News Headlines

News Headlines
Health care news from around the state and nation

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Governors Push to Expand Role of PAs, Telemedicine
HealthLeaders Media

The National Governors Association says states should review and consider easing scope-of-practice restrictions on physician assistants so they can help with growing patient workloads anticipated under healthcare reform and the Medicaid expansion.

“PAs are an important component of developing strategies to deliver healthcare more efficiently and effectively,” Washington Gov. Jay Inslee (D) said in prepared remarks accompanying the release of The Role of Physician Assistants in Health Care Delivery.

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Wealthy L.A. Schools’ Vaccination Rates Are as Low as South Sudan’s
The Atlantic

When actors play doctors on TV, that does not make them actual doctors. And that does not mean they should scour some Internet boards, confront their pediatricians, and demand fewer vaccinations for their children, as some Hollywood parents in Los Angeles have apparently been doing.

The Hollywood Reporter has a great investigation for which it sought the vaccination records of elementary schools all over Los Angeles County. They found that vaccination rates in elite neighborhoods like Santa Monica and Beverly Hills have tanked, and the incidence of whooping cough there has skyrocketed.

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Hospitals ask patients to pay upfront
KSBW

Get ready to whip out your credit card before you are wheeled into the operating room or undergo an MRI. Hospitals are increasingly asking patients to pay for procedures either upfront or before they are discharged. That’s because Americans are shouldering a greater portion of their health care bills, and medical centers don’t want to get stuck with patients that can’t pay. Traditionally, neither patients nor providers knew the exact price of procedures until after the insurer processed the charges.

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Driving Down Claims Denials
HealthLeaders Media

A few years ago, hospital financial leaders may have considered losing a small percentage of revenue to claims denials as simply the cost of doing business. However, times are changing rapidly as healthcare reform rolls out and margins tighten.

Robin Norman, senior vice president and chief financial officer at Virginia Hospital Center, a 342-staffed-bed institution with $421.6 million in total operating revenue in Arlington, says that getting a handle on denials is her single biggest concern when it comes to revenue.

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Penalty for Not Having Health Coverage Can Be Thousands of Dollars
The Wall Street Journal

If you’re opting out of the health-care coverage required by the Affordable Care Act, make sure you understand how much you’ll owe Uncle Sam as a result.

For a family of five, the penalty could be as high as $12,240 for the 2014 tax year, experts say. And for many people, the penalty will rise sharply in 2015 and 2016.

The massive health-care changes passed in 2010 are phasing in, and this is the first year most Americans must have approved health insurance.

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Obamacare doctor networks to stay limited in 2015
Los Angeles Times

Finding a doctor who takes Obamacare coverage could be just as frustrating for Californians in 2015 as the health-law expansion enters its second year.

The state’s largest health insurers are sticking with their often-criticized narrow networks of doctors, and in some cases they are cutting the number of physicians even more, according to a Times analysis of company data. And the state’s insurance exchange, Covered California, still has no comprehensive directory to help consumers match doctors with health plans.

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California Obamacare: Fewer Choices, No Directory
Newsmax

Californians looking for a doctor who accepts Obamacare have no directory to match their plans with available physicians. Provider networks are limited and Covered California customers say that they are having difficulty finding participating physicians, The Los Angeles Times reported.

As 1.2 million Californians get set to renew their policies and hundreds of thousands register for the first time, between Nov. 15 and Feb. 15, the number of doctors participating is in some instances being cut. The Affordable Care Act will see more clients under Covered California— which includes 10 insurers— but fewer choices of available doctors, according to the Times.

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Debate Grows Over Employer Health Plans Without Hospital Benefits
National Public Radio

Lance Shnider is confident Obamacare regulators knew exactly what they were doing when they created an online calculator that gives a green light to new employer coverage without hospital benefits.

“There’s not a glitch in this system,” said Shnider, president of Voluntary Benefits Agency, an Ohio firm working with some 100 employers to implement such plans. “This is the way the calculator was designed.”

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Small businesses help workers buy health plans
USA Today

When Monty Hagler learned his employee insurance premiums could rise as much as 38%, the small business owner decided he couldn’t afford coverage that complies with the health care overhaul.

He considered a variety of plans from different carriers, but they were too expensive or bare-bones.

“Unless we dramatically changed our plan and went with the most basic plan, I said, ‘this is not sustainable,’” says Hagler, owner of RLF Communications, a Greensboro, North Carolina-based marketing company.

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For Many New Medicaid Enrollees, Care Is Hard to Find, Report Says
New York Times

Enrollment in Medicaid is surging as a result of the Affordable Care Act, but the Obama administration and state officials have done little to ensure that new beneficiaries have access to doctors after they get their Medicaid cards, federal investigators say in a new report.

The report, to be issued this week by the inspector general at the Department of Health and Human Services, says state standards for access to care vary widely and are rarely enforced. As a result, it says, Medicaid patients often find that they must wait for months or travel long distances to see a doctor.

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Supporters, opponents of Proposition 46 make their case before Legislature
Sacramento Bee

One of the most contentious battles in the November election is over Proposition 46, an initiative to raise the cap for pain and suffering damages in medical malpractice lawsuits and require drug and alcohol testing for doctors. The high-stakes, big-money campaign has pitted insurance companies and medical care providers against consumer advocates and personal injury lawyers – the latest front in a decades-old fight.

Proponents of the measure are hoping the drug screening mandate will compel voters to more than quadruple the damages limit to $1.1 million, which would be the first adjustment to medical injury compensation in 39 years.

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Attorneys and doctors square off over Prop. 46
Santa Rosa Press Democrat

Two powerful professional groups — doctors and lawyers — are squaring off and spending more than $65 million on Proposition 46, one of six statewide measures on the Nov. 4 ballot.

Even the measure’s official title — “Drug and Alcohol Testing of Doctors. Medical Negligence Lawsuits. Initiative Statute” — is controversial, with critics asserting that Attorney General Kamala Harris, who assigns names to ballot measures, intentionally downplayed the initiative’s main goal.

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Governor vetoes VSP-backed plan to work with Covered California
Sacramento Business Journal

Once again, VSP Global got the door slammed on hopes to get access to new business through Covered California. Gov. Jerry Brown vetoed legislation Thursday that would have established a separate vision care marketplace with links to the exchange website — even though VSP and other vision plans agreed to front the money to get it going until operating costs could keep it afloat. Assembly Bill 1877 by Democratic Assemblyman Ken Cooley from Rancho Cordova would have created a vision care access council in state government, modeled after the state health benefit exchange.

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Governor’s veto is setback to VSP’s hopes to sell through Covered California
Sacramento Bee

Gov. Jerry Brown has vetoed a bill that Rancho Cordova’s vision insurer, VSP Global, says was necessary to let it sell coverage through the state-run health care marketplace, Covered California.

Brown on Thursday vetoed Assembly Bill 1877, which VSP says was an essential mechanism to providing access to millions of uninsured Californians.

VSP, the parent of Vision Service Plan, reacted with outrage.

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Governor signs bill by Lois Wolk to relieve patient suffering
The Reporter

Late Thursday Governor Edmund G.

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Vaccine Opt-Out Rate at Son’s School is 32 Percent — ‘Should I Freak Out?’
KQED Radio

Statewide, there has been a dramatic increase in parents choosing not to vaccinate their children. The rate of parents opting out by filing what’s called a “personal belief exemption,” or PBE, doubled over seven years.

Earlier this month, State of Health published a chart where people could look up any elementary school in California and see the PBE rate at their children’s schools.

ours after we published, Cosmo Garvin of Sacramento sent me a tweet. “Really nice work,” the tweet said. “But just found out PBE rate at my kid’s school is 32 percent. Should I freak out?”

Thirty-two percent. That means one in three kids is not vaccinated.

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Providers report big demand for mental health treatment
San Diego Union-Tribune

A surge of demand appears to be straining the county’s supply of mental health services. Several local community clinics are reporting that mental health visits are up more than 50 percent this year and some local hospitals say an influx of new Medi-Cal patients is exacerbating an ongoing shortage of long-term psychiatric beds. Growing demand, experts say, is sometimes resulting in longer wait times for patients, both for primary-care services and for long-term treatment of those with severe mental illness.

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Why Open Payments Irks Physicians
HealthLeaders Media

Days before the Centers for Medicare & Medicaid Services’ scheduled launch of the Open Payments website, the President of the American Medical Association said the release of potentially inaccurate data could “cause patients to question their trust in their physicians… [and] discourage research and care delivery improvements that benefit patients.”

In a statement released by his office, Robert M. Wah, MD, said doctors haven’t had enough time to correct payment information submitted by the pharmaceutical industry in error, some examples of which were made public last month.

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Unmasked, Cancer Survivors Face The Symbol Of Their Torture
National Public Radio

Every 15 minutes, for 10 hours a day, another patient walks into the radiation room at Vanderbilt-Ingram Cancer Center in Nashville. Each picks up a plastic mesh mask, walks to a machine, and lies down on the table underneath.

Nurses fit the mask over the patient’s face and shoulders. And then they snap it down.

“It was awful,” says Barbara Blades, who was diagnosed with cancer in her lymph nodes and tongue nine years ago. “It was awful to have your head bolted to a table. Not being able to move. Not being able to move your head.”

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Will Technology Replace Doctors?
The Health Care Blog

It’s a provocative question, but it’s also the wrong one. The question ought to be: When will healthcare fully embrace technology and all it has to offer? It’s widely known that the $2.8 trillion US health system has significant waste and errors – between 25% and 30% of our health dollars go to services that do not improve health. Technology has the ability to put a big dent in that through standardization, real-time insights, convenient gadgets and complex data analysis the human brain simply cannot perform.

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Health technology company adds space, staff with new round of financing
Sacramento Business Journal

SureClinical Inc, a two-year-old health-technology company in Rancho Cordova, is growing and raising money. The company sells cloud-based software for managing the information flow in clinical drug trials. SureClinical is now in 1,300 square feet of office space at 2865 Sunrise Blvd. In November, it has plans to expand into an adjoining 3,600 square feet of space for a total of nearly 5,000 square feet. That will allow the company to grow from 12 to 48 employees, SureClinical CEO Zack Schmidt said.

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Doctor shortage concerns growing in Inland Empire
Victorville Daily Press

Pointing to the shortage of physicians in San Bernardino and Riverside counties, Inland Empire Health Plan’s top official recently acknowledged that there is concern about how to care for the quickly-growing number of members. That concern is exacerbated by an aging physician workforce nearing retirement and a surge in patient enrollment through California’s health insurance exchange, IEHP CEO Dr. Brad Gilbert said.

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Anthem Blue Cross and Blue Shield Survey Finds Americans Want to Safeguard Family’s Financial Wellbeing
insurance newsnet

A lot has been written about the selfishness of Americans, but a new survey indicates quite the opposite.

According to a recent Anthem Blue Cross and Blue Shield (Anthem) survey, Americans would make large and small sacrifices for their loved ones. From handing over the last piece of dessert (88 percent) to forgo watching their favorite TV show so their loved ones can enjoy their favorite program (90 percent) to caring for them in illness (96 percent) – Americans are a committed bunch when it comes to their loved ones.

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Alameda Health System’s CFO says fiscal crisis could be solved in weeks
San Francisco Business Times

Alameda Health System, a public safety net system with visions of competing head-to-head with Kaiser Permanente and Sutter Health, is facing severe cash-flow problems and is asking Alameda County officials to restructure nearly $200 million in debt it owes the county. But CFO David Cox told me Friday afternoon that roughly $60 million in accounts receivable that weren’t fully accounted for in the fiscal 2014 books aren’t missing, and will be recaptured in the 2015 financials.

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Transbay hospital deal: Stanford Health Care, ValleyCare sign affilation agreement
San Francisco Business Times

Stanford Health Care and Pleasanton’s ValleyCare Health System have signed a merger agreement that will make the East Bay hospital system a subsidiary of Stanford’s health care system if certain conditions are met. They include the retention of ValleyCare’s medical staff and approval by regulators and ValleyCare’s so-called “corporate members,” a group of community leaders who have long helped govern the system in eastern Alameda County.

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