News Headlines

News Headlines
Health care news from around the state and nation

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Poll: Most Americans know little about Supreme Court health case
Washington Post

Most Americans haven’t heard much about the Supreme Court ruling that could result in the loss of health insurance for millions of Americans, according to a poll released Tuesday. About seven in 10 say they’ve heard only a little or nothing at all about the case, King v. Burwell, which challenges a key provision of the Affordable Care Act.

The court is expected to decide within the next two weeks whether it is illegal for the government to provide subsidies to consumers in states that have not set up their own exchanges and instead rely on the federal health insurance marketplace, or

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California is low-risk for MERS, health official says
Orange County Register

The risk of Middle East respiratory syndrome spreading to California is very low, Karen Smith, the state’s top health officer, said Monday. MERS, the deadly virus that is circulating overseas, has made headlines over the last month as it spreads through health facilities in South Korea, killing 16 people and infecting 150 in the largest outbreak outside the Middle East. It has not spread outside of South Korea’s hospitals into the wider community.

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If Supreme Court upends health law, critics and backers mobilize for next action
Washington Post

With a Supreme Court decision looming that could lead to the loss of health insurance for millions of Americans, supporters and opponents of President Obama’s health-care law already are mobilizing for the next stage of the battle: influencing policy alternatives if the court upends a key component of the law.

At issue in the court case is whether it is legal for the government to provide subsidies to consumers in the almost three dozen states that have not set up their own insurance exchanges and instead rely on the federal marketplace.

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Majority in U.S. wants Congress to ensure Obamacare subsidies, poll finds
Los Angeles Times

Nearly two-thirds of Americans want Congress to ensure that residents in every state can receive insurance subsidies though the Affordable Care Act, according to a new national poll conducted as the Supreme Court prepares to decide a legal challenge that could strip away the subsidies in more than 30 states.

Asked whether lawmakers should pass a law “so that people in all states can be eligible for financial help,” just one-quarter of those surveyed said no, according to the poll by the nonprofit Kaiser Family Foundation.

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HHS approves three state-based exchanges ahead of King decision
Modern Healthcare

The Obama administration has given the go-ahead to Arkansas, Delaware and Pennsylvania to switch from federally facilitated health insurance marketplaces to state-based ones.

The approvals come right before the U.S. Supreme Court will hand down a decision that could dramatically alter the course of the exchanges. Justices are expected to rule by the end of the month whether premium subsidies are legal in states that rely on HHS to operate their exchange. Conservative plaintiffs in King v. Burwell have argued the Affordable Care Act only allows the subsidies, known as premium tax credits, to be issued through exchanges established and operated by states.

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Vast data warehouse raises privacy concerns
San Francisco Chronicle

A government data warehouse that stores personal information on millions of customers is raising privacy concerns at a time when major breaches have become distressingly common. A government privacy assessment dated Jan.

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California Has Seen a 34% Increase in Medi-Cal Enrollment Since ACA

California leads the nation in enrollment in Medicaid, the national health program for low-income people, and has seen a 34 percent increase in enrollment since the Affordable Care Act took effect, according to a new report.

As the most populous state, it’s no surprise that California has the largest number of Medicaid enrollees — it did before the federal health law was enacted too.

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Lawmakers improve Medi-Cal funding — but will governor go along?
Sacramento Business Journal

The state budget approved by California lawmakers Monday would partially compensate health-care providers for two years of cuts in Medi-Cal funding during the Great Recession. But it would do nothing to boost rates in the future.

The legislative version of the proposed 2015-16 state budget includes $37 million to compensate providers for 10 percent cuts imposed between June 2011 and June 2013.

More than two-thirds of that — $25 million — would be be paid beginning next April 1 to doctors and other Medi-Cal providers to restore half the money they lost from those cuts. The remaining $12 million allocated by lawmakers would do the same for hospital-based skilled nursing facilities.

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Funding source or transformation tool? CMS, states disagree
Modern Healthcare

State officials have come to view a Medicaid hospital-improvement initiative primarily as a source of supplemental payments for providers, according to the Medicaid and CHIP Payment and Access Commission.MACPAC conducted a series of interviews with state and federal officials about a Medicaid hospital improvement initiative and uncovered a fundamental difference between what states and CMS officials understand about the purpose of the program.

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Medi-Cal Boom Strains Doctors and Budgets
Fox & Hounds

With Medicaid eligibility expanded nationwide under the Affordable Care Act, Medi-Cal enrollees have discovered that care in California is not keeping up with increased demand. “Today, more than 12 million Californians, nearly one-third of the state’s total population, are enrolled in the government’s health insurance plan for low-income, disabled and disadvantaged residents,” U-T San Diego reported.

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Pressure to boost Medi-Cal dental reimbursements
Capitol Weekly

Jim Wood tells a story about teeth that makes him smile.

Wood — a dentist and a state assemblyman from Sonoma County — remembers the time a patient of his who was an elementary school teacher told him about a student suffering from serious dental problems. The little girl’s family was poor and they lived in a rural area. They couldn’t find a dentist to treat her.

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Strong Growth Projected for ACOs in California
HealthLeaders Media

A report published by Health Affairs Blog suggests that ACOs in California are improving quality of care, saving money, and could provide a model for other states to follow. The report written by Stephen Shortell, dean of the UC Berkeley School of Public Health, and Richard M. Scheffler, a distinguished professor of health economics and public policy at the school, predicts the number of people taking part in ACOs in California will grow to 1.35 million by February of 2016—up from 915,285 in February of 2014—and that growth will be driven by the success of early ACOs and the federal government’s push to move away from the fee-for-service system.

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Insurance Still Doesn’t Cover Childbirth For Some Young Women
National Public Radio

Although the federal government recently clarified that most insurance plans must cover prenatal care as a preventive service without charging women anything out of pocket, it didn’t address a crucial and much pricier gap in some young women’s coverage: labor and delivery costs.

Perhaps that shouldn’t come as a surprise.

Insurers and some employers have long tried to sidestep paying for maternity care, which includes prenatal, delivery and postpartum services.  Individual plans typically refused to pay for pregnancy-related services until the Affordable Care Act established that maternity and newborn care are both essential health benefits that must be included in individual and small group coverage.

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Cost Containment Starts with Cost Clarity
Healthleaders Media

Cost containment and revenue cycle activities help shape a healthcare organization’s financial viability, driving down costs through thrifty spending and process improvements on one hand, and maximizing revenues by ensuring that funds owed are actually received using sensible practices and IT-based capabilities on the other. While cost containment has traditionally focused on purchasing and supply chain efficiencies, an increasingly productive and sustainable strategy involves process redesign. Revenue cycle has remained relatively consistent in its focus on minimizing denials and improving clinical documentation, but a growing number of organizations are looking to leverage IT in new ways.

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CMS Predictive Readmission Models ‘Not Very Good’
HealthLeaders Media

The way the Centers for Medicare & Medicaid Services predicts readmissions is likely neither the most accurate nor the fairest, researchers at Harvard Medical School claim. A study published in the May issue of the Journal of General Internal Medicine found that functional status, rather than comorbidities, was a better predictor of whether someone would be readmitted to the hospital.

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California Legislature Passes Budget Plan; Reaction Mixed
California Healthline

State officials and health care groups had mixed reactions to a budget plan (AB 93) passed by the California Legislature on Monday, Capital Public Radio’s “KXJZ News” reports (Orr, “KXJZ News,” Capital Public Radio, 6/15).

For more on the Legislature’s budget plan, see today’s “Capitol Desk” post.

Last month, Gov. Jerry Brown (D) released the revised version of his fiscal year 2015-2016 budget plan, which includes several health care proposals.

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Most Americans Say Drug Costs Are ‘Unreasonable,’ Although They Can Still Afford To Buy Them
Kaiser Health News

Nearly three in four Americans say the costs of prescription drugs are “unreasonable” — and most blame drugmakers for those prices, according to a poll released Tuesday.

The survey by the Kaiser Family Foundation found 74 percent of those taking prescription drugs find the costs unreasonable, as do 72 percent of those not taking such drugs. (KHN is an editorially independent program of the foundation.)

The poll builds on the results of an earlier Kaiser survey in April that identified high drug costs as the public’s top health care priority for Congress and the president. Drug costs have gained attention in the past year in part as a result of controversies surrounding Sovaldi and other new hepatitis C drugs, which can cure most cases of the deadly liver disease but at a price of $84,000 for a 12-week treatment. The high cost has strained Medicaid and Medicare budgets and left private insurers scrambling.

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Cigna surges on Anthem takeover report
USA Today

Shares of Cigna (CI) surged Monday following a report the health insurance giant has been approached by rival Anthem (ANTM) in a potential takeover overture.

Cigna shares closed up 11.74% at $153.43 following a report inThe Wall Street Journalthat Anthem had made two recent acquisition bids, the most recent in the range of $175 a share.

Based on the more than 257 million Cigna shares outstanding as of April 25, a deal that size would value the company at roughly $45 billion.

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UNH, Aetna join health-merger speculation list
USA Today

UnitedHealth and Aetna on Monday night joined the list of health giants said to be exploring a potential merger.

Citing unnamed “people familiar with the matter,” The Wall Street Journal said UnitedHealth has approached Aetna about a takeover valued at around $40 billion.

This came after a Journal report published earlier Monday cited anonymous sources saying that Anthem has approached Cigna about taking it over for about $45 billion.

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Kaiser names new chief nurse, wellness director
Manteca Bulletin

Kaiser has two new leaders in the Central Valley service area.

Patricia “Pidge” Gooch, RN, CENP, has been appointed Chief Nursing Officer for Kaiser Permanente in the Central Valley.

Gooch oversees nursing care, quality, and service standards at Kaiser Permanente Manteca Medical Center and Kaiser Permanente Modesto Medical Center.

She is a 1989 graduate of Ann May School of Nursing in Neptune, New Jersey. Prior to coming to Kaiser Permanente, Gooch was the Chief Nursing Officer of Doctors Hospital in Manteca.

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Top Dignity Health official to retire
San Francisco Business Times

Michael Blaszyk, longtime chief financial officer at Dignity Health, will retire in December.

Blaszyk joined the San Francisco-based health system in 2000, following a period of steep financial losses that totaled more than $1 billion.

He leaves an integrated delivery system with annual revenue of almost $11 billion in 2014 — and a profit margin of 8.3 percent.  Dignity Health has reported positive operating margins since 2003.