News Headlines

News Headlines
Health care news from around the state and nation

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Obama’s CMS nominee Slavitt could face rough road to confirmation
Modern Healthcare

President Barack Obama has nominated Andrew Slavitt as administrator of the CMS, the position he has held on an interim basis since Marilyn Tavenner stepped down in February.

As administrator, Slavitt oversees day-to-day decisions regarding implementation of the Affordable Care Act, Medicare, Medicaid, the Children’s Health Insurance Program, payment and delivery reform, healthcare fraud and improving health outcomes.

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Medicare’s Advanced Care Reimbursements a First Step
HealthLeaders Media

The Centers for Medicare and Medicaid Services this week unveiled a proposed rule change (p.246) that for the first time reimburses physicians and other providers for time spent with patients discussing end-of-life care.

R. Sean Morrison, MD, is a geriatrician and palliative medicine specialist at Mount Sinai School of Medicine in New York, and director of the National Palliative Care Research Center. He spoke with HealthLeaders Media about the long-awaited rule, what it represents, and its potential ramifications. The following is an edited transcript.

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It’s time to consolidate California’s dual insurance regulators, new report says
Sacramento Business Journal

The Affordable Care Act provides a powerful reason for California to ditch its complex system of dual insurance regulators in favor of a streamlined process, a new study concludes.

An enrollment shift in 2014 from the California Department of Insurance to the California Department of Managed Health Care — and the fact that DMHC now regulates the most enrollment in individual, small-group and large-group markets — suggests DMHC should be the single agency.

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Bill To Boost Medical Research Comes With A Catch
National Public Radio

The House of Representatives is planning to consider a bill Friday that could give a big cash infusion to medical research, which has been struggling in recent years. But the bill would also tweak the government’s drug approval process in a way that makes some researchers nervous.

Despite those worries, many scientists are cheering on the legislation.

“We’re very excited about the prospects for the 21st Century Cures Act,” says Dave Moore at the American Association of Medical Colleges.

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Healthcare watch: What qualifies as a special enrollment event in Obamacare
Los Angeles Times

Some of our biggest life events can change our healthcare coverage too.

Under the Affordable Care Act, many life changes, such as losing a job, having a baby, moving, divorcing and getting married, allow people to sign up for health insurance throughout the year, outside of the annual open enrollment period.

Obamacare enrollment runs from Nov. 1 through Jan. 31 for 2016 coverage.

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As Payers Merge, Hospitals Dream of their Own Health Plans
HealthLeaders Media

Hospital and health system leaders are facing the prospect of merged insurance giants that are so big and powerful they can call the shots in what will pass for “negotiating” a contract, prompting some to consider the alternate path of starting their own health plans.

The option will become more appealing if insurance company mergers go through as expected and if the combined companies start bullying hospitals that have few competitors from which to choose.

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Mergers of health insurers bode ill for our well-being
San Francisco Chronicle

The Supreme Court’s recent blessing of Obamacare has precipitated a rush among the nation’s biggest health insurers to consolidate into two or three behemoths. The result will be good for their shareholders and executives but bad for the rest of us, who will pay through the nose for the health insurance we need. We have another choice, but before I get to it, let me give you some background. Last week, Aetna said it would spend about $35 billion to buy rival Humana in a deal that will create the second-largest health insurer in the nation, with 33 million members.

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California fails at giving patients actual medical prices, report shows
Los Angeles Times

California received a failing grade once again in an annual report that shows how much access consumers have to actual prices for medical care. The report card issued Wednesday by two nonprofit groups found that 45 states, including California, fared poorly at making price information easily accessible on public websites or through claims databases for care at hospitals, clinics and physician offices.

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Medicare proposes payment changes to hospitals for hip, knee replacement
Washington Post

Federal health officials are proposing a major change in the way Medicare pays for hip and knee replacements, requiring hospitals to partly repay the government if patients get avoidable infections and other complications but rewarding them with extra payments if patients do well.

The proposal announced Thursday by the Centers for Medicare and Medicaid Services is part of the Obama administration’s efforts to overhaul the health-care system, in part by using the payment system to reward quality of care rather than volume of services.

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Federal Audits Of Medicare Advantage Reveal Widespread Overcharges
National Public Radio

Government audits just released as the result of a lawsuit detail widespread billing errors in private Medicare Advantage health plans going back years, including overpayments of thousands of dollars a year for some patients.

Since 2004, private insurers that run Medicare Advantage plans, an increasingly popular alternative to traditional Medicare, have been paid using a risk score calculated for each patient who joins. Medicare expects to pay higher rates for sicker people and less for those in good health.

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Drug Diversion’s Long Tentacles
HealthLeaders Media

For any executive who still thinks healthcare workers don’t pilfer opioid drugs from syringes and cabinets, and would never put patients at risk, a growing number of health system leaders now beg to differ. They’ve seen it wreak havoc on their organizations.

From Minneapolis to Denver to Jacksonville to El Paso, hospitals have learned the hard way how devastating drug diversion can be—not just to their reputations, but to their patients and their bottom lines as well.

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The App Will See You Now, But May Not Get The Diagnosis Right
Kaiser Health News

There’s a warning out today for those who go online or to apps to figure out why they have an upset tummy or nagging cough or occasional chest pain. Symptom checkers, those tools that ask for information and suggest a diagnosis, are accurate only about half of the time.

The finding is from a Harvard Medical School study that reviewed 23 sites, such as WebMD, the Mayo Clinic and DocResponse. One third listed the correct diagnosis as the first option for patients. Half the sites had the right diagnosis among their top three results, and 58 percent listed it in their top 20 suggestions.

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Online Symptom Checkers Can’t Replace The Real-Life Doc Just Yet
National Public Radio

We’ve all been there before: headache, dizziness, sore throat. Uh-oh! Better Google the symptoms or maybe try WebMD’s online symptom checker to see what’s wrong. But how accurate are these online symptoms checkers, anyway?

Turns out, millions of people are entrusting their health to some pretty lousy diagnostic systems. Researchers tested 23 online symptom checkers and found that the correct diagnosis was provided first on a list of potential illnesses only about a third of the time.

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Another View: Optometrists can help ease doctor shortage
Sacramento Bee

A Sacramento Bee editorial suggested that Senate Bill 622, which would allow specially trained doctors of optometry to administer immunizations and perform minor medical procedures, would enable optometrists to perform major surgery (“Facing hard choices on health bills,” July 7).

But this so-called surgery is extremely limited, amounting to removing skin tags and tiny lumps and bumps outside the eye of 5 millimeters or less, the size of a tiny red ant. This is not anything that consumers would view as surgery by any reasonable standard.

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Aetna-Humana merger will face tough antitrust review
Modern Healthcare

As federal trustbusters prepare to investigate the massive insurer consolidations now on the table, legal experts say the outcome of those reviews remains an open question.

Aetna CEO Mark Bertolini said the insurer is ready for government examination as it prepares to buy Humana for $37 billion. Aetna has already discussed possible divestitures.

“We took a conservative view of what we thought we would need to divest,” Bertolini said during a conference call with investors this week.

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Dignity Health names new area strategy executive
Sacramento Business Journal

Chris Champlin is the new chief strategy officer for Dignity Health in the Sacramento area. He replaces Cindy Holst, who started a new job July 1 as senior director of marketing and business intelligence in the health system’s San Francisco headquarters. Champlin, 50, will evaluate growth opportunities in the region, including mergers, acquisitions and joint ventures. His job also includes service-line development and planning, strategic marketing and sales.

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Martin Luther King, Jr. Community Hospital Opens its Doors Following Successful Completion of Accreditation Process
eurweb

Martin Luther King, Jr. Community Hospital (“MLKCH”) announced that the privately-owned, non-profit hospital is now fully licensed, accredited, and opening to the public on Tuesday July 7, 2015. An opening dedication is scheduled for August 7, 2015.

The Martin Luther King, Jr. Community Hospital is a brand new state-of-the-art facility, with all new equipment, technology, staff, and administration. MLKCH has a total of 131 beds, including 93 medical/surgical beds, 20 intensive care beds and 18 obstetrical beds. Inpatient specialties will include Anesthesiology, Cardiology, Emergency Services, Gastroenterology, General Medicine, General Surgery, Infectious Diseases, Neurology, Obstetrics & Gynecology, Ophthalmology, Orthopedics, Otolaryngology, Pathology, Radiology, Pulmonary Medicine and Urology.  The hospital’s medical staff includes six hospital-based physician groups that will be on-site 24/7.

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Desert Valley Hospital ranked among best in nation
Victorville Daily Press

Desert Valley Hospital has been ranked among the 100 Best Community Hospitals in the nation by Becker’s Healthcare. Two other Prime Healthcare Systems hospitals, Centinela Hospital Medical Center in Inglewood and Garden Grove Hospital Medical Center, made the 2015 list compiled by Becker’s. Prime Healthcare is based in Ontario and is led by CEO and Chairman Dr. Prem Reddy, founder of Desert Valley Hospital, who oversees the company’s 34 locations in 11 states.

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