News Headlines

News Headlines
Health care news from around the state and nation

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3 States Counter Obama’s Proposal For Medicaid Expansion
National Public Radio

States have a year to get full funding for Medicaid expansion under Obamacare. The governors of Utah, Wyoming and Montana are trying to get the money but their legislators may derail the efforts.

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Covered California Board About To Get Makeover
California Healthline

Three of the five Covered California Board of Directors seats are about to get newly appointed occupants in a shift that could have significant influence on the future of the four-year-old health insurance exchange. Two seats are becoming vacant because of expired terms and a third is open following a resignation. Robert Ross, president and CEO of The California Endowment, announced his resignation last month, effective Dec. 31, 2014.

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2015 Congress: 3 Initiatives for Payers
HealthLeaders Media

Healthcare is one of the most regulated industries in the country, with a host of federal and state agencies overseeing all the major stakeholders.

In last fall’s mid-term election, Republicans gained control of the Congress, seizing the Senate with a 54-46 edge over the Democrats and their duo of independent party allies. In the House, the GOP extended its voting margin over the Democrats, picking up 14 seats to post a 247-188 advantage.

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Blue Shield, Sutter Health reach contract impasse over cost, ‘antitrust’ issues
San Francisco Business Times

Blue Shield of California says its contract for self-funded clients at Sutter Health, which operates many of the largest hospitals in the Bay Area and the Sacramento region, has expired and an impasse in contract talks could result in roughly 145,000 members dropping Blue Shield’s service. The prior three-year contract expired at midnight on Dec. 31, according to Blue Shield spokesman Steve Shivinsky, and covers more than 140,000 HMO enrollees and 4,400 PPO enrollees in the region. Many of them work for self-insured companies.

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Blue Shield in dispute with Sutter Health over costs
Los Angeles Times

In a high-stakes fight over healthcare costs, insurance giant Blue Shield of California contends that a major hospital chain is trying to hide some of its business practices from public scrutiny.

The dispute has prevented Blue Shield and Sutter Health, which runs 23 hospitals in Northern California, from reaching a new contract that could affect numerous employers and consumers. Their previous agreement expired Dec. 31.

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About 145K Blue Shield members to be notified of Sutter Health contract expiration
Sacramento Business Journal

Almost 145,000 Blue Shield of California members who get their health benefits through work will be affected by a contract break with Sacramento-based Sutter Health — if it holds. Thousands more who bought individual insurance and live within 15 miles of a Sutter facility may also be affected. The contract that covers all these folks expired Dec. 31, after negotiations between Blue Shield and Sutter broke down New Year’s Eve.

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Emergency Health Insurance Regulation Issued
capital public radio

The California Department of Insurance issued an emergency regulation Monday intended to assure improved healthcare access to Californians. Commissioner Dave Jones says the regulation will require insurance companies to provide adequate numbers of doctors, clinics and hospitals to patients within specific service areas. “We’ve received complaints from consumers across the state about long waiting times, about inaccurate directories of providers, about being charged out-of-network costs when there isn’t an in-network provider. The list goes on and on and on.”

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Top Healthcare Quality Issues for 2015, Part 1
HealthLeaders Media

Healthcare has experienced fascinating changes during the last few years, and 2015 will be no exception.

Major programs stemming from the Patient Protection and Affordable Care Act are well under way, dozens of new quality measures and data galore are flowing into the public domain, and quality of care remains in the spotlight for providers at all levels. There are sure to be tweaks, especially where measures and performance commingle to affect payment. But here are six quality issues that warrant your attention in 2015.

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Hospital quality reporting may hold down prices
Modern Healthcare

More public reporting on hospital quality could help to reduce hospital prices, results of a study suggest.

The prices for two common cardiac procedures did not increase as quickly in states where the first public reporting on cardiac quality occurred when Medicare released it in 2007, researchers reported in the latest issue of Health Affairs. Prices for the same two procedures grew more quickly in states where cardiac quality data already was available.

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Infection control can reduce costs, improve outcomes
Modern Healthcare

Hospital intensive-care units carry a higher risk of mortality among elderly who develop an infection during their stay, according to a new study. Infection control efforts resulted in better health outcomes and reduced healthcare costs, the study also reports.

An analysis of health outcomes of more than 17,000 Medicare patients admitted to 31 hospitals in 2002 found those who had an infection while in an ICU were 35% more likely to die within five years of leaving the hospital.

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Big Data Not A Cure-All In Medicine
National Public Radio

Big data is a trendy term for the ever-expanding cloud of information that’s online and increasingly searchable. Some researchers say it could change the way medical research is done and the way individual doctors make medical decisions. Others say big data raises too many big questions — especially when it comes to medicine.

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Pregnant doctor finds intense pressure to have a Caesarean delivery
Washington Post

I had been at the hospital for two days in induced labor, unable to get out of bed or eat, tethered to a labor-inducing oxytocin drip. The doctors started to talk about stalled labor, a stuck baby, and going to the operating room. I had assisted at dozens of Caesareans when I was a medical student, but I didn’t think I was there yet. I started flipping through numbers on my cellphone, looking for friends who were obstetricians and pediatricians. I needed another opinion to keep me from a C-section.

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Self-Tracking Gadgets That Play Doctor Abound At CES
National Public Radio

When your kid’s ear is throbbing at 2 a.m., you might want to grab the car keys and head to the emergency room. But now you can pick up your iPhone instead.

A startup called CellScope has built a little ear probe that you clip on top of your iPhone camera. The footage streams into an app where you can view the inside the ear. You could be tempted to use this $79 device to diagnose yourself, and not seek real medical care, even if you needed it.

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Natividad, county officials take trauma center victory lap
Monterey Herald

Natividad Medical Center and Monterey County officials and staff celebrated the county-owned hospital’s formal designation as the area’s first Level II trauma center on Monday, the official first day of the highly prized distinction. At an event to mark the occasion at the hospital, Natividad’s interim CEO Dr. Kelly O’Keefe noted the historical nature of the achievement, which designates the venerable institution as the preferred destination for the most seriously injured patients from the county.

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