A health care administrator with ties to Western Virginia has been confirmed by the U.S. Senate as the new head of the federal agency that administers Medicare and Medicaid.

Marilyn Tavenner, who grew up in Henry County, will take over the Centers for Medicare & Medicaid Services (CMS) at a time of major change in the health care field.

She will be responsible for overseeing new policies under the Affordable Care Act, the new health care law that calls for more affordable insurance to be sold through exchanges and the expansion of Medicaid for the poor, among other things.

A Fieldale native, Tavenner graduated from a nursing school at Roanoke Memorial Hospital, now owned by Carilion Clinic. She worked for more than 25 years for HCA, a national hospital chain and parent company of LewisGale Regional Health System.

After starting as a nurse at Johnston-Willis Hospital in Richmond, Tavenner eventually became its chief executive officer. In 2005, incoming Gov. Tim Kaine selected her to run Virginia’s health department. After that, she served as deputy administrator and acting administrator of CMS.

“Marilyn brings with her a breadth of experience and expertise from virtually all angles of health care policy and delivery,” Kathleen Sebelius, secretary of the U.S. Department of Health and Human Services, said in a statement this week.

The number of Virginians covered by health insurance through an employer declined by nearly 10 percent over the past decade, according to a report released this week.

Just 65.6 percent of the state’s residents had insurance through an employer-sponsored plan in 2011, compared with 75.2 percent in 2000, the Robert Wood Johnson Foundation’s report found.

Other states saw more drastic drops, and the percentage of Virginians covered by workplace insurance in 2011 was about six points higher than the national average.

Still, consumer advocates said the numbers underscore the importance of offering more affordable insurance and other options as the costs of health care continue to rise.

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If Medicaid is expanded in Virginia, it likely will happen only with serious tinkering by state lawmakers.

As part of a budget bill that keeps the proposal alive, the General Assembly over the weekend created a legislative commission that will determine how Virginia applies one of the key provisions of the new federal health care law.

Under the Patient Protection and Affordable Care Act, states have the option of broadening Medicaid eligibility so that more low-income individuals are covered by the government insurance program.

But rather than accept the idea — and the federal funding that comes with it — outright, the General Assembly has made it contingent on whether suggested improvements to the federal proposal are deemed acceptable by the state commission.

That process will take months to play out, raising questions about whether the state will meet the Affordable Care Act’s goal of having the expansion in place by Jan. 1, 2014.

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As the General Assembly considers an expansion of Medicaid, Virginia’s top health official briefed a Roanoke audience this week on some of the challenges that lie ahead.

Secretary of Health and Human Resources Bill Hazel made no predictions on whether legislators will expand the government insurance program for the poor and disabled as part of the Patient Protection and Affordable Care Act.

But in a speech Monday at the Virginia Tech Carilion School of Medicine, Hazel said a key concern is whether the pledge of federal funding for much of the expansion will hold true over time.

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Virginia’s secretary of Health and Human Resources will be in Roanoke next week to talk about the Patient Protection and Affordable Care Act.

Bill Hazel is scheduled to speak at 7 p.m. Monday, Feb. 4,   at the Virginia Tech Carilion School of Medicine.

His talk will focus on how Virginians will be affected by the Affordable Care Act, a federal overhaul of the health care system that will require most U.S. citizens to have health insurance while expanding Medicaid and setting up exchanges through which the uninsured can purchase coverage.

Presented by Project Access of the Roanoke Valley, Hazel’s talk will be in the school’s main auditorium. A reception will be held before the speech at 6:15 p.m. in the foyer.

Admission is free, but space is limited. Those interested in attending are asked to RSVP to rvam@rvam.org by Friday, Feb. 1.

Carilion Clinic has been selected to participate in a government program aimed at doing two things for Medicare patients: lowering costs while improving care.

The Roanoke-based health care system is one of 106 nationwide that will be forming accountable care organizations, the U.S. Health and Human Services Department announced Thursday.

Read the rest of the story, published in today’s newspaper, by clicking here.

My colleague Duncan Adams was at the polls earlier today interviewing voters at the South Roanoke Fire Station.

Randolph Gregg was among them.

Gregg said he voted for Romney and Allen.

“Both parties have warts but at least the Republicans are not going to break down your door at 3 in the morning and force you to sign up for health insurance,” Gregg said.

With Medicare, Medicaid an Obamacare all common topics during the presidential race, I’m curious how many votes were influenced by the politics surrounding health care.

Please share your thoughts. Was health care a deciding factor in your vote?

Starting today, Medicare is fining hospitals that have too many patients readmitted within 30 days of being discharged.

The penalties are relatively small, with the Associated Press reporting the average amounts to about $125,000 per facility. But the broader implication is part of a national push to reduce hospital spending and improve the quality of health care by eliminating what have been labeled as unnecessary hospital readmissions.

The penalties are part of President Barack Obama’s Affordable Care Act.

This year, the penalty is capped at 1 percent of a hospital’s Medicare reimbursements. Most hospitals will pay less. In coming years, the maximum penalties will increase to 2 percent and then 3 percent.

“The smallest penalties are one hundredth of a percent, which 50 hospitals will receive,” reported  Kaiser Health News, an arm of the Henry J. Kaiser Family Foundation.

In Southwest Virginia, the penalties range from hospitals that are being not penalized to LewisGale Hospital Pulaski, which received the maximum 1 percent penalty, according to the data collected by Kaiser.

According to Kaiser, the Carilion Clinic and LewisGale Regional Health System hospitals being penalized are:

• Carilion New River Valley Medical Center, 0.7 percent
• Carilion Roanoke Memorial Hospital, 0.06 percent
• Carilion Tazewell Community Hospital, 0.49 percent
• LewisGale Hospital Alleghany, 0.25 percent
• LewisGale Hospital Montgomery, 0.34 percent
• LewisGale Hospital Pulaski, 1 percent
• LewisGale Medical Center, 0.61 percent

Health insurers owed Virginians slightly more than $43 million in rebates as part of the federal health care law.

Nearly 687,000 Virginians have received rebates on average of $115 from insurance companies because of a provision in the Affordable Care Act requiring at least 80 percent of premiums be spent on medical care as opposed to administrative costs. For employers with more than 51 workers the minimum threshold for premium dollars spent on medical care is 85 percent.

The law applies to the individual, small group and large group markets. Under the law the rebates had to be paid by Wednesday, with many people having received checks at the end of July.

In some instances the rebate could be used as a credit to offset future health care costs.

Did you receive a rebate?

Inspection reports detailing unsafe conditions and improper care of patients at nursing homes are now available online from the federal government.

The government’s Nursing Home Compare website has been updated to include the surveyor’s reports, the Centers for Medicare & Medicaid Services announced today. Read more »