News Headlines

News Headlines
Health care news from around the state and nation

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Months ahead of ACA sign-up, outreach underway
HealthyCal.org

Tracking down Monterey County residents who become eligible for free or discounted health insurance under federal health care reform might take an army. But an army is not what the county will get. Instead, officials are working with their counterparts in Santa Cruz County to land a $500,000 grant. With that cash, they hope to build a network of nonprofits and business leaders that can locate potential new Medi-Cal patients and others who may qualify for discounted coverage on the state run health insurance exchange known as Covered California.

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Health groups decry sequester; Obama signs order
Modern Physician

As expected, President Barack Obama on Friday signed an order for sequestration that sets in motion the automatic federal budget cuts outlined in the Budget Control Act of 2011. Along with the executive order, the Office of Management and Budget sent an 83-page sequestration report to Congress that includes calculations and percentages on how budget resources will be reduced. Earlier Friday, the president met with congressional leaders and later said the nation will get through the period of sequestration, but it will be a painful process.

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Medi-Cal expansion will test capacity
San Francisco Chronicle

In less than one year, the Affordable Care Act’s promise to bring health care to perhaps 1 million more California residents will be tested. On Jan. 1, 2014, Medi-Cal, the publicly funded health program for low-income and disabled residents, launches a huge statewide expansion. But making a promise is one thing, and delivering is another. In some places, it’s already difficult for many poor California residents to find a doctor who is able – or willing – to see them.

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Getting patients to where they need to be
Los Angeles Times

He knows all about his patients: who likes to cook, whose blood pressure is out of control, who is quarreling with her husband. He keeps track of their appointments and recalls many of their phone numbers by heart. Calvin Woodard isn’t a doctor or a nurse. Woodard is a driver. Every weekday, he ferries dozens of patients in an old white van to and from the To Help Everyone (T.H.E.) Clinic.

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Commission on doc pay urges shift from fee-for-service, end to SGR
Modern Healthcare

Starting with the premise that physician salary and expenses account for 20% of healthcare spending but the decisions doctors make influence another 60% of that spending, the National Commission on Physician Payment Reform has released a dozen recommendations to ultimately change how physicians are paid by public and private payers.

A year ago this month, the Society of General Internal Medicine convened the commission to suggest new ways to pay the nation’s physicians that could improve patient outcomes and lower healthcare costs. In a report released Monday, the commission concluded that the problems of physician payment are based on systemic issues, such as the traditional fee-for-service payment model, and problems pertaining specifically to Medicare, including the sustainable growth-rate formula to pay physicians and the operation of the Relative Value Scale Update Committee (RUC), which makes recommendations to the CMS.

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In Medical First, a Baby With H.I.V. Is Deemed Cured
New York Times

Doctors announced on Sunday that a baby had been cured of an H.I.V. infection for the first time, a startling development that could change how infected newborns are treated and sharply reduce the number of children living with the virus that causes AIDS. The baby, born in rural Mississippi, was treated aggressively with antiretroviral drugs starting around 30 hours after birth, something that is not usually done.

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Child born with HIV is ‘functionally cured’
Los Angeles Times

For the first time, doctors are reporting that a child born with HIV and put on an unusually aggressive treatment regimen has been functionally cured of the infection.

Now 2 years old, the Mississippi girl has only trace amounts of HIV in her bloodstream and has been able to keep the virus that causes AIDS in check without the help of medication, doctors said Sunday at a medical conference in Atlanta.

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Scientists say baby born with HIV apparently cured
Modern Healthcare

A baby born with the virus that causes AIDS appears to have been cured, scientists announced Sunday, describing the case of a child from Mississippi who’s now 2½ and has been off medication for about a year with no signs of infection.

There’s no guarantee the child will remain healthy, although sophisticated testing uncovered just traces of the virus’ genetic material still lingering. If so, it would mark only the world’s second reported cure.

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Obamacare could mean coverage for 38,000 uninsured county residents
Ventura County Star

In a surge that begins Jan. 1, nearly 40,000 uninsured Ventura County residents are expected to gain access to doctors, clinics and care.

Theoretically.

Whether the theory driving federal health care reform materializes locally or falls short depends largely on whether there are enough doctors to provide care.

Leaders of an area Medi-Cal system and a Ventura County health care network think the answer is yes.

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Aetna CEO Warns of Approaching Health Insurance ‘Premium Rate Shock’ in 2014 for Consumers and Others Under Accountable Care Act
Dark Daily

Next year, consumers and small businesses can expect what one health insurance CEO says will be, “Premium rate shock for 2014.” As this happens, clinical laboratories and pathology groups are likely to find it even more difficult to collect co-pays, deductibles, and out-of-pocket fees from patients who had medical laboratory tests performed.

The premium rate shock remark was made by no less than Mark Bertolini, the CEO of Aetna, Inc. (NYSE: AET). In his speech at an investor conference, he predicted premiums would rise by 20% to 50% next year before the government subsidies are applied. In some markets, rates could double, he added.

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Premium Shock? Fifteen Point Drop in Support for Obamacare Among Democrats
Heartland

Here’s an incredible statistic courtesy of the Kaiser Family Foundation’s tracking survey on the popularity of President Obama’s health care law: since the 2012 election, support for the law has dropped among Democrats by fifteen points. Opponents of the Affordable Care Act currently outnumber supporters (42 percent to 36), according to the Kaiser Family Foundation’s latest tracking survey.

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Proposed reform-law insurance tax rules issued
Modern Healthcare

The Obama administration has proposed rules implementing a health insurance premium tax to help fund the healthcare reform law, even as health insurers and Republicans continued a push to kill it. The health insurance tax is expected to collect $8 billion in 2014 and rise to $14.3 billion by 2018, according to the proposed rule. The proposed rule also specified entities that are exempt from the tax, including self-insured employers and any government entities.

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California lawmakers showered with gifts after shelving limits
Los Angeles Times

Despite efforts to restrict the practice, California elected officials were showered with gifts last year from special interest groups, including tickets to Lakers and Giants games, concerts, cigars, expensive meals, lodging at casino resorts, golf games and foreign travel, according to records released Saturday. In August, legislators killed a measure that would have prevented companies that hire lobbyists from providing lawmakers and their families with tickets to amusement parks, racetracks and professional sporting events, as well as rounds of golf, spa treatments and gift cards.

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Taking aim at chronic disease
Times-Standard

The best path to health may not be a New Year’s resolution, 88 percent of which are said to fail. It may be a six-week, 15-hour workshop taken for free by more than a thousand Humboldt County residents over the last four and a half years. ”Most people who make a New Year’s resolution don’t keep them very long. I haven’t made a formal one for years,” said Margaret Zlatkoff of Eureka. “But when I found out this class was going on again, I knew that was what I was going to do.”

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Atty. Gen. Kamala Harris urges funding for prescription tracking
Los Angeles Times

Calling prescription drug abuse an urgent public health problem, California Atty. Gen. Kamala D. Harris is pushing lawmakers to fund an effort to identify physicians who recklessly prescribe addictive medications.

Harris said in an interview that she wanted to use a state database of prescriptions, known as CURES, to draw a bead on doctors who abuse their prescribing powers, a controversial step discussed for years but never adopted.

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CMS issues rules on insurance program for small businesses
Modern Healthcare

The CMS issued both final and proposed rules Friday governing an insurance marketplace for businesses with fewer than 100 employees.

The Small Business Health Options Program, created under the healthcare reform law, will offer a marketplace of insurance plan options for small businesses beginning in 2014. States will have the option to allow businesses with more than 100 employees to purchase coverage through the SHOP Exchanges beginning in 2017.

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Teen birth rates keep falling
HealthyCal.org

The daily news is filled with disturbing social trends portending awful consequences around the corner, next year or for generations to come. The economy is sluggish, our safety net is unraveling, Social Security and Medicare are running out of money, and we can’t fix any of it because the government is broke and we’re buried in debt that will be passed down to our grandchildren. It can all be very depressing.

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Inside an ACO-Like Partnership
Health Leaders Media

Philadelphia-based Independence Blue Cross (IBC) says a pay-for-performance payment initiative with Abington Health, launched a year ago, is on track for success primarily because its physicians are engaged.

Doug Chaet, senior vice president of contracting and provider networks for IBC, says Abington is committed to the new model of healthcare that coordinates care to keep patients healthier.

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Health coverage: How affordable?
Sacramento Bee

New subsidies will help millions more Californians obtain health insurance. Lifetime limits and pre-existing conditions will no longer be taken into consideration in determining coverage. Already, young adults can remain covered up to age 26 under their parents’ health insurance.

All this and more is either in effect or will be implemented in 2014 as part of the Affordable Care Act. This revolution in health care coverage holds the promise of improving Californians’ overall health and helping them avoid financially crippling medical bills.

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Obamacare In Pictures
The Health Care Blog

A seasoned colleague recently told me that some PowerPoint presentations have no power and make no point. But sometimes, a picture really is worth a thousand words. Or maybe — in the case of any meaningful discussion of health reform, thanks to its density and complexity — it might be worth 10,000 words. Hence our handy little exhibit. This picture captures the 10,000 words it would require to explain with technical precision where President Obama’s Affordable Care Act fits relative to all health reform plans.

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The Patient-Centered Practice, Revisited
The Health Care Blog

It is as natural for doctors, hospitals, health plans and others to aggressively affirm their “patient-centeredness” as it is for politicians to loudly proclaim their fealty to the hard-working American middle class. Like the politicians, the health care professionals no doubt believe every word they say. The most accurate measure of “patient-centered” care, however, lies not in intentions but implementation.

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The Promises and Pitfalls of Pay for Performance
The Health Care Blog

There’s been a great deal of discussion about health care payment reform. Prominent in this discussion is “Pay for Performance” (P4P). The idea is simple — rather than pay providers based on volume of care (fee-for-service) or number of patients (capitation), tie their payment to a measure(s) of performance. There has been substantial concern about the quality of care delivered to patients, so pay for performance appears to make a lot of sense. Don’t we want to reward providers for good performance? Shouldn’t this encourage them to provide high quality care?

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