News Headlines

News Headlines
Health care news from around the state and nation

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Healthcare spending set to spike by 6.8% in 2015, report predicts
Modern Healthcare

Healthcare spending is expected to jump by 6.8% next year, spurred by the recovering economy and increased insurance coverage, according to an analysis by PwC’s Health Research Institute. The boost in spending follows a span in which healthcare expenditures had grown at a slower clip than the often double-digit increases of the 1990s and early 2000s. That’s spurred an ongoing debate over whether the trend could be attributed primarily to reforms associated with the Patient Protection and Affordable Care Act or the economic malaise brought on by the Great Recession.

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Transitioning to Bundled Payments
Health Leaders Media

As the healthcare industry moves away from fee-for-service reimbursements toward a bundled payment model that holds providers financially accountable for an entire episode of care, hospitals and health systems need strategies for maintaining cash flow and economic viability during the transition.

Despite the urgent need to adapt to the new reimbursement environment, healthcare organizations do not appear to be rethinking their payer relationships in large numbers.

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Want to Make Meaningful Use Really Mean Something?
The Health Care Blog

Adverse events – when bad things happen to patients because of what we as medical professionals do – are a leading cause of suffering and death in the U.S. and globally. Indeed, as I have written before, patient safety is a major issue in American healthcare, and one that has gotten far too little attention. Tens of thousands of Americans die needlessly because of preventable infections, medication errors, surgical mishaps, and so forth.  As I wrote previously, according to Office of Inspector General (OIG), when an older American walks into a hospital, he or she has about a 1 in 4 chance of suffering some sort of injury during their stay. Many of these are debilitating, life-threatening, or even fatal. Things are not much better for younger Americans.

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Reform Update: Congressional measure may ease concerns over readmission penalties
Modern Healthcare

As support grows for the need to adjust 30-day readmission-rate penalties for hospitals serving impoverished communities, hospital groups remain concerned that new measures and higher penalties anticipated next year will continue to hurt efforts to achieve the very quality measures the penalties are supposed to address.

Last Thursday, a group of U.S senators introduced legislation called the Hospital Readmission Accuracy and Accountability Act, which would require the CMS to account for patient socio-economic status when calculating risk-adjusted readmissions penalties.

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Rate regulation initiative raises big questions for Covered California
Sacramento Business Journal

A health insurance rate regulation initiative on the November ballot poses big questions about operations at the state health benefit exchange, including whether the measure, if approved, could muck up open enrollment at Covered California this fall. If the Insurance Rate Public Justification and Accountability Act is approved by voters, it would take effect Nov. 5, 2014, 10 days before kick off of open enrollment for 2015. The measure would give state Insurance Commissioner Dave Jones authority to reject health insurance increases considered “excessive.”

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As health-care law’s employer mandate nears, firms cut worker hours, struggle with logistics
Washington Post

Kevin Settles prides himself on being an early adopter. The owner of the mini-chain Bardenay in Boise, Idaho, says he was the first restaurateur in the country to get a federal license to distill liquor at a restaurant. He put Thai satay and baba ganoush on the menu despite his customers’ steak-centric palates.

So when the health-care law went into effect, Settles acted quickly. In September, he offered health insurance to dozens of his employees to comply with the Affordable Care Act, which requires all but the smallest businesses to extend coverage to their full-time workers.

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Calif. Agency Seeking Inaccuracies In ACA Doctor Listings
Law 360

A California regulator has set its sights on Anthem Blue Cross and Blue Shield of California, launching an investigation into whether the insurance plans misled their customers with directory listings of doctors covered by Obamacare, the agency said Friday.

The state’s Department of Managed Health Care said it is contacting all the providers listed by the plans to find out whether the health plans have violated state laws regulating the way they notify their enrollees of which doctors are in-network.

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The Long and Short of Health Numbers
The Health Care Blog

The notable five-year contraction in healthcare spending growth comes to an end next year, but not in a way that marks a dramatic reversal—at least, not yet. The Medical Cost Trend: Behind the Numbers 2015 report released today from PwC’s Health Research Institute (HRI) projects a medical cost trend of 6.8% for 2015, up only slightly from the 6.5% projected for this year. Our analysis, which measures growth in the employer-based market, incorporates input from health policy analysts, industry executives, earnings statements, government data and actuaries from more than a dozen insurance companies, whose companies cover a combined 93 million members.

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Healthcare moves toward shared risk
Healthcare Finance News

Many questions remain on how specific details of the Affordable Care Act will be resolved, but one significant trend is clear: the shift toward risk sharing among patients, providers and insurers is well underway.

That is the view of Andrew Croshaw, a partner with the healthcare intelligence firm of Leavitt Partners, who presented “Healthcare Reform: Where Are We Now?” at the HFMA ANI 2014 conference. He predicted that one-third of Americans would have a shared risk plan by 2020.

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Health-care inflation heating back up
Market Watch

Health-care inflation has hit a low point and is poised to start rising again, but it’s unclear whether annual medical cost hikes are heading back to the double-digit increases of years past. That’s the conclusion of a study released Tuesday by consultant PricewaterhouseCoopers’ Health Research Institute, which says medical costs will rise 6.5% this year and 6.8% in 2015. Actual medical spending growth, however, could be 4.8% when benefit plan changes are taken into account, but that figure still will be up from 2014, the report says.

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Senior Medicare Fraud Patrol Recovers $5.9M
Health Leaders Media

In a typical year, the national Senior Medicare Fraud Patrol (SMP), a federal program that helps beneficiaries identify scams, doesn’t recover much money. The average annual collection between 2008 and 2012 was a mere $1.2 million.

But a recent Office of Inspector General report tallying results for 2013 showed that the total for 2013 was $9.04 million, virtually all of which—$8.9 million—came from the California SMP program, run by California Health Advocates (CHA), a non-profit in Santa Ana.

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HFMA ANI: Data Key Healthcare System Efficiency, Says Gawande
Health Leaders Media

Hospitals and health systems must use data analytics to identify their sickest patients and reinvent the way healthcare is delivered in the United States, Atul Gawande, MD, said in his keynote address on Monday at the Healthcare Financial Management Association’s ANI conference in Las Vegas.

“The healthcare delivery system in America is broken, and we are not seeing the value and quality we would expect for the kind of money we are putting in,” said Gawande, a surgeon at Brigham and Women’s in Boston, a professor at the Harvard School of Public Health, a staff writer for The New Yorker, and the author of three books on how to improve the nation’s healthcare system.

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Defibrillators not required at California stores
Inland News Today

The California Supreme Court on Monday ruled that large retailers aren’t required to have defibrillators on hand to help treat customers and workers who suffer sudden cardiac arrest.

The ruling signals the end of a Southern California family’s wrongful-death lawsuit alleging Target was liable for a customer’s sudden death from cardiac arrest because it didn’t have one of the devices as part of its first-aid plan. The state Supreme Court ruled such a requirement was an unfair burden on Target.

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SVMH Summer Health Institute underway
Monterey Herald

After heating a large bowl of chocolate, Hartnell nursing instructor Toni Gifford pours some for the students sitting around the lab’s table.

The students, who are participating in a five-week long Summer Health Institute, have a mission. First, they have to dip strawberries, pretzels and almonds in the chocolate. Then, they have to spread chocolate all over their hands until they’re completely covered. Last, they have to slip on sterile surgical gloves, making sure none of the chocolate stains the outside of the gloves.

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First UC Davis doctoral nursing grads showcase research
Sacramento Business Journal

Five years after a nursing school was established at University of California Davis to build the ranks of nurse scientists and teachers, eight doctoral candidates have received their degrees. They are same eight who started class when the school opened its doors in 2010, an unusual lack of attrition. “They all graduated — and they did it in four years in a vigorous program at a Tier 1 university, which is remarkable,” said Marybeth Sharp, program director for the Gordon and Betty Moore Foundation that donated $100 million to get the school going.

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Oroville hospital recognized for safeguarding patients
Oroville Mercury-Register

The hospital rating service Heathgrades has put Oroville Hospital in the top 5 percent of hospitals at safeguarding patients from serious, potentially preventable complications during their hospital stays, according to a release from the hospital..

The Healthgrades 2014 Patient Safety Excellence Award, goes to hospitals that when compared to those in the bottom 5 percent, were:

Commands