News Headlines

News Headlines
Health care news from around the state and nation

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States That Declined To Expand Medicaid Face Higher Costs
National Public Radio

The 22 states that didn’t expand Medicaid eligibility as part of Obamacare last year saw their costs to provide health care to the poor rise twice as fast as states that extended benefits to more low-income residents.

It’s a counterintuitive twist for those states whose governors, most Republicans who opposed the Affordable Care Act, chose not to accept federal funds to extend Medicaid to more people.

A Kaiser Family Foundation survey of Medicaid directors in all 50 states and Washington, D.C., showed that those that didn’t broaden coverage saw their Medicaid costs rise 6.9 percent in the fiscal year that ended Sept. 30. The 29 states that took President Obama up on his offer to foot the bill for expanding Medicaid saw their costs rise only 3.4 percent.

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Dietary supplements send more than 23,000 people to the ER each year
Washington Post

Multivitamins, diet pills and energy boosters may not be the harmless substances you think they are.

In the first study of its kind, published Wednesday in the New England Journal of Medicine, researchers estimated that 23,000 people end up in the emergency room each year suffering from heart palpitations, chest pain, choking or other problems after ingesting dietary supplements. Most of those patients were young adults, children or the elderly.

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A Looming Tax On High-End Health Plans Draws Fire From Many Sides
Kaiser Health News

About half of all American adults get health insurance through their employer, and beginning in 2018, the government will impose heavy financial penalties on any employer-provided health plans it deems overly generous. The tax was designed to rein in health care inflation and raise tens of billions of dollars.

Former Sen. Jeff Bingaman, D-N.M., a member of the working group that created what’s come to be called the Cadillac tax, says if companies were more demanding shoppers, then insurers — as well as doctors, hospitals and other health care providers — would have stronger incentives to keep prices low.

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Medicare Part B premiums to rise 52% for 7 million enrollees
USA Today

For seven in 10 Medicare beneficiaries 2016 will be much like 2015. They will pay $104.90 per month for their Medicare Part B premium just as they did in 2015.

But 2016 might not be anything like 2015 for some 30% of Medicare beneficiaries — roughly 7 million or so Americans. That’s because premiums for individuals could increase a jaw-dropping 52% to $159.30 per month ($318.60 for married couples).

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Don’t Just Renew Your Medicare Plan. Shopping Around Can Save Money.
Kaiser Health News

Ten years after a prescription drug benefit was added to Medicare, 39 million older or disabled Americans have coverage to help pay for their medicine, including most of the 17 million with private insurance policies known as Medicare Advantage, an alternative to traditional Medicare.

The annual enrollment period for these private drug and Advantage plans for 2016 starts Thursday and runs through Dec. 7.

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Report: Medicaid costs hit record high as states look for efficiencies
USA Today

The Affordable Care Act’s expansion of Medicaid for the poorest of the poor led to record increases of nearly 14% for both Medicaid enrollment and spending nationally in fiscal year 2015, according to new data out Thursday by the non-profit Kaiser Family Foundation.

While the increases were in line with state projections, costs are expected to drop significantly in fiscal year 2016, the report shows.

To Obamacare supporters, the report is proof the health care law is improving access to insurance coverage to those who need it most.

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Covered California adds Medi-Cal option for some pregnant women
Southern California Public Radio

As of this week, uninsured pregnant women who make a moderate income can now apply through Covered California for a special Medi-Cal program for expectant mothers. The Medi-Cal Access Program is designed for pregnant women who make too much to qualify for regular Medi-Cal and between 213 and 322 percent of the federal poverty level ($33,936 and $51,312 a year). Those are the qualifying amounts for a family of two, but under the rules of the program, a pregnant woman counts as at least two people for income purposes.

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Number of 5-star hospitals decreases dramatically in CMS Hospital Compare update
Becker's Hospital Review

CMS updated its Hospital Compare database Oct. 8 with new patient experience survey results, and the number of hospitals receiving a five-star HCAHPS summary rating is down significantly since the last update in July.

When the ratings first went live in April, 251 hospitals earned the highest available rating of five stars. When the data were updated in July to reflect HCAHPS scores gathered from October 2013 through September 2014, that number shot up to 336.

Now, however, with HCAHPS data from January 2014 through December 2014, just 207 hospitals out of 3,539 earned a five-star HCAHPS summary star rating.

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New health ‘report cards’ give mixed reviews to local providers and plans
Sacramento Business Journal

New online quality report cards released last week show mixed results for Northern California’s biggest health plans and providers. California’s Office of the Patient Advocate, a state agency tasked with helping consumers find health care services, released the report cards, which are available in English, Spanish and Chinese. The cards compare the state’s 10 largest health maintenance organizations, six largest preferred provider organizations and more than 200 medical groups.

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Treatment Changes For DCIS Haven’t Affected Breast Cancer Deaths
National Public Radio

The number of women diagnosed with ductal carcinoma in situ, abnormal cells that sometimes become breast cancer, has soared since the 1970s. That’s mostly because more women have been getting screening mammograms that can detect the tiny lesions.

The vast majority of women diagnosed with DCIS have surgery, even though there’s considerable debate whether it’s needed, since DCIS sometimes never becomes invasive cancer.

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UnitedHealth again looks to fast-growing businesses in 3Q
San Francisco Chronicle

UnitedHealth Group’s third-quarter profit slipped, but the nation’s largest health insurer still beat Wall Street expectations due partly to fast growth in pharmacy benefits management and other areas outside its core business. Revenue from the Minneapolis company’s Optum unit, which runs prescription drug coverage, jumped 61 percent to $19.3 billion after UnitedHealth bought Catamaran, a pharmacy benefits manager, in a deal valued at more than $12 billion. Health insurance is the company’s primary business, but it has been relying more on Optum for growth.

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Blue Shield of Calif. Agrees To Limit Premiums, Recalculate Rebates
California Healthline

Blue Shield of California has agreed to limit its premiums for certain policies next year and in 2017, Payers & Providers reports.

Background
On Oct. 5, the California Department of Managed Health Care issued an order addressing Blue Shield’s premiums and medical loss ratio calculations.

DMHC spokesperson Rodger Butler said the agency had “significant concerns with some of the plan’s projected trends and target profit levels,” adding, “This warranted the department’s action to find a solution with the plan that will protect consumers and ensure rates are supported.”

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Marin Healthcare District will help fund revamping of Marin General’s mental health programs
Marin Independent Journal

The Marin Healthcare District board has agreed to provide Marin General Hospital with at least $400,000 to help improve mental health services at the hospital.

The district board oversees Marin General, but it ceded day-to-day control of the hospital to the nonprofit Marin General Hospital Corp. when Sutter Health returned control of the hospital in July 2010. The hospital corporation pays the district $500,000 a year to rent the hospital under the terms of a 30-year lease that took effect this year.

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Tri-City, UC San Diego form partnership
San Diego Union-Tribune

Tri-City Medical Center and the UC San Diego Health System have launched a wide-ranging partnership that could boost the Oceanside hospital’s patient count — and thus its long-term viability — while expanding the university’s geographic reach and increasing referrals to some of its highly specialized programs.

Their affiliation agreement, which the Tri-City public health district’s board unanimously approved Tuesday, is a major victory for the community hospital.

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OC panel wants a fix for critical overcrowding of psych patients in the ER
Orange County Register

Orange County supervisors said Wednesday they will lead a team of health care providers and law enforcement officials in an effort to unclog emergency rooms overwhelmed with patients needing psychiatric care.

“The front door is open for psychiatric patients, but the back door is not open … we have patients that linger for days in the ER,” said Suzanne Richards, CEO of Orange County Global Medical Center and KPC Health. She will be one of two hospital representatives on the new committee.

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Huntington Memorial Hospital Announces Paul L. H. Ouyang Elected Chairman of the Board of Directors
Pasadena Now

Huntington Memorial Hospital today announced that Paul L. H. Ouyang has been elected chairman of the board of directors of Huntington Hospital, effective immediately. Paul replaces Jim Rothenberg, who passed away in July.

“Paul’s extensive business experience is an incredible asset to the hospital, especially for our ever-changing healthcare industry,” said Stephen A. Ralph, president and CEO, Huntington Hospital.

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