The sole reason for Barbot and State Health Sharfstein these years has been to install the Affordable Care Act state health insurance system and the consolidation and deregulation of the health industry.  Eliminating public health structures and handing them to private corporations and/or private corporate non-profits.  Just as with Alonzo and the Baltimore City school board....making schools into businesses.....Barbot and Sharfstein has as their goal privatizing public health.

So, the Carlyle Group hedge fund controls Manor Care, the largest senior care centers in this area.  The Patterson Park development was simply the consolidation of senior housing away from downtown and city center.  You can bet that there will be affluent seniors living there as all health policy has everyone else aging at home with questionable health care businesses and robot health aids.

If you look at the privatization of public health you see that private non-profits do every sector of public health.....from senior and low-income care.....to mental health and social work, there are almost no public agencies that run or oversee public health.  Why is this important?  Remember, the ACA mirrors the consolidation and deregulation of the banking industry.  It's goal is to build global health systems that are profit-driven and predatory just like Wall Street banks.  So, if Maryland has no public agencies providing oversight, providing unbiased health data, providing public advocacy and avenues for justice-----which Barbot and Sharfstein have worked hard to dismantle----then we have in health care what we have today in Wall Street banks.  Only with health care......when people are fleeced and denied access to ordinary medical procedures it becomes life and death.  Impoverishment by predatory criminal banks ranks second to predatory health services.



Baltimore health commissioner announces her resignation Dr. Oxiris Barbot was one of the longest serving members of the Rawlings-Blake cabinet

Mark Reutter March 12, 2014 at 3:37 pm Story Link 6

Oxiris Barbot served as Baltimore’s health commissioner for four years.

One of the few remaining members of Mayor Rawlings-Blake’s original cabinet, Dr. Oxis Barbot, is leaving as commissioner of the city health department, effective April 26.

Barbot will return to New York City to become first deputy commissioner of health. Jacquelyn Duval-Harvey, who joined the city as a deputy health commissioner, will serve as interim director when Dr. Barbot departs next month.

Administrative Turnover since 2010

Barbot joins a long list of high-level departures from the current administration.

Among the turnover have been the top administrators of Fire, Police, Public Works, Transportation, Schools, Finance, General Services, Recreation and Parks, Mayor’s Office of Information Technology, Mayor’s Office of Human Services, Mayor’s Office of Policy and Communications, and the Baltimore Development Corp.

Also: Chief of Staff, Mayor’s Office of Criminal Justice, Deputy Chief of Government and Community Affairs, Mayor’s Office of Minority and Women-Owned Business Development, and Office of Inspector General.

“I would like to thank Dr. Barbot for her years of dedicated service to Baltimore,” Mayor Rawlings-Blake said in a media release this afternoon.

“Her enthusiasm for health and wellness is infectious, and she has left a rich legacy of progressive policies to move our city forward. Dr. Barbot understood that Baltimore had to be aggressive in more than just treatment, but also in addressing the underlying issues that led to poor health – particularly in our most vulnerable communities.”

Barbot was appointed commissioner of health in July 2010, five months after Rawlings-Blake became mayor following the resignation of Sheila Dixon, who had been convicted of a corruption charge.

As health commissioner, Dr. Barbot led a 1,200-employee agency, with a budget of nearly $140 million, responsible for health policy and programs, including control of infectious diseases, emergency preparedness, maternal-child health, restaurant inspections, animal control and chronic disease prevention.

In 2011, Barbot spearheaded the roll out of the mayor’s Healthy Baltimore 2015, a comprehensive health policy agenda that included a ten-point plan for improved public health.

Otherwise, she has kept a low profile in city government.

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Do you know that all across the country this new approach to dental care for the poor and children is rife with fraud and abuse as one government watchdog and justice group after another document how Medicaid and funding for this health care is fleeced by fraud.  Kool Smiles has a record of lawsuits all across the country as it was brought to Baltimore and allowed to expand.

When I talk with the poor in the city asking about just this they will tell you they no longer use it because they are being exploited.  We are being experimented on....is what I hear as people getting care they know they do not need begin to question to motives.  Even those dental outfits attached to public schools have parents stating they are getting unnecessary care.  Filling baby teeth with lots of dental work knowing all these teeth are shed is outright fraud and I hear this report from parents with children in schools across the city.

Now, are all dental offices treating children and the poor bad?  Of course not.  It is the failure of having even the most basic of oversight of medical and dental health care institutions that creates the environment for those wanting to fleece to come.  We need strong health fraud laws and to rebuild public justice oversight and prosecution of health care fraud in Maryland and Baltimore!



Dental coverage doesn't guarantee its use

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By Meredith Cohn 7:00 a.m. EST, January 16, 2014  BAltimore Sun

Those who have dental insurance don’t always use it to get care, according to a new study from the University of Maryland School of Dentistry.

The researchers found that education is needed before people value their dental health, which can impact their overall health.

“You can’t just hand people coverage and say, ‘there, that’s better,’” said Richard J. Manski, professor and chief of Dental Public Health at the dental school. “You need to offer some inducements, some promotional campaign to change people’s attitudes and beliefs. We hope this starts the process of a new way of thinking about the problem.”

Manski was the first author on the study, published in the American Journal of Public Health.

The researchers looked at older people who had insurance and didn’t have coverage to see who was using care. They found some factors keeping people from getting care can’t be changed such as age. But health status changes and attitudes can be influenced through outreach – though it will take time.

Other factors increasing use of dental care include improving the economy and unemployment rate, as well as increasing the number of providers.

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How do you think that will work.....it already has patients with chronic illness told that they cannot be readmitted inside a window of time no matter the urgency if the problem is tied with the last entrance to the hospital.  Think that is hyperbole?  Patients are being told to take care of these issues at home and directed to home health care rather than re-admit.  This places critical health care in the hands of people not trained to handle it and indeed, it has been policy in Maryland for years.

People are dying from this as hospitals do not allow the patient to stay long enough with the initial visit to address the malady.  They are rushed through with minimum hospital stay and tracked into off-site clinic follow-up that is not sufficient for most needs.


How Hospital Care Is Changing In Maryland
 January 14, 2014

Our series has focused on how the Affordable Care Act is changing health care in the state, and there are many questions about why Maryland’s health-insurance exchange website isn’t working better. But, today we’re focusing on another big development, one of the biggest changes in Maryland’s health system in four decades.

This change will give  Maryland hospitals incentives to make sure patients don’t have to be re-admitted, and incentives to reduce the cost of care. Maryland will also keep its power to set rates for all hospital services, a unique authority for a state to have. To help get a better grasp on the changes, Sheilah Kast talks with Maryland’s Health Secretary, Dr. Joshua Sharfstein and Carmela Coyle, President and CEO of the Maryland Hospital Association.
Produced by Matt Purdy - mpurdy@wypr.org
Our series ‘The Checkup:  How Health Care Is Changing in Maryland’ is made possible by grants from CareFirst BlueCross BlueShield, the Baltimore Association of Health Underwriters, and HealthCare Access Maryland.


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The problems with MD's health exchange are not isolated,......all of MD public policy is a disaster because none of it is written by public advocates.....it is entirely written by the corporate 1% that make policy simply to move profit to the top....ergo, people are not placed in charge because of talent but because of having the 3 monkey syndrome.....SEE NO EVIL, HEAR NOT EVIL, SPEAK NO EVIL....public policy in policing, education, development are all failures and hundreds of billions of the state's revenue have been lost just during O'Malley's tenure as Mayor of Baltimore and now Governor of Maryland.

Remember, the goal with these state health systems is to end Medicare and Medicaid as Federal programs and dismantle them through state policy!  We want to be shouting for Expanded and Improved Medicare for All!!

Also, please know it is not the democratic party bringing these republican policies forward.....it is neo-liberals that have control of the democratic party.  We simply need to rebuild the democratic party by running labor and justice to reverse all of this trash!


Maryland officials were warned for a year of problems with online health-insurance site
Sarah L. Voisin/The Washington Post - Lucia Argueta Ramos, 60, left, of Brooklyn, Md., talks to health navigator Leidy Rambarde at Community Clinic in Takoma Park. Ramos is trying to get health coverage for herself.

By Aaron C. Davis and Mary Pat Flaherty, Published: January 11 E-mail the writers

More than a year before Maryland launched its health insurance exchange, senior state officials failed to heed warnings that no one was ultimately accountable for the $170 million project and that the state lacked a plausible plan for how it would be ready by Oct. 1.

Over the following months, as political leaders continued to proclaim that the state’s exchange would be a national model, the system went through three different project managers, the feuding between contractors hired to build the online exchange devolved into lawsuits, and key people quit, including a top information technology official because, as he would later say, the project “was a disaster waiting to happen.”


The repeated warnings culminated days before the launch, with one from contractors testing the Web site that said it was “extremely unstable” and another from an outside consultant that urged state officials not to let residents enroll in health plans because there was “no clear picture” of what would happen when the exchange would turn on.

Within moments of its launch at noon Oct. 1, the Web site crashed in a calamitous debut that was supposed to be a crowning moment for Maryland officials who had embraced President Obama’s Affordable Care Act and pledged to build a state-run exchange that would be unparalleled.

Instead, by the next morning only four people had signed up using the Web site — and amazed that anyone had gotten through the system successfully, state officials contacted each of them to make sure they were real. The site’s problems continue to prevent Marylanders from signing up for health insurance. As of Friday, 20,358 people had selected private plans, and state officials have said they do not expect to come close to their initial goal of 150,000 by the end of March.

This report is based on a Washington Post review of thousands of pages of previously undisclosed documents, including e-mails, internal reports, audits and court records, along with interviews with dozens of current and former contractors, state officials and others. The review shows that the creation of the exchange was dysfunctional from the start and that there were repeated missteps at almost every level.

On the morning of Oct. 1, shortly after Obama had proclaimed that Maryland would lead the charge in signing up residents for new health-care plans, the director of the state’s health exchange was repeatedly rejected by the network before she became the first to log on, with the help of her IT staff.

Since then, an unknown number of Marylanders have experienced the same frustration with the Web site and have been prevented from signing up for health insurance.

As the state continues to try to fix the site, Gov. Martin O’Malley (D) and state lawmakers are working to enact emergency legislation to spend millions to help insure those who could not sign up and had to begin the year with no coverage.

With many Marylanders still facing frozen computer screens and error codes when they attempt to select insurance, O’Malley is expected this coming week to decline an offer by the Obama administration to temporarily take over parts of the troubled site, despite the urging of some state Democrats to embrace the move. This past week, O’Malley acknowledged that the rollout “did not meet our expectations” but said that many things have been fixed and the state’s site is improving.

It’s a situation far different than what O’Malley predicted on a sunny morning in March 2010, less than 24 hours after Obama signed the Affordable Care Act. O’Malley called reporters to the entrance of an Anne Arundel County emergency room to announce that Maryland would begin drafting plans to “immediately begin the work to ensure our state leads the nation.”

‘There is a risk . . .’

Of the 14 states that opted to build and run their own health-insurance marketplaces, Maryland was among the earliest and most enthusiastic supporters of what became known as “Obamacare.” And it became the second state, trailing California, to enact legislation creating an exchange.

Lt. Gov. Anthony G. Brown (D), the highest-ranking elected official charged with implementing the law, was invited to speak across the country about the state’s early success. The Obama administration began depositing tens of millions of dollars in state accounts to pay for development, thinking Maryland’s exchange might be built so early that other states could copy it.

But out of public view, reports of trouble started arriving.

The first came in the fall of 2012, just over a year before the exchange was to launch. Auditors from the Portland, Maine-based firm of BerryDunn found that exchange officials were missing early deadlines to begin building the IT backbone for the public Web site, known as the Maryland Health Connection. The exchange was supposed to have signed agreements with state agencies that would allow them to link data from sources such as Medicaid and the Department of Motor Vehicles to the nascent site. But most agencies had not heard from the exchange or were unaware that the work was even overdue. The findings were summarized in a Nov. 1, 2012, letter to the president of the Maryland Senate and the speaker of the House of Delegates.

Almost $9 million in federal money was set aside to pay BerryDunn to be the watchdog for the high-profile project, with the expectation that Maryland officials would use the assessments to correct course as needed. The Post obtained copies of the confidential documents.

At the exchange’s temporary offices in north Baltimore during the fall of 2012, no one could produce for BerryDunn standard project plans showing a timeline and checklist for how the main IT contractor, from Fargo, N.D., would get the job done. The exchange’s staff, then just seven full-time state employees and borrowed ones from other agencies, “may not be sufficient to complete the work,” BerryDunn said in a PowerPoint presentation delivered to senior state officials in December. Five of the presentation’s slides began with: “There is a risk . . .”

One proved particularly prescient: Maryland might build all of the components of its health-insurance exchange and then put them together and find out they do not work, the presenters said. It was a serious risk, because the state also did not appear to be leaving itself with enough time to “complete, verify and test all system components before go-live.”

The 10 months that remained before the launch would go by quickly, the consultant warned, but corrective action could get the project back on track.

Two of O’Malley’s Cabinet members, his senior IT advisers and leaders of the exchange received copies of the confidential monthly reports, according to distribution lists. The first was also summarized in the technically worded letter to lawmakers. Aides to the legislative leaders said that the significance of the warning was not clear at the time and that they never knew the outside audits continued.

Late in 2012, the consultant’s reports focused increasingly on warnings that no one seemed to be in charge. Maryland Health Secretary Joshua Sharfstein; Human Resources Secretary Ted Dallas, the Cabinet member in charge of Medicaid; and Rebecca Pearce, the exchange leader, tried to make decisions together. It was a “three-headed-monster. . . . The next meeting could overrule the last. It was classic, you know, nothing was moving,” said one official who spoke on the condition of anonymity for fear of reprisal.

Within the exchange, Pearce, who had been lured away from a top job at Kaiser Permanente to run the system, was jostling with her own project manager for day-to-day control. Sunny Raheja was a state contractor who preceded Pearce on the exchange and would go to Sharfstein for decisions, according to documents as well as exchange officials who witnessed the dysfunction.

Ultimately, Raheja, who declined to comment, was replaced, and Pearce brought in a Medicaid IT specialist to run the technical side.

As Pearce’s new project manager began, the outside auditor said there was still no dis­cern­ible plan for building the exchange, no oversight by the state and poor communication among the contractors hired to build the online site.

“There is also no overall Master Project Plan and schedule that is being utilized to manage the milestones and activities necessary for the entire program effort,” BerryDunn warned in a Feb. 25 report.

The consultant broke the project into 11 categories and began labeling them as red, yellow or green — seven were in red, four were in yellow.

“From our perspective, agreement on a consolidated work plan will need input from all . . . so that there is a common understanding of what needs to occur between now and Oct. 1, 2013.”

In e-mails, Pearce’s new project manager said the situation appeared untenable. He resigned after a month, and the third project manager in three months took over in April — with six months to go before the site would launch.

“I think the wheels came off very early on,” said Amir Segev, who was deputy IT director for the exchange from February to May.

Segev said he left after only a few months “because it was a disaster waiting to happen.”

Contractors at odds

By May, the Obama administration was deciding which states would be allowed to proceed with building their own exchanges and which ones it would force to use the federal exchange. The team gave Maryland a deadline of June 1 to prove a core task: Its rudimentary software would have to communicate with a data hub the federal government was building to let states check whether health-care enrollees were eligible for subsidies.

The month of May became a sprint to make the deadline.

On one of the last days before the deadline, a federal team arrived at the Maryland IT contractor’s office in Linthicum, south of Baltimore, and sat in the front row of the briefing room with computers at each desk and a projection screen on the wall.

One part of the screen showed a fake enrollee’s information being sent from Maryland; the other showed the response from the federal hub. The two connected, and Maryland passed. Despite the internal turmoil and negative audits, the state seemed to finally be on the right path.

Sharfstein, the state health secretary, and Pearce called together the production team. Pearce put her foot on a chair and thanked everyone with a deep sense of relief evident in her voice.

News of the success also passed quickly to Brown and O’Malley, who began touting it in public appearances.

But as they celebrated, feuding between the two contractors in charge of doing much of the technical work to get the Web site running was getting worse.

Shortly after it had won Maryland’s initial $50 million contract, Noridian Healthcare Solutions, a company that grew out of Medicare claims processing, hired a Florida company — run by a former executive of Noridian’s parent firm — that renamed itself EngagePoint.

Noridian and EngagePoint agreed to share profits for development of the exchange, according to court documents filed by the companies — a move that state officials said they were made aware of only much later.

But within months of joining forces, the two were fighting over costs.

By July, according to court documents, infighting had brought work to a near-standstill.

Meanwhile, the software used successfully to pass the June test had to be replaced with newer and untested versions needed to meet federal security requirements.

In an interview, Sharfstein said the dispute had become a major distraction by then.

“For a while, we tried to play marriage counselor, but it was clear these were two companies that couldn’t work together well,” he said.

And another federal test was looming.

On Aug. 26, five weeks before the launch date, Maryland faced its final major test with federal overseers, a more thorough demonstration of how each part of its system would work.

This one did not go as well.

When the test got to the part of having a fictitious person choose a health plan, the Web site crashed. It also could not fully send enrollment data to insurers or e-mail Marylanders when they successfully selected a plan — something it still cannot do.

BerryDunn, the consultant, said the state must “hold Noridian to scheduled” deadlines and make 65 other changes. The state, it warned, also needed to start focusing on contingencies, knowing some parts of the site were bound to fail.

On a weekend in early September, Sharfstein logged on to measure the problems for himself. “You don’t want to know what he thought,” Pearce relayed in a message to her team, according to a testing report.

Pearce would soon send an e-mail titled “12 days out,” pleading with contractors to finish the job after she visited their Linthicum office on the evening of Sept. 18 and found it nearly empty.

“There’s a management methodology that has 4 aspects: pamper/pull/push/pummel. I think I have tried all of them at some point during this process,” she wrote at 11:24 p.m. “Tonight I am begging . . . we have got to make this reality.”

The success of the exchange was also becoming freighted with political implications as Brown launched his campaign for governor. In an early-morning e-mail on Sept. 23, Sharfstein wrote to Pearce, under a subject line “from today’s [Baltimore] Sun.”

He pasted in a line from U.S. Sen. Barbara Mikulski’s endorsement of the lieutenant governor the day before: “While we’re fighting to save Obamacare, we know that in Maryland we have a health exchange that’s ready to go because of Anthony Brown,” the Maryland Democrat said.

Pearce forwarded the e-mail to the heads of Noridian and EngagePoint, adding one line: “It’s time to get this right. Now. Period.”

Noridian chief executive Tom McGraw responded with military sparseness: “Understood.”

Testers filed their final report on Sept. 13, calling the last version of the software they could review “extremely unstable.” Internal testing of one aspect of the site found 449 defects, almost half of which would probably trouble the final release.

‘What’s wrong?’

On a conference call at the start of the final week of September, senior aides gave O’Malley a high-level summary of expected troubles with the exchange.

The Web site would not allow some people to check for subsidies or to select plans, but everyone should at least be able to log on, he was told, according to several aides.

The governor ended the call, said John Griffin, his chief of staff, saying the state should “move forward.”

But two days later, Griffin requested that a roomful of aides to the governor and Brown vote on whether to proceed. Most gave the Oct. 1 launch a green light. The next day, O’Malley smiled as Obama visited Prince George’s County and praised state leaders for being ready to roll.

Just after midnight on Oct. 1, programmers in the Linthicum office listened through a speaker phone to the anxiety growing in Pearce’s voice as she tried to log on, according to several people on the call. The site was not yet viewable publicly, but it should have allowed her to sign on. If there was one part of the site everyone agreed would work, it was this.

They waited for a second try and then a third as she reentered her name and address. Everything was correct. “What’s wrong?” she demanded.

No one was sure. Someone noticed that Pearce had left blank a box for the four-digit extension of her Zip code. Maybe the computer code required every single data field to be filled in to proceed. Try adding that, one manager said.

Pearce did not know the extension to her Zip code. They listened as she Googled it and attempted a fourth sign-on.

Click. She was in.

At 8 a.m., the exchange was supposed to launch simultaneously with other states, but it froze. The exchange posted a message online asking residents to come back in four hours.

Finally, at noon, officials watched from a command center in Baltimore as about 10,000 people logged on to the site, pinging servers in Fargo.

Screens showed blank graphs that should fill with enrollees moving through each phase of the system: creating accounts, checking for subsidies, shopping for plans, purchasing.

The stroke of noon came and went. No one logged on. No one bought health care.

The next morning was scarcely better. In the subject line of an e-mail to fellow contractors at 6:53 a.m., Noridian’s McGraw typed “Maryland is Down,” and wrote,“We cannot get through.”

More than 24 hours after the launch, there were just four people who had selected plans and eight more who appeared to have logged on.

An IT contractor wrote to state officials on Oct. 2 wondering if the four were “legitimate,” since contractors could not even access the site. She questioned if they might be fictitious accounts from prior phases of testing.

But later that day, the exchange’s chief information officer responded with good news: “The team has researched the 4 records and have determined these are for real customers. 3 applicants and 1 dependent. Applications have been processed albeit very slowly and sporadically.”

Pearce, who resigned under pressure in December, declined to comment on many aspects of the exchange’s development but said the wholesale failure on Oct. 1 “was a complete surprise to all of us.”

“We didn’t know it would be broken when we turned it on,” she said.

The day after the failed launch, Pearce sent an e-mail to the heads of Noridian and EngagePoint demanding answers.

“Gentlemen,” she wrote. “As the executives in charge of this program I would like to understand from you exactly what is happening with the project, and what you are doing to address our issues.”

But by the end of the first week of October, relations between the two companies were so strained that Pearce and Sharfstein acted as go-betweens. After more weeks of fighting, EngagePoint, the subcontractor, made a bold proposal to state officials, urging them to allow it to take over the project entirely. Days later, Noridian instead fired EngagePoint, whose programmers packed up their laptops and left, leaving some of the software in Ukraine, where EngagePoint had hired programmers.

It was now up to Noridian to fix the site — with few employees certain of where to begin. It began making offers to hire back fired EngagePoint workers it said were key to fixing the site.

EngagePoint chief executive Pradeep Goel was aghast. “We are not going to respond to ridiculous emails from Noridian demanding our team members show up for work after being escorted out of the office,” Goel wrote to McGraw and Noridian’s attorneys on Oct. 26. “Are you people on crack cocaine?”

EngagePoint persuaded a judge to sign a restraining order that blocked Noridian from hiring back workers to fix the site. Noridian countersued, and the state entered the fray, siding with Noridian for the sake of Marylanders who needed a functioning site.

Through its attorney, Daniel Graham, Noridian declined to discuss its work with EngagePoint, citing the ongoing litigation. In a statement, the company said that “the complexity of this project has led to a number of major issues beyond what was anticipated.” But the company believes that recent improvements have made the system easier to use and said it “will continue to work with the State” to improve it further.

Karen See, a spokeswoman for EngagePoint, said the firm would not discuss its work, also citing the lawsuits.

The full effect of the failed project on the two companies remains unclear. Both had expanded rapidly to build the Maryland site, expecting it could give them a foothold in the potentially lucrative health-exchange market.

Before the launch, the state had allocated about $100 million in federal money for the construction of its exchange, and, according to one estimate, it has spent tens of millions more since Oct. 1. It is unclear how much of the added costs federal officials will agree to cover. But the bigger question is how many people the state can sign up.

Maryland’s next deadline is March 31, the date by which it expected 150,000 people to have used the site to select health insurance, excluding Medicaid. Officials have said the state will not meet that goal.

“It’s a problem for the people of Maryland, a problem for the people that Obamacare was supposed to help,” said Peter Beilenson, chief executive of the Evergreen Health Co-Op, a new Maryland insurer that launched its business on a bet that it could compete with the state’s bigger insurers on a smooth-running Maryland exchange.

The company had a waiting list of more than 1,000 people who were expected to sign up with it when the exchange turned on.

For months, however, it could barely sign up one. On its best day in recent weeks, its staff helped 10 people navigate Maryland’s site. Evergreen still has more than 1,000 people waiting to buy insurance.





Jennifer Jenkins, Jenna Johnson and Amy Goldstein contributed to this report.


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Did you know that HUMANA is a private health plan that seeks to draw seniors out of the public Medicare by front-loading these plans with perks but in the longer term will undermine this strong Federal program and it is deliberate?

HUMANA AND JOHNS HOPKINS TEAM UP WITH MANAGED-CARE NETWORK



BALTIMORE, Dec. 1 /PRNewswire/ -- Humana Inc., one of the nation's largest health maintenance organizations, and Johns Hopkins, one of the premier medical centers in the country, are teaming up to form physician networks throughout the state of Maryland.

Humana members also will be able to use Johns Hopkins hospitals and facilities in the state.

"This strategic affiliation is the first of its kind for Johns Hopkins," Health System President and CEO James A. Block, M.D., said. "We are tremendously pleased to be able to work with Humana, not least because of its experience nationwide in serving a managed-care population covered by Medicare."

The affiliation is between Johns Hopkins HealthCare LLC, led by John D. Stobo, M.D., which represents The Johns Hopkins Health System and The Johns Hopkins University School of Medicine, and Human Group Health Plan, Inc. of Washington, D.C., a wholly-owned subsidiary of Humana Inc.

Humana will use primary and specialty physician networks being formed by Johns Hopkins, such as the Wilmer Eye Network and networks in cardiology and pediatrics, and work with Johns Hopkins to develop a full complement of other networks in the state.

"This relationship with a medical center that has an international reputation for quality and innovation is terrific news for Humana and its members," said Humana Senior Vice President Phil Garmon, who also noted that Johns Hopkins Hospital has been rated best in the country for five consecutive years by "U.S. News & World Report" and more faculty physicians from its school of medicine than any other have been listed in the book, "Best Doctors in America." "It should be a mutually beneficial relationship for both parties. Humana obtains access to networks of quality physicians and high caliber medical facilities in Maryland and Johns Hopkins can utilize our many years of experience in managed care to develop and expand its networks."

Michael E. Johns, M.D., dean of the School of Medicine, added that, "As Humana's enrollment grows in central Maryland, this agreement will serve to heighten access to the faculty practice at Hopkins. This is another vote of confidence from a leading managed-care organization for the way in which we are responding to the changing health-care marketplace."

Humana Inc., headquartered in Louisville, Ky., is one of the nation's largest publicly-owned HMO companies with more than 3.8 million members in 22 states and the District of Columbia. Humana offers quality and affordable coordinated care in the form of HMOs, preferred provider organizations, point-of-service organizations, along with administrative-only services. In addition, Humana is one of the nation's largest providers of "HMO-style" health care to seniors through its federally approved Medicare products. -0- 12/1/95

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Did you know that the UMMS has leveraged itself with so much credit bond and financial instrument debt that it is cutting staff and patient access to pay for unneeded expansion?  Do That the UMMS executives have received a 75% pay increase--Wall Street CEOs no less--while simply a state university administrator?  That UMMS has been allowed a status of quasi-governmental organization making it unaccountable to the public for which it works and using that status will not allow health industry staff there to unionize?  That the health reform took this public institution from handling all people coming though the door to denying certain care and access so as to make this public institution profitable?

We have a very, very bad situation with our public health institutions in MD and Balt.  Johns Hopkins which controls public policy has eliminated most public health status and with reforms are now ending what is left of public health.  Now, private non-profits/quasi-governmental status keeps the public from accessing data and oversight.  It makes our public institutions run like corporations instead of public interest institutions.  People in Baltimore fear going to the hospital these days because level and quality of care has fallen with these reforms.  If people are being denied access and labor protesting wages and work conditions, do we need this money spent on State of the Art?


New University of Maryland Shock Trauma tower opens $160 million upgrade offers more space to help speed flow of care

By Meredith Cohn, The Baltimore Sun 7:48 a.m. EST, November 8, 2013

When severely injured patients at the University of Maryland Shock Trauma Center needed rides between floors, there was only one way to fit all the life-saving staff and equipment in the cramped elevators.

"I used to crawl in bed with the patient," said Melissa Reece, nurse manager of the trauma operating rooms. "I'm glad I don't have to do that anymore."

New elevators offer more than enough room. Reece and the 673 others who work in what may be the nation's busiest trauma center can spread out a little now that a 140,000-square-foot, $160 million tower officially opened on Lombard Street. Dignitaries were slated to cut the ribbon Friday, though three-quarters of the space already is in service.

The trauma hospital, part of the University of Maryland Medical Center, opened in 1989, designed to handle 3,500 patients a year. But it has served more than 8,000 in each of the past several years. These are many of the state's worst victims of car accidents and falls, and to a lesser extent, violence.

The new and redesigned spaces accommodate the most sophisticated equipment and processes that speed the flow of care, according to those who work there. Dozens of doctors, nurses and other staff, as well as patients, contributed ideas. Planning began five years ago.

"We didn't need to be talked into this because the demand was so high," said Jeffrey A. Rivest, president and CEO of the medical center. "We definitely had our eye on the money, but we had no doubt about the need."

Trauma care has evolved into a specialty, like other areas of medicine. The Trauma Center Association of America reports there are more than 600 trauma centers embedded within the nation's nearly 6,000 hospitals. They serve some 678,000 injured patients annually and support other hospitals in their regions.

And despite advances in care, trauma is the fourth leading cause of death nationally, accounting for about 170,000 a year, and is a leading cause of disability, according to the association.

Shock Trauma has the highest designation for such a center, called a Primary Adult Resource Center, because it has availability of specialized medical staff and equipment at all times. It's the only such center in Maryland and the only center in the country that operates as a stand-alone facility.

Johns Hopkins Hospital, Hopkins Children's Center, Hopkins Bayview Medical Center, Sinai Hospital and a handful of other hospitals around the state also serve trauma patients in their emergency departments.

The injured cannot take themselves to Shock Trauma, though they can go to the UM Medical Center's emergency department. More than two-thirds of Shock Trauma's patients arrive by ambulance or helicopter from the scene, and the rest are transferred from other hospitals that don't believe they are equipped for a particular case.

The roof can now accommodate four helicopters at a time, including the president's Marine One. Because of security, the hospital can't say under what circumstance the president would be taken there, but officials are prepared.

A statewide emergency management system makes the trauma center designations and manages where patients are transported.

Dr. Richard Alcorta, state EMS medical director, said Shock Trauma's expansion benefits the entire state because the center can now accept more of the most complex patients from the field and from other emergency departments, and can even potentially train more emergency medical responders.

For example, he said, sometimes it's better for patients taken to rural hospitals to be flown to Shock Trauma for immediate surgery instead of waiting for a surgical team to arrive there. Other times, trauma doctors elsewhere may not have the proper expertise for a patient, or a doctor in another emergency department may need to call Shock Trauma for guidance.

"By expansion of their capacity, we're able to see a significant increase in referrals they can accept," Alcorta said. "We were realizing there were times when the inn was full."

As health care needs in the state continue to grow, other hospitals have also made investments, including Johns Hopkins Hospital, which opened a $1.1 billion set of towers in April 2012.

Mercy Medical Center opened its new $400 million hospital in December 2010. Others who have started or finished improvements in recent years include Saint Agnes Hospital, Harford Memorial Hospital, Johns Hopkins Bayview Medical Center, Carroll Hospital Center, Anne Arundel Medical Center, Baltimore Washington Medical Center and MedStar Franklin Square Hospital, according to the Maryland Health Care Commission.

For its expansion, Shock Trauma for the first time sought contributions from the public. It received $35 million, including $1 million gifts from the late Tom Clancy and his wife, Alexandra, Willard Hackerman, Edward St. John, George Doetsch Jr., Frank and Janet Kelly, and the University of Maryland Medical System and School of Medicine's leadership team. Another $50 million came from the state and $2 million from the federal government. The University of Maryland Medical System funded the rest with cash and debt.

Major improvements include 10 new operating rooms that allow patients to be moved more quickly from the intake area, called the Trauma Resuscitation Unit, which can handle up to 26 people at once.


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Johns Hopkins medical unit rarely finds black lung, helping coal industry defeat miners' claims Part 2 of a 3-part series, 'Breathless and Burdened: Dying from black lung, buried by law and medicine'
By Chris HambyemailBrian RossMatthew Mosk 7:00 am, October 30, 2013 Updated: 7:06 am, October 30, 2013 Retired miner Steve Day, 67, needs supplemental oxygen 24 hours a day to breathe.

F. Brian Ferguson/Center for Public Integrity

• The Center for Public Integrity reports how a prominent law firm has withheld evidence of black lung in cases over the years, helping to defeat the benefits claims of sick miners.

Wednesday: The Doctors

• The Center, in partnership with ABC News, reports on the crucial role played by doctors — including a unit at the nation’s top-ranked hospital — in helping to beat back miners’ benefits claims. Reports will appear on publicintegrity.org and abcnews.go.com, and televised segments will air on World News and Nightline.

Friday: The Next Battleground

• The Center reports on the newest battle in the long-running war between coal companies and miners, revealing the latest industry effort to defuse emerging scientific evidence and contain its liabilities.

Consulting fees in black lung cases flow directly to Johns Hopkins By Chris Hamby October 30, 2013 GLEN FORK, W.Va. — Across Laurel Creek and down a dirt road in this sleepy valley town is the modest white house where Steve Day grew up. For more than 33 years, it was where he recuperated between shifts underground, mining the rich seams of the central Appalachian coalfields and doing his part to help make Peabody Energy Corp. the nation’s most productive coal company. Now, it’s where he spends most days and nights in a recliner, inhaling oxygen from a tank, slowly suffocating to death.

More than a half-dozen doctors who have seen the X-ray and CT images of his chest agree he has the most severe form of black lung disease. Yet his claim for benefits was denied in 2011, leaving him and his family to survive on Social Security and a union pension; they sometimes turn to neighbors or relatives for loans to make it through the month.

The medical opinions primarily responsible for sinking his claim didn’t come from consultants-for-hire at a private firm or rogue doctors at a fringe organization.

They came from a respected household name: the Johns Hopkins Medical Institutions.

The Johns Hopkins University often receives attention for its medical discoveries and well-regarded school of public health, and its hospital recently was ranked the nation’s best by U.S. News and World Report.

What has remained in the shadows is the work of a small unit of radiologists who are professors at the medical school and physicians at the hospital. For 40 years, these doctors have been perhaps the most sought-after and prolific readers of chest films on behalf of coal companies seeking to defeat miners’ claims. Their fees flow directly to the university, which supports their work, an investigation by the Center for Public Integrity and ABC News has found. According to the university, none of the money goes directly to the doctors.

Their reports — seemingly ubiquitous and almost unwaveringly negative for black lung — have appeared in the cases of thousands of miners, and the doctors’ credentials, combined with the prestigious Johns Hopkins imprimatur, carry great weight. Their opinions often negate or outweigh whatever positive interpretations a miner can produce.

For the credibility that comes with these readings, which the doctors perform as part of their official duties at Johns Hopkins, coal companies are willing to pay a premium. For an X-ray reading, the university charges up to 10 times the rate miners typically pay their physicians.

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Email (required) More options ▼ Dr. Paul Wheeler, the longtime leader of a unit at Johns Hopkins that for decades has read X-rays and CT scans for coal companies defending black lung benefits claims

ABC News

Doctors have come and gone from the unit over the years, but the leader and most productive reader for decades has been Dr. Paul Wheeler, 78, a slight man with a full head of gray hair and strong opinions.

In the federal black lung system, cases often boil down to dueling medical experts, and judges rely heavily on doctors’ credentials to resolve disputes.

When it comes to interpreting the chest films that are vital in most cases, Wheeler is the coal companies’ trump card. He has undergraduate and medical degrees from Harvard University, a long history of leadership at Johns Hopkins and an array of presentations and publications to his credit. In many cases, judges have noted Johns Hopkins’ prestige and described Wheeler’s qualifications as “most impressive,” “outstanding” and “superior.” Time and again, judges have deemed him the “best qualified radiologist,” and they have reached conclusions such as, “I defer to Dr. Wheeler’s interpretation because of his superior credentials.”

Yet there is strong evidence that this deference has contributed to unjust denials of miners’ claims, the Center found as part of a yearlong investigation, "Breathless and Burdened." The Center created a database of doctors’ opinions — none previously existed — scouring thousands of judicial opinions kept by the Labor Department dating to 2000 and logging every available X-ray reading by Wheeler. The Center recorded key information about these cases, analyzed Wheeler’s reports and testimony, consulted medical literature and interviewed leading doctors. The findings are stark:

• In the more than 1,500 cases decided since 2000 in which Wheeler read at least one X-ray, he never once found the severe form of the disease, complicated coal workers’ pneumoconiosis. Other doctors looking at the same X-rays found this advanced stage of the disease in 390 of these cases.
• Since 2000, miners have lost more than 800 cases after doctors saw black lung on an X-ray but Wheeler read the film as negative. This includes 160 cases in which doctors found the complicated form of the disease. When Wheeler weighed in, miners lost nearly 70 percent of the time before administrative law judges. The Labor Department does not have statistics on miners’ win percentage in all cases at this stage for comparison purposes.
• Where other doctors saw black lung, Wheeler often saw evidence of another disease, most commonly tuberculosis or histoplasmosis — an illness caused by a fungus in bird and bat droppings. This was particularly true in cases involving the most serious form of the disease. In two-thirds of cases in which other doctors found complicated black lung, Wheeler attributed the masses in miners’ lungs to TB, the fungal infection or a similar disease.
• The criteria Wheeler applies when reading X-rays are at odds with positions taken by government research agencies, textbooks, peer-reviewed scientific literature and the opinions of many doctors who specialize in detecting the disease, including the chair of the American College of Radiology’s task force on black lung.
• Biopsies or autopsies repeatedly have proven Wheeler wrong. Though Wheeler suggests miners undergo biopsies — surgical procedures to remove a piece of the lung for examination — to prove their cases, such evidence is not required by law, is not considered necessary in most cases and can be medically risky. Still, in more than 100 cases decided since 2000 in which Wheeler offered negative readings, biopsies or autopsies provided undisputed evidence of black lung.

In an interview, Wheeler held strongly to his views. In his telling, he is more intellectually honest than other doctors because he recognizes the limitations of X-rays and provides potential alternative diagnoses, and he is adhering to a higher standard of medical care by demanding biopsies to ensure patients get proper treatment.

“I’ve always staked out the high ground,” Wheeler said.

The university defended Wheeler, saying in a statement he “is an established radiologist in good standing in his field.”

X-ray readings compared By Chris Hamby and Chris Zubak-Skees October 30, 2013 For decades, Dr. Paul Wheeler has led a unit of radiologists at Johns Hopkins who often are enlisted by the coal industry to read X-rays in black lung benefits cases. The Center for Public Integrity identified more than 1,500 cases decided since 2000 in which Wheeler was involved, reading a total of more than 3,400 X-rays. In these cases, he never found a case of complicated black lung, and he read an X-ray as positive for the earlier stages of the disease in less than 4 percent of cases. Subtracting from these the cases in which he ultimately concluded another disease was more likely, this number drops to about 2 percent.

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Consulting fees in black lung cases flow directly to Johns Hopkins

By Chris Hambyemail 7:00 am, October 30, 2013 Updated: 7:06 am, October 30, 2013
Wikimedia Commons 

Johns Hopkins medical unit rarely finds black lung, helping coal industry defeat miners' claims By Chris Hamby, Brian Ross and Matthew Mosk October 30, 2013 Johns Hopkins is not the only university where doctors frequently appear as coal-company witnesses in federal black lung benefits cases, but the Baltimore institution appears to be a special case.

Other schools require doctors to perform such consulting on their own time and limit the hours they spend doing it. There is a line, albeit a sometimes fuzzy one, between the doctor’s opinion as a consultant and as a university representative.

Experts at schools including the University of Cincinnati, Washington University in St. Louis and Case Western Reserve University submit opinions that often favor coal companies, but this consulting is not part of their work for the university.

At Johns Hopkins, no line exists. It is part of the doctors’ jobs to provide interpretations for coal companies, who are willing to pay top dollar for a report from one of these doctors.

Lawyers who represent miners said the doctors they use charge between $65 and $100 to read an X-ray. Johns Hopkins charges $100 to read an X-ray with no abnormalities; the rate rises to $750 if there are markings to be interpreted, as in the bulk of black lung cases, said Dr. Paul Wheeler, the longtime leader of the section. When the doctors testify, they charge $600 an hour, he said.

Earlier this year, Wheeler said during a deposition the fee for an X-ray with abnormalities was $500. When the Center for Public Integrity asked Hopkins which amount — $500 or $750 — was correct, university officials declined to answer.

The university said the fees from deposition testimony go to a scholarship fund while the fees from X-ray readings go to the radiology department.

University representatives refused to say how much money Hopkins receives from coal companies, but said the radiologists in its Pneumoconiosis Section review between 2,000 and 3,000 possible black lung cases a year. These doctors also read films in cases other than black lung benefits claims, and provide interpretations to companies that want to monitor the health of their workers. It is unclear whether the number of cases referenced by the university includes all of this work or only black lung cases; university representatives did not answer a request for clarification.

During a deposition in a case decided in 2009, a doctor no longer at the university testified that radiologists received bonuses for being “productive.” The physician could not be reached for comment. Wheeler said he didn’t know how his salary or bonuses were calculated.

In a statement, referencing its doctors’ status as government-certified X-ray interpreters, or “B Readers,” the university said: “There are no financial incentives associated with this program for our B-readers or the radiology department. There are no bonuses or other salary supplements paid to doctors related to the volume of examinations read, expert testimony, or other aspects of the B-reader program at Johns Hopkins.”


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Raise your hand if you see how consumers will be soaked and have no choice or control if these health systems promoted by Evergreen get off the ground..EVERYBODY.  Imagine, a automobile manufacturer, mechanics, auto insurance, and auto sales all fell under the same corporate umbrella.  How do you think consumers would fare as regards quality/access and service?  The manufacturer sells you a car reasonably priced because once you have it they will soak you with the insurance rate, repair bills, and re-sale.  THAT IS THE TECHNOLOGY MODEL OF SELLING A CELL PHONE FOR NEXT TO NOTHING AND THEN SOAKING PEOPLE FOR CONNECTION, APPS, AND DOWNLOADS.

For those not reading the Wall Street news that is the goal of these 'co-op' systems that will handle largely the middle-class because they are the one's with enough wealth to soak.  So, think Hopkins hospital with its own insurance, medical device/procedure R and D, teaching school, and control of  public health and you have the concept of EVERGREEN.  If you join them you have to buy and use everything else in the system.  This is naked capitalism and you see they are labelling it as socialism with the co-op theme.

MD citizens have already decided they are going with Universal Care.  We know health care is a right and that trillions lost to health fraud need to fund equal care for all.  Health care is not for-profit--it is life and death!


Evergreen faces challenges in delivering health insurance Small businesses may be the future of health insurance co-op in Maryland


By Meredith Cohn, The Baltimore Sun 12:04 p.m. EDT, October 29, 2013

Four weeks since it began selling health insurance on the state's new marketplace for the uninsured, Evergreen Health Cooperative Inc. has signed up only five people.

That's a long way from the nonprofit health insurance provider's first-year goal of 15,000 people, so Evergreen is already shifting focus.

Technical problems making it difficult for people to register for the state exchange culminated last week for Evergreen when its plans disappeared from the exchange offerings. The plans were restored after a short time.

Statewide, more than 3,100 people have signed up for health coverage on the exchange, according to the latest numbers released by the Maryland Health Connection. There are about 800,000 uninsured Marylanders.

Evergreen isn't waiting for the exchange to start working properly. For now, the co-op has switched focus from individuals buying its insurance on the exchange to small businesses buying plans directly from Evergreen, said Dr. Peter Beilenson, the former city health commissioner who started it. (The state's small-business exchange has been delayed until Jan. 1.)

"We obviously were predicating most of our business on the exchange market, which is not bearing fruit right now," Beilenson said. "That was a problem for us in two ways: financially in terms of generating enough members and for our mission. We did this for the middle class who would qualify for subsidies."

But the co-op was new and nimble enough to switch "almost overnight to small businesses," he said. "We think it will provide us with enough members to get through until the exchange is running smoothly."

Evergreen's small group rates were approved Oct. 25, so no group has enrolled yet, but the prices are below average and attracting attention from businesses and brokers, Beilenson said. The co-op will depend on enrollment to survive — members' premiums will pay to run the co-op and cover startup costs. Any profits would be returned to the plans.

The co-op's small-group rates are at the lower end of the spectrum, with an average premium of about $368 per insured, according to data from the Maryland Insurance Administration.

The lower rates may reflect Evergreen's model. The co-op employs its own doctors, who work in one of four centers for a salary rather than fee-for-service. The idea is to focus on prevention while managing multiple chronic conditions and staving off costly emergency visits and hospital stays.

Evergreen also offers a traditional plan using a network of doctors.

It's cost that matters most to small businesses, and a competitive premium will serve Evergreen well, said Karen Davis, a professor in the Johns Hopkins University's department of health policy and management. There is a "fair amount of evidence" that shows Evergreen's patient-centered model cuts costs, she said.

But insurance tends to be dominated by large insurance companies, so it remains unclear whether Evergreen and co-ops in other states can slice off enough business.

"The major challenge is size and scale," Davis said. "But the advantage Evergreen has is that its model of care is more effective. … I think they're in a better position than most of the co-ops."

Nationwide, 24 co-ops received federal funding as part of the Affordable Care Act. Evergreen got $65 million in federal loans, but all but about $13 million will go to a required reserve fund

Others wanted to start co-ops in Maryland, seeing the potential to compete with traditional insurance companies and bring down prices. One was MedChi, the state medical society, which planned to start a co-op largely on the Eastern Shore but was stymied when Congress cut startup funding.

"We're very supportive of the idea of co-ops and think they can work really well," said Gene Ransom, MedChi's CEO. "I don't think they have an easy task ahead. We are rooting for Evergreen because more competition is good for the marketplace."

Beilenson said Evergreen has made other adjustments to survive. It has hired some staff from the insurance industry to serve as a balance with those employees who know more about public health. It has raised $5 million in startup money from private foundations and another $1 million from other private sources for marketing, including a new TV ad (federal law prohibits explicit marketing with government money).

"I think we're well-positioned," Beilenson said. "We think we know what we're doing. And we think we have a really good product.

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Do you know that Johns Hopkins is partnered with MedStar Washington DC?  Do you know that Maryland deliberately has policy that keeps Medicare from auditing in the state?  Do you know that entitlements are fleeced of 1/2 of total spending in fraud?

Billions are lost to Medicare and Medicaid in Maryland every year because there is absolutely no oversight!

OIG: MedStar Washington Hospital Center Overbilled Medicare $1.06M

Written by Bob Herman (Twitter | Google+)  | October 29, 2013

  MedStar Washington Hospital Center in Washington, D.C., will have to repay more than $1.06 million in Medicare reimbursements to the government after an audit from the HHS Office of Inspector General found incorrectly billed inpatient and outpatient claims.

The OIG looked at 313 claims the hospital billed during 2010 and 2011. The 926-bed MedStar Washington Hospital Center, a teaching hospital, was found to have complied with Medicare billing requirements on only 44 percent of the claims.

Errors cited in report included billing Medicare for inpatient services when they should have been billed as outpatient or observation — one of the most common errors in OIG audits — as well as incorrect diagnosis-related group codes, excessive billed units of outpatient services and noncovered dental services, among other errors.

Officials at MedStar Washington Hospital Center agreed with most of the OIG's findings and recommendations, but they disagreed with some of the agency's review of the hospital's outpatient billing. The OIG stood by its report and maintained that all "findings and recommendations are valid."



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First. we have to make clear that health care reform is all about consolidating health records so that health data can be sold to data-miners for profit.  That is what the Maryland private health insurance/co-ops plan to use as an income vector.  We already see where the state of Washington is selling its citizen's health data for revenue and we know that if Maryland had a free press we would hear the same thing is happening or is set to happen here.

When we heard that the Affordable Care Act website was being built by a global US corporation linked with Bush, when we know that all of MD senior care businesses are now owned by hedge funds again connected to Bush...Carlyle Group..and we know that Hopkins has a super-computer on campus to launder all that data throught its computers....we know that all data generated by MD citizens will be used to data mine for profit.  YOU DON'T NEED TO BE A ROCKET SCIENTIST TO SEE THAT.

We have a crises in quality of health care and accountability in MD over these few decades and it will get worse if this Hopkins-medical business reform is left to run its course.  The costs of health care is driven by health fraud by the health industry and profiteering by the same people left to write the policies for health reform in MD.  How do you address recovering fraud and lowering profit if the same people doing the crime are working on our dime?


Hundreds of hospice patient records potentially breached


By Carrie Wells, The Baltimore Sun 7:30 p.m. EDT, October 20, 2013

Hundreds of patient records at a Pasadena-based hospice-care nonprofit were potentially compromised in a security breach, the center said.

An employee at Hospice of the Chesapeake, which serves about 370 terminally ill patients daily in Anne Arundel and Prince George's counties, is believed to have emailed spreadsheets containing patient medical data to a personal email account to complete work from home, said Sandie Anderson, a Hospice for the Chesapeake spokeswoman.

Someone else may have accessed the email account with the patient data, which included names, ages, dates of service and diagnoses, according to the nonprofit. The data did not include Social Security numbers, dates of birth or financial account information.
More than 500 patient records were potentially compromised, and the results of the hospice center's internal investigation have been turned over to Anne Arundel County police, Anderson said. The center provides mostly in-home care.

Hospice of the Chesapeake said it has reviewed its policies to ensure such a situation does not happen again, and has notified those involved. The center became aware of the potential breach in August.

Anderson declined to say whether the employee involved was disciplined, citing a policy of not discussing personnel matters.




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Why is a state so blue so desperate to avoid public hospitals?  MD is not blue....it is corporate and having private and non-profit hospitals rather than public keeps the public from oversight and enforcement as well as accessing data.  We watch as public money goes to private Johns Hopkins for dispersal for instance.  What you get are health institutions built by Hopkins that are basically extensions of this private institution.  Hopkins has built itself into a global presence with taxpayer money and controls Baltimore because of its ability to control the money coming in for services.  Hopkins made itself the public sector.

This is why MD went with private health systems and not public/Universal Care.  As people are beginning to see, the Affordable Care Act will greatly reduce people's access to ordinary hospital care and it is all done to maximize health industry profits.  What we want is Universal Care or expanded and enhanced Medicare for All so that everyone will have the same health care access.  Health costs are driven by health fraud and profiteering, not patient's use of health care.  In MD we lose billions of dollars each year to health fraud and these private non-profits are ground zero for this.  Now, we have national health chains coming for the poor and elderly already rife with fraud.

We do not want releases from Medicare rules..we want Medicare to rule!


State releases new plan on Medicare waiver


By Andrea K. Walker, The Baltimore Sun 12:12 p.m. EDT, September 27, 2013

The way hospitals do business would get a complete overhaul under a plan proposed by state health officials that they hope to test for five years.

The plan released by the Maryland Department of Health and Mental Hygiene Friday would tie hospital spending to the state economy and virtually eliminate a payment model based mostly on how many patients the medical facilities treat.

The proposal is part of an application that must be approved by the federal Centers for Medicare and Medicaid Services to update the state's Medicare waiver, an agreement with the federal government unique to Maryland that allows the state to set hospital rates.

The proposal is updated from one that state officials first presented in February that brought criticism from hospitals and insurance companies that complained it lacked details.

The state then formed a committee that included hospitals and insurers to provide their input. The trade association that represents the hospitals supports the revised proposal.

"The goals will be very challenging for hospitals as the ideas included have never been tried nor tested before on this scale," said Carmela Coyle, President and CEO of the Maryland Hospital Association. "Hospitals will have to find ways to provide care at a lower cost than today."  PROFITS NOT PEOPLE FOR SURE!

The new proposal includes more specifics, including the exact amount of spending increases hospitals would be allowed.

The 36-year-old waiver creates a system in which insurers pay the same cost to all hospitals for procedures, and funds uncompensated care so there is no need for public hospitals. But the state has had a hard time meeting waiver test that requires it to show Medicare costs grow more slowly than the rest of the country.

State health officials said its plan would result in the state's Medicare costs growing $330 million less than that of the rest of the country in five years.

But they acknowledge the plan is innovative and they want to put a date limit on it to see if it works. If the plan does not seem to be working, the state will move to the same Medicare model as the rest of the country, according to the proposal.

Rather than basing rates on Medicare cost per admission, the new plan is population-based. It would cap hospital spending to 3.58 percent in the first three years — the year-over-year growth rate over the last decade.

The plan calls for reducing costs by working on reducing admissions and implementing programs that focus more on preventive care, such as the use of accountable care organizations, where groups of doctors, hospitals, and other health care providers coordinate the care of patients.

The state says the waiver test is based on an old health care model that focuses on inpatient hospital stays. Health care is moving toward a model of keeping patients out of the hospital by providing sufficient preventive and outpatient care.

The plan still must be approved by the Centers for Medicare and Medicaid Services. The state is also taking public comments on the proposal through Oct. 7.



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This article is written by the Heritage Foundation.....a conservative think tank.  You see that it does highlight the fact that the underserved are rarely served by Enterprise Zones....but more importantly it pushes for ever more deregulation....if you are going to make health care into global corporations you need to shed the regulations and oversight.  Maryland is tops in doing just that!

Lowering code standards to build clinics in blighted buildings while ending access for the poor to hospitals that will more and more require private health insurance.  Medicare and Medicaid are having separate compounds built to take the public health plans out of what will be private, profit-driven systems.

Maryland's Health Enterprise Zones Need The Right Incentives And Rules

By Stuart Butler Kaiser Health

Feb 23, 2012

As an architect of the urban "enterprise zone" idea more than 30 years ago, a recent proposal in Maryland to set up Health Enterprise Zones (HEZ) understandably caught my eye. The original enterprise zone was designed to spur economic activity in depressed neighborhoods through reduced local taxes and regulation, together with federal and state tax incentives to encourage investment. The aim was to grow innovation and reduce obstacles to both local and outside entrepreneurs. Several states have created these zones, and a federal version was enacted under President Bill Clinton.

Butler

The Maryland HEZ proposal is similar in its approach. The bill -- which was unveiled by state Lt. Gov. Anthony Brown and based on recommendations from an expert panel -- works to expand health services in the state's underserved areas. If enacted, available properties would become inexpensive, and medical providers would receive property and income tax breaks to set up shop in these zones. Plus, the health zones could receive additional, targeted funding. And, dovetailing with the health enterprise zones, the state would create a Maryland Health Innovation Prize.

I'm struck by the similarities in the strategies these two forms of enterprise zones enlist, which is why Maryland's HEZ is an important initiative. By definition, depressed or underserved areas lack adequate resources for their population. And medical providers -- who are often burdened with high student loans and their own needs -- are reluctant to practice there. But the right tax incentives, along with easier access to inexpensive medical facilities and lower start-up costs, can make the venture more worthwhile for providers. The early enterprise zones focused on the zoning, building codes and the removal of tax liens on available property for the same reason: to encourage new ventures and business investments.

Steering contracts, such as for electronic medical records, as well as new money for the HEZ program into these medically underserved areas is probably needed. But the experience in urban economic development -- from the Model Cities program of the 1960s to today's generous corporate infrastructure and other city-offered benefits -- suggests some caution. When local or state governments are distributing funds, the type of development often ends up benefiting well-connected interests rather than addressing the needs of local residents in the most effective ways. Indeed, enterprise zones, with their emphasis on deregulation and tax reductions rather than direct funding, were in many ways the mirror image of the heavily funded Model Cities projects, which often resulted in expensive buildings but little impact on local poverty.

To avoid this pitfall, the health enterprise zones should keep a strong focus on how to reduce expensive barriers to the availability and creative use of private health resources. To be successful, Maryland's program should include steps to pare back regulations. For instance, it would make sense to suspend the Certificate of Need requirements in a health enterprise zone, or at least simplify them. These certificates are required before medical facilities can be built or acquired in states like Maryland, and obtaining these certificates can be a long and costly process.

Similarly, there must be a focus on zoning and other land-use rules, such as regulations affecting public housing. Often, incorporating health services in depressed and underserved areas requires the ability to transform vacant public housing units into walk-in clinics. Land-use red tape typically slows down the process.

An effective health enterprise zone also would need to modify state rules for government health programs like Medicaid, so that health providers are rewarded for innovative services. For example, Denver Health in Colorado operates a highly effective nurse-run, 24-hour call center for families that can address their needs quickly and send prescriptions to close-by pharmacies. This has reduced emergency room costs and handled residents' health concerns quickly in areas that do not have any nearby medical facilities. But Medicaid's payment rules usually do not reward such initiatives.

Maryland's health enterprise zone program should consider establishing a zoning board of medical and local neighborhood leaders who can continuously identify regulations and program rules that get in the way of providing services quickly and creatively in poor and underserved neighborhoods. The state also should agree, in advance, to streamline the process by which such regulations could be changed or eliminated. My experience from urban enterprise zones suggests that there will be no shortage of recommendations.




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Raise your hands if you think that aiming cuts to Medicare(M) towards hospitals not at M benefits is a back door cut to benefits!  That's right.  The cuts to M spending will be felt by the quality of services rendered and by staff who will see increased workload and/or cuts to pay and benefit.  Why do health insurers like that?

The bulk of health care costs come from health fraud/waste.  Entitlement spending is almost 1/2 fraud.  Fraud/waste often comes from preventative medicine..multiple uses of testing such as blood labs and Xrays for example.  Fraud/waste happens in more complicated hospital procedures but it is more rare.  Using heart stents or orthopedic surgery are two areas of fraud we know.  What we see with health reform is a push to these very preventative health areas with the most fraud/waste.  Doctors keep fraud. Insurers keep profit.


Policies placing the burden of cuts to the hospital cut access to the costly hospital procedures and give the patient's staff the burden of poor working conditions, a lose lose for the patient.  Why would insurance companies like this?  They don't pay for hospital labor so won't feel that and the cost of multiple lab tests are cheaper than serious hospital procedures requiring hospital stays.  M patients will see is less access to quality of life procedures and more blood checks for high levels of salt, sugar, and fat. Longevity falls.


Rate-setting commission recommends no increase in hospital charges Hospitals hoped increased rates would offset sequestration cuts


By Andrea K. Walker, The Baltimore Sun 9:49 p.m. EDT, April 25, 2013

The state's hospitals would absorb all of the 2 percent Medicare cuts required by federal sequestration under a proposal released Thursday by the state panel that sets hospital rates.

The recommendation by the staff of the Health Services Cost Review Commission would mean that state hospitals would not get rate increases for the last three months of fiscal year 2013, a decision that prompted intense criticism from medical institutions that say they already operate on slim margins.

Hospitals sought a rate increase to help offset the cost of the federal budget cuts and said they will have to cut services and jobs without one.

"Our view is now is not the time to impose yet another cut on Maryland hospitals," said Carmela Coyle, president and CEO of the Maryland Hospital Association. "We are too financially fragile."

Insurers, however, supported the plan recommended by the commission staff.

The commission is scheduled to vote on the proposal Wednesday. Collectively, hospitals would lose about $7 million to $8 million a month under the proposal for April, May and June, the commission said.

The Medicare cuts are part of $85 billion in across-the-board federal spending reductions known as sequestration. The U.S. Department of Health and Human Services plans to cut $15.5 billion under the plan, with much of it coming from Medicare.

Medicare patients will not face reductions in benefits under sequestration. Instead, the federal government specifies cuts should be made to payments to hospitals and doctors and to monthly payments made to private plans that administer parts of Medicare.

The cost review commission staff, which developed the recommendation not to increase rates, declined to comment, saying its views were clear in the recommendations posted on its website.

Maintaining hospital rates was one of three options considered by the commission staff. The option supported by hospitals would have treated revenue lost from sequestration as a one-time "unusual expense," and rates would have risen to compensate. Hospital rates would have increased 0.16 percent for the last quarter of the fiscal year, which runs through June.

Another plan would have split the sequestration impact between insurers and hospitals. Half of the sequestered revenue would have been treated as a one-time expense and hospitals would have gotten a 0.08 percent increase in rates until the end of the fiscal year.

The state's largest insurer had no comment on the staff's final recommendation Thursday, but had supported not increasing rates for hospitals.

Increasing hospital rates would have "diluted" the intent of sequestration, which was to reduce federal expenditures nationally by 2 percent, wrote a CareFirst BlueCross BlueShield executive in a March letter to the rate-setting commission.

CareFirst and the rate-setting commission staff said they also worried how raising rates would affect the state's Medicare waiver, an agreement with the federal government unique to Maryland that allows the state to set hospital rates.

The state must pass a test to maintain the waiver. Maryland keeps the waiver if the average cost per admission rises no faster than in other states. The state is in the process of negotiating a new waiver test with the federal government.

Rate increases would "erode the state's position on the current waiver test and disadvantage Maryland under any new waiver test," CareFirst said in its letter.

The hospital association, which represents 46 acute-care hospitals in the state, has tried to sway the commission to make up for the cuts with higher rates. The group issued a report Thursday detailing financial troubles it says the state's hospitals are facing.

As a group, the hospitals' operating margin was 0.8 percent for the first eight months of fiscal year 2013, the second-lowest performance in 14 years, the report said. Twenty-five of Maryland's 60 hospitals — 42 percent —have negative operating margins, according to the report. In other words, they were losing money caring for patients.

The rate-setting commission increased rates by 0.3 percent last year, when inflation was expected to increase by 2.11 percent, the report said.

In its recommendation, the commission staff said hospitals are more profitable as a group this year than they were last year despite the reduced operating margin.

The rate-setting commission will begin discussing fiscal 2014 rates in coming weeks and said it will look at the impact of sequestration then.

Hospitals will have to make cuts immediately once a decision is made. Coyle said the cuts will likely have to come from services and jobs.

"There is no ability for hospitals to say 'OK, we're just not going to purchase this new piece of equipment next year,'" Coyle said.

The commission staff's recommendation isn't final and will be further debated at Wednesday's meeting. Coyle hopes some commissioners will have a change of heart. She said the federal law enabling the waiver requires the rate-setting commission to ensure hospitals are financially sound.

"I feel strongly there is still a chance, and I hope the commissioners will take a good hard look at the financial condition of hospitals and really think about rejecting the staff's recommendations," she said.


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FOR THOSE PEOPLE STILL THINKING THAT THESE THIRD WAY CORPORATE DEMOCRATS ARE GOING TO DO ANYTHING FOR THE PUBLIC.....THIS STATE OF MASSACHUSETTS....HOME OF HARVARD...IS NOW TAKING THOSE UNFUNDED PENSIONS AND ENDING THEM ONCE AND FOR ALL, PLACING ALL CITIZENS ON WHAT WILL BE A PUBLIC SERVICE-STYLE HEALTH COVERAGE.....THE RICH DON'T WANT TO BE EXPOSED TO TB YOU KNOW!

Massachusetts governor seeks to revamp retiree health care By Hilary Russ, Reuters
Jan. 11, 2013 1:30PM PST

Massachusetts Governor Deval Patrick addresses the first session of the Democratic National Convention in Charlotte, North Carolina September 4, 2012. REUTERS/Eric Thayer Related Articles

(Reuters) - Massachusetts Governor Deval Patrick said on Friday that he will file legislation to overhaul benefits for public retirees, including a proposal to double the number of years an employee would have to serve to be eligible.

The bill would require most current employees of the state and its cities, towns and school districts to work for 20 years instead of 10 years to become eligible for health benefits when they retire.

Retirees would also have to pay a higher percentage of their health insurance premiums, leaving the employer responsible for a smaller share.

The changes, which would not apply to current retirees or to employees who are within five years of retiring, would also raise the minimum age of eligibility to 60 from the current 55.

States' public pension systems are facing large unfunded liabilities that have led to reforms in most states. But massive gaps in public funds to pay for post-employment benefits have received less attention - until now.

On average, states have set aside only about 5 percent of what is estimated to be their retiree health care and other non-pension benefits such as life insurance. At the end of 2010 that left a $627 billion gap, according to a report by the Pew Center on the States.

In response, a growing number of states and cities have begun eliminating or reducing health coverage for retirees.

The proposed Massachusetts legislation could save the state and its local governments up to $20 billion over the next 30 years, Patrick said in a statement.

The commonwealth is scheduled to sell $230.5 million next week and an additional $1.2 billion over the next few months, according to a statement from Massachusetts Treasurer Steven Grossman.

"We think this nation-leading reform work will be reflected in lower interest costs for Massachusetts taxpayers," Grossman said.

The $230.5 million sale of general obligation refunding SIFMA index bonds was postponed from December.



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I AM LOOKING AT WHAT BUSINESSES ARE ASSOCIATED WITH THESE.  IN BALTIMORE WE HAVE THE HEDGE FUND CARLYLE GROUP OWNING ALL OF THE MEDICARE FACILITIES WHICH IS A BAD THING....
Federal government announces 5 new ACOs in Maryland

By Andrea K. Walker 5:10 p.m. EST, January 10, 2013  Baltimore Sun

The federal government announced the creation of 106 new accountable care organziations, including five in Maryland, that will provide coordinated care to Medicare patients.

Accountable Care Organizations are groups of doctors, hospitals, clinics and other health care providers created under health reform that work together to care for patients.

The hope is that the coordinated care will help reduce medical errors and result in cost savings by  keeping people healthier.

More than 250 accountable care organizations have been created around the country since passage of health reform.

The new groups created in Maryland are  the AAMC Collaborative Care Network; Lower Shore ACO, LLC;  Maryland Collaborative Care, LLC; Northern Maryland Collaborative Care, LLCS; and the Southern Maryland Collaborative Care, LLC
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The important message about Future Care is that it is a national hospital chain that operates with a for-profit mission and as such places profits over people as regards the level and quality of care and how it works with labor.  I have heard on many occasions people saying you really need to visit your loved one in a Future Care geriatric nursing facility......oddly it has a grand banner that says 'Best place to Work'.  Here is discussion centered on concern for health care as a non-profit vs profit entity:


'In one session participants also noted that in previous times local health care leadership was provided by the heads of large, community-based businesses, who would identify important local needs in health care or education, formulate solutions and find the resources needed to get it done. But many of these businesses have subsequently become global enterprises intensely focused on short-term shareholder value. Their CEOs now come from outside the community, generally stay only a few years and often fail to provide leadership on community needs. Participants agreed that if we are going to be successful in addressing today’s pressing local, state and national issues in health care, the leaders of local health care systems will have to step up to the challenge of filling this critical leadership vacuum'.

The bottom line is that people want health care out of the profit realm.


FutureCare wants to give employees a boost up the corporate ladder This top workplace is known for giving workers opportunities to advance and even change careers


FutureCare senior vice president Jeffery Attman and CEO and President Gary Attman (right) at the company's Canton Harbor facility. (Doug Kapustin, Special to The Baltimore Sun / November 19, 2012)

By Steve Kilar, The Baltimore Sun 1:24 p.m. EST, November 19, 2012

A dozen years ago, Demetri Gambrill began working after school at FutureCare Health and Management as an activities assistant. The 28-year-old is now a geriatric nursing assistant, thanks to education that the company sponsored.

"They sent me to school to become a nursing assistant. I didn't have to pay for anything — not books, not tests, not tuition," Gambrill said. All he had to do was write a letter showing interest in the program and commit to working for FutureCare for at least a year after completing the training, he said.

For the second year in a row, FutureCare — a private company founded in 1986 and based in Pasadena — placed first on The Baltimore Sun's Top Workplaces list among large companies in the Baltimore region. Members of FutureCare's staff said that part of the company's continued success in the WorkplaceDynamics survey is because of internal opportunities for advancement. The potential for upward mobility, experts agree, plays a role in keeping employees satisfied.

After nearly a decade as a nursing assistant, Gambrill said he's ready to once again try something new. Since August, he has been training in the medical records division of FutureCare's Sandtown facility.

"I wouldn't mind trying that next" as a full-time job, he said. Though Gambrill admits working in records full time would have at least one shortcoming: "I couldn't go without having interaction with my residents," he said. "Even when I go on vacation, I call and check on them."

Stories of advancement are common among FutureCare's roughly 2,500 employees. The company prides itself on the opportunities for growth at its 12 Baltimore-area skilled nursing centers.

"You may be a great aide, but you may think you would also be a great RN," said Gary L. Attman, FutureCare's president and CEO. "We want you to accomplish your dreams. I think people who work for us know that."

It's not uncommon for staff working at the lowest levels, including housekeepers, to be offered a spot in one of FutureCare's many in-house training programs, said Holly O'Shea, the company's corporate counsel and vice president of human relations.

The company has a dedicated training center at its Irvington facility, where staff members can go for advancement classes including wound care and intravenous venipuncture certifications, she said.

Educational opportunities are not limited to offerings within the company. FutureCare also provides for up to $2,500 a year in tuition reimbursement as long the employee's ability to serve the company is furthered by the course or degree, O'Shea said.

Offering training and tuition reimbursement is smart business, said Susie Coddington, a professor at Johns Hopkins Carey Business School in Baltimore.

"It costs more to get a new employee than keep a good one," Coddington said. Plus, morale is likely to be lower among employees who feel they are in dead-end jobs, she said.

"Where there's potential, they're always willing to give the opportunity, and that in turn leads to quality care being given," said Christie Waterman, 39, the director of nursing at the company's Canton facility.

She started out in 2007 as an evening shift supervisor and was promoted after completing a family nurse practitioner program while working, she said. FutureCare was "really flexible with my schedule" while taking outside classes, she said.

Offering training opportunities and promoting from within motivates employees in two significant ways, said Gilad Chen, a professor of organizational behavior at the University of Maryland's Robert H. Smith School of Business.

First, it "sends a signal that the company cares about treating [current employees] fairly," Chen said. Second, learning and advancement opportunities give employees hope that they could have a long future with the company, he said.

Among the drawbacks of relying too much on internal advancement is the potential for a lack of diversity of new ideas among employees, Chen said. There is also the problem of creating competition among employees, he said.

But overall, Chen said, those who study workplaces "see that companies that promote from within have more motivated workforces."

O'Shea, 40, finished her undergraduate degree and went to law school while working at FutureCare, she said, and believes FutureCare benefits when its employees advance within the company. "Inclination meets opportunity is FutureCare. If you're willing to put forth the effort, FutureCare will meet you," she said.

"We can always move up in FutureCare," agreed Mabel Pilgrim, 56, who was a certified nursing assistant and is now the director of payroll. She's held at least a half-dozen different positions during her years with the company, she said. Each of those positions endowed her with new skills, she added.

"There's nothing that I can't do or nothing that I won't do," Pilgrim said. "That's the bottom line of our job descriptions: And anything else. Residents are the bottom line."

Although most of Brad Segree's time is spent supervising physical therapists at several FutureCare facilities, there are times when he's needed to jump in and actually treat patients, said the 43-year-old Segree, a regional manager of rehabilitation services.

"There's nothing like seeing a patient you've worked with begin to feel better," he said.

Segree started as a physical therapist at FutureCare's NorthPoint facility 11 years ago and believes he could retire from the company: "I'm still learning a lot. I hope to continue to grow."

Copyright © 2012, The Baltimore Sun


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89 Md. facilities bought drugs from firm linked to meningitis outbreak More sterility problems found at New England Compounding Center

By Andrea K. Walker, The Baltimore Sun 8:36 p.m. EDT, October 24, 2012

The federal Food and Drug Administration identified 89 medical facilities in Maryland that bought drugs from the Massachusetts manufacturer being investigated for a national fungal meningitis outbreak.

The facilities are among more than 3,000 in numerous states that the FDA said received drugs from the New England Compounding Center as evidence of widespread sanitary issues at the company continues to come to light.

The list of facilities in Maryland covers a large swath of the medical community. It includes hospitals such as the University of Maryland Medical Center, Greater Baltimore Medical Center and Northwest Hospital, as well as doctors' offices, clinics and rehab facilities.

The medical facilities on the new list bought drugs other than preservative-free methylprednisolone acetate, an injectable steroid used most often to ease back pain. That drug has been linked to the outbreak. Federal regulators previously identified only those facilities, including seven in Maryland, that bought that steroid, but want the medical community and the public to be aware of other potential risks.

"The New England Compounding Center had lapses in sterility and so the FDA wants clinicians and patients and the public to be aware that there is an increased risk, given their findings," said Dr. Lucy Wilson, a medical epidemiologist at the Maryland Department of Health and Mental Hygiene's infectious disease bureau.

So far, Wilson added, the outbreak has been linked to just three lots of the steroid drug.

"Be vigilant, be aware, but the real risk is the link to those three lots," Wilson said.

Earlier this month, the FDA recommended that medical facilities contact patients who received any injectable drugs that were shipped from New England Compounding on or after May 21. Before that, as the outbreak spread, regulators asked medical facilities to get rid of any drugs they got from New England Compounding even if those drugs have not been implicated in the meningitis outbreak.

Fungal meningitis cases continue to grow, sickening 317 people and killing 24 in 17 states. In Maryland 17 people have been sickened and 1 has died.

Several Maryland hospitals contacted Wednesday said they have stopped using drugs from New England Compounding.

"As soon as the FDA alert came out about NECC in general we took everything off the shelf that we had from them," said Lisa Polinsky, director of pharmacy for LifeBridge Health in Baltimore. LifeBridge's Northwest Hospital and Sinai Hospital of Maryland bought drugs from the company.

The hospitals purchased a topical cream and an injectable medication used in neurology cases. Because of privacy concerns Polinsky would not say if patients had received any of the medications, but said that the hospitals were following FDA guidelines on contacting patients.

Katzen Eye Group purchased single doses of the drug Avastin, which is used to treat wet age-related macular degeneration and diabetic macular edema. While there was no link to contamination, the group said it is closely following patients who received the drug.

"We immediately notified all patients who were treated with Avastin and will continue to follow-up with them to ensure their continued safety and well-being," said Dr. Richard Edlow, Katzen's CEO.

The University of Maryland Medical Center said it destroyed any drugs from New England Compounding earlier this month. It did not purchase any injectables from the company, so it was not contacting patients, said a spokeswoman, Karen Lancaster.

Baltimore Washington Medical Center, owned by the University of Maryland Medical System, destroyed any drugs from the company on Oct. 8 and also did not buy an injectables, she said.

The outbreak has prompted calls for stronger regulation of compounding pharmacies, which are monitored and licensed by state boards, unlike drug manufacturers, which are under the FDA's jurisdiction.

Critics say that as the compounding pharmacy industry evolved from mom-and-pop businesses into large facilities that act more like drug manufacturers, it has opened the door for more contamination. Demand for compounding has increased because of drug shortages.

Greater Baltimore Medical Center in Towson said it does not use compounding pharmacies regularly but has turned to them more as drugs grow harder to find.

"We try not to send things out to a compound pharmacy, but with the drug shortage and patients who need medication, we are sometimes left in a lurch," said Charles Haile, GBMC's chief of infectious disease and chairman of the pharmacy committee. "The FDA is not doing enough to nip this issue in the bud and allow for a better supply chain,"


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WHAT WE ARE SEEING IS A HANDOVER OF ALL THINGS MARYLAND TO MEGA-CORPORATIONS.  BELOW YOU SEE BALTIMORE IS COMPLETELY RUN BY MANOR CARE OWNED BY THE CARLISLE GROUP.  IS THAT WHO YOU WANT RUNNING YOUR LOCAL CARE FOR SENIORS?
Other Senior Care providers near: Baltimore, MD
Assisted Living Home Care Nursing Home Dementia Care

ManorCare Health Services - Rossville

Quail Run Assisted Living Yes

ManorCare Health Services - Roland Park

ManorCare Health Services - Towson

ManorCare Health Services - Ruxton

ManorCare Health Services - Ruxton

ManorCare Health Services - Woodbridge Valley

Springhouse of Pikesville Yes


THIS IS WHO MANOR CARE IS:  THE CARLISLE GROUP AND THEY JUST WENT PRIVATE IN 2008.  THAT MEANS WE CAN'T SEE WHAT THEY ARE DOING.  CARLISLE GROUP IS THE LARGEST HEDGE FUND IN THE WORLD.

Stock/Bond Holders On December 21, 2007, Manor Care, Inc. completed its transaction with The Carlyle Group to take the company private. Shares of Manor Care stock ceased trading on the New York Stock Exchange at the closing of the stock market on December 21.  Shareholders who hold stock certificates should have received instructions from Manor Care’s stock transfer agent, National City Bank, on how to surrender their shares in exchange for $67 cash per share.  If you were a Manor Care stockholder and need information on surrendering your shares of Manor Care stock or have any questions related to your share ownership, please contact:

National City Bank Shareholder Services Operations

Dept. 5352 


3rd Floor - North Annex


4100 W. 150th Street


Cleveland, Ohio 44135


Phone: (800) 622-6757

Mailing Address:  


National City Bank Shareholder Services Operations

P.O. Box 94720

Cleveland, Ohio 44101-4720

To read the press release announcing the closing of the transaction with The Carlyle Group, please click on this link. News Release: Carlyle Closing






THIS WAS FROM LAST YEAR'S CITY BUDGET:

Last week $621,960 in state funds was approved to hire eight registered nurses and Dynamic Medical Support Services to monitor residents eligible for the Maryland Medical Assistance Program. This week the city Health Department seeks permission to spend $180,900 in state funds to hire three more RNs, plus $504,000 to hire four more private agencies – Karib Services, Inc., Trulife Health Services, Welltrust Co. and Milda Primrose Lewis, Inc. as case monitors. The monitors will visit the homes of medical assistance clients at least every 90 days, according to the agreement.

Trulife Health Services LLC in Columbia, MD is a private company categorized under Services (Unclassified). Our records show it was established in 2008 and incorporated in Maryland.


  Karib Services is headed by VP for Norbrook Medical Equipment
& Supplies.......he is a lawyer from Austin, Texas.

Norbrook Medical has been serving the home medical needs of Maryland residents since 2008. As one of the area’s leaders in sleep apnea machines and supplies, oxygen accessories, incontinence supplies, wheelchairs and scooters, we have the home medical equipment you need “for this time of your life” and the knowledge to get you the best products and services.

Norbrook Medical Equipment and Supplies Inc. is accredited by ACHC - Accreditation Commission for Health Care Inc. We are members of the local Chamber of Commerce, MNHCA and the VGM Group national network of homecare providers.



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Baltimore is a city with a high number of rowhouses having lead paint problems.  We need the health department tracking these children because trying to determine 'least exposed' in an underserved community where moving from house to house is quite frequent and visits to a doctor may be infrequent will create the liklihood of failed tracking.

More important to Baltimore's families is that the Maryland legislature with Maggie McIntosh at the lead reacted to this Federal mandate by passing laws that protect landlords against lead paint lawsuits by precisely defined guidelines for reporting exposure to lead paint (if only we could get this same legislature to define fraud that well).  This was done so as to keep landlords interested in properties that should be condemned for the levels of lead paint in these houses.

Baltimore needs to rescind that new lead paint legislation and shut down those rowhouses with dangerous levels of lead.  It is not better to keep a property occupied than to protect a family from exposure.

Maryland seeks comment on low-level lead exposure Federal guidelines expand caseload while funding cut

By Timothy B. Wheeler, The Baltimore Sun 6:47 p.m. EDT, September 11, 2012

State health officials are seeking the public's advice on how to deal with new federal guidelines expanding the number of young children deemed at risk of harm from low-level lead exposure. The Maryland Department of Health and Mental Hygiene is considering whether to have local health departments follow all young children testing positive for low levels of toxic lead in their bloodstream, or to leave the least exposed youngsters to doctors and other health care providers to track.

Earlier this year, the federal Centers for Disease Control and Prevention effectively halved its long-standing threshold for acting on low-level lead exposure in young children. The new level of 5 parts per billion potentially adds 3,500 new cases in Maryland to the 500 identified two years ago under the old, higher exposure threshold. But the CDC also cut federal aid for local and state health agencies to follow lead poisoning cases. Even small amounts of lead have been shown to cause lasting learning and behavioral problems in young children.

State health officials also are seeking public comment on whether the state should notify parents of children whose blood tests in previous years showed lead levels between 5 and 9 parts per billion and recommend those youngsters be retested. The CDC had recommended doctors contact their patients, but at least some providers have said they have no ready way of identifying those children.

The deadline for commenting is Sept. 28. For more information and directions on how to comment, go to dhmh.maryland.gov or call 410-767-6499.