News Headlines

News Headlines
Health care news from around the state and nation

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Governor proposes Medi-Cal rate increase for health plans, not providers
Sacramento Business Journal

Gov. Jerry Brown’s revised budget proposal puts $125 million into rate increases for Medi-Cal managed-care health plans, but includes nothing for providers.

The lack of provider rate relief despite a state’s budget surplus brought a swift reaction from a broad coalition of providers and others that launched a $10 million media campaign this week to convince lawmakers and the governor to increase Medi-Cal provider pay.

“Hospitals and other providers are paid by Medi-Cal at rates substantially below Medicare, placing health-care providers and their patients in a precarious situation,” Duane Dauner, president and CEO of the California Hospital Association, said in a news release. Pay cuts in 2011 put California rates close to worst in the nation — and this affects access to care as more providers drop out of the program, coalition members say.

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Scope makers staying mum at FDA superbug hearing
Los Angeles Business Journal

A Food and Drug Administration panel of medical experts are convening this week to examine the spread of scope-related superbugs at several U.S. hospitals, including those in Los Angeles, but the major scope makers linked to the outbreaks won’t be speaking during the discussions. Olympus Corp. and and two other medical device manufacturers were invited to speak at the hearing but “for various reasons they’ve declined to participate,” the Los Angeles Times quoted Dr. Stephen Ostroff, the FDA’s acting commissioner, as saying.

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Patient-Centered Research Can Improve Chronic Pain Care and Address Opioid Abuse
The Health Care Blog

For more than a decade, the United States has faced an escalating opioid abuse crisis. The number of deaths associated with abuse of these prescription painkillers more than tripled between 1999 and 2012 and now outstrips the number associated with any other drug, according to the US Centers for Disease Control and Prevention. The problem is estimated to approach $56 billion in costs to society.

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Population Health Hot-Spotting
HealthLeaders Media

Theorists in healthcare have tried over the years to apply some version of the Pareto principle to the health of a population. While Pareto’s theory was that 80% of the land in Italy was controlled by 20% of its population, healthcare leaders believe that when applying the principle to population health, the real number of patients who use a disproportionate share of resources is less than 5%.

News Headlines Article Contractor Optum Declares Its Job Done
The Wall Street Journal

The contractor tapped to rescue the flailing in the fall of 2013 declared its work finished Thursday and said it doesn’t plan to continue overseeing the website that sells subsidized insurance to millions of Americans as part of the federal health law.

“Having achieved the goal of making a stable and reliable platform for people seeking coverage, Optum will not rebid to continue the role of senior adviser,” said Matt Stearns, a spokesman for the company, the technology unit of insurer UnitedHealth Group. “Our job has been completed.”

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1 in 4 adults had insurance but still couldn’t afford medical care
Washington Post

More than 1 in 4 adults who bought insurance for themselves or their families last year had to skip needed medical care because they couldn’t afford it, according to a study released Thursday by Families USA, a consumer health group.

Some signed up for coverage on the new health insurance exchanges under the Affordable Care Act and received financial assistance to help pay their premiums and some of their out-of-pocket costs. Others bought their plans directly from insurance companies.

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Covered California Takes Conservative Fiscal Move Toward Self-Sufficiency
California Healthline

Covered California officials yesterday released a budget proposal for the 2015-16 fiscal year. As expected, the agency has scaled down its advertising and outreach budget, and cut back the large initial outlay for information technology services. Those moves lay the fiscal groundwork for the exchange’s long-planned effort to become self-sufficient by the end of the next fiscal year. There were two developments that were less expected:

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Critics Say Budget Revision Neglects Social Welfare
capital public radio

Democratic lawmakers have been advocating for Governor Jerry Brown to include more money for state subsidized child care in his budget revision. The Legislative Women’s Caucus has called for an investment of at least $600 million this year. But Brown says another recession is likely around the corner and the state has to consider ongoing costs.

“I don’t want to get caught in the jaws of the persistent fiscal instability of the state government of California,” he says. “There it is.”

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Health and social service advocates cry foul over Brown’s revised budget
Contra Costa Times

Gov. Jerry Brown’s revised budget would boost spending on health and social services by about $1.7 billion over the current year, but it left advocates screaming for more to restore cuts made during the Great Recession.

The state’s tattered social safety net will be front and center in Brown’s negotiations with Democratic lawmakers from now through the June 15 constitutional deadline for enacting next year’s budget, wrangling over how to spend about $2 billion in better-than-expected tax revenues that aren’t already earmarked for other purposes.

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‘This is a matter of public safety’: California Senate approves controversial bill prohibiting vaccine exemptions
Orange County Register

The bill was approved on a 25-10 vote after a series of emotional hearings this year at which opponents called for preserving parental rights on the matter.

The measure would prohibit parents from seeking vaccine exemptions for their children because of religious or personal beliefs.

The bill, which now goes to the Assembly, would make medical waivers available only for children who have health problems. Other unvaccinated children would have to be homeschooled.

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Calif. Moves Closer To Banning Vaccine ‘Personal Belief’ Exemptions
National Public Radio

California’s state Senate has passed a bill to eliminate “personal belief exemptions” that currently allow parents to opt out of having their school-age children vaccinated.

SB 277, sponsored by Democratic Sens. Richard Pan of Sacramento and Ben Allen of Santa Monica, passed 25 to 10 and now advances to the Assembly.

The bill’s sponsors introduced the legislation following an outbreak of measles in Disneyland that started in December and sickened dozens. Most of those who became ill had never been vaccinated against measles.

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Controversial bill prohibiting vaccine exemptions drives Democrats into Republicans’ arms
Orange County Register

Carmen Joseph registered as a Democrat 30 years ago, upon turning voting age.

She still cares about stymieing climate change, narrowing income inequality and bolstering safety net programs. She’s still pro-choice.

But on Saturday, Joseph will re-register as a Republican over one issue: SB 277.

The divisive bill – which was approved Thursday by the state senate on a 25-10 vote – would toughen California’s mandatory vaccine laws, requiring shots for all students enrolled in public and private school, unless they obtain a medical waiver. Parents would no longer be allowed to choose not to immunize their children because of personal or religious beliefs.

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21st Century Cures bill advances with House debate down to quibbles
Modern Healthcare

The 21st Century Cures legislative debate in the House is down to quibbles. The Health Subcommittee of the House Energy and Commerce Committee passed the bill, unanimously, by voice vote, to the full committee. The full committee said it would take up the bill next week. “This is a product deserving of the committee’s support,” said Rep. Frank Pallone (D-N.J.), the ranking member of the Energy and Commerce Committee. Pallone’s support is notable.

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California lawmakers must address doctor shortage
Fresno Bee

Medi-Cal, California’s health care program for low-income people, has become big business.

Thanks to the Affordable Care Act, which broadened eligibility for the program, Medi-Cal’s rolls have swollen to about 11 million people, or more than 1 in every 4 state residents.

Persistent reports suggest that the state lacks enough doctors to care for all those people. Or at least enough doctors who are willing to provide care at the rates the state has been willing to pay, which are among the lowest in the nation.

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Hospitals aim to cut water use, safely
Sacramento Business Journal

California hospitals are big water users. They operate around the clock, every day — and being dirty is not an option.

Think patient care and hygiene. There’s room-cleaning, instrument sterilization, infection control, food prep and laundry. Heating and cooling systems use water — and so do some treatments. Water use varies by hospital size, but California hospitals are trying to cut use by 25 percent overall as the state faces its fourth year of drought.

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Feds Say That In Screening Colonoscopies, Anesthesia Comes With No Charge
Kaiser Health News

Earlier this week the federal government clarified that insurers can’t charge people for anesthesia administered during a free colonoscopy to screen for colorectal cancer. That’s good news for consumers, some of whom have been charged hundreds of dollars for anesthesia after undergoing what they thought would be a free test. But the government guidance leaves important questions unanswered.

Under the health law, most health plans have to provide care that’s recommended by the U.S. Preventive Services Task Force without charging members anything out of pocket. The only exception is for plans that have grandfathered status under the law.

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Specialty medical providers urge patients to look beyond ‘brand names’
The Business Journal

The number of high-quality specialty medical programs available in the Central Valley has grown over the years, but many physicians are still struggling to raise awareness among the local population.

Patients seeking specialty care will often travel outside the region without realizing the same level of care is already available locally, said Dr.

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Revenue Cycle: The Essential Office
HealthLeaders Media

Revenue cycle leaders at hospitals and health systems oversee the complex interplay of financial necessity, clinical work, and regulations. To them falls the detail work of collecting payment from insurers and patients, bridging the gap from the finance office to physicians to ensure that clinical activities are properly documented, and negotiating with the information technology and analytics groups for the tools to wrestle data into submission. The tasks necessary for an effective revenue cycle have expanded and become vastly more complex.

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Final steps underway for new Sonoma West Medical Center on Palm Drive Hospital site
Santa Rosa Press Democrat

The yearlong retooling of Palm Drive Hospital, re-branded as Sonoma West Medical Center, is almost finished, with final remodel and renovation work expected to be completed by the end of next week.

Supporters of the hospital, with a slimmed down bed count and plans to offer specialty outpatient care, say they’re hoping for a grand reopening at the end of the month, depending on the scheduling of final bureaucratic steps.

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St. John’s in Camarillo plans $80 million expansion
Ventura County Star

A groundbreaking is expected in September for the new expansion of St. John’s Pleasant Valley Hospital in Camarillo.

Darren Lee, president and CEO of St.

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Hospital gets a B rating for safety
The Record Gazette

San Gorgonio Memorial Hospital fared better than other area medical facilities in the latest round of safety ratings released by The Leapfrog Group, a nonprofit organization that monitors safety and transparency in healthcare. The ratings of A through F were applied to more than 2,500 hospitals across the country, based on an institution’s ability to prevent errors, injuries, accidents and infections.