News Headlines

News Headlines
Health care news from around the state and nation

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A Ruling Against Obama Would Damage, Not Negate, a Health Care Legacy
New York Times

The night his administration’s Affordable Care Act passed in 2010, President Obama described the victory the way he hopes historians will: as a “stone firmly laid in the foundation of the American dream.”

But Mr. Obama’s prospects for a legacy of expanding health care coverage in the United States for generations have rarely seemed as uncertain as they do today. The Supreme Court is expected to rule by the end of the month on a critical provision of the Affordable Care Act — insurance subsidies for millions of Americans — and even Mr. Obama’s closest allies say a decision to invalidate the subsidies would mean years of logistical and political chaos.

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Hospital cost of uninsured: $900 per patient, per year
Modern Healthcare

New research suggests the financial strain on hospitals and households will be immediate and significant if a U.S. Supreme Court decision ends subsidies for health insurance in 36 states. As many as 6.4 million Americans who bought insurance may drop it and become a financial burden to providers. The study, published by the National Bureau of Economic Research, found a “minimum and unavoidable” demand for hospital care among the uninsured at an annual cost to hospitals of $900 a patient.

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Obamacare is just the beginning of healthcare reform: Holtz-Eakin
Yahoo Finance

The Affordable Care Act, or Obamacare, is back in the spotlight once again. This time it’s under dissection by both the Congressional Budget Office and the Supreme Court.

The highest court in the U.S. will decide on King vs. Burwell before the end of June. The case could potentially end the subsidies of 6.4 million Americans who buy their health care through the Affordable Care Act. Meanwhile, the CBO has released an analysis on the costs of repealing Obamacare– a repeal that it says could add $137 billion to the U.S. deficit over the next 10 years. The number comes from an estimated $353 billion in deficits and an economic boost from increased supply of labor that would remove $216 billion from the deficit.

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Covered California health insurance exchange at a crossroads
Contra Costa Times

As millions of Americans nervously await the U.S. Supreme Court’s ruling on a key provision of the health care law — whether or not federal subsidies are legal in 34 states that don’t run their own insurance exchanges — California’s newly insured can breathe a bit easier.

Even if the court rules in favor of the plaintiffs trying to gut the law, imperiling the subsidies 6.3 million people are using to help pay their insurance bills, the decision should have no immediate effect on California and other states that have set up their own state-run exchanges.

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Calif. Health Officials Aid People Facing Astronomic Drug Bills
National Public Radio

Specialty medicines have forced some to choose between treatment and paying rent. California will put a lid on the amount anyone enrolled in most Obamacare plans can be charged for high-end medicine.

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Bill aims to free ASC docs from some meaningful use rules
Modern Healthcare

Senate Finance Committee this morning will mark up a bill meant to adjust meaningful-use requirements for physicians using ambulatory surgery centers.

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Legislation that Could End Unwanted Medical Treatment
The Health Care Blog

Roughly 25 million Americans have been subjected to unwanted medical treatment at some point in their lives, and that means we have a healthcare system that is not listening to patients. We all say we believe in patient-centered health care, and now we have a bill in the U.S. Congress that would put our money where our mouths are. Literally.

Senators Mark Warner (D-VA) and Johnny Isakson (R-GA) introduced legislation this month that would make sure Medicare recipients and their doctors know how much or how little treatment those patients would want as they approach the end of life.

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California Caps What Patients Pay For Pricey Drugs. Will Other States Follow?
Kaiser Health News

Expensive specialty medicines used to treat cancer and chronic illnesses have forced some very ill Americans to choose between getting proper treatment and paying their rent.

To ease the financial burden, the California agency that governs the state’s Affordable Care Act marketplace issued landmark rules recently that will limit the amount anyone enrolled in one of those plans can be charged each month for high-end medicine.

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Program to curb ‘doctor-shopping’ for drugs launches next week — but already there’s trouble
Sacramento Business Journal

A new system to prevent patients in California from obtaining overlapping drug prescriptions from multiple doctors is scheduled to launch July 1, but providers say it has problems.

The Controlled Substances Utilization Review and Evaluation System — better know as CURES — provides a database to help providers identify patients who are “doctor-shopping” for drugs.

State staffing and support for the initial program were decimated by budget cuts during the recession. The system, which is run by the California Department of Justice, was hard to use, the data old. Legislation signed into law in 2013 levied a $6 fee on provider licenses to generate money to modernize and staff the program.

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Boy Leukemia Patient Weighs in as Big Vaccine Exemption Vote Nears
KQED Radio

Rhett Krawitt, the 6-year-old Marin leukemia patient who became a vaccination poster child during the state measles outbreak that began in Disneyland, is going to Sacramento Wednesday to speak out in favor of SB277.

That bill, which would require all California children to be vaccinated in order to attend school, could come up for a floor vote in the state Assembly this week. SB277 has already passed the Senate.

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AMA Renews Call for ICD-10 Contingencies
HealthLeaders Media

Less than 100 days before the federally mandated switch to the ICD-10 diagnostic code, the American Medical Association is renewing its call for contingency plans to ensure that physicians struggling to meet the Oct. 1 implementation are not unfairly penalized, nor care disrupted.

“This transition to ICD-10, if it goes forward on Oct. 1, and that appears to be the current trajectory, [means] it is absolutely imperative that there is better end-to-end testing, a grace period, and hardship exemptions in place,” says recently elected AMA President Steven J. Stack, MD.

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Drug, Hospital M&A Spurs Big Insurers To Eye Mega-Deals
Yahoo! News

Big health insurers want to get bigger to cut costs and fatten profit, of course, but seem to be moving faster now to consolidate in response to mergers elsewhere in the health care system.

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When Does Workplace Wellness Become Coercive?
Kaiser Health News

Christine White pays $300 a year more for her health care because she refused to join her former employer’s wellness program, which would have required that she fill out a health questionnaire and join activities like Weight Watchers.

“If I didn’t have the money … I’d have to” participate, says White, 63, a retired groundskeeper from a Portland, Ore., community college.

ike many Americans, White gets her health coverage through an employer that uses financial rewards and penalties to get workers to sign up for wellness programs.  Participation used to be a simple matter — taking optional classes in nutrition or how to stop smoking. But today, a small but growing number of employers tie those financial rewards to losing weight, exercising or dropping cholesterol or blood-sugar levels — often requiring workers to provide personal health information to private contractors who administer the programs.  The incentives, meanwhile, can add up to hundreds, or even thousands, of dollars a year.

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Tech problems may crimp launch of state’s new prescription drug database
Los Angeles Times

One week before California unveils an enhanced prescription drug database, some health providers say the upgraded program will be incompatible with their computer systems, hobbling their access to the tool that is meant to combat drug abuse.

Nearly every state in the country operates a prescription drug monitoring program, which tracks when certain narcotics are prescribed and dispensed. After a Times investigation found California’s existing drug database, the Controlled Substances Utilization Review and Evaluation System, or CURES, was woefully underused and underfunded, lawmakers passed a law in 2013 to increase funding for the system.

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Moneyball For Doctors and Nurses (and the People Who Run Hospitals)
The Health Care Blog

Michael Lewis’ 2003 best seller Moneyball recounts how Oakland Athletics’ manager Billy Beane beat the big-payroll odds in major league baseball by using analytics to field a competitive team. The dynamic between Beane and his Yale-trained geek, Peter Brand is the central theme: together they fought off naysayers using Brand’s sabermetrics model later credited with the Red Sox World Series win the next season.

This week, thousands of financial officers from across multiple sectors in healthcare will descend on Orlando for the Healthcare Financial Management Association Annual Institute (ANI), a four day potpourri of knowledge-sharing sessions punctuated by keynotes from industry luminaries and an active exhibit floor.

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The Affiliation Option: Half Step or Future State?
HealthLeaders Media

One question plaguing hospital and health system senior executives is whether their organization has the size and the scale to effectively manage a major business disruption underway in healthcare. If it doesn’t, seeking to acquire or be acquired may once have been the only choice—but no longer.

Many organizations believe they can find the same benefits on a much quicker time frame, and with less of the political fallout that arises in hospital M&A. Earlier this year, Tenet Healthcare finally bowed out of a proposed acquisition of five hospitals in Connecticut after years of regulatory and political wrangling. With time of the essence in adapting to provisions of the Patient Protection and Affordable Care Act, as well as the commercial shifts going on simultaneously, such delays can put necessary changes on hold amid the uncertainty. Even if a merger does go through, the cultural aspects often are much trickier than the financial details involved in M&A.

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Visualizing Health Policy: Health Care Coverage and Access for Men, 2013-2015
Kaiser Family Foundation

This Visualizing Health Policy infographic provides a snapshot of men’s health care and insurance coverage issues, including health status, access to care and use of services. It compares the uninsured rates of men and women, their cost barriers to care, their connection to clinicians, and their use of prescription drugs, screening, and counseling services. Fewer men than women gained coverage between October 2013 and March 2015, and the uninsured rate continues to be higher for men than women. Although men are less likely than women to experience cost barriers to care, uninsured men are twice as likely as all men to report cost barriers resulting in delayed care or reduced prescription medications. Men are also are less likely to have seen a health care provider in the past two years and seek screening services or discuss their sexual health with providers.

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Almost 2 in 5 employers now offer a virtual doctor visit benefit

The number of employers offering telemedicine options to employees is already high, and it’s growing quickly.

The research group Towers Watson tells VentureBeat that 38 percent of the employers it surveyed now offer some sort of telemedicine service to employees.

Many employers believe that by enabling remote doctor visits for simple health problems they can cut down on costs related to missed work and lowered productivity caused by illness.

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Healthcare startup Heal gets $5 million in seed funds
Los Angeles Business Journal

Heal, a healthcare startup that aims to bring old-fashioned doctors’ house calls into the digital age, has secured $5 million in funding from technology, health, business and entertainment leaders and investors. Investors in Heal’s seed round included: Slow Ventures; March Capital; Pritzker Capital; and investors including: Qualcomm Executive Chairman Paul Jacobs; James Lassiter, founder of Overbrook Entertainment; Stephen Rader, founder of Clarity Partners; Jamie McCourt; Lionel Richie; and Mike Wortsman, former President of Univision.

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CalPERS to keep eye on health rolls
Sacramento Bee

Keep those marriage and tax records handy, state workers and state retirees. You’re going to need them. A bill headed to Gov. Jerry Brown’s desk requires that state employers periodically verify the eligibility of the dependents on their health plans. Senate Bill 98 follows a CalPERS audit last year that found 9,000 people were wrongly listed as dependents eligible for state medical coverage.

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UCSF Benioff Children’s Hospital Offers Free Oakland House, Plus Money to Move It
NBC Bay Area

Stories of runaway rent and real estate prices dominate the headlines, but this story is the opposite of those. An 81-year-old house at 5204 Martin Luther King Jr. Way owned by UCSF Benioff Children’s Hospital Oakland is being offered for free to someone who will move it elsewhere. They’re also providing $20,000 to help the new owner with relocation costs.

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Fresno Surgical Hospital recognized for low-cost services
Fresno Bee

Fresno Surgical Hospital’s average spending per Medicare beneficiary is lower than the state and national average, the hospital said Tuesday, citing a report from the Centers for Medicare and Medicaid Services.

The risk-adjusted spending per Medicare admission (out of 713 eligible admissions) for 2014 was $17,445 at the physician-owned surgical hospital, compared to California’s $19,838 and the nation’s $19,679.