News Headlines

News Headlines
Health care news from around the state and nation

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AHA: Hospital RAC Audits Rising
Health Leaders Media

Hospitals are being hit hard with a “dramatic increase” in records requests and audits from Medicare Recovery Audit Contractors, with a 28% increase in complex denials in the third quarter of this year compared with the first.

Auditors sought to review medical records documenting more than $10 billion in Medicare payments from 2010 to Sept. 30, 2013, of which $2.5 billion was denied. And of those RAC investigations that resulted in a denial of payment, hospitals appealed 47%, with a 67% success rate in getting the decision overturned.

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Study: Rural ED Doctors Make Fewer Errors When Using Telehealth
iHealthBeat

Emergency department physicians in rural hospitals make fewer medication administration errors when they consult with a pediatric critical care specialist via a videoconferencing system, according to a new study published in the journal Pediatrics, Reuters reports. For the study, researchers from the University of California-Davis Children’s Hospital examined data on 234 children with serious illnesses or injuries who were seen at one of eight rural EDs in Northern California from 2003 to 2009.

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The Obamacare success stories you haven’t been hearing about
Los Angeles Times

Last summer Ellen Holzman and Meredith Vezina, a married gay couple in San Diego County, got kicked off their long-term Kaiser health plan, for which they’d been paying more than $1,300 a month. The cause wasn’t the Affordable Care Act, as far as they knew. They’d been living outside Kaiser’s service area, and the health plan had decided to tighten its rules. That’s when they discovered the chilly hazards of dependence on the individual health insurance market.

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Companies Prepare to Pass More Health Costs to Workers
The Wall Street Journal

Companies are bracing for an influx of participants in their insurance plans due to the health-care overhaul, adding to pressure to shift more of the cost of coverage to employees. Many employers are betting that the Affordable Care Act’s requirement that all Americans have health insurance starting in 2014 will bring more people into their plans who have previously opted out.

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Displaying Lab Prices on EHR Systems Cuts Costs
Health Leaders Media

A new study adds to a growing body of evidence suggesting the potential for significant healthcare cost reductions when physicians know the up-front cost of ordering routine lab tests.

The latest study involved 215 primary care physicians at Atrius Health, an alliance of six non-profit medical groups, and a home health and hospice agency in Massachusetts that uses an integrated electronic health record system.

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It’s not Obamacare, it’s business
POLITICO

Insurance companies are ready to unleash an expensive PR blitz to get 7 million new customers once HealthCare.gov is fixed. But don’t expect them to sell “Obamacare.” Big insurers and the stock analysts that track them say that once the White House is sure its enrollment website is working, the companies will barrage the airwaves with messages encouraging people to join new health insurance exchanges, either by signing up directly with insurers or by giving the website another shot.

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‘Obamacare’ has no impact on Medicare enrollment
Times-Standard

Coordinators at the Area 1 Agency on Aging said in a recent press release that they want to make sure seniors understand that the Affordable Care Act (also known as “Obamacare” or the ACA) has no impact on the current open enrollment process for Medicare Part D (prescription drug plans).

They report that the HICAP office is being inundated by calls from “upset seniors worried about their health coverage and concerned that they should sign up for coverage through the Affordable Care Act.”

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Why Universal Health Care Is Our Inalienable Right
The Huffington Post

In the political firestorm over the ungainly rollout of the Affordable Care Act, or Obamacare, one central question that should be front and center in our national debate seems to have receded into the background, and that is whether universal health care is a fundamental right or a privilege. It is a legal question but also a conceptual one that says a lot about where we are as a nation today, especially in the political realm.

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The dirty secrets behind Boehner’s ’spiking’ Obamacare premiums
Los Angeles Times

Perhaps in an effort to defuse reports that House Speaker John Boehner is making out pretty well as a first-time insurance customer under the Affordable Care Act, Boehner’s office put out the word this weekend that his family healthcare premiums will be much higher next year than now. That outstanding stenographic service, Politico.com, swallowed this story whole. “John Boehner’s premiums spike under Obamacare,” Politico declared in a Sunday piece.

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Obamacare news: Medical experts say health care reform was necessary
MedCity News

At its basic level, federal health reform, popularly known as Obamacare, is an attempt to enlarge the pool of insured Americans to help more people be able to afford health care.

It marks the first major advance toward universal health care, which has been promoted by leaders dating back at least to President Harry Truman, who served from 1945 to 1953.

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ID Verification Lagging on Health Care Website
New York Times

Just days before the Obama administration’s self-imposed deadline to fix the troubled federal health insurance website, officials said Monday that they were aware of another problem that has prevented thousands of people who were unable to verify their identity from shopping for health plans. Many users of the website have had their applications cast into limbo after they uploaded copies of documents like driver’s licenses, Social Security cards and voter registration cards, or sent them to the office of the federal insurance marketplace in London, Ky.

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Supreme Court will take up new health law dispute
Modern Healthcare

The Supreme Court has agreed to referee another dispute over President Barack Obama’s healthcare law, whether businesses can use religious objections to escape a requirement to cover birth control for employees.

The justices said Tuesday they will take up an issue that has divided the lower courts in the face of roughly 40 lawsuits from for-profit companies asking to be spared from having to cover some or all forms of contraception. The court will consider two cases. One involves Hobby Lobby, an Oklahoma City-based arts and crafts chain with 13,000 full-time employees. Hobby Lobby won in the lower courts.

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40M? 30M? 15M? How Many Uninsured Americans Are There? We’re About To Officially Find Out.
The Health Care Blog

THCB reader Ed Vandenberg writes in with this friendly little conversation starter: The voluntary enrollment in Obamacare will provide an interesting perspective on the liberal ‘factoid’ that some 43M people are uninsured. The actual number of long-term uninsured, of course, is something like 15M (and even that number probably assumes some static population). So essentially, enrollment in Obamacare will give lie to the story board of the uninsured.

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California health insurance decision has political fallout
Sacramento Bee

The implementation of the federal health care program popularly known as Obamacare will obviously affect the lives and finances of tens of millions of Americans.

Obviously, too, as the nation’s largest state, California’s implementation will play a major role in the program’s success or failure.

But setting aside the human impacts for the moment, there are also heavy political effects, both nationally and in California.

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Trying To Make Sense of the Covered California Numbers
The Health Care Blog

I’ve read a number of reports in recent days gushing over the progress Covered California is making leading the nation in signing up people for Obamacare. But, I am having trouble understanding how the numbers should make anyone gush with enthusiasm. Covered California, the state health insurance exchange, has a goal of enrolling 500,000 to 700,000 subsidy eligible Californians by March 31, 2014.

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These Californians Greeted Canceled Health Plans With Smiles
KALW

Barbara Neff of Santa Monica is one of the roughly 1 million Californians who recently got word that their health insurance coverage would be expiring soon. The canceled plans sparked a political firestorm as people realized President Obama’s promise — “If you like your plan, you can keep it” — didn’t apply to everyone.

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For an example of how health reform can work, look to California
Sacramento Bee

It goes without saying that the rollout of Obamacare was an epic disaster. But what kind of disaster was it? Was it a failure of management, messing up the initial implementation of a fundamentally sound policy? Or was it a demonstration that the Affordable Care Act is inherently unworkable?

We know what each side of the partisan divide wants you to believe.

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California is far outpacing its own enrollment projections on the health care exchange
Sacramento Bee

Say what you will about the Affordable Care Act, but give California credit. Not only are we far outpacing Washington’s health care rollout, we’re among several states outpacing our own enrollment projections while states depending on the federal website lag far behind.

Nearly half of October enrollments were in California and New York. While New York maintained its strong opening in November, California figures have improved dramatically. What are we doing right that the feds aren’t?

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Hospital Lobbyists Aren’t So Savvy in Dealing With Hospital Ratings
The Huffington Post

Lately hospital lobbyists appear flummoxed by a relatively new and powerful phenomenon in health care they can’t seem to control: public reports comparing the quality of care different hospitals provide to their patients. A variety of organizations now issue hospital comparisons, from U.S. News & World Report to Consumer Reports to my own nonprofit founded by employer purchasers of health benefits, The Leapfrog Group, which in many respects pioneered the public reporting enterprise back in 2000.

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California’s Leading Renal Care Organization Disappointed by Cuts to Dialysis Treatment
IT Business Net

The California Dialysis Council (CDC), the State’s leading organization of patient advocates, dialysis providers, and renal physicians, expressed dissatisfaction and concern over the Centers for Medicare and Medicaid Services’ (CMS) plan to cut funding for patients with kidney failure, or end stage renal disease (ESRD). Late on November 22, CMS announced in a final rule its plans to apply a 12 percent cut to funding for dialysis treatments over the next three to four years, starting in 2014. Such action is particularly concerning given that over 80 percent of ESRD patients are Medicare recipients.

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Sansum Clinic Now Covered by UC Care Thanks to Protests
Daily Nexus

After months of protest from UCSB employees, UC Care for has moved Sansum Clinic — a medical foundation with facilities throughout Santa Barbara — into the UC Select tier of university employee health care.

The announcement comes after months of negotiations with Sansum Clinic and Cottage Hospital, after UCSB employees protested the fact that the UC Select tier covered none of the major care providers in Santa Barbara, forcing those with that plan to travel to Lompoc, Santa Maria or Ventura for medical attention.

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