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Ballot initiative faces opposition from California insurance companies and doctors’ group
Live Insurance News

The California Medical Association (CMA), a health insurance organizations coalition, the California Hospital Association (CHA), and other groups have announced their intentions to work together to oppose a ballot measure that is meant to create California insurance regulation for rate increase on health plans and policies. According to the CMA president-elect, Paul Phinney, this ballot initiative doesn’t do anything to help control the causes of the cost increases in the healthcare system. He added that “I just think this initiative is the wrong idea.”

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Is California Ready for Millions of Newly Insured?
California Healthline

Three million to four million Californians will become eligible for health insurance in 2014 thanks to the Affordable Care Act, but will the state’s health care workforce be able to handle the new demand? “Because persons who have health insurance tend to use more primary care than persons who are uninsured, there is concern that the current supply of primary care providers (physicians, nurse practitioners and physician assistants) may not be adequate to meet demand,” said Janet Coffman at UC-San Francisco’s Philip R. Lee Institute for Health Policy Studies.

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Medicaid, CHIP costs swell to $444 billion
Modern Healthcare

The second annual report (PDF) from the congressionally chartered advisory group on Medicaid quantified the program’s historic size and recommended a series of initiatives to improve the quality of care it funds while reducing costs and fraud.

The Medicaid and CHIP Payment and Access Commission, established by the Children’s Health Insurance Program Reauthorization Act of 2009, is the first nonpartisan congressionally supported agency focused entirely on issues affecting Medicaid and the State Children’s Health Insurance Program.

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Providers see rise in insurer, Medicare revenue
Modern Healthcare

Hospital and health professional revenue from commercial insurers and Medicare climbed 5.21% during the year that ended in January, the latest Standard & Poor’s Healthcare Economic Indices show (PDF).

Commercial insurer revenue increased 7.05% during the period while Medicare revenue climbed 2.4%.

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4 Tech Success Strategies for Hospitals
Health Leaders Media

Changes wrought by technology are making an indelible mark in service lines for health systems big and small. This is being reflected in a hospital when a patient is given an iPod with a Pandora app to listen to any music she wants to hear as she waits for an oncological exam (You want Motown, you’ve got it!) and in the surgical suite where physicians use da Vinci robotic systems for minimally invasive procedures, as well as new cloud-based data systems that allow clinicians instantaneous access to a patient’s heart rhythms.

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Consumers see rare dip in hospital prices
Modern Healthcare

Consumer hospital prices dropped 0.1% in February for the first time since November 2010, the latest figures from the U.S. Bureau of Labor Statistics’ Consumer Price Index show. The decline is only the sixth monthly drop recorded for hospital consumer prices since January 1997, the earliest date for which data is available. In February 2011, hospital consumer prices climbed 0.4%. For the year that ended last month, hospital consumer prices increased 5.3% compared with 6.4% the prior year.

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CMS delays 5010 enforcement, again
Modern Healthcare

The CMS will not begin enforcing the mandated move to Version 5010 transaction standards for an additional three months, until after June 30.

The deadline for the switch to the 5010 standards was Jan. 1. In November, the CMS announced that although it was not changing the actual deadline for complying with the standards, it would not initiate enforcement action until March 31.

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Recession hastens decline in employer-sponsored coverage, survey finds
Modern Healthcare

Employer-sponsored insurance declined across all income categories between 2007, the year the Great Recession began, and 2010 among nonelderly Americans, newly released survey results show.

Analysis of the survey, conducted by the Center for Studying Health System Change for the National Institute for Healthcare Reform, found job losses were the main culprit behind the drop in employer-sponsored coverage. The National Institute for Healthcare Reform, a not-for-profit, was formed by labor and automakers Chrysler Group, Ford Motor Co. and General Motors.

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UC Davis ranks highly in rural health care training
Sacramento Business Journal

The UC Davis School of Medicine ranks among America’s top medical schools for the quality of its educational programs in rural medicine, primary care and research, according to U.S. News & World Report. This year’s rankings for “Best Graduate Schools 2013” place the school ninth among rural medicine specialty programs, 24th among top schools for primary-care training and 42nd among research institutions.

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Stanford gene researchers see diabetes develop
San Francisco Chronicle

A team of Stanford researchers has unveiled the most detailed biological profile of a human being done so far: a peek at one man’s genetic foundation, along with snapshots, taken dozens of times over the course of a year, of the millions of proteins and other molecules that are in constant flux in his body. In a stroke of shocking good luck – for the scientists, if not necessarily the patient – the profile subject developed Type 2 diabetes during the study, allowing researchers to follow in real time the molecular changes that took place as the illness progressed.

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Wireless medical monitors transforming patient care
Marin Independent Journal

It’s hard to find a better example of how technology is revolutionizing patient care than the tiny edible sensor Proteus Biomedical of Redwood City plans to begin selling this fall in the United Kingdom.

When the grain-of-sand-size sensor is integrated into a drug tablet or capsule and activated by stomach fluid, it signals when the medicine was taken to a patch on the patient’s body.

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CMS seeks to curb avoidable hospitalizations of nursing home patients
Modern Healthcare

The CMS announced a $128 million collaborative program aimed at reducing the unnecessary hospitalizations of nursing home patients and to improve care at those facilities.

The CMS Medicare-Medicaid Coordination Office and the Center for Medicare and Medicaid Innovation will run the program. Officials plan to disperse the money among about seven coordinated-care providers, who will then work with about 15 long-stay nursing homes.

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Bill would shift seniors from Medicare to federal-worker health plans
Modern Healthcare

A Senate Republican bill would move seniors from Medicare into the federal employee insurance program beginning in 2014.

The measure, sponsored by Sen. Rand Paul (R-Ky.), would allow seniors to choose from coverage among the 250 plans now offered to federal employees with the same average subsidy of about 75% provided by the federal government. The measure would reduce Medicare costs over the coming decade by about $1 trillion, according to the nonpartisan Congressional Budget Office.

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MedPAC: Hospitals Should Get 1% Payment Update in 2013
Health Leaders Media

The Medicare Payment Advisory Commission’s (MedPAC) submitted its payment policy report to Congress Thursday. Its recommendations cover hospital inpatient and outpatient services, and ambulatory surgical care among other services. Rates for hospitals and their outpatient departments should increase 1% starting in 2013, the commission recommends, but E&M (evaluation and management) visits in hospital outpatient settings should be reimbursed the same as other outpatient settings or physicians’ offices, and ambulatory surgical centers should get .5% more in 2013.

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New Report Shows California’s HMOs Deficient in Providing Access to Adequate Substance Abuse Treatment
Market Watch

A new report issued by the state of California reveals that California health plans are doing an exceedingly poor job of providing quality care to individuals in need of alcohol and drug dependency treatment. The Healthcare Quality Report Card, issued by the California Office of the Patient Advocate, compares the quality scores of California’s eight largest HMOs against national performance and against each other in 38 clinical categories.

Opinion/Editorial

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Obamacare drives up health care costs for everyone
San Francisco Chronicle

The Centers for Medicare and Medicaid Services recently released their annual report on health care spending in America. And surprise, surprise – spending continues to grow. It amounted to 17.9 percent of the nation’s gross domestic product in 2010, or $2.6 trillion. But the annual rate of growth was lower than it had been most of the past 50 years – just 3.9 percent.

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Romney-fication of health care reform
Orange County Register

Massachusetts Gov. Deval Patrick just exhorted legislators to overhaul the way the state pays for health care. He’s pushing for an end to the traditional arrangement of compensating doctors and hospitals for each service they provide. It’s not yet clear what will replace this “fee-for-service” payment system. But there’s growing support for a “global budget” model, under which primary care physicians would receive annual lump sums for each of their patients – regardless of how little or how much care they needed.

Blogs

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Learning from Massachusetts’ Health Care Experiment
The Health Care Blog

Former Gov. Mitt Romney has taken considerable heat during the Republican primaries for the health-care legislation that passed while he was in office. Sadly, election-year politics have overshadowed the real lessons of Massachusetts’ experiment. The core question then-Gov. Romney was trying to answer was this: Should Massachusetts continue to pay hospitals more than $1 billion a year to care for the poor, or should it create a way for individuals to purchase their own insurance?

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Getting Doctors to Think About Costs
New York Times

My first formal lesson on health care costs occurred one afternoon on the wards when I was a medical student. The senior doctor in charge, a silver-haired specialist known for his thoughtful approach to patient care, had assembled several students and doctors-in-training to discuss a theoretical patient with belly pain. After describing the patient’s history and physical exam, he asked what tests we might order. One doctor-in-training proposed blood work. A fellow student suggested a urine test. Another classmate asked for abdominal X-rays.

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A Safety Checklist for Patients
The Health Care Blog

Far too many patients are harmed rather than helped from their interactions with the health care system. While reducing this harm has proven to be devilishly difficult, we have found that checklists help. Checklists help to reduce ambiguity about what to do, to prioritize what is most important, and to clarify the behaviors that are most helpful. The use of checklists helped to reduce central-line associated bloodstream infections at The Johns Hopkins Hospital, in hospitals throughout Michigan, and now across the United States.

  

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