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AHA: Field-test e-reporting of quality measures
Modern Healthcare

The American Hospital Association is urging the Agency for Healthcare Research and Quality to include providers in the field-testing and development of health information technology-enabled quality measures. In an eight-page letter, submitted in response to an AHRQ request for information, the AHA said providers and vendors had struggled with the quality measurements they were required to document electronically as part of the first phase of the federal government’s electronic health-record system incentive program.

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State health care shift causes concern
San Diego Union-Tribune

Adriana Ramirez works as a medical assistance at an Imperial Beach clinic, yet even she is bewildered by the looming transition that will move two of her children out of the state’s Healthy Families program and enroll them in Medi-Cal.

“Are my kids going to get the same benefits? Is it going to affect them in any way? Are we going to still qualify?” she wonders.

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Life Expectancy Shrinks for Less-Educated Whites in U.S.
New York Times

For generations of Americans, it was a given that children would live longer than their parents. But there is now mounting evidence that this enduring trend has reversed itself for the country’s least-educated whites, an increasingly troubled group whose life expectancy has fallen by four years since 1990. Researchers have long documented that the most educated Americans were making the biggest gains in life expectancy, but now they say mortality data show that life spans for some of the least educated Americans are actually contracting.

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The Business Case For Nurse Practitioners
The Health Care Blog

This week the American Academy of Family Physicians (AAFP) issued a new report describing its vision of primary care’s future. Not surprisingly, the report talks about medical homes, with patient-centered, team-based care. More surprisingly, though, it makes a point to insist that physicians, not nurse practitioners, should lead primary care practices.

The important questions are whether nurse practitioners are qualified to independently practice primary care, and whether they can compensate for the primary care physician shortage. On both counts the AAFP thinks the answer is “no.”

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USC forms kidney research center at Keck School of Medicine
Los Angeles Business Journal

The University of Southern California and the nonprofit University Kidney Research Organization have partnered to establish the USC/UKRO Kidney Research Center at USC’s Keck School of Medicine. UKRO, a Los Angeles-based group that supports medical research for the causes, treatments and prevention of kidney disease, made an initial $3.5 million pledge to support the establishment of the center, which will conduct both basic and applied research programs at USC.

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Kaiser Permanente Northern California scores high in national rankings
Sacramento Bee

Kaiser Permanente Northern California is the eighth-best commercial health plan in the country – and the third-best Medicare plan – in the National Committee for Quality Assurance’s 2012 ranking of health plans in the United States.

Kaiser’s regional HMO was the highest ranked commercial plan in the state and scored among the top 10 nationally in 20 of the 49 measures of clinical excellence.

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Cedars-Sinai and UCLA cut from Los Angeles health plan
Los Angeles Times

Two of the most prestigious names in Southern California healthcare — Cedars-Sinai and UCLA — are getting shut out of a major insurance plan for being too expensive. In a bold cost-cutting move, Anthem Blue Cross has eliminated doctors affiliated with the hospitals from a health plan offered to about 60,000 employees and dependents at the cash-strapped city of Los Angeles. The city opted for Anthem’s plan because it will save $7.6 million in annual premiums next year by excluding physicians from the two institutions known for tending to the Southland’s rich and famous.

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Fundraising to pay for cancer treatment
San Francisco Chronicle

When Michelle Shutzer was diagnosed with late-stage colon cancer two years ago, she initially shunned the idea of holding a fundraiser or soliciting money from friends and family to pay for any out-of-pocket costs associated with her illness. For the 42-year-old San Francisco woman, who works as a professional fundraiser, asking people for help comes naturally – just not for herself. But after undergoing four different, grueling chemotherapy regimens, she is now pursuing naturopathic treatments that are not covered by her health insurance.

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Southwest hospitals looking for new leader
The Press-Enterprise

The search for a new leader of two of southwest Riverside County’s major hospitals is under way as the CEO leaves for a job in Los Angeles. Friday, Sept. 21, will be the last day on the job for Ken Rivers, CEO of Southwest Healthcare System, which runs Rancho Springs and Inland Valley medical centers. Rivers is leaving to become president and CEO of Hollywood Presbyterian Medical Center in Los Angeles. “It was a great opportunity that found me …,” Rivers said. “I wasn’t looking and a gentleman from the corporation called me.”

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Hospital update: Peninsula construction projects move ahead
San Jose Business Journal

Hospital projects along the peninsula continue to move forward, pumping more than $4 billion into hospital and related medical construction projects. That includes a new San Carlos outpatient clinic being built by Sutter Health and its Palo Alto Medical Foundation affiliate, a rebuild of Kaiser Permanente’s Redwood City medical center, the massive hospital rebuilds at Stanford Hospital & Clinics and Lucile Packard Children’s Hospital, and a new 148,000-square-foot, four-story inpatient pavilion at Sequoia Hospital, also in Redwood City.

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Health reform 2.0: States balking at new insurance exchanges
KFMB TV

Under the Affordable Care Act, the Obama administration’s controversial reform of health care, states are supposed to assist uninsured Americans in buying health coverage by setting up so-called “insurance exchanges.”

But, many states are dragging their heels on building the necessary infrastructure — and some have outright refused to do so.

This lack of action poses a significant challenge to get the law up and running.

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MLR Bill Passes House Committee
Health Leaders Media

A bill that would amend two important medical loss ratio provisions of the Patient Protection and Affordable Care Act was passed by a House committee Thursday. HR 1206 (Access to Professional Health Insurance Advisors Act of 2011) is best known as an effort to amend the MLR rule to exclude broker and agent fees and commissions from administrative expense calculations. However, the bill would also give states the final say on MLR waiver requests.

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Rapid change for region’s health care providers
Sacramento Business Journal

Just since January, Catholic Healthcare West has changed its name, ended its church affiliation and transformed itself into a national company. Sutter Health has expanded its urgent care network and applied for a state license to run an HMO. Adventist Health is thinking about filing for one. Other local health systems have beefed up primary care or upgraded facilities to woo patients as competition stiffens.

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IHA names 47 top-performing California medical groups, surprisingly not including Hill Physicians
San Francisco Business Times

The Integrated Healthcare Association has once again named the “top performing” medical groups in the Golden State, a list that typically varies little from year to year. But this year a regular is missing from the roster of groups scoring in the top 25 percent on quality measures. The missing link is San Ramon’s Hill Physicians Medical Group, long a strong supporter of IHA and its nationally known Pay for Performance program.

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Top 5: Silicon Valley Health Plans
San Jose Business Journal

This week the Business Journal published a list of the top Health Plans. The list was ranked by local* enrollment. Information was obtained from company representatives. Here is a sneak peek of the top five health plans. In order for a plan to be considered for the list, the total local* enrollment must be provided. The top 5 health plans combined have over 1.5 million enrolled locally in their health plans. A breakdown of the total enrollment statewide and local physician providers can be found in the print edition.

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Health Insurance Exchanges Work
The Health Care Blog

The Salt Lake Tribune Editorial Board recently used strong words to criticize the Utah Health Exchange. Its perspective ran afoul of our firm’s recent experience with the Utah exchange, which has been overwhelmingly positive. Like many small businesses, the triggering event for our involvement in the Utah Health Exchange was the appearance of our insurance broker who laid out a spreadsheet presenting a 22 percent increase in next year’s premium costs. Disappointed, we asked our broker to review other options.

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A little patience for the health IT revolution
Modern Healthcare

How long did it take American farmers to widely adopt hybrid corn? Honestly, I don’t know, but I do remember what I was told about that kind of adoption—30 years.

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Health exchange reconsidering stance on stand-alone vision plans
Sacramento Business Journal

Stand-alone vision plans may not barred from selling to individuals through the California Health Benefit Exchange after all. Making no promises, executive director Peter Lee said Tuesday the board expects to revisit the matter at its Oct. 16 meeting. Exchange staff confirmed Wednesday they are in discussions with VSP Global, the company that blasted the Aug. 23 board decision to keep them out of this part of the program for at least a year.

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