News Headlines

News Headlines
Health care news from around the state and nation

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Health care for small companies: A conversation with the head of a private insurance exchange
Orange County Register

Imagine walking into a Nordstrom stocked with only a single pair of black shoes – no options for size, color or shape. Now think of a single insurance plan for all people, regardless of their age, income, medical needs or personal preferences.

Ron Goldstein, CEO of Orange-based Choice Administrators, a private health insurance exchange company, used the Nordstrom metaphor to explain the appeal of multiplan insurance exchanges for small businesses as opposed to plans that are one size fits all.

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Insurance coverage for mammograms jeopardized by new guidelines, congresswoman and breast cancer survivor says
Washington Post

Earlier this week, the U.S. Preventive Services Task Force (USPSTF), an independent group of doctors and health-care experts, issued draft recommendations on mammography for women at various ages. Their recommendations could lead to insurance companies dropping coverage of mammograms for women under age 50, as well as other preventive techniques that would help protect young women from getting breast cancer and help those who do have it.

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Drug Prices Trend Up, and States Want to Know Why
The Wall Street Journal

Should drug makers be required to disclose their costs to justify rising prices? This is what a growing number of state legislatures are considering. Over the past several weeks, lawmakers in a handful of states stretching from California to Massachusetts have introduced bills in a bid to force the pharmaceutical industry to conduct an economic striptease.

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Rehab facilities in line for Medicare raise—and must report quality data to get it
Modern Healthcare

Inpatient rehabilitation facilities would get a 1.7% rate increase from Medicare in fiscal 2016 under a proposed rule the CMS issued Thursday.

The policy would deliver $130 million more to rehabilitation facilities than they received in fiscal 2015. However, the increase is significantly smaller than the 2.4% raise they received in fiscal 2015. The rule would also make a portion of reimbursement contingent on reporting on several new quality measures.

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Thousands May Have Been Shorted On Insurance Subsidies After Calculation Error
Kaiser Health News

Thousands of families with a disabled or deceased parent may have received a lower subsidy than they deserved to buy health coverage through the federal insurance marketplace as a result of a calculation error by the federal government.

In addition, some who should have been eligible for Medicaid may have been turned away, leaving them on the hook for higher-priced private insurance coverage.

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Study: Satisfaction with ObamaCare tops traditional plans
The Hill

People who bought coverage through ObamaCare are generally more satisfied than those with other types of insurance, according to a new national survey.

ObamaCare customers rated their satisfaction over the last year as 696 out of 1,000, compared to the 679-point rating by customers with employer-based plans, according to a large survey by the consumer research firm J.D. Power.

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California, Washington shine during special Obamacare sign-ups
CNBC

Now that’s a West Coast offense! Two states that run their own Obamacare markets—California and Washington—are blowing away the much-larger, federally run HealthCare.gov when it comes to signing up customers during a tax season grace period. That special enrollment offer is open to people who only just learned they owe a fine for not having health insurance last year.

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Gender Pay Gap Persists in Nursing
Health Leaders Media

The gender pay gap in the United States may vary according to who’s measuring it—the White House says women earn 77% of what men earn, while a Pew Research Center survey says women earn 84% of what men earn—but it’s always there, even in the female-dominated nursing profession.

In fact, that gap is about $5,148 per year when adjusted for factors such as education and experience. And according to a study, nursing’s gender pay gap hasn’t narrowed in 25 years.

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Surgeon General Vivek Murthy wants to move U.S. health care toward a ‘prevention-based society’
Washington Post

My overarching goal is to get every individual, every institution and every sector in America…to ask themselves the question [of] what they can do to improve the health and the strength of our nation. The health challenges that we face right now are too big to be solved by the traditional health sector alone. We can’t build more hospitals and clinics and, solely based on that, expect that we are going to solve the health challenges that we face.

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Technological Change Creates a ‘Blind Spot’ in Physician Credentialing
HealthLeaders Media

When a patient suffered a cascade of complications after robotic surgery, his lawyers thought the doctor, the hospital, and the device maker should be liable. But in a malpractice case involving the da Vinci Surgical System, the courts disagreed. The 2013 decision that Intuitive Surgical, the maker of da Vinci, was not responsible for the action of a poorly trained doctor may be good news for the medical device makers.

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Merging Practices Into an ACO a Tricky Business
Health Leaders Media

Sometimes the best way to integrate electronic medical record (EMR) systems is not to integrate them — at least not right away, Jim Walton, DO, MBA, president and CEO of Genesis Accountable Physician Network, said here.

Walton, who came on board at Dallas-based Genesis — a network of 500 primary care physicians and 900 specialists — in 2013, was faced with the task of integrating the practices and transitioning them from being in an independent practice association (IPA) to being an accountable care organization (ACO).

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