News Headlines

News Headlines
Health care news from around the state and nation

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McClellan sees Pioneer quality measures having wide impact
Modern Healthcare

Debate over quality measures among Medicare’s first accountable care organizations and federal officials will likely have significance for the 220 (and growing) other accountable care efforts under Medicare, a former CMS administrator says. Dr. Mark McClellan, director of the Brookings Institution’s Engelberg Center for Health Care Reform and one-time head of the CMS, speaking at the National Accountable Care Organization Summit in Washington late last week said the CMS had not yet finalized a response to critics of quality targets as accountable care under Medicare enters its second year.

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Slowdown in health care costs to continue
San Francisco Chronicle

There’s good news for most companies that provide health benefits for their employees: America’s slowdown in medical costs may be turning into a trend, rather than a mere pause. A report Tuesday from accounting and consulting giant PwC projects lower overall growth in medical costs for next year, even as the economy gains strength and millions of uninsured people receive coverage under President Barack Obama’s health care law.

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Health-care law’s network for resolving confusion shows mixed results
Washington Post

About half of Americans say they don’t know how the Affordable Care Act will affect them. Four in 10 think the 2010 law has been repealed or overturned, or they are unsure where it stands. So chances are good that when the major provisions kick in next year, including online health insurance marketplaces and new standards for health plan costs and coverage, people are going to have questions. Lots of questions. When they do, the biggest one of all may be where to turn for answers.

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Campaign aims to educate uninsured about ACA coverage options
Modern Healthcare

In a scramble before open enrollment for the health insurance exchanges begins in October, Enroll America on Tuesday will launch Get America Covered, a campaign to educate Americans about the coverage options available to them under the 2010 health reform law. Led by former Obama administration official Anne Filipic, Enroll America is the not-for-profit group charged with coordinating efforts to help uninsured Americans learn about the healthcare insurance benefits available in the Patient Protection and Affordable Care Act—and then help them enroll in coverage.

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California Budget Puts Some Health Care Issues on Hold
California Healthline

California’s budget agreement announced and approved last week puts a couple hotly contested health care issues on hold, making some stakeholders nervous and angry, but for the most part, this year’s balancing act is kinder to health and social services than any spending plan over the past half decade, according to legislators and veteran Sacramento watchers. “I would take this budget over the last five eight days a week,” said Darrell Steinberg, Senate President Pro Tempore and one of the budget’s main architects.

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State Fiscal Plan Leaves Hole in Sacramento County’s Health Budget
capital public radio

The state plans to take nine million dollars out of Sacramento County’s health budget next year.

It says counties won’t need as much money because uninsured people in regional health programs will move over to state-managed Medi-Cal under the Affordable Care Act.

Ann Edwards is a chief county executive with Sacramento. She says there will be significant savings on health care next year, but there may not be enough money to treat the remaining uninsured.

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Inpatient or outpatient? It makes a difference with Medicare
Times-Standard

When you go to a hospital, does it make any difference if you’re considered an “inpatient” or an “outpatient?” Yes, it does. Your hospital status (whether the hospital classifies you as an inpatient or outpatient) affects how much you pay for hospital services like X-rays, drugs and lab tests. It also may affect whether Medicare will cover care you get in a skilled nursing facility. You’re an inpatient starting the day you’re formally admitted to the hospital with a doctor’s order. The day before you’re discharged is your last inpatient day.

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Hold off on DSH cuts till reform takes hold
Fierce HealthFinance

Last month the Centers for Medicare & Medicaid Services issued a proposed rule that would cut supplemental Medicaid disproportionate share hospital (DSH) payments by $1.1 billion over the next two years. This stunned the executives of many of our nation’s almost 2,000 affected hospitals. They were bracing themselves for a much larger cut–$18.1 billion through 2020–as called for by the Affordable Care Act.

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Does This Move Defeat the Purpose of Obamacare?
San Francisco Chronicle

The Patient Protection and Affordable Care Act, set to go into full effect on Jan 1., is certain to have broad-reaching impacts on the way that insurance companies sell their products to consumers. Some insurers, like Aetna , have been jockeying for position in the Medicaid arena, purchasing Coventry Health Care for $5.7 billion to take advantage of the coming Medicaid expansion. Other insurers have chosen to enter new markets and utilize the transparent state-run health exchanges being formed under the PPACA, also known as Obamacare, to expand their presence.

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Obamacare Rollout Seen Slowed by Confusion Over Benefits: Health
San Francisco Chronicle

Judith Mayer Lynn, uninsured and battling breast cancer, should be a fan of the Affordable Care Act. Instead, she barely knows about it.

The 56-year-old Nevada woman was unaware of subsidies in the law that will help people like her buy coverage in 2014, she said in an interview. Lynn didn’t know the act requires insurers to pay for prescription drugs, hospital stays and other services she’s spent the last two years scrimping to afford.

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Patients Shoulder Nearly 25% of Medical Bills
Health Leaders Media

Higher co-pays, deductibles and other fees have held patients responsible for nearly 25% of their medical bills and forced physicians to become reluctant bill collectors, a new study from the American Medical Association shows. For the first time in its six year history the AMA’s National Health Insurer Report Card examined the portion of medical bills that patients are responsible for through co-pays, deductibles and coinsurance.

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Pace of Rising Medical Costs Slowing
Health Leaders Media

As work to implement the Patient Protection and Affordable Care Act continues, a new report projects that for the fourth consecutive year, the pace of medical cost increases will slow. Taking into account the spread of less expensive care options such as retail clinics and a decline in hospital readmissions, in 2014 healthcare cost are projected to increase by 6.5%, according to the Medical Cost Trend report from PwC’s Health Research Institute. That is a full percentage point lower than the 2013 projected rate.

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Aetna will exit California’s individual health insurance market
Los Angeles Times

Aetna Inc. said it would stop selling individual health insurance policies in California next month, and nearly 50,000 existing policyholders will have to find new coverage by January.

The company’s announcement Monday comes a month after it opted not to participate in California’s new state-run insurance market for consumers, a key component of the new federal healthcare law.

Aetna was a distant fourth in the state’s individual health market with a 5.2% market share in 2011, according to Citigroup data.

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ACOs Widespread, Yet Challenged
Health Leaders Media

Accountable Care Organizations is increasing dramatically across the United States and showing quality and efficiency successes, many providers are struggling to implement the programs, often due to the wide range of required performance measures.

That was the message delivered this week by Elliot Fisher, MD, MPH, director of The Dartmouth Institute for Health Policy and Clinical Practice, and Mark McClellan, MD, PhD, former administrator of the Centers for Medicare & Medicaid Services, and a commissioner of the Food and Drug Administration.

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State partnership exchanges running into problems
Modern Healthcare

Some states that will be running their health insurance exchanges with help from the federal government are not receiving necessary information in a timely fashion, which may inhibit their ability to effectively prepare for the launch of their marketplaces, according to a study released Friday from the Urban Institute.

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Observation of Prostate Cancer Safe, Saves $$$
MedPage Today

Observation topped initial treatment for low-risk prostate cancer in terms of cost and effectiveness, according to a decision-analysis study.

Both active surveillance and watchful waiting proved more effective and less expensive than immediate treatment. In a comparison of the two observation strategies, watchful waiting added 2 months of quality-adjusted life expectancy and saved $11,000 to $15,000 versus active surveillance, depending on the patient’s age.

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How much would a new L.A. city health department cost? $330 million, says budget analyst
Los Angeles Daily News

Creating a new Los Angeles city health department could take between one and two years and cost at least $333 million a year, with only about $75 million of that made up in fees, the city’s top budget analyst said in a report. City Administrative Officer Miguel Santana said the proposal from the AIDS HealthCare Foundation to create a separate city agency apart from the county Department of Public Health would create a number of other problems for the city, which still has a deficit of more than $100 million, by prohibiting any contracting with the county for assistance.

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S.F. grudgingly backs Kaiser rate hike for public workers
Los Angeles Times

Officials who oversee the healthcare plans that cover San Francisco public employees this week excoriated Kaiser executives for failing to adequately explain a proposed rate increase but ultimately voted to back it.

The city’s public workers have seen their healthcare costs spiral while they have accepted pay cuts and furlough days at the bargaining table. In an unusual move, labor unions teamed up with San Francisco’s Health Service System earlier this year to demand greater transparency from Kaiser.

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Blue Shield may take L.A. contract from Anthem Blue Cross
Los Angeles Times

Blue Shield of California, already facing a Los Angeles ethics complaint over potential conflicts of interest, is poised to take a lucrative health insurance contract for city workers away from rival Anthem Blue Cross.

The proposed three-year deal is still subject to approval by L.A. Mayor Antonio Villaraigosa. Under Blue Shield’s offer, the city would pay 2% more, or $112 million, in premiums next year for these HMO and PPO plans.

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UC Davis researcher gets cancer grant
Sacramento Business Journal

Sacramento-area Hyundai dealers and Hyundai Hope on Wheels, a nonprofit committed to finding a cure for childhood cancer, will donate a $75,000 next week to Dr. Jay Balagtas for his work to establish a pediatric long-term survivor clinic and care program at the UC Davis Cancer Center. UC Davis is one of 40 recipients of the 2013 Hope on Wheels scholar grant program, which helps principal investigators pursue research and launch clinical programs aimed at improving the lives of children battling pediatric cancer.

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Alameda Hospital in affiliation talks
San Francisco Chronicle

Alameda Hospital’s board will consider pursuing a deal to hand over management of the financially ailing hospital to Alameda County’s health system, a deal the hospital’s top manager says will provide the cash needed to keep its doors open.

The Alameda Health Care District Board meets tonight to discuss approval of a non-binding letter of intent to pursue a merger with the Alameda Health System, and the county health system’s board is set to discuss it Tuesday. A deal could be closed by the end of this year.

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Monterey County health officials hope to be spared from state budget cuts
Monterey Herald

Monterey County officials remain hopeful that Natividad Medical Center and county public health programs will be spared from a $300 million cut in state health care funding for the uninsured included in the budget passed by the state Legislature on Friday.

Harry Weis, chief executive officer of Natividad, said Friday he believed both the county and its Salinas hospital are “in a good position” and have “a very low probability” of losing state funding.

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Kern Health Systems allocates $26M to Kern County providers
KERO

Kern Health Systems has allocated over $26 million in grant money to Kern County Providers.

Kern Health Systems is committed to improving the medical services capacity of Kern County healthcare providers who routinely serve Kern County’s low income population. Over the last eight months, Kern Health Systems has worked together with both Safety-Net and Rural Health Care providers to enhance access to quality healthcare services for its Kern Family Health Care members as well as the greater Kern County community.

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Doctor Shortage Looms in Health Care Reform
Yahoo! News

Few would argue with the notion that health care reform will result in huge changes in the way physicians practice and patients receive care. But on the front lines, doctors themselves possess unparalleled insight into how these shifting sands will impact their own ranks — and that awareness inspires dread in many of them. Combined with an aging population, the influx of nearly 32 million newly insured people into the U.S. health care system by 2016 — a direct result of the Affordable Care Act — will lead to an unavoidable consequence: a shortage of primary-care physicians, the doctors we see when we have the flu or need to monitor chronic illnesses such as diabetes.

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Hoag Hospital’s no-abortions decision
Los Angeles Times

The emails already are flying around the Internet in Orange County, they’re predictably from women, and they’re saying let’s forget about getting our medical care at Hoag Hospital in Newport Beach.

Hoag said it was not the review of its services, prompted by its partnership with St. Joseph Health, a Roman Catholic-affiliated institution, that led to its decision to stop performing elective abortions. The hospital does too few of them — about 100 a year — to maintain the required level of excellence, a spokesman said.

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