News Headlines

News Headlines
Health care news from around the state and nation

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CMS considering alternatives to ‘two-midnight’ rule
Modern Healthcare

Faced with withering criticism, CMS officials are asking for ideas on how to design a new payment system for treating Medicare patients who need only a day or so in the hospital.

The issue has turned into an administrative mess for the CMS, with billions of Medicare dollars at stake flowing to thousands of hospitals and doctors. Last October, Medicare implemented a new rule to clarify that patients needed two nights in the hospital to qualify for inpatient-hospital rates, but that so-called “two-midnight” rule has become more controversial than the old system.

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Jerry Brown, legislative analysts differ on healthcare costs
Los Angeles Times

Last week Senate leader Darrell Steinberg (D-Sacramento) said his caucus would “kick the tires” on Gov. Jerry Brown’s calculation that higher healthcare costs would gobble up a large portion of California’s surplus tax revenue. If the governor’s estimates were too high, Steinberg said, that could free up more money for other government services. The goal is to “add up $50 or $100 million at a time” until there’s enough cash for other programs he wants to fund, like preschool for poor children.

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Practice Fusion adds clinical data base tool that tracks Rx market share, disease trends
San Francisco Business Times

San Francisco’s Practice Fusion, a fast-growing online medical records and patient appointment-booking company, is introducing a new tool to help users track health trends, including the market share of individual pharmaceutical drugs. The newbie: Insight, an interactive clinical database containing an anonymous subset of information from 81 million patient records that tracks use of 2,000 drugs. It’s likely the largest private patient record database in the U.S.

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Obama: ‘In five years it will no longer be called Obamacare.’
Washington Post

Just about everyone calls the Affordable Care Act “Obamacare” — even the White House. But is President Obama returning to his old stance that the health-care law should not have his name attached to it? At a fundraiser in Potomac, Md., Monday night, Obama backed off the term that his administration shunned, and then embraced. “First of all, in five years it will no longer be called Obamacare, because when something is working, they’re definitely not going to — there will be a whole renaming process similar to National.

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Covered California board to discuss budget, program changes
Sacramento Business Journal

The board of Covered California will discuss an evaluation of open enrollment and get information about proposed program changes for 2015 at its meeting Thursday in Sacramento. The meeting runs from 10 a.m. to 4 p.m. It will be held in the East End Complex Auditorium at 1500 Capitol Ave. The session open to the public is expected to begin about noon.

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Covered California Enrollee Claims Issues Finding Doctor
ABC News

Action News continues to investigate Covered California and how new insurance plans are affecting local patients.

Last week, Action News told you about a young woman who was unable to see a doctor despite having a health insurance plan through Covered California. Haley Green, 26, was able to get surgery on her hand and is recovering. She had a severed tendon in her hand and couldn’t see an orthopedic specialist until more than a week later.

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Panel Takes on State Health Care Issues
California Healthline

The health care picture in California is coming into focus with significant recent progress but an even greater amount of work remains to be done, according to a panel of experts assembled yesterday in Sacramento by the Public Policy Institute of California. Panelists at the event, part of PPIC’s series on California’s future, discussed the expansion of Medi-Cal and the creation of Covered California and posed questions about the next steps in health care reform.

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CMS Proposes Meaningful Use Extensions
Health Leaders Media

CMS‘ meaningful use adoption timetable, recently bombarded by more bad news, is getting some breathing room. On Tuesday, CMS published a proposed rule that would provide eligible professionals, eligible hospitals and critical access hospitals more flexibility in how they use electronic health record systems to meet Meaningful Use requirements. The proposal from CMS and the Office of the National Coordinator for Health IT would let providers use 2011-certified EHRs, or a combination of 2011- and 2014-certified EHR technology, for the 2014 reporting period in Medicare and Medicaid EHR incentive programs.

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Observation, Two-Midnight Rules Hit in Hearing
Health Leaders Media

Hospital officials and a Medicare advocate expressed their extreme frustration with Medicare’s two-midnight and observation rules before the House Ways and Means Subcommittee on Health hearing Tuesday, saying that not only are the policies not working, they’ve also added huge costs and quality issues for providers and patients.

“We know the two-midnight rule was spawned out of an attempt to limit lengthy stays and add clarity to the definition of an inpatient,” said Amy Deutschendorf, senior director of clinical resource management at Johns Hopkins Hospital in Baltimore.

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Legislators decry broken Medicare payment appeals process
Modern Healthcare

Legislators from both sides of the aisle expressed concern during a congressional hearing Tuesday that vigorous federal investigations of potential Medicare fraud could result in providers that have done nothing wrong being unfairly punished.

While legislators stressed that they want transgressors punished, they worried that the system for appealing Medicare payment decisions is so broken that it offers little protection for providers that have been wrongly denied reimbursement for treatment they delivered.

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CMS proposes stretching Stage 1 in EHR incentive program
Modern Healthcare

Healthcare providers will have one extra year to use 2011 Edition software in their electronic health record systems under the federal incentive program for health IT under a proposed rule the CMS issued Tuesday. Providers scheduled to jump to the program’s Stage 2 criteria will have another year to stay at Stage 1.

Hospitals, physicians and other eligible professionals trying to meet the program’s Stage 1 meaningful-use criteria can continue to use 2011 Edition software under the proposal, which will give them “more flexibility,” according to a joint announcement by the CMS and the Office of the National Coordinator for Health Information Technology.

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Fiscal analyst says Jerry Brown overstating Medi-Cal costs
Sacramento Bee

When Gov. Jerry Brown was asked last week about the reliability of his revenue estimates, which came in higher than he initially projected, Brown responded that while revenue may be out-performing his expectations, costs have come in higher than expected, too.

“Expenditures meet the revenues almost precisely,” he said. But according to the Legislature’s nonpartisan fiscal analyst, Brown not only continues to underestimate revenue, but may be overestimating costs, as well.

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Hospital authority bill clears Assembly — with big changes
Bakersfield Californian

A bill that would allow the creation of a hospital authority to run Kern Medical Center passed the state Assembly with major changes Monday.

But those changes — which would transfer union contracts with the county to the new authority and shift all KMC’s assets and liabilities over as well — are not set in stone. And the county, its largest employee union and the bill’s author, Assemblyman Rudy Salas, D-Bakersfield, expect to swap revisions to AB 2546 as it moves through the legislative process.

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Diabetes increases Sacramento-area hospital costs by $80M, study says
Sacramento Business Journal

Patients with diabetes account for one in three hospitalizations in California, and these stays cost almost $2,200 more than those for non-diabetic patients, a new study shows. Diabetic patients add an extra $1.6 billion annually to California hospitalization costs, including $80.2 million at hospitals in the Sacramento region, researchers concluded.

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State seizes failing Alameda County health insurance provider
Inside Bay Area

The state has seized an Alameda County health insurance provider that covers more than 200,000 residents, most of them on Medi-Cal, saying it was at risk of going under.

As more Californians fall under Medi-Cal, the state’s health care program for the poor, the Alameda Alliance for Health was one of a handful of local providers poised to cover them after the new national health law took effect this year.

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Nurses file for union election at Sutter’s Modesto hospital
Sacramento Business Journal

Registered nurses have filed for a union election at Modesto Memorial Medical Center, a Sutter Health hospital that has not been organized since it opened in 1970. Nurses want to join the California Nurses Association/National Nurses United. They filed a petition with the National Labor Relations Board on Friday to request a secret-ballot election. To bring in the union as their representative, they need a majority of nurses who participate in the election to vote “yes.”

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Kaiser pharmacist strike averted
San Diego Union-Tribune

A threatened pharmacist strike failed to materialize at Kaiser Permanente’s Southern California facilities Monday as talks continued between the two parties.

Kaiser notified its customers Monday that the Guild for Professional Pharmacists canceled a work stoppage that was set to begin on March 19. “We remain in contract negotiations with the Guild and hope to reach an agreement soon,” Kaiser stated.

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Nurses call for more staffing at San Francisco General Hospital
KTVU.com

Nurses with San Francisco General Hospital dumped a pile of scrubs at the mayor’s office Tuesday morning. The nurses marched in just after 11 a.m. and gathered on the main City Hall steps inside the rotunda. They said they came to call for increased staffing at San Francisco county facilities, including General Hospital. After a brief stay on the steps, they attempted to meet with the mayor. After getting no responses, the nurses dropped off a pile of scrubs.

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Merced hospital gets ‘A’ rating for patient safety
Sacramento Bee

Mercy Medical Center Merced received favorable feedback from a recent report released by the Leapfrog Group Hospital Safety Score — a program that grades hospitals on the overall performance in keeping patients safe.

The report, which covered data from 2012 and the first quarter of 2013, gave Mercy an “A” rating.

Leapfrog graded more than 2,500 general hospitals in the United States using hospital safety data on infections, injuries and medication errors.

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Riverside County Wants Healthier Cities
HealthyCal.org

Obesity. Heart disease. Stroke. Lung Cancer. Almost two-thirds of the deaths in Riverside County are linked to poor nutrition, lack of physical activity and tobacco use. And the county ranks just about last (54th out of 56 California counties) on making the physical environment conducive to health.

The Riverside County Health Coalition is fighting the problem by getting local governments to prioritize health and recently released a Healthy City Resolution Tool Kit and held a one-day conference to help the 28 local cities get started.

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City approves hospital expansion plan
The Press-Enterprise

Riverside Community Hospital will add more than 200 beds, build two new towers, add parking and renovate old buildings over the next 30 years, under a plan the City Council approved Tuesday. The $315 million expansion started in 2013 with construction of a new parking garage and office building. The rest of the project on the 22.5-acre downtown Riverside campus is covered by zoning changes, an environmental report and a long-term plan approved Tuesday.

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LAUSD earmarks $50 million for campus health clinics
Los Angeles Daily News

Los Angeles Unified is poised to expand its efforts to make access to health care easier for schoolchildren with an allocation of $50 million for wellness centers on campuses.

The scale of the plan to open facilities that will serve kids and community members alike is unprecedented for the district, noted Los Angeles Trust for Children’s Health Executive Director Maryjane Puffer.

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UC Davis nursing school dean part of health care advisory group
Sacramento Business Journal

University of California Davis nursing school dean Heather Young was the only nurse leader on working group created to advise President Barack Obama on ways to improve the nation’s health care system from a management and design perspective. The Systems Engineering for Healthcare Working Group was created by the President’s Council of Advisors on Science and Technology as one of various groups that study issues and report to the president.

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Scripps Health, Rady’s unite on hospice
San Diego Union-Tribune

Scripps Health will partner with Rady Children’s Hospital San Diego to offer pediatric hospice services to children from throughout the region, the health system announced Tuesday.

Chris Van Gorder, chief executive of Scripps Health, said the agreement formalizes a relationship that has existed since his organization entered the hospice realm last year after San Diego Hospice, then the region’s largest hospice provider, folded amid the pressures of a looming Medicare audit.

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Dignity Health reports $17.4M operating loss
San Francisco Business Times

Dignity Health lost $17.4 million on operations in the first quarter of 2014, a huge swing from operating income of $42.3 million for the same quarter last year. Overall, the parent company to local Mercy hospitals reported net income of $65.6 million on revenue of almost $2.6 billion for the quarter. That’s down from net income of $248.1 million on revenue of $2.5 billion for the same period last year, according to company financial data posted on its website May 15.

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