News Headlines

News Headlines
Health care news from around the state and nation

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California battles whooping cough epidemic
Modern Healthcare

California officials are battling the worst whooping cough epidemic to hit the state in seven decades as a recent rebound in cases raises questions about the effectiveness of the pertussis vaccine.

Doctors emphasize that the inoculation has led to fewer deaths than in the past and in instances where people do get sick, their illnesses aren’t as severe. But California officials say the limited protection of the vaccine introduced in the 1990s has led to the rise in cases.

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Pricey ‘breakthrough’ drugs confound Medicaid rate-setting
Modern Healthcare

Actuaries say it’s getting increasingly difficult to advise states on sound rates for Medicaid managed-care plans because high-priced specialty drugs like Sovaldi continue to hit the market at a rapid clip.

The American Academy of Actuaries is asking the CMS to give states new flexibility in funding approaches to deal with the expensive new drugs.

“A new therapy … has the potential to diminish the ability of the actuary to accurately project future expenses from historical experience because of the significant change in practice patterns and costs that such new treatments can create,” the organization said in a November letter to the CMS.

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Good News From CMS at Last? Maybe Not
The Health Care Blog

I’ve been looking at the latest CMS national healthcare expenditure data and the accompanying commentary by CMS staff. The 2013 numbers are a pleasant surprise, showing for the fourth straight year minimal increase in healthcare spending relative to economic growth. The CMS staff commentary, however, suggests that such good news may not be repeated:

“The key question is whether health spending growth will accelerate once economic conditions improve significantly; historical evidence suggests that it will.”

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Covered CA glitch diverting some to Medi-Cal
San Diego Union-Tribune

With a key deadline arriving today, the state’s health insurance exchange has continued to increase enrollment even as computer glitches divert some who seek to enroll or renew existing policies.

Californians have until midnight today to enroll and have their policies start on Jan. 1. While open enrollment lasts until Feb. 15, policies purchased after today will not start on New Year’s Day.

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Crunch time again for health insurance sign-ups
San Francisco Chronicle

President Barack Obama’s push to cover America’s uninsured faces another big test Monday. This time, it’s not only how the website functions, but how well the program itself works for millions who are starting to count on it.

Midnight Monday, Pacific time, is the deadline for new customers to pick a health plan that will take effect Jan. 1, and for current enrollees to make changes that could reduce premium increases ahead of the new year. HealthCare.gov and state insurance websites are preparing for heavy online traffic before the deadline, which gives consumers in the East three hours into Tuesday to enroll.

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Health reform proves a mixed bag in Kern
Bakersfield Californian

Margaret Pendley has had chronic pain since the double whammy of a car accident in February and a fall a month later.

The restaurant server has been on disability since the accident, and has spent much of this year trying to find a pain management specialist who will accept her insurance, a Blue Shield of California plan purchased through the state health exchange, Covered California.

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Health benefit exchange enrollment help offered
Red Bluff Daily News

Building on high enrollment in 2014, Covered California recently funded the non-profit agency, California Health Collaborative, to provide personal and one-on-one assistance for eligible consumers to enroll in the state’s health benefit exchange.

The Collaborative has joined forces with the Humboldt, Butte, Shasta, and Tehama 211 systems in northern California to help get the word out to those in need.

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California health insurance exchange aims to increase Latino enrollment
San Jose Mercury News

Twice a day, San Jose insurance agent Ruben Villanueva offers KZSF-AM La Kaliente’s Latino listeners tips about consumer finance and all kinds of insurance. This month, he’s been reminding his Bay Area-wide audience that Californians need to sign up for health coverage by midnight Monday if they want to be insured on Jan. 1.

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Health care challenge: More coverage often means higher cost
North Bay Business Journal

California’s new health-benefits exchange greatly expanded coverage to millions of residents, but the costs of doing so may be difficult to contain, an overseer of the exchange said at the Business Journal’s Health Care Conference.

The keynote speaker at the Nov. 18 conference was Susan Kennedy, part of the five-member board for the exchange, called Covered California, created after the 2010 Patient Protection and Affordable Care Act, commonly called ACA or Obamacare.

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Uninsured rates fell under Obamacare, but who’s reaping the benefit?
Los Angeles Times

Hospitals and health insurers have reaped a financial windfall from the 2014 rollout of the federal health law, even beyond what was expected.

Now, employers and consumers are seeking a share of the Obamacare dividend.

For years, insurance companies and hospitals told Americans that one reason their insurance bills were so high was because they were paying the hidden cost of medical care for the uninsured.

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Editorial: Obamacare is working, but problems must be solved
Fresno Bee

With the first open enrollment deadline for Obamacare approaching, the good news is that the Affordable Care Act is making a difference here.

At last count, only 11% of Californians were living without health insurance, down from 17% last year at this time. Doctors and local emergency rooms are seeing a dramatic drop in uninsured patients. Sick people can no longer be denied coverage because of a pre-existing condition. Parents can keep their grown children on their insurance. Enrollment is easier.

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Patients outraged after losing doctors under Obamacare
CBS News

Kevin McCarthy of Thousand Oaks, California, was surprised last spring, when he learned his family doctor of 14 years could not accept the Blue Shield insurance he’d purchased under Obamacare.

He said he was “outraged” because when he was shopping for his policy, Blue Shield confirmed his doctor was covered. “We were duped,” McCarthy said. “Hoodwinked is another good term.”

Here’s what happened. Insurance companies — to save money — are quietly selling what are called “narrow networks.”

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Confusion Over Job-Based Insurance Can Shortchange Consumers
National Public Radio

Misunderstandings about whether some types of job-based coverage disqualify consumers from signing up for subsidized insurance through the health law’s marketplaces may lead some people to buy skimpier employer plans instead.

In recent weeks, some of the people called assisters, who help shoppers find coverage, say consumers are being told by employers that their bare-bones plans meet the minimum requirements under the law.

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Western Health Advantage CEO Garry Maisel named chair of HMO trade group
Sacramento Business Journal

Garry Maisel, CEO at Western Health Advantage, is the new chairman of the California Association of Health Plans. The Sacramento-based trade group represents 42 managed-care plans that provide coverage to more than 22 million Californians.

Maisel assumed the helm as California enters a second year of enrollment for the state health benefit exchange and Medi-Cal expansion under the Affordable Care Act. Stakes are huge: Health plans signed up more than 3 million new members in the first go round.

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130 women hospital and health system leaders to know — 2014
Becker's Hospital Review

These 130 women, who are current executives at hospitals and health systems across the nation, demonstrate outstanding leadership within the hospital and healthcare industry and were chosen based on a wide range of management and leadership skills, including oversight of hospital or health system operations, financial turnarounds and quality improvement initiatives.

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Gilead raids Genentech to add to cancer ranks
San Francisco Business Times

Gilead Sciences Inc., coming off its first cancer drug approval and with more in its portfolio, hired Dr. Philippe Bishop away from Genentech Inc. to head its cancer drug programs.

Bishop since 2007 had been vice president of oncology product development at South San Francisco-based Genentech, running dozens of drugs through hundreds of clinical trials. That list includes the blockbuster breast cancer drug Avastin, the antibody-drug conjugate Kadcyla, a $10,000-a-month drug that targets breast cancer, and another breast cancer drug, Perjeta.

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Health Care Registries: Powerful Tool, Narcoleptic Name
The Health Care Blog

Don’t let the name fool you—registries are important. Here are three powerful functions they can enable: 1) Collect data on real-world patient outcomes. 2) Create a feedback mechanism for health care providers — how well are patients faring under treatment? 3) Facilitate changes in care, and improvements in outcomes, based on that feedback.

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