News Headlines

News Headlines
Health care news from around the state and nation

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Medi-Cal cuts to hit nursing homes hard
San Francisco Chronicle

A specific type of nursing home — one that devotes some of its beds to hospital care — is being particularly hard hit by the looming state Medi-Cal cuts. These are homes to some of the oldest, sickest residents in the state. While Medi-Cal reimbursements to doctors, hospitals and pharmacists are being cut by 10 percent, these so-called “distinct part skilled nursing facilities” are facing cuts of up to 30 percent off the current rates.

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Systems with ACOs say benefits are strategic, not financial
Modern Healthcare

The Medicare Shared Savings Program is not producing rapid rewards for the systems that are piloting accountable care organizations in the initial wave of the project.

“Becoming an ACO doesn’t improve the bottomline, to say the least,” said Mark Hiller, vice president of innovative solutions at Premier, which has developed an accountable care financial model for systems thinking of introducing the program. In fact, the opposite is true, with ACOs actually having a negative impact on hospital finances.

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Providers at odds over timeline for ending SGR
Modern Healthcare

Providers remain split over who should determine quality measures under a replacement Medicare physician payment system and how quickly to move away from the current reimbursement model, according to industry groups. The divisions among various types of healthcare providers emerged in recent weeks as industry groups responded to congressional initiatives to replace Medicare’s sustainable growth-rate formula. The Senate Finance Committee and two House panels have requested comments on replacing Medicare’s physician pay system, which has long been a goal of many physician groups.

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Cost of Dying: A shift in how we end our lives
The Mercury News

The experience of death is changing in America, gradually shifting from costly, high-tech battles against death in hospitals into hospices that gently accept the inevitable end. A new national database shows that 25 percent of Medicare patients died in a hospital in 2010, down from 28 percent in 2007. More than 47 percent died in hospice environments, often at home, up from 42 percent.

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Inefficient insurers will pay consumers $500M under Obamacare rules
POLITICO

Insurers who failed to meet Obamacare efficiency rules will return $500 million to consumers across the country this summer, the Obama administration announced Thursday — but the chunk of change Americans will see depends heavily on where they live. A state-by-state breakdown of where rebates are headed suggests recipients in Washington state will see the biggest checks, with 3,000 consumers due to receive rebates of more than $500 each.

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Counties build bridge to Obamacare
HealthyCal.org

The Supreme Court decision that kept Obamacare intact made one major change to the legislation: the Medicaid expansion became optional. But California, one of the states leading on reforms, started the expansion of the state Medicaid program—known as Medi-Cal— three years ago. The early expansion in California and other states was intended to show the benefits and pitfalls of reforms before they were rolled out nationwide and to provide models for success.

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Health Care Reform Outreach Campaign Kicked Off By Obama Administration
The Huffington Post

The Obama administration on Monday kicked off its public education campaign to get the uninsured to sign up for health coverage, with a new call center and a revamped website intended as the market entry point for millions of new consumers.

The campaign is expected to target 2.7 million younger consumers between the ages of 18 to 35, whose participation in new online health insurance exchanges is vital to the success of President Barack Obama’s 2010 healthcare reform law.

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Administration begins ObamaCare push
The Hill

The Obama administration on Monday launched its effort to educate consumers about their ObamaCare benefits with a new government website and a toll-free number to answer questions. The moves come in preparation for Oct. 1, the date when enrollment begins in ObamaCare’s new state and federally-run health insurance exchanges. Polls have suggested that the public is largely in the dark about the new marketplaces and the healthcare coverage they offer, posing a challenge to the administration as it enacts President Obama’s signature domestic achievement.

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Part D was less popular than Obamacare when it launched
Washington Post

Health and Human Services is in the opening throes of attempting to enroll millions of Americans in a brand new, and relatively unpopular, health insurance program. It’s a massive task only made more difficult by widespread opposition and political divisions. But it is, as Sabrina Corlette puts it, “not the federal government’s first time at the rodeo.”

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Physicians Aren’t Driving Up Health Care Costs
The Health Care Blog

Recent interest in variability of cost for medical procedures is justified and long overdue. In an article in the New York Times on June 2, 2013, “The $2.7 Trillion Medical Bill,” Elizabeth Rosenthal writes from the point of view of a patient who has received a bill for colonoscopy. She then researches costs of the procedure in a number of markets in the U.S., finding a range of pricing from an average of $1,185 to a high of $8,577.

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HHS unveils insurance marketplace educational tools
Modern Healthcare

HHS on Monday unveiled its new HealthCare.gov website and an around-the-clock call center to educate consumers about the open-enrollment process for the health insurance exchanges that is scheduled to start on Oct. 1. The announcement was expected, as HHS Secretary Kathleen Sebelius and CMS Administrator Marilyn Tavenner had said for months that HHS would launch a public-outreach campaign this summer. Then sources confirmed on Friday that the CMS had planned demonstrations in three Florida cities this week to showcase the website and call-in center.

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HHS’ reform education effort appears near
Modern Healthcare

A confluence of events signals HHS will launch its anticipated healthcare reform law education and outreach campaign next week.

Since early spring, HHS Secretary Kathleen Sebelius and CMS Administrator Marilyn Tavenner have said the department would kick off a nationwide public outreach effort this summer, although representatives for HHS have not provided a timeline or schedule of events.

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Hospitals cut some surgery prices after CalPERS caps reimbursements
Los Angeles Times

When the California Public Employees’ Retirement System told its Anthem Blue Cross members it would pay only up to $30,000 for a knee or hip replacement surgery, some patients shopped around for a cheaper hospital.

What may be more surprising is that about 40 higher-priced hospitals in the state cut their surgery prices significantly to avoid losing patients.

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Newly insured to deepen primary care doctor gap
Modern Healthcare

Getting face time with the family doctor could soon become even harder.

A shortage of primary care physicians in some parts of the country is expected to worsen as millions of newly insured Americans gain coverage under the federal healthcare law next year. Doctors could face a backlog, and patients could find it difficult to get quick appointments.

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Probe sought of competitive bidding for durable medical equipment
Modern Healthcare

U.S. Reps. Glenn Thompson (R-Pa.) and Bruce Braley (D-Iowa), who previously called on CMS Administrator Marilyn Tavenner to delay the second round of Medicare’s Durable Medical Equipment Prosthetics, Orthotics and Supplies (DMEPOS) competitive-bidding program, have now appealed to HHS Inspector General Daniel Levinson to investigate issues related to its implementation.

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Promise of price cut on hospital bills is in limbo
Modern Healthcare

Huge list prices charged by hospitals are drawing increased attention, but a federal law meant to limit what the most financially vulnerable patients can be billed doesn’t seem to be making much difference.

A provision in President Barack Obama’s healthcare overhaul says most hospitals must charge uninsured patients no more than what people with health insurance are billed.

The goal is to protect patients from medical bankruptcy, a problem that will not go away next year when Obama’s law expands coverage for millions.

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New health care plan calls for 40,000 new doctors
San Gabriel Valley Tribune

Dr. Reed Wilson operates his private practice in a city famous for its extravagance and nip/tuck reputation.

But despite his Beverly Hills, 90210 address and his proximity to specialists who use scalpels and Botox to break the spell of aging, Wilson and other primary care physicians from Los Angeles and beyond are fighting to preserve the heart of their profession. It is a challenge in today’s health care landscape for primary care doctors, Wilson and other say.

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Lawmaker seeks to expand medical provider services
Santa Cruz Sentinel

California is projected to face a shortage of as many as 17,000 doctors within two years, a problem that is especially acute in rural areas and minority communities.

One Democratic lawmaker has proposed a package of bills intended to fill that provider gap by expanding the health services that can be provided by nurse practitioners, optometrists and pharmacists.

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Tenet Healthcare buying Vanguard Health for $1.8B
USA Today

Tenet Healthcare Corp. is buying Vanguard Health Systems Inc. for about $1.8 billion, helping to expand its service offerings and broaden its geographic reach.

Tenet will pay $21 per share, a 70% premium to Vanguard Health’s Friday closing price of $12.37.

Shares of Vanguard Health soared $8.14, or 65.8%, to $20.51 in premarket trading Monday.

The companies said Monday that the transaction also includes $2.5 billion in debt and value the entire deal at $4.3 billion.

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Tenet Healthcare to buy Vanguard Health for $1.73 billion plus debt
Reuters

Hospital operator Tenet Healthcare Corp will buy smaller rival Vanguard Health Systems Inc for about $1.73 billion plus the assumption of debt to expand into new geographies, further evidence of consolidation being driven by U.S. President Barack Obama’s healthcare reforms.

U.S. hospital stocks have rallied this year as investors expect the companies to benefit as more Americans are covered by health insurance and hospitals lose less money treating the uninsured.

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Lodi Health at a crossroads
Lodi News-Sentinel

On a March afternoon 61 years ago, a man in a suit and tie cut the ribbon, officially opening Lodi Memorial Hospital to some 8,000 visitors present for the 2 p.m. open house. The women in wide-brimmed hats and children in striped T-shirts were eager to tour the three-story building on South Fairmont Avenue they had watched workers build in the middle of a field for more than seven years.

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Free health care clinic in San Bernardino draws thousands
Inland Valley Daily Bulletin

When the lumber yard where Johnny Wilson worked was closed in 2008, he lost his medical insurance despite having mounting health issues. He approached several organizations that offer free services, but they turned him away. That’s what brought him to the National Orange Show Events Center at 4:30 a.m. Saturday for the Care 4 a Health IE clinic. “Tomorrow, I will be here at 4 a.m.,” he said.

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How Misplaced Reimbursement Incentives Drive Healthcare Costs Up
The Health Care Blog

For all of those out there anticipating the 2014 official role out of Obamacare, also known as the ACA (Affordable Care Act), here is a cautionary tale. Many years ago, as I was growing my cardiology practice, it became evident that diagnostic services for my specialty, like stress tests, echocardiograms, etc., were done less efficiently and cost more at the local hospital, then in the office. This stimulated many groups in the 1980s and 90s to install their own “ancillary” diagnostic services.

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Why a Health Insurance Penalty May Look Tempting
New York Times

Often, when the government wants you to do something, it makes you pay if you don’t. That would seem to be the case with Obamacare, which penalizes companies for not providing health care. But in that penalty, there could be a paradoxical result: dropping health coverage could save companies a lot of money. Once new health insurance exchanges are up and running in October, companies with 50 or more full-time employees will face a choice: Provide affordable care to all full-time employees, or pay a penalty.

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