty of uncertainty before open enrollment begins November 1. Meanwhile, Senator Bernie Sanders's single-payer proposal continues to gain fans. We'll get the latest on how national politics is shaping the health care debate across the country.  

GUEST:

elliothospital.org

At the first of two public forums Wednesday night in Manchester, the heads of Elliot and Southern New Hampshire Health Systems took questions on what their proposed partnership would mean for patients, staff and the region's healthcare landscape.

Peter Biello

The Boston Globe published revelations on Saturday of dangerous delays in care and unsanitary conditions at the Manchester VA Medical Center.

Recently, VA Secretary David Shulkin told a Senate Committee that an important program designed to help veterans get care at private hospitals was running out of money sooner than expected. He was talking about the Veterans Choice program.

Meanwhile, here in New Hampshire, the program has slowly required more and more administrative help from employees at the Manchester VA. Assistant Director of the medical center, Kevin Forest, recently said as much to the State Veterans Advisory Committee.

Weekly N.H. News Roundup: June 30th, 2017

Jun 30, 2017

Governor Sununu and other New Hampshire lawmakers announced their opposition to the proposed healthcare bill from the U.S. Senate.  "Keno-garten" comes to the Granite State, but critics worry the new funding from the electronic gambling game Keno won't be enough for widespread full-day kindergarten programs. And Mayor Ted Gatsas of Manchester announces his re-election campaign, amongst some controversy. 


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