News Headlines

News Headlines
Health care news from around the state and nation

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CMS Demonstration Saves $25 Million While Increasing Quality of Care
The American Journal of Managed Care

The first year of CMS‘ Independence at Home Demonstration led to both higher quality care and saved $25 million, an average of $3070 per participating beneficiary.

All 17 participating practices improved quality in at least 3 of the 6 quality measures with 4 practices meeting all 6 measures. Overall, 9 practices met quality measures and successfully reduced Medicare expenditures and will receive incentive payments of $11.7 million.

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HIV vaccine approach nears human trial
San Diego Union-Tribune

For decades, scientists have struggled to develop vaccines to stop the spread of HIV. And for decades, the vaccines have failed. HIV mutates at a ferocious pace, outrunning the immune system’s antibodies.

Studies published Thursday demonstrate that the immune system can be accelerated so it’s primed and ready to block HIV infection.

The studies describe a multi-pronged approach to an HIV vaccine, each one demonstrating a component of the process.  Assembling all these components into a vaccine for humans is the final step. Testing could take place in about two years, the scientists say.

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Roundtable: Mergers, Acquisitions, and Partnerships
HealthLeaders Media

M&A in the hospital and health system business used to be relatively simple: big hospital or system buys smaller hospital or system. But in 2015, as organizations nationwide try to navigate the vast geographic differences in the pace and nature of healthcare reform, their solutions are equally myriad. Some consolidation activity is in the traditional vein of direct acquisition or merger of equals, but many new partnerships involve the creation of new entities to tie systems together, whether geographically or otherwise.

Hospitals and health systems, recognizing the growing importance of care coordination and the value in unified patient management and tracking, are acquiring organizations once thought far outside their purview, such as imaging centers, surgery centers, primary care practices, and even LTAC, skilled nursing, or home health groups. Further, some hospitals are partnering in everything short of assets through ACOs or other patient- and cost-management structures.

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Covered California awards multimillion-dollar PR and marketing contracts
Sacramento Business Journal

Covered California has awarded new multimillion-dollar contracts for marketing and public relations services. Campbell Ewald got a three- to five-year marketing contract worth up to $52.2 million a year. Ogilvy Public Relations got a three- to five-year contract worth up to $2 million annually. Effective this month, the agreements were announced midweek. The job: to spread word that affordable health insurance is available through Covered California.

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CMS raises reinsurance payouts to health insurers
Modern Healthcare

An Affordable Care Act provision intended to protect health insurers from excessive medical costs received a boost from the CMS late Wednesday, a move that will directly help the finances of insurers that have enrolled sicker members.

Reinsurance payments to health insurers that offer ACA-compliant individual plans inside and outside the exchanges will rise for the 2014 benefit year, according to a CMS memo. Reinsurance, along with risk corridors and risk adjustment, are the ACA’s “market stabilization” provisions.

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Preparing for ICD-10; It’s Coming, Ready or Not
HealthLeaders Media

As October 1 draws closer and closer for the implementation of ICD-10, the remaining resistance by some physicians and their advocates, such as the American Medical Association (AMA), appears to be slowly waning.

The AMA still supports new legislative efforts to derail ICD-10, arguing physicians have enough on their plates between implementing electronic health records (EHR) and new payment and delivery models. At the same time, the organization is providing training tools for physicians to prepare for the changeover.

Certainly not all physician practices and their business associates are opposed to the change. The big question that remains is whether all of the players will be ready on October 1.

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Drug companies donated millions to California lawmakers before vaccine debate
Sacramento Bee

A subplot to the vociferous debate over the student vaccination bill moving through California’s Capitol is opponents’ allegations that the effort reflects the influence of the pharmaceutical industry.

Critics of Senate Bill 277, which would eliminate the personal belief and religious exemptions for schoolchildren, accuse the measure’s supporters in the Legislature of doing the bidding of donors who make vaccines and other pharmaceuticals.

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Congressional Bills Would Mandate Equal Coverage For Pills And IV Cancer Therapy
Kaiser Health News

A bipartisan group of House and Senate legislators introduced bills last week that would require health plans to cover the growing number of oral chemotherapy pills as favorably as they do intravenous chemotherapy. But an insurance trade group says that as long as drugmakers continue to increase the prices of the oral drugs, parity legislation amounts to a “shell game” that will push up everyone’s premiums.

In recent years, states have passed oral chemotherapy parity laws at a steady clip. They’re on the books in 39 states and the District of Columbia, according to the American Cancer Society’s Cancer Action Network.

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Birth control pills should not be prescription-only
Los Angeles Times

In a surprising moment of bipartisan unity, Republicans and Democrats seem to be in agreement that it’s time to remove the prescription requirement for oral contraceptives. Right before Memorial Day, Sen. Kelly Ayotte (R-N.H.) and Sen. Cory Gardner (R-Colo.) introduced legislation aimed at making birth control pills available over the counter, and now Sen. Patty Murray (D-Wash.) has introduced a Democratic bill that also would add insurance coverage for a future OTC pill.

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CalPERS approves 7.2% increase in HMO rates as drug costs climb
Los Angeles Times

One of the nation’s biggest healthcare buyers, the California Public Employees’ Retirement System, said its HMO premiums are rising by 7.2% next year as pharmacy costs climb.

Rates for PPO, or preferred provider organization, plans are going up even more at 10.8%, on average, for 2016.

The sharp increases mark a departure from two years of more modest increases of about 3% at the giant pension fund.

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Patient access to local nursing homes limited
Times-Standard

As of last week, patient access to all six skilled nursing homes for long-term care in Humboldt County has been limited or cut off, according to state Department of Health Care Services and local elder care officials. The result? Families are being presented with the choice to put ailing loved ones into assisted-living facilities without medical care, take them back into their own homes or send them to nursing homes as far away as Santa Rosa.

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Lucile Packard Children’s Hospital’s Ed Kopetsky is the Lifetime Achievement winner for the 2015 Bay Area CIO of the Year awards
Silicon Valley Business Journal

Anyone who has wrestled with new business software can appreciate the challenge that Ed Kopetsky faced. As CIO of Stanford Children’s Health and the Lucile Packard Children’s Hospital, Kopetsky led the three-year planning and deployment of a new system called Epic to handle physician orders and patient records for the entire hospital.

In a very real sense, the upgrade put the whole organization on the line.

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Sutter to celebrate new hospital with festivities Saturday
Sacramento Bee

Sutter Medical Center will welcome the brand new Anderson Lucchetti Women’s and Children’s Center to its midtown campus Saturday with a full day of activities at the hospital and at nearby Sutter’s Fort. For the past decade, Sutter Health has been making plans for a $750 million renovation to its flagship location – a multibuilding campus bordered by K Street and Capitol Avenue along 28th and 29th streets..

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