News Headlines

News Headlines
Health care news from around the state and nation

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Many Obamacare dropouts in California picked up employer coverage, state says
Los Angeles Times

Nearly half of the estimated 700,000 Californians who have dropped their Obamacare policies during the past two years have enrolled in an employer-based plan, a new report from the Covered California exchange shows.

In a news conference Thursday, Peter Lee, the organization’s executive director, said there were about 1.3 million Californians enrolled in the exchange’s plans as of June 30. That was about two-thirds of the 2 million who have enrolled in the exchange since it opened Oct. 1, 2013.

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Bill Would Add Nurses, Physician Assistants To Pharma Disclosure Database
National Public Radio

A bill proposed Wednesday by two U.S. senators would require drugmakers and medical device manufacturers to publicly disclose their payments to nurse practitioners and physician assistants for promotional talks, consulting, meals and other interactions.

The legislation would close a loophole in the Physician Payment Sunshine Act, which requires companies to report such payments to doctors, dentists, chiropractors, optometrists and podiatrists. Companies have so far released more than 15 million payment records, covering August 2013 to December 2014.

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UC Davis researchers get $15.5M to build new generation of whole-body scanner
Sacramento Business Journal

A research team at University of California Davis has received a five-year, $15.5 million grant to build an imaging device that combines two technologies to scan the whole body at once while reducing time and radiation exposure. The scanner could drop the radiation dose by a factor of 40 or decrease scanning time from 20 minutes to 30 seconds. Or do a combination that drops both the dose and the time by lesser amounts.

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Financial health shaky at many Obamacare insurance co-ops
Washington Post

A new breed of health insurers created under the Affordable Care Act — representing one of the government’s most innovative attempts in decades to foster better coverage — is on shaky financial ground in many of the 23 states where the plans began.

The nonprofit health plans were envisioned as a consumer-friendly counterweight to for-profit insurers, a way to provide more competition, greater consumer choice and better coverage in markets typically dominated by big commercial carriers. The government allocated billions of dollars in loans for them.

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Where did one third of Covered CA’s customers go?
San Diego Union-Tribune

Nearly half of the estimated 700,000 Californians who have dropped their Obamacare policies during the past two years have enrolled in an employer-based insurance plan, according to a new report from the Covered California health exchange.

In a news conference Thursday, Peter Lee, the organization’s executive director, said there were about 1.3 million Californians enrolled in the exchange’s plans as of June 30. That was about two-thirds of the 2 million who have enrolled in the exchange since it opened on Oct. 1, 2013.

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Medicare Advantage star ratings reveal mix of high, low performers
Modern Healthcare

More Medicare Advantage plans nabbed top quality marks for their 2016 plans than last year, a potential sign that private insurers are trying to meet the federal government’s standards for high-quality products and coordinated healthcare for seniors. But the CMS‘ star ratings, released Thursday, also showed that private Medicare plans are still failing on many levels, particularly when it comes to prescription drug benefits.

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States ’shocked’ they’re on the hook for rising Medicare premiums
Modern Healthcare

State Medicaid agencies are bracing for hundreds of millions in new obligations thanks to a significant increase in Medicare premiums.This past summer, the 2015 Medicare Trustees Report projected Part B premiums would increase by 52%—up to $159.30 a month from $104.90. However, most Medicare beneficiaries will be spared as roughly 70% pay their Part B premiums through deductions from their Social Security benefit payments. A policy called “hold harmless” shields beneficiaries from any premium hikes that outpace cost-of-living increases.

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CMS ratings of dialysis providers show most remain mediocre
Modern Healthcare

For the second year in a row, the nation’s top two kidney-care providers performed at significantly different levels of quality, according to CMS data released Thursday. DaVita beat out competitor Fresenius in the four- and five-star categories.The CMS began publicly posting one- to five-star ratings for nearly 6,000 U.S. dialysis facilities in January after a delay as providers including DaVita and Fresenius continue to battle CMS’ methodology in achieving the ratings. The scale is meant to help dialysis patients evaluate quality at treatment centers.

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CMS announces first shared-risk program for kidney care
Modern Healthcare

The CMS announced on Wednesday the first suite of accountable care organization models specifically geared toward treatment of end-stage renal disease (ESRD). More than 600,000 people in the U.S. live with the condition, which requires patients to undergo costly, but life-sustaining dialysis treatments each week that account for nearly 6% of Medicare spending.The 13 ESRD seamless care organizations, called ESCOs, began to share this month the financial risks for treating Medicare beneficiaries with kidney failure in 11 U.S. states.

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California Approves Laws To Cut Use Of Antipsychotics In Foster Care
National Public Radio

Efforts to protect children in foster care from being inappropriately medicated with powerful antipsychotic drugs got a big boost forward on Tuesday, when California Gov. Jerry Brown signed three bills into law designed to reform prescribing.

Overprescribing of psychiatric meds for foster youth is a persistent problem nationwide, with children given the drugs at double or triple the rate of those not in foster care.

In 2011, the federal Government Accounting Office found nearly 1 in 4 children in foster care was taking psychotropic medications, which include antipsychotics, antidepressants, mood stabilizers and stimulants.

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Medical Prices Higher In Areas Where Large Doctor Groups Dominate, Study Finds
Kaiser Health News

Prices for many common medical procedures are higher in areas where physicians are concentrated into larger practice groups, according to a new study.

The October Health Affairs study examined the average county prices paid by preferred provider insurance organizations in 2010. It focused on 15 high-volume, high-cost medical procedures across a variety of specialties, including vasectomy, laparoscopic appendectomy, colonoscopy with lesion removal, nasal septum repair, cataract removal and knee replacement.

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Heart transplant test maker to gov’t agency: You’re killing us
San Francisco Business Times

Unless the federal agency that sets reimbursement rates for Medicare has a change of heart, a Peninsula company with a test that helps predict heart transplant rejection could have three months to live. That’s no exaggeration, says Peter Maag, the president and CEO of CareDx Inc. (NASDAQ: CDNA): A proposed 77 percent drop in the rate that Medicare would reimburse the Brisbane company for its AlloMap test is less than CareDx’s costs.

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California agency ranks Kaiser as best HMO, Anthem and Cigna as best PPOs
Los Angeles Times

Kaiser Permanente was the highest-rated HMO and Anthem Blue Cross and Cigna the top-rated PPOs in a new state report.

The California Office of the Patient Advocate released ratings Wednesday of 10 HMOs, six PPOs and more than 200 medical groups, just as Californians prepare to choose their health plans for next year from their employers or Covered California, the state’s Obamacare exchange.

The reviewed health plans provide coverage to more than 16 million California residents.

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State regulators approve Blue Shield’s bid to buy Care1st
Sacramento Business Journal

The state managed-care regulator has approved Blue Shield of California’s plan to buy a for-profit Medi-Cal HMO in Southern California. The $1.2 billion deal to buy Care1st Health Plan closed Thursday. The Monterey Park-based plan serves more than 524,000 enrollees, most of them in the Medi-Cal program. The company has a small presence in Arizona and Texas.

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Blue Shield’s deal with regulators on $1.2-billion acquisition draws fire
Los Angeles Times

Beleaguered insurer Blue Shield of California won state approval for its $1.2-billion acquisition of a Medicaid health plan, but the nonprofit company’s deal with regulators drew heavy criticism.

The California Department of Managed Health Care said it extracted several key concessions from Blue Shield in an agreement unveiled Thursday.

Ending a high-stakes and lengthy battle, the company agreed to permanently relinquish its longtime state tax exemption.

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