News Headlines

News Headlines
Health care news from around the state and nation

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Anthem Blue Cross widens Covered California network with 3,800 doctors, major hospitals
Sacramento Business Journal

Anthem Blue Cross has added 3,800 doctors and several major hospitals — including UC Davis Medical Center and Cedars Sinai Medical Center — to its Covered California network, the Thousand Oaks-based health insurance giant said late Wednesday. In addition to UC Davis Medical Center, in Sacramento, and Los Angeles’ Cedars Sinai, historically seen as a high-cost facility, Anthem said it’s added Huntington Memorial Hospital, Keck Hospital of USC and USC Norris Comprehensive Cancer hospital to its exchange network “effective immediately.”

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Sebelius OKs Foundation Subsidies for QHP Enrollee Premiums
Health Leaders Media

Hospital officials hoping to route financial subsidies to patients struggling with health insurance exchange plan premiums sighed with relief Thursday after HHS Secretary Kathleen Sebelius said in a letter it’s okay for them to do so, if they follow certain protocols.

But the funds must be transferred to patients through private, not-for-profit foundations, and only for patients selected for their “financial status,” not for their health status. Sebelius further said the Centers for Medicare & Medicaid Services “would expect that premium and any cost sharing payments cover the entire policy year.”

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How many patients should your doctor see each day?
Washington Post

In light of the allegations that some Veterans Affairs Department health clinics used elaborate schemes to hide the records of patients who had waited months for care, I began to wonder what a normal caseload would look like for an average physician outside the VA system. And if your doctor has a larger-than-average caseload, is he or she able to give you the attention you need?

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Stanford conference focuses on big data in health care
San Francisco Chronicle

Technological advancements are generating exponentially more information about people’s health than ever before, but there is no easy way to make sense of all of it.

Experts say this huge influx of digital information, dubbed “big data,” could improve everything from the drug-discovery process to personalized predictions for patients’ disease risks. Yet much of this data remains siloed within the institutions that gather it, unable to be accessed, analyzed or used by outsiders.

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If We Want Lower Health Care Spending, We Are Going to Have to Pay for It
The Health Care Blog

Ultimately, spending less on health care is a relatively easy task: We either need to consume fewer services, or spend less on the services that we consume. But much like we teach our Kellogg students about maximizing profits, the devil is in the details. It’s certainly tempting to ask the government to swoop in on a white stallion and solve all our problems by fiat.

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Californians gripe about Obamacare enrollment snags, lack of doctors
Los Angeles Times

Nearly 1,500 Californians have complained to state regulators in the last four months about their Obamacare coverage purchased through California’s insurance exchange.

New data reveal the biggest category of complaints centers on getting confirmation of health plan enrollment and basic issues such as getting an identification card to obtain care.

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Bill to Expand Health Care to Undocumented Immigrants Faces Tough Test in Legislature
The California Report

The clock is ticking for legislation wending its way through the state Capitol. Next Friday is the last day for bills to pass their house of origin – or not. One bill facing a live-or-die moment this week would extend health care coverage to the undocumented. It would do so in part by allowing them to enroll in Medi-Cal. A new report released Wednesday by UC Berkeley and UCLA estimates that would increase state costs by $350 million, about 2 percent of the Medi-Cal budget. Opponents say that’s too much.

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Actors, musicians are big beneficiaries of Obamacare
Los Angeles Times

In 2011, actress Lynda Berg didn’t make enough money to qualify for health insurance through her union. And, on her own, she had trouble finding a plan she could afford because she’s a survivor of breast cancer, considered a preexisting condition.

The uncertainty of not having a health plan was stressful and at times expensive, she recalls. A few years ago she fell and broke her hand and elbow and ended up paying $4,000 for her medical care.

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Covered California Continues To Have Issues
ABC News

Heather Thomas is an independent insurance agent here in Fresno and has been licensed for eleven years.

“The majority of my clients are health insurance. Especially with this new Covered California,” said Thomas.

She said she’s having a difficult time helping her clients find doctors who accept insurance plans they bought through Covered California. One client needs weight loss surgery.

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Chances are your doctor and you are confused about Covered California
Los Angeles Daily News

Most of 2,300 physicians surveyed statewide said they were confused about their participation in health networks sold on the Covered California exchange, which has led to negative impacts on patient care, according to results released Thursday.

The California Medical Association sent e-mails to physicians who were members of medical associations statewide and received responses to 15 questions in two days.

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As mental health coverage expands, providers not always there
USC Annenberg

At the start of the year, before the state’s health insurance exchange was enrolling people in earnest, California rolled out a huge new addition to its Medicaid benefits.

Following the Affordable Care Act’s passage, Medi-Cal, the state’s Medicaid program, expanded coverage to those with mild and moderate mental health problems. The benefits previously were limited to very select groups and the most severely ill patients.

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KSBY investigates: Navigating the mental health system part 1
KSBY

There are more than 7 million people in the United States living with severe mental illnesses and 3.3 million of them are untreated at any given time.

The number of untreated continues to rise.

KSBY met a Paso Robles family who is close to this issue. For more than a decade they have dedicated their time to helping their son and others who are faced with severe mental illness.

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Payer Backlash May Slow Unnecessary Spinal Fusion Surgeries
Health Leaders Media

Annual US spine fusion surgeries have skyrocketed over the last decade, rising from about 260,000 in 2002 to about 460,000 in 2011, according to federal data. And recent media reports have raised alarms over the proliferation and overuse of spine fusion procedures. Now CMS officials are cracking down and leading a backlash against unnecessary spine fusion procedures, according to Joseph Gregory, a surgical devices analyst at London-based GlobalData.

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A New Era in Value-Driven Pharmaceuticals
The Health Care Blog

At the end of March the Amercian College of Cardiology (ACC) and the American Heart Association (AHA) issued a joint statement saying they “will begin to include value assessments when developing guidelines and performance measures (for pharmaceuticals), in recognition of accelerating health care costs and the need for care to be of value to patients.” You may have heard of value-based medicine, but are we entering a new era of value-based medications or value-driven pharma?

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Sutter HMO’s biggest client is Sacramento County
Sacramento Business Journal

There’s a new HMO in town — and its business has economic ripples in the region. Sutter Health Plus was approved by state regulators last year and kicked off coverage Jan. 1. The health maintenance organization has enrolled more than 5,000 people so far and plans to expand to the Bay Area in 2015. Sutter’s biggest client is Sacramento County. Roughly one in five Sutter Health Plus members are Sacramento County employees or their dependents.

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West Contra Costa health care crisis looms with expected closure of Doctors Medical Center
Contra Costa Times

While various stakeholders scramble for a “Hail Mary” to dig up the cash needed to save Doctors Medical Center, county health officials are trying to figure out how to patch the gaping hole that would be created by the closure of a hospital that receives over 40,000 visits to its emergency room every year.

But a stark reality faces West Contra Costa residents who suffer life-threatening emergencies if the hospital closes: Some may die.

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Hospital receives designation for improving elderly care
Paso Robles Daily News

Twin Cities Community Hospital announces its recent designation as the first NICHE – Nurses Improving Care for Healthsystem Elders – Hospital in San Luis Obispo County. The NICHE designation indicates a hospital’s commitment to elder care nursing excellence through patient-centered, evidence-based, interdisciplinary approaches that promote better outcomes for older adults.

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