News Headlines

News Headlines
Health care news from around the state and nation

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Primary Care Medi-Cal Providers About To Be Hit by Double Rate-Cut Whammy
California Healthline

Primary care providers on Jan. 1 will have their Medi-Cal reimbursement rates lowered — twice on the same day. A two-year Medicaid federal rate increase for primary care providers is due to expire on the first day of 2015. On the same day the California Department of Health Care Services plans to implement its state-ordered 10% reduction in reimbursement rates for fee-for-service Medi-Cal primary care providers.

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Half of Doctors Listed as Serving Medicaid Patients Are Unavailable, Investigation Finds
New York Times

Large numbers of doctors who are listed as serving Medicaid patients are not available to treat them, federal investigators said in a new report.

“Half of providers could not offer appointments to enrollees,” the investigators said in the report, which will be issued on Tuesday.

Many of the doctors were not accepting new Medicaid patients or could not be found at their last known addresses, according to the report from the inspector general of the Department of Health and Human Services. The study raises questions about access to care for people gaining Medicaid coverage under the Affordable Care Act.

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In Ebola outbreak, bad data adds another problem
Modern Healthcare

As health officials struggle to contain the world’s biggest-ever Ebola outbreak, their efforts are being complicated by another problem: bad data. Having accurate numbers about an outbreak is essential not only to provide a realistic picture of the epidemic, but to determine effective control strategies. Dr. Bruce Aylward, who is leading the World Health Organization’s Ebola response, said it’s crucial to track every single Ebola patient in West Africa to stop the outbreak and that serious gaps remain in their data.

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Health law impacts primary-care doc shortage
Modern Healthcare

When Olivia Papa signed up for a new health plan last year, her insurance company assigned her to a primary-care doctor. The relatively healthy 61-year-old didn’t try to see the doctor until last month, when she and her husband both needed authorization to see separate specialists.She called the doctor’s office several times without luck.”They told me that they were not on the plan, they were never on the plan and they’d been trying to get their name off the plan all year,” said Papa, who recently bought a plan from a different insurance company.

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Religious nonprofits challenge health law
Modern Healthcare

In the latest religious challenge to the federal healthcare law, faith-based organizations that object to covering birth control in their employee health plans argued in federal appeals court Monday that the government hasn’t gone far enough to ensure they don’t have to violate their beliefs.Plaintiffs including a group of Colorado nuns and four Christian colleges in Oklahoma argued in the 10th U.S. Circuit Court of Appeals in Denver that a federal exemption for groups that oppose contraceptives, including the morning-after pill, violates their beliefs.

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Mitch McConnell’s Obamacare gambit
POLITICO

In high-level strategy sessions on Capitol Hill, Republicans are going through reams of historical information and sitting through marathon slide show presentations, trying to figure out how to gut Obamacare through a complicated budget process that requires only a simple majority — a sign of how seriously they’re taking their best shot yet at dealing a long-term blow to the health care law.

Behind closed doors, Washington’s top budget experts have quietly met with Sen. Mitch McConnell, the incoming majority leader, and the Senate Republican Conference to detail options for action next year.

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How do you rate the first year of Covered California?
Southern California Public Radio

Our health care system has changed at a dizzying pace under the Affordable Care Act. And many of us are adapting to these new realities, a little more than a year into the life of Covered California, the state’s health insurance exchange set up under the federal law. The California Healthcare Foundation’s Center for Health Reporting documents these profound shifts in a comprehensive package of stories that launched today.

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Despite Decline, Elective Early Births Remain A Medicaid Problem
National Public Radio

Nearly 9 percent of the births covered by Medicaid — or about 160,000 each year — were elective deliveries before 39 weeks of gestation. Early deliveries like those can lead to worse health outcomes for mothers and children and higher costs, according to a study published Monday.

The research, conducted by AcademyHealth and two state Medicaid medical directors, found the early elective delivery rate for 12 states in which trend data were available had fallen from nearly 11 percent in 2007 to 8.2 percent in 2011. But looking at the latest available data from 2010 to 2012, the average rate was 8.9 percent, according to the study in Health Affairs.

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Blue Shield moves into Medicaid with Care 1st deal
Los Angeles Times

Looking to seize on the massive expansion of Medicaid, Blue Shield of California said it has agreed to acquire Monterey Park health plan Care 1st for an undisclosed sum. Until now, nonprofit Blue Shield hasn’t participated in Medi-Cal, the state’s Medicaid program for lower-income people.

As a result, it has missed out on the program’s growth to 11.3 million Californians as part of the expansion under the federal Affordable Care Act.

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Blue Shield of California to enter Medi-Cal/Medicaid services market by acquiring Care1st Health Plan
Pasadena Star

Blue Shield of California on Monday announced it will enter the Medi-Cal/Medicaid market by acquiring Care1st Health Plan.

The all-cash transaction is expected to close in the second half of 2015. Financial terms were not disclosed.

Paul Markovich, president and CEO of Blue Shield of California, said the move will fulfill his company’s not-for-profit access and mission to stay affordable.

“Acquiring Care1st — a growing, values-based company with deep Medicaid experience — is the ideal way for us to not only enter a new market but also to help transform it together,” Markovich said in a statement.

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Blue Shield of California to add 500,000 enrollees with purchase of Care1st Health Plan
Sacramento Business Journal

Blue Shield of California has agreed to purchase Care1st Health Plan, a Monterey Park-based Medicaid and Medicare specialist that boasts more than 524,000 enrollees. Terms were not announced, but the all-cash transaction is expected to close in the second half of 2015, subject to standard conditions, including regulatory approvals in California, Arizona, Texas and at the federal level.

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Feds Release Strategic Health IT Plan
HealthLeaders Media

With the first national health IT interoperability roadmap imminent, the 2015–2020 Federal Health IT Strategic Plan is doubling down on making incompatible information systems collect, share and use health data with each other.

The 20-page plan, updated every three years, was released Monday, following collaboration with more than 35 federal agencies and the authors of the plan at the U.S. Department of Health and Human Services’ Office of the National Coordinator for Health Information Technology (ONC).

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Hospitals to Congress: Don’t Delay ICD-10
HealthLeaders Media

The nation’s leading hospital associations want the lame duck Congress to avoid further delays of the Oct. 1, 2015 implementation date for the ICD-10 diagnostic coding set.

In a letter to House and Senate leaders in both parties, the American Hospital Association, America’s Essential Hospitals, the Association of American Medical Colleges, Catholic Health Association of the United States, and three other hospital associations said the “implementation delays have been disruptive and costly for hospitals and health systems, as well as to healthcare delivery innovation, payment reform, public health, and healthcare payment.”

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Doctors Are Slow To Adopt Changes In Breast Cancer Treatment
National Public Radio

Cancer doctors want the best, most effective treatment for their patients. But it turns out many aren’t paying attention to evidence that older women with early stage breast cancer may be enduring the pain, fatigue and cost of radiation treatment although it doesn’t increase life expectancy.

Researchers from Duke University Medical Center analyzed the impact of a large randomized trial published in 2004 that compared treatment options for women over the age of 70 with early-stage breast cancer. That study compared cancer recurrence and survival rates among women who had surgery, chemotherapy and radiation to that of women who had surgery and chemotherapy only.

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New director of autism center plans to greater reach
Orange County Register

The Center for Autism & Neurodevelopmental Disorders in Santa Ana, which was founded in 2001 as For OC Kids, helps children, teens and young adults who have been diagnosed with autism spectrum and other neurodevelopmental disorders. Catherine Brock, who earlier this year was named the center’s new executive director, says the plan going forward is to expand the types of services, experts and resources it provides its clients and to broaden its reach.

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KMC update: Staffers ready for Ebola, budget picture brightening
Bakersfield Californian

Kern County supervisors got a taste Monday of the preparations Kern Medical Center has made to handle a potential Ebola case they hope will never come.

A hospital worker, muffled in layers of protective blue clothes and masks, twisted through an arcane ritual of decontamination. Stand in a bleach bath.

Sit in a “dirty” chair.

Strip off one set of blue paper booties.

Disinfect double-gloved hands with alcohol.

Pull off another layer of clothes.

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Retail Clinics Solidify Their Market Niche
HealthLeaders Media

The market for retail healthcare clinics, once a destination for shoppers with sore throats and sniffles, is reaching maturity.

When Woonsocket, RI-based CVS Health opened its first walk-in medical clinic 14 years ago, the focus was on a handful of conditions including sore throat diagnosis and treatment. Now the pharmacy giant is a major player. It opened 170 MinuteClinics this year and has set a goal to have 1,500 retail clinics operating by 2017, according to Nancy Gagliano, MD, a senior VP at CVS Health and chief medical officer of MinuteClinic.

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Walgreen tests virtual doctor visits through app
San Diego Union-Tribune

Walgreen is testing a new telemedicine service that lets patients see a doctor without leaving home or visiting any of the drugstore chain’s clinics.

The Deerfield, Illinois, company said Monday that patients in California or Michigan can now contact a physician around the clock through Walgreen’s mobile application for smartphones or tablet computers.

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Dental gap: Coverage slips through reform’s cracks
Modern Healthcare

Dental care is a peculiar niche of the U.S. healthcare system. Even though teeth and gums are just as much part of the human body as kidneys or elbows, they are insured differently—a lot differently.

When the Patient Protection and Affordable Care Act was written and debated, comprehensive dental insurance never really became a focal point. Lawmakers ultimately created a few provisions that may boost access to oral care, but dental coverage still escapes the grasp of millions of Americans.

Dental plans garnered national attention after it was discovered that HHS overstated 2014 enrollment figures in the ACA’s insurance exchanges. The government included almost 400,000 stand-alone dental plans, which are much cheaper and separate from standard health plans. After accounting for those, the number of people who were enrolled in full-service medical plans was 6.7 million. A House committee plans to grill CMS Administrator Marilyn Tavenner on the numbers Tuesday.

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Two Calif. biomed advocacy groups to merge
Modern Healthcare

Two advocacy organizations representing the California biomedical and life science sectors will merge to create a unified voice for the nearly 1,300 companies they represent, the groups announced Monday. The San Diego -based California Healthcare Institute and the San Francisco, Calif.-based Bay Area Bioscience Association will merge next year to become the California Biomedical Innovation Alliance. The new organization, expected to be formed by the end of the first quarter of 2015, will represent the state’s “entire biomedical ecosystem” under one roof, a press release said.

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