News Headlines

News Headlines
Health care news from around the state and nation

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Medicare payments still lean toward volume, not value
Modern Healthcare

Of the $360 billion in payments Medicare made to providers in 2013, 58% continued to flow through traditional fee-for-service models with no regard for quality or outcomes, according to a new analysis by the employer-backed Catalyst for Payment Reform.

HHS recently announced ambitious targets to accelerate the government’s move to value-based models, such as accountable care organizations and bundled payments. Tuesday’s report is Catalyst for Payment Reform’s first look specifically at Medicare.

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Floor Vote Next for Nurse Practitioner Bill
California Healthline

A bill that would allow nurse practitioners in California to practice without physician supervision under certain circumstances passed the Senate Committee on Appropriations in a 5-0 vote on Monday and now heads to the Senate floor.

SB 323, by Sen. Ed Hernandez (D-West Covina), would allow nurse practitioners to practice without the supervision of a physician if certified by an authority such as a hospital, medical group, accountable care organization or clinic. Under the bill, nurse practitioners could manage the health of patients, conduct assessments and order and prescribe medications, lab tests and medical devices.

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Healthcare for those in U.S. illegally could cost California $740 million a year
Los Angeles Times

Extending state-subsidized healthcare coverage to people in the country illegally could cost California as much as $740 million annually, according to a Senate fiscal analysis released Monday. The report affixes a price tag to the proposal for the first time since Sen. Ricardo Lara (D-Bell Gardens) introduced his bill last December. Researchers at UC Berkeley and UCLA estimate that, in California, about 1.8 million people who are in the country illegally lack healthcare coverage. Around 1.5 million of them would qualify for Medi-Cal.

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Whooping Cough Vaccine Effectiveness Fades — and Fast
KQED Radio

Lately, Californians have been focused on a significant measles outbreak that just ended. But in the last five years, state health officials have declared an epidemic of whooping cough (also known as pertussis) twice — in 2010 and in 2014, when 11,000 people were sickened and three infants died.

Now a new analysis from a recent whooping cough epidemic in Washington state shows that the effectiveness of the Tdap vaccine used to fight whooping cough waned significantly. For adolescents who received all their shots, effectiveness within one year of the final booster was 73 percent. That rate plummeted to 34 percent within two to four years.

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California health care bill for illegal immigrants on hold
Contra Costa Times

Closely watched California legislation that would extend free or low-cost health care coverage to immigrants who are in the country illegally is on hold until month’s end, when it will either be moved to the full Senate for a vote or shelved.

The Senate Appropriations Committee on Monday agreed to refer Senate Bill 4, among dozens of other bills, to the committee’s suspense file. That is where bills that would cost more than $50,000 in state general funds are held until they can be reviewed against the state budget.

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Health care: Illegal immigrants would get Medi-Cal under California bill
Inside Bay Area

The backbreaking work in California’s chili pepper fields and cherry orchards wasn’t so noticeable when farmworker Antolin Gonzalez was young. But the 49-year-old south Santa Clara County farmworker now suffers from dizziness, allergies from dust and pesticides, swollen feet and throbbing backaches — even eyesight problems from prolonged exposure to ultraviolet light.

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Undocumented Immigrants Have Limited Health Care Coverage, ‘Health For All Act’ Would Expand It
capital public radio

The “Health For All Act” would allow lower-income undocumented immigrants to sign up for full Medi-Cal coverage. It would allow others to buy health insurance completely on their own.

Some urgent and acute health care needs of undocumented people are already covered by Medi-Cal.

“Currently federal law requires the state to cover emergency and pregnancy services to the undocumented population,” says Amber Didier, policy analyst with the Legislative Analyst’s Office.

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Health Net boosted by Medicaid expansion, ACA exchanges
Modern Healthcare

First-quarter profit at Health Net edged slightly upward, but the effects of the Affordable Care Act on the health insurer’s swelling membership and top line was perhaps more notable.

Health Net’s Medicaid enrollment increased 31% in the first quarter of 2015 compared with the same period last year, totaling more than 1.7 million low-income Americans. That’s more than half of the company’s 3.2 million members. Health Net sells Medicaid managed-care plans in Arizona and California, both of which expanded Medicaid under the healthcare reform law to people making up to 138% of the poverty line.

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Pioneer ACO Program Saves $384 Million, OK’d for Expansion
HealthLeaders Media

The Pioneer ACO model, a controversial Medicare program geared to incent doctors and hospitals to improve quality and reduce costs and redundant care, in two years saved more than $300 per year for each of the 600,000 beneficiaries enrolled and is ready to be scaled up, Centers for Medicare & Medicaid Services officials said Monday.

“Today, I can proudly say that this ACO model has surpassed this important milestone, based on its positive results,” Patrick Conway, MD, chief medical officer and acting principal deputy administrator for CMS said at a telephone news conference.

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A novel Rx for rising California health-care costs
Fresno Bee

California’s health-care system suffers from many problems, but two in particular conspire to drive up costs and reduce access to care, especially in low-income communities.

One is a shortage of primary care doctors. With the federal Affordable Care Act giving public or private health insurance to millions of Californians for the first time, it’s getting more and more difficult, especially here in the Valley, for many to find a doctor who will take them as a patient.

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Largest U.S. health insurer inks deal with Sutter affiliate to serve 63,000 patients
Sacramento Business Journal

United Healthcare, the nation’s largest health insurer, and the 1,200-physician Palo Alto Medical Foundation are launching an accountable care organization to serve 63,000 Bay Area patients enrolled in United’s employer-sponsored health plans. The new arrangement builds on the Sutter Health affiliate’s prior ACO networks with Cigna (40,000 patients) and Anthem Blue Cross (60,000 patients), for a new total of 163,000 between the three health plans.

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Patients Not Hurt When Their Hospitals Close, Study Finds
Kaiser Health News

A hospital closure can send tremors through a city or town, leaving residents fearful about how they will be cared for in emergencies and serious illnesses. A study released Monday offers some comfort, finding that when hospitals shut down, death rates and other markers of quality generally do not worsen.

Researchers at the Harvard School of Public Health examined 195 hospital closures between 2003 and 2011, looking at health experiences in the year before and the year after the hospital went out of business. Their paper, published in the journal Health Affairs, found that changes in death rates of people on Medicare — both those who had been in the hospital and among the broader populace — were no different than those for people in similar places where no hospital had closed.

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Telemedicine Reimbursement and Licensure Expands in State Regulations
HealthLeaders Media

Over just six months, state regulating bodies show moderate improvement in telemedicine policies and laws, the American Telemedicine Association reports this week.

At its annual meeting in Los Angeles this week, the ATA reported that 24 states and Washington, D.C., now have enacted parity laws requiring comparable coverage of and reimbursement for services delivered via telemedicine as is available for in-person services, by state-approved private insurance plans, state employee medical plans, and Medicaid.Three more states than had such laws in effect last September.

Telemedicine regulation was tracked in a national survey conducted last fall and updated this spring, according to ATA’s Coverage and Reimbursement Report.

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It’s time to make Blue Shield of California a for-profit insurer

As a native of the Boston area, I often view California with a mix of awe, intrigue and bewilderment.

What’s it like to have cities laid out in a sensible grid? Why isn’t everyone in the same hurry I am? Doesn’t all that sunshine get just the slightest bit annoying? How can you drive for eight hours and still be in the same state?

Lately, I’ve cast that awe, intrigue and bewilderment away from the folksy foibles of Left Coast life and toward a story quickly becoming a tornado in a teapot: Blue Shield of California.

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Tahoe Forest Hospital CEO search firm: Process could take 4-6 months
Tahoe Daily Tribune

Jake Dorst is officially serving as Tahoe Forest Hospital District’s interim CEO, as a search for a permanent leader begins.

At a special Friday meeting, the hospital board of directors unanimously approved amending Dorst’s chief information officer contract to include the CEO role for a six-month period.

According to his new contract, which is effective until Nov. 1 or upon the start date of a CEO, Dorst will be paid $244,482, up from his $190,000 CIO annual compensation.

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Low Price Mammograms Offered At Henry Mayo In May

With a dedication to fighting breast cancer through early detection and timely treatments, the Sheila R. Veloz Breast Center is offering a special price for digital 3D mammograms during the month of May. “Henry Mayo is thrilled to be able to offer the latest technology available in order to detect breast cancer,” said Terry Lynn Bucknall, the director of women’s imaging services at Henry Mayo.