OLATHE, Colo. – El sondeo más reciente del Instituto de la Salud de Colorado ("Colorado Health Institute") encontró que la cifra de personas del estado sin cobertura de salud se mantuvo estable en aproximadamente seis por ciento. En el Centro de Salud Familiar River Valley ("River Valley Family Health Center"), que cubre Delta, Montrose y Olathe, la cantidad de pacientes no asegurados creció cinco por ciento en 2018. El CEO Jeremy Carroll dice que debido a que los centros ofrecen tarifas de descuento a la gente sin seguro, esa cresta es significativa.

"Solo le cobramos $15 en una consulta medica a quien este 100% abajo en el nivel federal de pobreza. Ese costo para River Valley es significativamente mayor, $150 o $160, asi que tenemos que descartar esa diferencia."

Los Centros Comunitarios de Salud atendieron en 2018 al 40 por ciento de los no asegurados de Colorado, y en algunos centros el 85 por ciento no tiene seguro. La cobertura de Medicaid también bajó significativamente el año pasado, un dos por ciento. Carroll dice que como los centros dependen de los reembolsos de Medicaid para sufragar los costos de la atención sin seguro, esa pérdida de ingresos puede dificultar que se sigan brindando los servicios

Los centros comunitarios de salud también han visto una alza en la cantidad de pacientes que temen permanecer inscritos en Medicaid, y que sus hijos sigan inscritos, por temores sobre la nueva regla federal de cobro público. La norma cambió la forma en que la gente que planea solicitar una "Green Card" accede a los beneficios públicos, y algunos pacientes evitan los controles regulares Carroll dice que la continuidad en los cuidados es importante para el bienestar de los pacientes, especialmente si tienen condiciones como hipertensión o diabetes.

"Y si vienen hasta que esten real, realmente mal, llevara meses estabilizarlos de nuevo o, en el peor caso, tendremos que internarlos en el hospital. Eso le cuesta al sistema mucho mas dinero."

Otros resultados de la investigación del "Colorado Health Institute" refleja lo que los centros están viendo en todo el estado: un aumento en la cantidad de pacientes que reciben atención médica, dental y conductual. Entre 2014 y 2018, más de la mitad de los centros de red de seguridad, "Safety Net Centers", añadieron atención a la salud conductual y más de un tercio de los centros ofrecen atención dental en sus instalaciones.

El mas reciente estudio del "Colorado Health Institute" encontro que la cantidad de gente del estado sin cobertura medica se mantuvo estable en un seis por ciento aproximadamente. Pero para los Centros Comunitarios de Salud de Colorado, "Community Health Centers", las tasas de no asegurados van subiendo. Un reporte de Eric Galatas (guh-LATT-us).

El estudio del CHI puede ser consulado en www.coloradohealthinstitute.org/research/CHAS.

Recent research shows approximately half of people who die by suicide had contact with a health care professional within the month prior to their death.

However, a recent study shows only 8% of hospitals are currently implementing all four recommended suicide prevention practices: safety planning, warm handoffs to outpatient care, patient follow-up and lethal means counseling.

Melissa Tolstyka, director of Behavioral Health Services for Trinity Health Ann Arbor, said a seamless transition from inpatient to outpatient care is critical. At Ann Arbor, she saw a 46% increase in compliance with comprehensive suicide risk assessments and patients discharged on the suicide care pathway now receive a safety plan, which she sees as progress.

"We continue to see a need for really robust programming," Tolstyka explained. "Not just within the behavioral health world, but in the medical world as well. Our organization really wanted to focus on bringing the behavioral health and the medical services together to enhance our safer suicide care practices for our patients."

The initiative is being piloted across various units at Trinity Hospitals in Ann Arbor and Grand Rapids including the emergency department, psychiatric medical and inpatient nursing units. If you or anyone you know is struggling or in crisis, help is available 24 hours a day, seven days a week, by calling or texting 988, the Suicide and Crisis Lifeline.

Casie Sultana, clinical nurse leader for Trinity Health Grand Rapids, prioritizes patient well-being, emphasizing support and improvement over solely managing risks within the facility.

"We want to be someplace that people feel welcome to come to who are dealing with suicide," Sultana emphasized. "You feel so alone. It's a very lonely journey and we want people to come seek help and feel welcomed when they do that."

Susan Burchardt, clinical services manager at Trinity Grand Rapids, advised other hospitals considering a similar program to learn from organizations already using it.

Support for this reporting was provided by The Pew Charitable Trusts.


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Access to reduced-price medication is a necessity for many rural Missourians with low income.

Rep. Cindy O'Laughlin, R-Shelbina, the Senate Floor Leader, said Big Pharma is trying to confuse legislators with unrelated hot-button topics such as abortion access and illegal immigration in a last-ditch effort to stop the state from joining a program to force drugmakers to sell medicines at a discount.

"Appealing to nuclear topics, which really do not apply in this situation, is a disingenuous way to try to defeat a bill that is actually good for Missouri," O'Laughlin asserted.

O'Laughlin pointed out the program is transparent, and uses the tax money saved to help low-income families deal with chronic conditions such as diabetes.

The drugmakers object to the government forcing them to give significant discounts, arguing hospitals' and for-profit pharmacies' bottom lines, particularly those owned by pharmacy benefits managers, are being exploited. Nationally, 46% of contract pharmacy agreements involve pharmacies linked to the three largest benefits managers.

Rep. Tara Peters, R-Rolla, introduced the 340B contract pharmacy access billand said the lobbying is absurd.

"Federally, 340B program does not allow for abortion drugs," Peters stressed. "Why would any legislation that we're trying to pass in the state allow for that? I mean, the thought of that even being in existence is absolutely ludicrous."

The Missouri Senate passed the bill 27-3 on Monday and it now goes to the House.


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Alabama is running out of time to tackle Medicaid expansion this legislative session.

More than 230 people gathered earlier this month with the group Alabama Arise, urging state lawmakers to prioritize the issue. Their message: Access to health care isn't just a matter of policy, it can be a matter of life and death.

Debbie Smith, Cover Alabama campaign director for Alabama Arise, said as the session winds down, the group will continue to echo the call for increased access to health coverage. She thinks it would not only save lives but revitalize communities across the state.

"Over 80% of our rural hospitals are operating in the red," Smith pointed out. "Not a great stat. About 19 rural hospitals are at immediate risk of closure, and those are the lifeblood of those communities. They're on life support."

Smith emphasized hospitals at financial risk also put their workforce at risk. Those who are against Medicaid expansion believe it is ultimately unaffordable for the state. However, Smith argued it could save the state nearly $400 million over the next six years. According to the Public Affairs Research Council of Alabama, those savings would be enough to cover the cost.

The council's study also showed Medicaid expansion would generate nearly $2 billion of economic growth. Beyond economic benefits, Smith pointed to the stark disparities in maternal and infant mortality rates in Alabama.

She stressed Medicaid expansion would do more than provide health care coverage during pregnancy or postpartum, it is about ensuring comprehensive coverage.

"We've been lucky enough to expand Medicaid coverage up to 12 months postpartum but we still need to figure out how to cover people before they even get pregnant," Smith asserted. "It's really important for people to have health coverage so they can address any kind of issues they might have, like if they have diabetes or high blood pressure that might affect their pregnancy in the future."

With limited time left in the legislative session, she noted one option could be Gov. Kay Ivey's executive authority to enact Medicaid expansion. Smith added using the power could be the simplest path forward, backed by the promise of additional funding from the American Rescue Plan.