News Headlines

News Headlines
Health care news from around the state and nation

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White House warns cutting Medicare will shift costs
USA Today

If Congress addresses the nation’s budget deficit by cutting Medicare, that will simply shift health care costs to the private sector and not address the underlying issues, Obama administration officials said Tuesday at a White House briefing.

“If you only focus on Medicare, you shift the costs,” Health and Human Services Secretary Kathleen Sebelius said, adding that Medicare and Medicaid are not the reason health costs are going up.

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Doctors, non-physicians battle over medical turf
Los Angeles Times

A series of bills to expand the roles of nurse practitioners and other healthcare professionals has set off a turf war with doctors over what non-physicians can and can’t do in medical practices.

Citing a doctor shortage in California, state Sen. Ed Hernandez (D-West Covina) has proposed legislation that would redefine professional boundaries for nurse practitioners, pharmacists and optometrists to help treat what is expected to be a crush of newly insured Californians seeking care next year under the federal healthcare law.

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Health costs significantly higher in U.S., report finds
Modern Healthcare

Private insurers in the U.S. last year paid significantly more—up to 26 times as much in one case—for common procedures, hospital and doctor visits and prescriptions when compared with private and public insurers in 10 other countries, a report shows. The report, by the International Federation of Health Plans, did find a few instances where average prices paid in other countries mostly matched those of the U.S., but such occurrences were rare. Instead, U.S. private insurance prices widely exceeded those of other countries.

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Value-based insurance plans gain momentum
Modern Healthcare

The movement among employers to push insurers to adopt health plan benefit designs that improve medical outcomes without raising costs is slowly gathering steam, according to an employer coalition pushing payment reform.

While only 11% of payments that commercial insurers made to in-network providers in 2012 were “value-oriented,” according to a survey from Catalyst for Payment Reform, that’s more than halfway to its goal of 20%, which the group hopes to attain by 2020.

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Insurers eager to maintain authority over healthcare premiums
Los Angeles Times

While most of us face uncertainty with the rollout of healthcare reform, some insurance companies in California have been feeling their oats lately. Here’s how they’re responding to Insurance Commissioner Dave Jones’ warnings that their latest rate increases are unreasonable: Stuff it, Dave. That essentially was the response of Blue Shield of California and Anthem Blue Cross after Jones flayed their proposed premium hikes — up to 20% for Blue Shield customers and up to 18% for Anthem.

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Study: Claims costs in individual insurance market to rise
Modern Healthcare

A new study finds that insurance companies will have to pay out an average of 32% more for medical claims under President Barack Obama’s healthcare overhaul. What does that mean for you? It could increase premiums for at least some Americans. If you are uninsured, or you buy your policy directly from an insurance company, you should pay attention. But if you have an employer plan, like most workers and their families, odds are you don’t have much to worry about.

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9 in 10 Health Plans Still Tied to FFS Model
Health Leaders Media

The Catalyst for Payment Reform (CPR), an independent, non-profit group working on behalf of large healthcare purchasers, Tuesday released its first annual National Scorecard on Payment Reform, which showed that 89.1% of these payments are still based on the traditional fee-for-service model and not tied to improving quality outcomes or reducing waste. The balance, 10.9% of payments made by commercial health plans to providers, are value-oriented, CPR determined.

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Doc EHR market remains competitive
Modern Healthcare

Epic Systems Corp. has more physicians and other eligible professionals who have attested as meaningful users of complete electronic health records systems in the ambulatory-care setting than any other vendor in a still-crowded and intensely competitive field, an analysis of federal data shows. The Verona, Wis.-based developer has 27,694 or 20.9% of eligible professionals or EPs with complete EHRs in ambulatory care who met federal meaningful-use criteria under the Medicare portion of the EHR incentive payment program.

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How Immigration Reform Influences Health Care Reform
Voice of OC

Fred Bauermeister has watched them pass through his clinic doors for decades: chronically ill, uninsured men, women and children who have delayed medical care because they are in the country illegally. But now a political deal may be in the works that after many years could bring health benefits to millions of undocumented people. A bandwagon of endorsements last week by congressional Republicans have aligned with vows by President Obama and Senate Democrats to establish comprehensive immigration reform.

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Healthcare Reform Law Creates 111M Hours of Paperwork: Study
Becker's Hospital Review

The Patient Protection and Affordable Care Act has imposed approximately 111.4 million hours of paperwork, according to a new study from American Action Forum, a conservative think tank. Based on that finding, the AAF said it would take 55,742 employees working 2,000 hours in a year to complete the red tape required in the PPACA. Some of the most time-consuming provisions of the law, according to the AAF, are:

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More employers considering exchanges for retiree health coverage: survey
Modern Healthcare

More than 60% of employers offering coverage to Medicare-eligible retirees are reconsidering the way they provide coverage, according to an Aon Hewitt survey released Tuesday.

About 20% of the respondents now use a private insurance exchange, but that approach could become much more popular in the future, the survey suggests, with two-thirds of respondents saying they are considering that approach.

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100 Great Hospitals in America
Becker's Hospital Review

Becker’s Hospital Review is pleased to announce its 2013 annual list of “100 Great Hospitals.” Each of following organizations have an interesting story behind them, some dating back to the 18th century, and contribute to the American healthcare landscape, whether they be community hospitals or academic medical centers, large flagship facilities or small specialty hospitals. These organizations continually improve upon themselves and are innovators for medical treatments, research, technology and care delivery.

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Bill would let hospitals conduct income means test for charity care
FierceHealthcare

Maine lawmakers are considering a measure that would align state law regarding eligibility for charity care with the Affordable Care Act by allowing hospitals to conduct an income means test.

Hospitals would not be able to refuse care, but could consider a patient’s assets, as well as their income in determining whether those without insurance could pay all or part of their bill, the Maine Sun Journal reported.

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Lumbar Spine MRIs ‘Frequently Inappropriate’
Health Leaders Media

In Canada, more than half the requests for MRI scans of patients’ lumbar spines were “substantially” inappropriate or of uncertain value, a finding the study’s author says is probably even greater in the United States.

“The thing about Canada is that we have limited access to MRI, whereas in the United States, effectively, you don’t have limits for people who can afford it; there’s no waiting list and no limitations on access,” says Derek J. Emery, MD, associate professor and neuroradiologist at the University of Alberta, and principal author of the paper published Monday as a Research Letter in JAMA Internal Medicine.

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Anaheim General to close in May
Orange County Register

Anaheim General Hospital, which made a rare turnaround two years ago after a near-fatal loss of federal funds, will go out of business in May. The closure will result in the loss of 142 hospital beds at a time when Orange County hospitals are preparing to serve more patients because of the federal Affordable Care Act. An announcement memo to employees Monday came two weeks after the state Department of Labor Relations fined the hospital’s owner, Tustin-based Pacific Health Corp., more than $7 million for failing to pay wages, issuing checks that bounced and collecting insurance premiums but not paying for coverage.

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New tests will refine prostate cancer diagnoses
Sacramento Bee

Sophisticated new prostate cancer tests are coming to market that might supplement the unreliable PSA test, potentially saving tens of thousands of men each year from unnecessary biopsies, operations and radiation treatments.

Some of the tests are aimed at reducing the false alarms, and accompanying anxiety, caused by elevated PSA readings.

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UCSF study suggests flaw in ER laws
San Francisco Chronicle

In an attempt to lower soaring Medicaid costs, some states have come up with a plan: Don’t pay for emergency-room patients who aren’t sick enough to be there. The problem, a new UCSF study points out, is that when patients walk through the door, it’s actually difficult to tell just how sick they are. Nearly a dozen states have proposed or enacted plans to deny or limit reimbursements, or require co-payments, for patients who go to the emergency room for conditions that turn out to be something a primary-care doctor could have treated.

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US study: Fewer dying in hospitals, more at home
Sacramento Bee

Surveys show most Americans would rather die at home than in a hospital. Now, a new government study suggests more and more people getting their wish.

The researchers studied the deaths of patients admitted to a sampling of hospitals. They determined that hospital deaths accounted for 29 percent of U.S. deaths in 2010, down from more than 32 percent in 2000.

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Blue Shield of California Foundation makes $10.7M in Q1 grants
San Francisco Business Times

The Blue Shield of California Foundation said Tuesday it’s making $10.7 million in grants this quarter, including more than $8.3 million to support community health centers and nonprofits focused on health care and coverage issues, and $2.3 million to anti-domestic violence programs. Up to $5 million of the total funds 200 community health centers statewide, officials said March 26. The San Francisco-based foundation is the philanthropic arm of giant non-profit insurer Blue Shield of California.

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Six Months Out Health Plan Execs Say They Doubt Exchanges Will Be Ready
The Health Care Blog

As the Obama administration continues its top secret effort to build federal insurance exchanges in about 34 states while 16 states are doing it on their own, that continues to be the big question. HHS is using IT consulting firm CGI for much of the work on the exchanges and the federal data hub. CGI has their plate full since they are not only working on the federal exchange but also doing work for the state exchanges in at least Colorado, Vermont, and Hawaii.

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Medicaid expansion fight harms you: Our view
USA Today

The biggest selling point for President Obama’s health care law was that 30 million uninsured people would get coverage, about half through private insurance and half through an expansion of Medicaid, the federal-state program for the lowest-income Americans. Now, in too many states, the Medicaid portion is in serious jeopardy.

Thanks to last June’s Supreme Court ruling that made the expansion optional for states, a group of Republican governors and legislators has opened a new front in their ideological war against ObamaCare — at the expense of their poorest residents, their state’s hospitals and their own state budgets.

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Don’t expand Medicaid
USA Today

Of all the bad ideas related to ObamaCare, depending upon Medicaid to do the heavy lifting to “insure” Americans is about the worst of the bunch. Medicaid was not built to handle the economic stresses of dealing with the number of people it already has in the program. If you don’t believe me, ask President Obama himself, who in 2009 called Medicaid a “broken system that doesn’t work.” This broken system is already putting extreme pressure on state budgets, and that will only increase over time.

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