News Headlines

News Headlines
Health care news from around the state and nation

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Medicare drug costs to fall in 2014, but donut hole widens
Yahoo! News

There will be good and bad news next year for seniors using Medicare’s prescription drug program. Overall, enrollees can expect a year of flat or decreasing Medicare prescription drug costs, according to data released last week by the federal government. The government said Medicare’s per-beneficiary drug costs fell 4 percent last year. As a result, some of the most important numbers in the program’s 2014 Part D will drop by roughly the same amounts.

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Final Health Care Reform Law Regulation Limits Employee’s Out-of-Pocket Expenses
Workforce Management

A final health care reform law regulation limits employee out-of-pocket expenses for group health care plans. The final regulation was issued Feb. 20 by the U.S. Department of Health and Human Services. According to the law, an employee’s maximum annual out-of-pocket expenses cannot exceed the maximum limit allowed for that year for contributions to health savings accounts. The regulation will go into effect starting in 2014.

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Hospital CPI growth slows in January
Modern Healthcare

Hospital consumer prices climbed 0.2% in January after December’s 0.7% increase, according to the Bureau of Labor Statistics’ Consumer Price Index. The figures are seasonally adjusted. In January 2011, the hospital CPI increased 0.3%. Last month’s gain was a result of growth in inpatient hospital consumer prices, which increased 0.4% in January. Meanwhile, outpatient hospital consumer prices dropped 0.1%.

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Paul Markovich: President/CEO, Blue Shield of California
San Francisco Business Times

Company: Blue Shield of California is one of the state’s largest health insurers, with 3.3 million enrollees and $10 billion in 2012 revenue. Background: Markovich became president and CEO Jan. 1, after longtime chairman and CEO Bruce Bodaken retired at year-end. Previously, the 16-year Blue Shield veteran had held titles of president, chief operating officer and before that, senior vice president of the nonprofit health plan’s Large Group Business unit.

In the 1990s, he had an earlier stint at Blue Shield in product development, leaving in early 2000 to launch a short-lived consumer-driven health plan. He’s also worked at Definity Health and Booz Allen Hamilton.

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U.S. funds 25 states to test new Medicaid models
Yahoo! News

The Department of Health and Human Services said on Thursday that it would provide 25 of the 50 states with funding to test new ways to lower costs and improve care within the national Medicaid program for the poor. The first states to receive State Innovation Model awards are Arkansas, Maine, Massachusetts, Minnesota, Oregon and Vermont, which will implement plans to transform their healthcare delivery system under President Barack Obama’s healthcare reform law, which sets aside $300 million for the overall venture.

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Governors Fall Away in G.O.P. Opposition to More Medicaid
New York Times

Under pressure from the health care industry and consumer advocates, seven Republican governors are cautiously moving to expand Medicaid, giving an unexpected boost to President Obama’s plan to insure some 30 million more Americans. The Supreme Court ruled last year that expanding Medicaid to include many more low-income people was an option under the new federal health care law, not a requirement, tossing the decision to the states and touching off battles in many capitols.

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$300M to boost Medicaid, CHIP innovation
Modern Healthcare

Six states were awarded nearly $300 million by HHS to implement payment and delivery changes to their Medicaid and Children’s Health Insurance Program plans.

The State Innovation Model awards, which were authorized by the Patient Protection and Affordable Care Act, will fund Medicaid pilot programs in Arkansas, Maine, Massachusetts, Minnesota, Oregon and Vermont that aim to improve care quality and lower costs.

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CMS lags in recouping overpayments: report
Modern Healthcare

A new report says the state of Illinois still owes the federal government more than $140 million for overpaying a Chicago academic medical center that didn’t provide as much free and discounted care to the poor as it claimed more than a decade ago. That outstanding debt involving the University of Illinois Hospital & Health Sciences System was by far the single largest uncollected payment cited in a report this week from the HHS‘ inspector general office, which concluded the CMS needs to get more aggressive in recouping money from state Medicaid programs.

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Brown may forge alliance with GOP governors on health plan
Los Angeles Times

When Gov. Jerry Brown meets with the nation’s other governors this weekend in Washington, D.C., he will find common ground with some unlikely counterparts on an unlikely issue: President Obama’s healthcare plan.

Among the governors now moving nearly as aggressively as Brown to implement the federal healthcare law are conservatives who have long fought to unravel it. They are finding that they cannot afford to pass up Obama’s offer of billions of dollars in federal aid to cover expansion of their Medicaid programs for the poor.

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Pre-existing benefits program looks at changes
Sacramento Business Journal

As the federal program serving Californians with pre-existing medical conditions prepares to wind down by the end of the year, people covered by the insurance pool may see some benefit changes. The Affordable Care Act authorized the feds to spend $5 billion on the program nationwide over three years and money is getting tight.

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Flu shots only 9% effective for elderly
San Francisco Chronicle

It turns out that this year’s flu shot is doing a startlingly dismal job of protecting senior citizens, the most vulnerable age group. The vaccine is proving only 9 percent effective in people 65 and older against the harsh strain of the flu that is predominant this season, the Centers for Disease Control and Prevention said Thursday. Health officials are baffled as to why this is so. But the findings help explain why so many older people have been hospitalized with the flu this year.

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Predicting No-Shows to Put an End to Waiting at the Doctor’s Office
Wired News

When you’re stuck waiting an hour past your appointment time at the doctor’s office you can thank those patients who decided to never show up at all. That’s because when too many people are no-shows one day, doctor’s offices often overbook another day. But just as with overbooked flights, that strategy often backfires, causing too many people to show up on the overbooked day.

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Health coalition lists dozens of medical ‘Don’ts’
Los Angeles Daily News

Don’t use feeding tubes in patients with advanced dementia. Don’t use drugs to aggressively treat diabetes in those older than 65. Don’t automatically use imaging technology for minor head injuries in children and headaches in adults. And don’t give antacids to babies with reflux. Those are among the 90 medical “don’ts” on a list being released Thursday by a coalition of doctor and consumer groups. They are trying to discourage the use of tests and treatments that have become common practice but may cause harm to patients or unnecessarily drive up the cost of health care.

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Early elective deliveries decline: Leapfrog
Modern Healthcare

The percentage of hospitals hitting the Leapfrog Group’s early elective delivery target rate of less than 5% of deliveries rose to 46% as of the end of 2012 from 39% in 2001. In addition, 75% of the 773 hospitals reporting to the employer-backed not-for-profit healthcare quality group improved their rate of early elective deliveries, with the national average falling to 11.2% of deliveries from 14% in 2011, according to a Leapfrog news release.

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Administration Issues Final Rule on Minimum Benefits Under Obamacare
Insurance Journal

The Obama administration on Wednesday issued its long-awaited final rule on what states and insurers must do to provide the essential health benefits required in the individual and small-group market beginning in 2014 under the healthcare reform law.

A cornerstone of President Barack Obama’s plan to enhance the breadth of healthcare coverage in the United States, the mandate allows the 50 states a role in identifying benefit requirements and grants insurers a phased-in accreditation process for plans sold on federal healthcare exchanges.

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Tenet inks agreement to acquire Calif. hospital
Modern Healthcare

Tenet Healthcare Corp., Dallas, announced it has signed a definitive agreement to acquire Emanuel Medical Center, Turlock, Calif., for undisclosed terms.

The planned purchase of the Evangelical Covenant Church-affiliated hospital with 209 staffed beds is designed to expand Tenet’s integrated healthcare network in California’s Central Valley, where the for-profit chain already owns Doctors Medical Center of Modesto and Doctors Hospital of Manteca, according to a news release.

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Medical experts: Doctors should think twice before ordering these 90 tests, procedures
Southern California Public Radio

A campaign sponsored by the American Board of Internal Medicine (ABIM) has released a list of 90 medical procedures and tests that health providers shouldn’t perform in certain situations. The Choosing Wisely campaign “is focused on encouraging physicians, patients and other health care stakeholders to think and talk about medical tests and procedures that may be unnecessary, and in some instances cause harm.”

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