News Headlines

News Headlines
Health care news from around the state and nation

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Healthcare workers say stop Medi-Cal cuts of $1 billion
Sacramento Press

Health insurance firms – among them Anthem Blue Cross and Blue Shield of California – medical professional associations – including the California Hospital Association and the California Medical Association – and the Service Employees International Union United Healthcare Workers West bused thousands of advocates to Sacramento today for a huge Medi-Cal rally at the Capitol. It was all about the Medi-Cal cuts in California.

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Showdown between state, counties over health-care budget funding
Capitol Weekly

A major budget battle has erupted between the Brown administration and California’s counties over health-care spending, with the governor hoping to divert some $2.5 billion from the counties over the next three years. At issue is money – initially, $300 million — that the counties use to provide care for the indigent. But Brown in his 2013-14 draft budget wants to hang on to that money, saying the indigent will be covered by Medi-Cal as the new federal health care reforms kick in at the beginning of next year.

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Great Recession spawns Great Debate over health spending
Modern Healthcare

Economists and policymakers are puzzling over how big an impact the Great Recession and its aftermath are having on reducing healthcare spending, whether the economic upswing will unleash pent-up demand for care, and whether the current lower spending is actually good for Americans’ health. New research shows that household health spending declined even among those with private insurance and medical needs.

Out-of-pocket costs for children with special medical needs declined between 2007, when the recession began, and 2009, the year the recession officially ended, a newly published study in Health Affairs says.

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Hospitals Lagging on PSO Contracts
Health Leaders Media

A brief and little-known provision in the health reform law says any hospital with more than 50 beds will be shut out of the 2015 health insurance exchange plan offerings if it doesn’t have a contract with one of 77 federally approved patient safety organizations. Few have these contracts now. While the Patient Protection and Affordable Care Act provision takes effect with exchange plans as of January 1, 2015, for planning purposes, hospitals will have to meet requirements long before health plans release their offerings three months earlier, on October 1, 2014.

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Physicians Face Unexpected Obamacare Loophole
The Health Care Blog

Doctors who contract with state health insurance exchanges next year might find themselves on the hook for treatment costs resulting from what many are calling a loophole in the Affordable Care Act. Some say the provision might prompt doctors to avoid the exchanges altogether, while other experts say few health care providers are aware of the issue and likely won’t know about the loophole until it’s too late.

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Poll Finds Support Slumping for Health Law
The Wall Street Journal

Americans’ unease with President Barack Obama’s health-care law has intensified, just as the administration is gearing up to persuade people to sign up for some of its major provisions, a Wall Street Journal/NBC News survey finds.

Prior Journal/NBC polls have found more people calling the health law a bad idea rather than a good one. But the number calling it a bad idea reached a high of 49% in a poll of 1,000 adults taken between May 30 and June 2, with 43% “strongly” holding that view.

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Navigator organizations fight concerns about fraud, lack of training
Modern Healthcare

With final details for state insurance exchanges still in the works, organizations are starting to hire people to help consumers through the enrollment process that will begin on Oct. 1. They’re doing so while fending off concerns of conflicts of interest, shoddy training and the potential for fraud.

The Patient Protection and Affordable Care Act establishes grant funding for guides who will, for example, educate consumers on ways to apply for tax credits and subsidies. They may not steer them to particular plans.

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Sebelius denies fundraising for healthcare reform
FierceHealthcare

U.S. Department of Health & Human Services Secretary Kathleen Sebelius said Tuesday she didn’t ask companies regulated by her department for money to help a private nonprofit group implement President Barack Obama’s healthcare reform law. But she admits calling three companies–Johnson & Johnson, the drug maker; Ascension Health, a large Roman Catholic healthcare system; and Kaiser Permanente, the health insurer–asking for their support.

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New healthcare model cut even more costs in year two: insurer
Yahoo! News

The nation’s largest experiment in delivering medical care in an innovative way has reduced costs and improved the quality of care even more in its second year than in its first, according to the insurance company behind it. The nonprofit CareFirst BlueCross BlueShield launched its “Patient-Centered Medical Home” program in January 2011 among primary-care providers serving about one-third of its 3.4 million members in Maryland, Washington, D.C., and northern Virginia.

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Another Arrow in the Quiver for Attempt To Reverse Medi-Cal Cut
California Healthline

The chant was long and loud and seemed like it would never stop: “Hey! Hey! What do you say! Stop the cuts right away!” Marquesha Harris was one of an estimated 8,000 people who descended on Sacramento Tuesday for one of the biggest health care protests ever at the Capitol. She wasn’t up on the specific details of the provider rate cut at the center of the protest, but she was sure of one thing: There have been too many cuts to Medi-Cal, she said.

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Commercial insurers less likely to offer ACOs ‘upside-only’ shared-savings arrangements, study finds
Modern Healthcare

Commercial insurers participating in accountable care arrangements are less likely than Medicare to use payment models featuring the “upside-only” shared savings preferred by providers, according to an analysis released Wednesday by the Premier healthcare alliance. Premier’s study of 85 ACO payer arrangements showed that more than one-third of these are for upside-only shared savings—where savings are split evenly between insurers and providers and there are no penalties imposed for failing to meet goals.

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ACO Shared Savings is Top Payer Partnership
Health Leaders Media

Early adopters of Medicare accountable care organizations have a preference for a one-sided risk model while commercial ACO participants look for care management fees, according to a survey released Wednesday by Premier healthcare alliance.

The Premier survey looks at 85 payer arrangements covering 1.8 million covered lives for 22 participants of its PACT (Partnership for Care Transformation) population health collaborative program.

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HHS to develop data-sharing plan for outcomes research
Modern Healthcare

Two HHS agencies announced they are partnering with one another to develop an interoperable data infrastructure to support patient-centered outcomes research. Such research compares the effectiveness of various treatments and procedures, within the framework of what works best for patients.

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Blue Shield, Anthem owe CA small firms millions of dollars
Health Leaders Media

Blue Shield of California owes $24.5 million in rebates to thousands of small-business customers, and rival Anthem Blue Cross will return $12 million to small firms under requirements of the federal healthcare law. The annual rebates were disclosed in reports to state regulators, and the final tally from some companies may change before they are paid out by Aug. 1. The rebate is required under the federal Affordable Care Act when insurers fail to spend a minimum of 80% of premiums on medical care for individual and small-business customers.

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Should state close ‘loophole’ in health care law? Yes
Sacramento Bee

The federal health care reform law, the Affordable Care Act, holds the promise of bringing potentially lifesaving coverage to millions of Californians if we all live up to our shared responsibility – individuals, government and businesses. Under the ACA, individuals must have health care coverage through either their employer, the private market or subsidized government programs. The government provides subsidies through the new health care exchange to help individuals and businesses afford coverage. Businesses of 50 or more full-time employees must provide affordable coverage or pay a penalty to offset a portion of the taxpayer cost.

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