T-Bones score early in win over Blasters

The Kansas City T-Bones struck early Sunday afternoon and didn’t look back, beating the Joplin Blasters, 5-3, at CommunityAmerica Ballpark.

The T-Bones got on the board first in the bottom of the first. After leadoff hitter Starlin Rodriguez was hit by a pitch from Joplin’s starting pitcher Carlos Fuentes (0-1), Rodriguez stole second. Tyler Massey then doubled to centerfield, scoring Rodriguez and giving Kansas City an early 1-0 lead. Joplin pitchers would hit five Kansas City batters in the game, one shy of tying the American Association record.

Kansas City strengthened its lead in the second when, with one out, Brandon Tierney singled to center and then came in on a home run by Brett Wiley. Rodriguez, at the plate for the second time in as many innings, singled and advanced to third on Nate Tenbrink’s single. Massey then got his second hit and second RBI, as he knocked in Rodriguez with a hit to right, giving the T-Bones a 4-0 lead. Rodriguez and Massey each had two hits in the game for Kansas City.

In the third inning, T-Bones starting pitcher Sean Furney walked the first two batters, Oscar Mesa and Mitch Glasser. With one out, Charlie Valerio doubled to right field, scoring Mesa. Willie Cabrera cut Kansas City’s lead in half, 4-2, when he grounded out to second baseman Wiley, scoring Glasser.

Furney (3-1) threw five innings, allowing five hits and two runs. After Evan DeLuca and Brett Zawacki pitched three scoreless innings, Mark Haynes (3) picked up the save, even though he allowed one run — his first of the season — on one walk and one hit.

The T-Bones (10-14) will continue to play host to the Blasters (9-14) on Monday night at 7:05. Tickets are available by calling the Providence Medical Center Box Office at CommunityAmerica Ballpark at 913-328-5618.
– Story from Matt Fulks, T-Bones

Study: Health providers struggle in states that don’t expand Medicaid

by Bryan Thompson, KHI News Service

A new study by Georgetown University’s Health Policy Institute found stark differences between states that have expanded Medicaid eligibility under the Affordable Care Act and those — like Kansas and Missouri — that haven’t.

Researchers conducted interviews with leaders of major hospital systems and federally qualified health centers in seven states. Three of the states had not expanded Medicaid (Missouri, Tennessee and Utah), while the other four (Arkansas, Colorado, Kentucky and Nevada) had. The goal was to see the effect of the Medicaid decision on the health care delivery system in each state.

Since a 2012 Supreme Court ruling made Medicaid expansion optional for states, 19 have opted not to expand eligibility. Expansion would extend health coverage to an estimated 150,000 Kansans who make less than 138 percent of the federal poverty level, which is annual income of $16,242 for an individual and $33,465 for a family of four.

Gov. Sam Brownback and other Kansas legislative leaders remain opposed to Medicaid expansion, while Kansas health advocates have formed an alliance in support of it.

Jack Hoadley, one of the Georgetown researchers, said during a Wednesday conference call on the study that hospitals and clinics in expansion states had far fewer patients who couldn’t pay for their care, meaning the facilities were much stronger financially.

The additional financial resources led to better relationships with other health providers and better coordination of health care services, he said, and health systems in expansion states were more likely to have the resources needed to integrate behavioral health care with primary care.

“Often the results we see in a study are somewhat ambiguous,” Hoadley said. “You see some factors pointing you in one direction, some factors pointing you in another direction. But this is a case where we really saw consistently and dramatic differences between what we were being told by the executives who worked in facilities in Medicaid expansion states versus those who came from non-expansion states.”

One of the executives interviewed for the study was Paul Taylor, CEO of Ozarks Community Hospital. The organization has hospitals and clinics in southwest Missouri, which has not expanded Medicaid, and across the border in northwest Arkansas, where Medicaid eligibility was expanded in 2014. His organization was described as “a living experiment.”

“I guess we have the scars to prove it,” Taylor quipped.

He said Ozarks Community Hospital primarily is a safety net provider.

“We’re also a living experiment because our patient payer mix is 90 percent governmental and uninsured,” Taylor said. “The bargain of the Affordable Care Act was supposed to be that you’re ultimately going to get paid less by the governmental payers — by Medicare, and to some extent by Medicaid — in exchange for which a large percentage of your uninsured patients were then going to be covered under Medicaid.

“Hospitals that have a large commercial insurance patient payer mix were able to soften the blow in non-expansion states. Those like OCH that did not were hit the hardest.”

Before Medicaid expansion, 33 percent of the emergency room patients at Taylor’s hospitals in both Missouri and Arkansas were uninsured. With Medicaid expansion, that figure has fallen to around 10 percent in Arkansas. Meanwhile, the uninsured rate among ER patients in Missouri has ticked up to at least 40 percent, he said.

As a consequence, Taylor cut the number of full-time employees at his organization’s Missouri hospital by about 100. A similar number of employees have been added at the Arkansas hospital.

“We hung on, frankly, as long as we could in Missouri, waiting for the Legislature to change its mind about expansion, but we finally just simply had to give up,” Taylor said. “If we hadn’t reduced our payroll in Missouri, we were jeopardizing the entire system. … If it weren’t for the positive operating margin we’re experiencing in Arkansas, the entire system would be out of business.”

Taylor said Ozarks Community Hospital made a commitment to integrated medical and behavioral care. Psychologists are stationed in the medical clinics so they can provide same-day mental health care for patients found to have behavioral needs during a regular medical check-up.

“We’re doing it, even in Missouri, even though a number of the patients that are getting that model of care are uninsured, and so we’re simply covering the cost,” he said. “And, frankly, the way we’re covering the cost is because we have a positive operating margin in Arkansas. So, the expansion state is benefiting Missouri to a certain extent simply because we’re able to continue the mission because we’re making a little bit of money down there.”

Taylor also said he sees a cross-border “brain drain.” Providers who have a choice are opting to practice in Arkansas, the state they perceive as having a brighter economic future.

The mood among hospital administrators from Missouri and Arkansas is as different as night and day, Taylor said.

“It’s gloom and doom with my fellow small and rural hospital administrators in Missouri. They’re all just hanging on,” he said. “And none of them are optimistic that there’s going to be Medicaid expansion in the state of Missouri.”

But things are looking up in Arkansas. He recently replaced the radiology equipment at a hospital in Gravette, Ark., at a cost of close to $3 million.

“There’s no way I guarantee an expenditure like that for my hospital down there unless I’m real confident that the future looks bright,” Taylor said. “There’s an imaginary dividing line in the border between Missouri and Arkansas, but there’s a real qualitative difference in what’s going on in health care right now.”

The nonprofit KHI News Service is an editorially independent initiative of the Kansas Health Institute and a partner in the Heartland Health Monitor reporting collaboration. All stories and photos may be republished at no cost with proper attribution and a link back to KHI.org when a story is reposted online.

– See more at http://www.khi.org/news/article/new-study-states-that-dont-expand-medicaid-are-hurting-themselves#sthash.1OjhyuKw.dpuf

Storms possible this afternoon

National Weather Service graphic
National Weather Service graphic

Scattered non-severe thunderstorms are possible this afternoon with another round possible overnight, according to the National Weather Service.

Severe storms are possible on Tuesday afternoon through Tuesday evening, the weather service said.

All modes of severe weather are possible with damaging winds, large hail, dangerous lightning and flash flooding the main threats, according to the weather service. However, a few tornadoes are possible as well.

Today there is a 30 percent chance of showers and thunderstorms, mainly after 1 p.m., the weather service said. The high will be near 89, with a south wind of 3 to 8 mph. Less than a tenth of an inch of rain is likely.

Tonight, there is a 30 percent chance of showers and thunderstorms mainly after 1 a.m., according to the weather service. The low will be around 72, with a south wind of 5 to 8 mph. Less than a tenth of an inch of rain is likely.

Tuesday, there is a 50 percent chance of showers and thunderstorms, and some of them could be severe, according to the weather service. The high will be near 90, with heat index values as high as 97. There will be a south southeast wind of 7 to 17 mph with gusts as high as 26 mph. Between a tenth and quarter inch of rain is possible.

Tuesday night, there is a 70 percent chance of showers and thunderstorms, mainly before 1 a.m., according to the weather service. The low will be around 71. A south southwest wind of 8 to 14 mph may gust as high as 18 mph. New rainfall amounts may be between a tenth and a quarter of an inch.

Rain leaves the forecast for the rest of the week. Wednesday will be sunny and hot, with a high near 97, the weather service said. There will be a south southwest wind of 3 to 8 mph. Wednesday night, the low will be around 74, according to the weather service.

Thursday, it will be mostly sunny with a high near 95, according to the weather service. Thursday night, expect a low of 73.

Friday, it will be mostly sunny with a high near 91, the weather service said. Friday night, the low will be around 59.