News Headlines

News Headlines
Health care news from around the state and nation

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Feinstein Bill Puts Excessive Health Insurance Rate Hikes In The Bullseye

Sen. Dianne Feinstein of California thinks the federal government should be allowed to hold the line against the rising cost of health insurance.

Feinstein has introduced a bill that would let the Health and Human Services secretary reject excessive rate hikes in states that don’t have that authority.

Regulators in California and 14 other states lack the ability to block health insurance premium increases they consider to be unreasonable.

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Are Medicare ACOs Working? Experts Disagree
Kaiser Health News

One of the missions of the 2010 federal health law is to slow the soaring cost of health care. A key strategy for Medicare is encouraging doctors, hospitals and other health care providers to form accountable care organizations (ACOs) to coordinate beneficiaries’ care and provide services more efficiently. Under this experimental program, if these organizations save the government money and meet quality standards, they can be entitled to a share of the savings. Participation is voluntary.

In August, Medicare officials released 2014 financial details showing that the so far the ACOs have not saved the government money. The 20 ACOs in the Pioneer program and the 333 in the shared savings program reported total savings of $411 million. But after paying bonuses, the ACOs recorded a net loss of $2.6 million to the Medicare trust fund, a fraction of the half a trillion dollars Medicare spends on the elderly and disabled each year.

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Less frequent mammograms urged
San Diego Union-Tribune

The American Cancer Society has issued new guidelines for when women should get mammograms, the latest chapter in an ongoing debate on how useful the screening is in detecting breast cancer.

The society, one of most influential patient advocacy groups in the country, recommends reducing the frequency of recommended screenings for those with normal risk of breast cancer. They don’t apply to women at high risk, the society says.

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Obama loses another round in House Republicans’ ACA lawsuit
Modern Healthcare

The Obama administration suffered yet another setback Monday in its attempts to fend off House Republicans’ lawsuit alleging it funded part of the Affordable Care Act without permission from Congress. U.S. District Judge Rosemary Collyer rejected the administration’s request to immediately appeal her earlier ruling that House Republicans have standing to sue the administration. Had she agreed to the so-called interlocutory appeal, a federal appeals court could have agreed to hear the matter before the case was resolved in District Court.

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Medicare Advantage star ratings may change to address fairness complaints
Modern Healthcare

Top CMS officials signaled this week that the agency will consider altering Medicare Advantage quality ratings to adjust for socio-economic characteristics of a plan’s enrollees. Health plans that primarily serve low-income members and people who are dually eligible for Medicare and Medicaid complain they unfairly get lower star ratings that make them ineligible for bonuses and put them in danger of losing their Medicare contracts. The CMS has the statutory authority to boot a plan if it has fewer than three stars for three straight years.

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Why this Harvard radiologist still recommends women get mammograms at age 40
Washington Post

A high-quality screening mammogram is still considered the best way to catch breast cancer as early as possible. But members of the medical community disagree on what age all women should start getting annual mammograms, and breast cancer screening has become an increasingly polarizing topic as a result.

Experts agree that every woman over 50 needs a mammogram at least every two years to ensure they are in good health, while those under 40 years old do not. The controversy involves women in their forties, a group that is in more of a gray area when it comes to the benefits versus the harms of regular screening. (Note that women at high risk for breast cancer, such as those with a BRCA1 or BRCA2 mutation, fall under a separate set of guidelines.)

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Why Is Mammogram Advice Still Such A Tangle? Ask Your Doctor

Stephanie Nichols is a stay-at-home mom in Boston. She’s 44 now and says she first thought about getting a mammogram when she turned 40.

“I had heard from a number of friends all around the same age that they’re all getting mammograms,” she says. So it came as no surprise when her doctor brought up the topic at her next routine exam.

But what was surprising, she says, was that, after discussing family history and personal health, her doctor determined that because Nichols was not at high risk for getting breast cancer, it was probably too soon to get that first scan.

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New Mammogram Recommendations: A Guide
New York Times

Q. What are the new recommendations about mammograms, and how do they differ from the old ones?

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OK, When Am I Supposed To Get A Mammogram?
National Public Radio

If you’re confused about when to start getting mammograms and how often you should be getting them, you’re not alone. The very organizations that are responsible for telling us when and how often to get those screenings don’t agree.

More than half of women 40 and older think they should be getting a mammogram every year, according to a recent NPR-Truven Health Analytics poll. That’s despite the fact that the U.S. Preventive Services Task Force recommends getting one only every other year — and only after women turn 50.

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Lawmakers stall on funding discussions for developmentally disability programs
Long Beach Press-Telegram

Efforts to find ways to boost funding for programs for those with developmental disabilities appear to have stalled in Sacramento, and some organizations fear the matter may not be raised until the end of the year, or in January.

The topic was to be discussed during two special sessions, one called in June after Gov. Jerry Brown approved the state’s $167 billion budget, then after the regular legislative session closed on Sept. 11.

So far, there have been no formal statements by legislators on when the matter might be discussed.

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Medical board: Check out your doctor online
Sacramento Business Journal

The Medical Board of California wants patients to check out their doctors online. The regulatory agency that oversees more than 130,000 doctors in the state has launched a public relations campaign to raise awareness that patients can verify doctors’ licenses — and get information about disciplinary action against them — on the Internet. A demonstration about how to do it will be held at Arden Fair Mall in Sacramento on Friday and Saturday.

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Workplace issues might be missing link between education, health

It has long been known that health and life expectancy are correlated with education levels. The more education you have, the longer you are likely to live. But no one knows exactly why that relationship exists.

New research points to part of the answer: people with less education are more likely to work in jobs that make them sick.

That might seem obvious, but until now it was a hunch that had never been quantified.

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CalPERS scrubs 18,000 people from health insurance rolls
Sacramento Bee

CalPERS has shed 18,000 people from its employer-provided medical insurance rolls, fund officials said Monday, after a rigorous two-year review that looked for ineligible dependents who received coverage even though they didn’t qualify.

The system figures state and local governments and school districts with health insurance plans administered by CalPERS have saved a combined $122 million annually in lower premiums and avoided medical costs since the inception of the review in 2013, including savings from 6,700 ineligible people voluntarily removed by members.

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Collective Health Raises $81M, Goes National with Anthem and Blue Shield of CA
HIT Consultant

October is open enrollment season across the U.S. when the annual window opens for millions of Americans to change health plans. To make this process less confusing, Collective Health is bringing employer health insurance into the 21s century and shifting the focus from profits to people. Today, the enterprise health insurance software and services leader Collective Health has raised $81 million in Series C funding led by Google Ventures and returning investors NEA and Founders Fund along with Maverick Capital, Redpoint Ventures and RRE Ventures.

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Petaluma Valley Hospital operator finalists named
North Bay Business Journal

Four organizations will be considered to run Petaluma Valley Hospital, when the long-running arrangement with St. Joseph Health ends in 2017. St. Joseph Health, Sutter Health, Prime Healthcare Services and Strategic Global Management responded to Petaluma Health Care District’s request for proposals and now will invited to conduct due diligence and submit bids.

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Hospital re-opens with new focus + New health program targets South LA seniors
USC Annenberg

IT, culture helps reborn L.A. hospital shed ‘Killer King’ past: Martin Luther King, Jr. Memorial Hospital re-opened last July after patient safety was called into question. The South LA hospital is now using IT to maximize resources in the medically under-served community. New Preventive Health Program Helps South L.A. Seniors Get ‘HAPPI’: A community-based research project launched to help South LA seniors access preventative care. Healthcare officials hope the public will be better informed about the services they have access to, improving the community’s quality of life.