Low Medicaid reimbursements hurting N.J. in the ER: Opinion
The culinary specialists involved in the cooking and preparation of these meals take great pride in their work. “I love to cook and to be around food,” said Downs. “There’s nothing like hearing someone say they love your cooking, especially in the military.” Culinary Specialist Seaman Terrica M. Sanders, also assigned to NMCSD’s galley, takes pride in working at the galley as well and enjoys the opportunity to handle duties typically reserved for higher-ranking culinary specialists. “There are many things I like about being a culinary specialist,” Sanders said. “My favorite benefit is that I have several opportunities to step up regardless of rank.” Lt. Cmdr. Tinsika Riggs, Head of NMCSD’s Nutrition Management Department, oversees the entire food operation at NMCSD, which comprises approximately 150 military and civilian staff. She enjoys the opportunity of being in charge of a large-scale galley operation. “When I was a kid, I used to look through Christmas catalogs and dream of having all the toy foodservice equipment (little ovens, snow cone machines) and having my own operation on my front lawn,” Riggs said. “I never thought I would oversee an operation like this back then, but I can’t imagine being anywhere else.” At NMCSD, the galley’s menu is on a 21-day cycle, which means the meals differ daily for 21 days and then the cycle repeats. The Nutrition Management Department decides what type of meals to serve via a menu review board. “We look at many things when planning a menu, including: nutritional quality, popularity, variety and cost,” Riggs said. “It is quite a balancing act to offer things to our patients and the public that are healthy and popular while also being fiscally responsible.” If a change in a menu item is recommended, then the galley staff implements it during the menu review board. The galley staff also reviews comment cards weekly and adapt the menu per customer preference as able. Breakfast is prepared about an hour beforehand.
Pediatric Clinic Opens Offering Specialists Closer to Home
The Powell family is used to rides in the SUV. Eight year old Alyssa was going to Kansas City for weekly cancer treatments at Children’s Mercy. Alyssa says, “It was hard to be away from family and not know what was gonna happen.” Her two younger siblings went along too but a new clinic brings those visits closer to home. Alyssa’s mom Becky Powell, Lamar, says, “Here its a thirty minute drive not a two hour drive. Going to Kansas City took all day, driving, the appointments, then driving home. It takes a lot out of us. The whole week we spend just recuperating from our trip up there.” Alyssa says, “We’re going once a month now, so it wont take as a long and I can get back to school and play with my friends and see my teachers. So it’ll be easier. The same is true for the Lantz family from Neosho. 7 year old Braidon helped with the ribbon cutting that announced the partnership between Children’s Kansas City and Freeman Health. He suffered a tick bite that ended up affecting his entire immune system. Braidon had to have surgeries, be treated for pancreatitis and was diagnosed with Addison’s disease. and being able to have local visits makes life easier and less costly for families.
This report card assesses the support each state provides their emergency care systems. New Jersey received a D-plus a significantly lower score than the C-plus the state received in the last report in 2009. That decline is due in large part to poor access to needed specialists. New Jersey received an F for its Medical Liability Environment, as it did in 2009. Malpractice insurance premiums in our state continue to be more than 30 percent higher than the national average. A small pool of insurers, a lack of pretrial screening, and no caps on awards for noneconomic damages are major contributors to this problem. The report also noted that New Jerseys Medicaid fees for physicians were only 40 percent of the national average. This ranks our state among the lowest in the country for Medicaid physician reimbursement and is a major impediment to recruiting and retaining vital specialists to the state. While recent changes from the Affordable Care Act will temporarily increase Medicaid rates for primary care, it leaves reimbursement for specialty care unreasonably low. This combination of low reimbursement and high liability cause needed specialists to decline to be on call for ER patients. ACEP proposes that New Jersey join Florida and other states in enacting legislation that provides liability protection for physicians who provide emergency care mandated under the Emergency Medical Treatment act. This would encourage more specialists to provide on-call service to local hospital emergency departments, helping to ensure all patients get quality, timely care and appropriate follow-up. That would mean more orthopedists to reset broken bones. More ophthalmologists to tend to eye injuries. More cardiologists to treat life-threatening heart attacks.
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