News Headlines

News Headlines
Health care news from around the state and nation

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Senators set to push for details on CMS Innovation Center
Modern Healthcare

Senators will get their first chance Wednesday to press for operational details from the head of a fledgling CMS office with the power to drive wide-scale changes in Medicare and Medicaid.

Dr. Richard Gilfillan, director of the Center for Medicare and Medicaid Innovation at CMS, will make his first congressional appearance before the Senate Finance Committee to provide details about the inner workings of the office created by the 2010 healthcare overhaul to test new models of delivering and funding care in Medicare and Medicaid.

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Berwick: Quest Program Results ‘A Breakthrough’
Health Leaders Media

In what former Centers for Medicare & Medicaid services administrator Don Berwick, MD, called “a breakthrough,” hundreds of hospitals in a data- practice-sharing project have shown significant reductions in cost, mortality, and infections.

Some 333 hospitals are participating in the Premier Healthcare Alliance’s data- and practice-sharing project called Quest. Premier’s President and CEO Susan DeVore says the project has saved 92,000 lives and $9.1 billion, compared with what would be expected for its hospitals.

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Autism Rate Rises to 1 in 50 Kids
Yahoo! News

The percentage of U.S. kids with autism continues to rise, with the latest estimate showing the highest numbers yet. About 1 in 50 U.S. children (2 percent) ages 6 to 17 have an autism spectrum disorder, according to a new report based on a national survey of parents in 2011 and 2012. That’s up from about 1 in 86 children (1.16 percent) reported to have autism in the 2007 survey.

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Meaningful use can be stretch even for EHR pioneer
Modern Healthcare

Vanderbilt University Medical Center was a pioneer in the use of health information technology and rolled out its homegrown StarPanel electronic health record back in 2001. But this early experience didn’t mean that meeting the meaningful-use requirements for the federal government’s health IT incentive program was an easy task for the Nashville academic medical center.

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Richer health benefits cost 47% more, industry report warns
Los Angeles Times

Premiums for comprehensive health insurance are 47% higher than other policies without all of those benefits, a new industry study shows, but those higher rates also yield lower deductibles. The report issued Tuesday by eHealth Inc., the company behind online shopping website eHealthInsurance.com, adds to a steady drumbeat of predictions about “rate shock” when the federal healthcare law kicks in next year.

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O.C. might slash funding to model healthcare nonprofit
Los Angeles Times

Orange County officials are considering slashing funding to a Santa Ana nonprofit that has become a community model for its public health outreach efforts in the county’s poorest neighborhoods.

The head of Latino Health Access said she believes questions over the group’s funding have their roots in a dispute two years ago when county supervisors questioned why the nonprofit had to use the word “Latino” in its name and referred to its outreach workers as “promotores.”

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Unhealthiest counties lead in preventable hospital stays
Modern Healthcare

The unhealthiest counties in the nation have the highest rates of preventable hospital stays, smoking and adult obesity, according to the 2013 County Health Rankings, a joint effort of the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. The healthiest counties, meanwhile, had higher numbers of primary-care doctors. The least-healthy counties experienced 82.8 preventable hospital stays per 1,000 Medicare enrollees, while in the healthiest counties the rate was 57.2 per 1,000.

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Habits, not hospitals, affect counties’ health rankings
Visialia Times-Delta

Residents of the nation’s least healthy counties die at twice the rate of those living in their states’ healthiest counties, despite a major improvement in the rate of premature deaths, according to a national survey of county health statistics released Wednesday.

The full implementation next year of the 2010 health care law could improve health statistics overall, experts say, but real change in health statistics can come only if Americans start eating better and exercising more.

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AHIP: Hospital Inpatient Pricing Up Sharply
Health Leaders Media

Prices for inpatient hospital care rose 8.2% between 2008 and 2010, with wide price and cost growth fluctuations recorded across states and localities over the timeframe, according to a study by America’s Health Insurance Plans.

Even after adjusting for more numerous or complex procedures performed per admission, prices climbed sharply for most types of hospitalizations.

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Health System Strategy: Remaining Relevant by Building Primary Care Delivery Beyond Physician Employment
Becker's Hospital Review

The fee-for-service model that has allowed hospital-dominated health systems to use capital investments and inpatient market share to garner financial returns is quickly shifting towards a population health and risk-sharing reimbursement model. There are multiple reasons for this shift including the economic recession, healthcare reform and technological advancements in both information and medical technology.

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Court: Can generic drug maker be sued over design?
Modern Healthcare

The Supreme Court seemed skeptical Tuesday of allowing generic drug manufacturers to be sued in state court for a drug’s design defects if federal officials approved the brand-name version the generic drug copied.

The justices heard arguments from generic manufacturer Mutual Pharmaceutical Co, Inc., which wants a $21 million judgment dismissed. A New Hampshire jury gave that to Karen L. Bartlett after she took sulindac, the generic form of the drug Clinoril, in 2004.

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Two-Plan model of Medi-Cal Managed Care in Imperial County
Imperial Valley Weekly Chronicle

The County Board of Supervisors will move forward to create a Local Initiative as part of a Two-Plan model of Medi-Cal Managed Care in Imperial County.

At Tuesday’s meeting Robin Hodgking Director of County Public Health reported that they have remained engaged in planning for the mandated transition of Imperial County form the traditional Medi-Cal free-for-service model to a managed care model of healthcare financing and service delivery.

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Federal EHR payouts top $12.3 billion
Modern Healthcare

About 219,257 hospitals, office-based physicians and other eligible professionals have shared in just over $12.3 billion in federal electronic health-record incentive payments under the American Recovery and Reinvestment Act of 2009, according to government figures through February. The CMS, which operates EHR incentive payment programs under Medicare, Medicaid and Medicare Advantage, reported that $725 million was spent on incentives by the programs in February alone.

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Fundraising to pay the medical bills
San Francisco Chronicle

Since June 2012, this has been Farmington attorney Kristen Garlans’ life: her boss died, which eventually resulted in her losing her job; a drunk driver killed a close friend; and a beloved aunt died. And then a nagging health concern turned out to be non-Hodgkin lymphoma. Without a job, Garlans, 33, qualified for Medicaid. She’s still waiting to hear about supplemental security income.

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Lacking access to public clinics, Sacramento’s poor crowd local ERs
Sacramento Bee

The emergency room in Sacramento County has become the primary care clinic for many the region’s poor.

Four years ago, Sacramento County supervisors began shoring up successive budget deficits by making large cuts to public health clinics that primarily serve the poor. Since those cuts began, the number of patients at public health clinics in Sacramento County has fallen by about 50 percent, or 80,000, the latest county figures show.

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Hospitals, insurers clash over rising prices
Modern Healthcare

Hospitals and insurers are clashing over new research that found surges in hospital inpatient pricing, even as the Obama administration argues that hospital costs are moderating. The largest health insurer advocacy group, America’s Health Insurance Plans, touted a study by its researchers and published in the March issue of the American Journal of Managed Care that inpatient hospital prices increased 8.2% annually from 2008 to 2010.

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Inyo-Mono hospital news
Sierra Wave

In hospital news in Inyo and Mono, our facilities and officials face lots of changes as the Health Care Reform Act unfolds, other regulations grow and administrators plan to leave or return to their work.

The Northern Inyo Hospital Board was scheduled to meet Wednesday at 5:30 pm in the board room on Birch Street. On the agenda, a possible hospital management agreement with Renown Hospital in Reno.

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Melanoma Drug Succeeds in Late-Stage Trial
New York Times

A cancer drug based on a tumor-killing virus has for the first time succeeded in a late-stage clinical trial, giving a lift to a technology that has long tantalized doctors and researchers. Amgen, which is developing the drug, said late Tuesday that it had met the primary goal of a Phase 3 clinical trial in patients with advanced melanoma, the deadliest type of skin cancer.

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Mammogram benefits for older women weighed
San Francisco Chronicle

UCSF researchers say older women who have breast screenings every two years appear to have health results just as good as those who undergo annual mammograms, regardless of their breast density or whether they have taken hormone therapy for menopause. In contrast, younger women ages 40 to 49 with extremely dense breasts who got screened every two years were more likely to have large tumors or advanced-stage disease than those who underwent annual testing.

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County decides on Medi-Cal managed care
Imperial Valley News

Amid the backdrop of national health care reform, more than 52,000 Imperial County residents are set to undergo unrelated changes in how their Medi-Cal benefits are managed. The county Board of Supervisors decided to transition into Medi-Cal managed care Tuesday. Medi-Cal managed care is a state-mandated organizational system best described as a community of local independent health care providers who work together to manage Medi-Cal patients’ care.

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Medicaid expansion faces struggles over immigrants: report
Modern Healthcare

A new report highlights the struggles certain states may face in expanding their Medicaid programs under healthcare reform because of high numbers of immigrant residents who won’t qualify for the federal coverage. Some states have relatively higher proportions of illegal and recent immigrants in the pool of adults under age 65 who are expected to gain Medicaid coverage in 2014 under the Patient Protection and Affordable Care Act, according to an analysis of U.S. Census Bureau data by the Robert Wood Johnson Foundation.

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House lawmakers reintroduce RAC reform legislation
Modern Healthcare

Two House members are again pushing legislation aimed at improving the Recovery Audit Contractor program, which the lawmakers say causes unnecessary costs and bureaucratic headaches for hospitals. Reps. Sam Graves (R-Mo.) and Adam Schiff (D-Calif.) introduced the Medicare Audit Improvement Act of 2013, which would make changes to the law that created the RAC program, the decade-old Medicare Modernization Act.

For instance, the legislation would place a hard cap on Medicare auditors’ additional document requests—or “ADRs”—to 2% of hospital claims, with a maximum of 500 ADRs for every 45 days. Graves and Schiff introduced a version of the bipartisan legislation last October during the 112th Congress.

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Proposal limits waiting period for health insurance
Modern Healthcare

Employers who offer health insurance coverage to their employees must offer that benefit no more than 90 days after those employees start working, according to a proposed rule that implements part of the healthcare reform law.

Before the Patient Protection and Affordable Act, employers could have waited longer to provide health insurance coverage to employees, said Michael Rosenbaum, a partner with Drinker, Biddle & Reath in Chicago.

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1 in 3 seniors dies with dementia and when parents ignore doctors
Southern California Public Radio

One in three U.S. seniors dies with Alzheimer’s disease or another form of dementia, says a sobering new study, which also found that in many cases, the dementia causes or contributes to death. HealthDay says between 2000 and 2010, the rate of Alzheimer’s-related deaths rose 68 percent, prompting one expert to call it a “public health crisis.” A shortage of nurses in neonatal intensive care units doesn’t appear to be good for the infants in those ICUs, says new research.

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Accountable Care Organizations Can Change Everything, But Only If We Get the Definition Right
The Health Care Blog

Writing in the March 20 issue of JAMA, Drs. Douglas Noble and Lawrence Casalino say that supporters of Accountable Care Organizations (ACOs) are all muddled over “population health.” This correspondent says the article is what is muddled and that the readers of JAMA deserve better. According to the authors, after the Affordable Care Act launched the Medicare Accountable Care Organizations (ACOs), their stated purpose has morphed from Health-System Ver. 2.0 controlling the chronic care costs of their assigned patients to Health System Ver. 3.0 collaboratively addressing “population health” for an entire geography.

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Five Prime, UCB team up on search for drugs
San Francisco Business Times

Five Prime Therapeutics Inc. and Belgian drug developer UCB S.A. will work together to discover biologic targets and drugs to treat fibrosis-related inflammatory diseases and central nervous system disorders. South San Francisco’s Five Prime could receive about $16 million from an upfront fee, technology access fees, research funding and research milestones. It also could receive other fees from UCB, product-related milestone payments and royalties on global sales of products tied to each protein licensed from Five Prime’s library of about 5,600 proteins.

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Republicans bleed slow-moving ObamaCare: Column
USA Today

In 2012, opponents of the Affordable Care Act (ACA) lost both at the Supreme Court and the ballot box. As a result, many opponents vowed to engage in scorched-earth tactics defunding the law or shutting down government. Last week, House Budget Committee Chairman Paul Ryan, R-Wis., announced where he stood with the release of a budget proposal he says would repeal ObamaCare.

The week before, however, the House of Representatives continued another approach, a back door that could slow or undermine the law’s implementation with small cuts unlikely to spark a confrontation.

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