Issue link: https://beckershealthcare.uberflip.com/i/1161749
41 41 CEO/STRATEGY Kamala Harris unveils healthcare plan: 5 things to know By Ayla Ellison D emocratic presidential can- didate Sen. Kamala Har- ris released the details of her healthcare plan July 29, a few days before the second Democratic presi- dential debate. Five things to know: 1. The California senator's plan in- cludes a role for private insurance companies. Under her plan, peo- ple could either purchase govern- ment-administered insurance plans or buy plans from private payers, accord- ing to NPR. 2. "We will allow private insurers to offer Medicare plans as part of this system that adhere to strict Medicare requirements on costs and bene- fits," Ms. Harris wrote. "Medicare will set the rules of the road for these plans, including price and quality, and private insurance companies will play by those rules, not the other way around." 3. Ms. Harris calls for a shifting to an expanded Medicare system over a 10-year period. This is longer than the four-year transition period included in Vermont Sen. Bernie Sanders' plan, according to CNN. 4. Mr. Sanders' plan includes an addi- tional 4 percent income-based premi- um on households making more than $29,000. Ms. Harris' plan exempts households making below $100,000 and incudes a higher income thresh- old for families living in high-cost areas, according to CNN. To pay for this change, Ms. Harris' plan would tax stock trades at 0.2 percent, bond trades at 0.1 percent and derivative transactions at 0.002 percent. 5. A campaign aide told CNN that Ms. Harris' proposal would also cap out- of-pocket costs at $200 and expand Medicare's coverage to dental, vision and long-term care. n South Dakota hospital churned through 27 CEOs in 9 years By Ayla Ellison T he Indian Health Service hospi- tal on the Rosebud (S.D.) Sioux reservation made efforts to im- prove quality of care after its emergen- cy department temporarily closed, but it continued to face several challenges, including untrained staff and leadership turnover, according to HHS' Office of Inspector General. The IHS closed Rosebud Hospital's emergency department in December 2015 after CMS identified several pa- tient safety issues at the facility. The OIG report identifies several issues that led to the ED closure, including staffing shortages, changing and inconsistent hospital leadership, and lack of over- sight by IHS. The OIG report includes statements from IHS officials about the quality of care and leadership challenges at Rose- bud Hospital. Officials said the hospital had 27 CEOs in the 9 years leading up to the ED closure, averaging 3 CEOs per year. "Many of these CEOs served in an acting capacity and lasted only a few months before they left voluntarily, were fired by IHS, or were removed by a tribal resolu- tion," states the OIG report. "Although many of these CEOs may have initially appeared to be a good fit, several IHS officials indicated that the CEOs often lacked experience and were ill-equipped to fulfill that role." The emergency department re- opened seven months later after IHS provided additional resources to the hospital and entered into a systems improvement agreement with CMS, which required IHS to update certain policies and revise governing board by- laws. Despite the many improvements at Rosebud Hospital prompted by the systems improvement agreement, staff continued to report concerns about the frequent rotation in hospital leadership, according to the OIG. IHS completed the systems improvement agreement in September 2017. Less than a year later, CMS found new compliance issues in the hospital's ED during a com- plaint survey. The hospital failed to en- sure that the ED call system was working and failed to provide emergency care for two patients who came to the ED with behavioral health needs, according to the OIG. Rosebud Hospital was set to lose its Medicare contract in August 2018, but CMS extended the termination date to November 2018 after IHS submitted a plan of corrections. CMS revisited the hospital a few weeks before the termina- tion date and determined the deficien- cies had been corrected. To address the problems identified in the case study of Rosebud Hospital and to avoid similar problems at other IHS hospitals, the OIG made the following four recommendations to IHS: 1. Develop and implement a staffing program for recruiting, retaining and training clinical and leadership staff in remote hospitals. 2. Enhance training and orientation for new hospital leaders to ensure that they follow IHS directives and continue im- provement efforts. 3. Continue to take steps to ensure ear- ly and effective intervention when IHS identifies problems at hospitals. 4. Develop procedures for temporary ED closures and communicate those proce- dures with receiving hospitals and EMS to ensure that they are adequately pre- pared to receive diverted patients during such events. IHS concurred with all four recommen- dations and said it will use the findings and recommendations in the OIG re- port to improve its management and operations. n