News Headlines

News Headlines
Health care news from around the state and nation

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CMS admits underpaying dual-eligible health plans
Modern Healthcare

The CMS has revealed that it underpays health plans that enroll large numbers of people who are dually eligible for Medicare and Medicaid, and the agency plans to modify its risk-adjustment model to make up for the underpayment.In response to persistent and vocal complaints from health plans questioning the accuracy of the CMS’ model for predicting costs of dual-eligible beneficiaries, the agency conducted a retrospective analysis of its 2014 plan data.The CMS uses a prospective model (called the CMS-HCC) to calculate risk scores, using health status in a base year to predict costs in the following year.

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Digital-health and Big Pharma companies’ biggest headaches in shaking up healthcare with analytics
Silicon Valley Business Journal

Digital-health companies are shaking up the medical industry with big-data analytics that improve treatments and efficiency, but they’re running headlong into challenges around cultural differences and data-protection requirements. Experts from digital-health, pharmaceutical and medical-device companies gathered with intellectual property attorneys Thursday at the Sheraton Palo Alto Hotel for a conference hosted by law firm White & Case LLP.

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A swallowed pill appears to deliver weight loss without gastric surgery
Los Angeles Times

A gastric balloon that’s swallowed like a pill and then sits in the stomach filled with fluid helped patients lose more than a third of their excess weight over a four-month period, researchers have reported.

The Elipse device has not been approved for weight loss by the Food & Drug Administration. But it is one of a new generation of “gastric balloons” aimed at helping the obese lose weight and improve related health conditions without undergoing an invasive and largely permanent replumbing of the digestive system.

In July, the FDA approved the “Reshape Dual Balloon” system, which is put in place during a 30-minute procedure during which a patient is mildly sedated.

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Obamacare’s Tax Credits: A Prisoner’s Dilemma for Insurers, Consumers
The Health Care Blog

Donald Trump has been screaming about premiums going up this year for Obamacare health insurance policies.

But he should see what happens when they go down.

That’s what has happened in Indiana, where average premiums for 2016 health coverage on the Obamacare exchange is 12.6 percent lower than in 2015.

Because of that figure, journalists have declared Indiana the big winner, since premiums are rising by 10.2 percent on average across the country.

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Marketplace Plans Covering Out-Of-Network Care Harder To Find
Kaiser Health News

Health plans that offer coverage of doctors and hospitals outside the plan’s network are getting harder to find on the insurance marketplaces, according to two analyses published this week.

Two-thirds of the 131 carriers that offered silver-level preferred provider organization plans in 2015 will either drop them entirely or offer fewer of them in January, an analysis by the Robert Wood Johnson Foundation found. Those cutbacks will affect customers in 37 states, according to the foundation.

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California hospitals could cut inpatient costs 25% and save $10 billion, study says
Los Angeles Times

California hospitals may be wasting $10 billion a year on excessive patient stays despite the state’s reputation for tightly managed care, according to a new analysis of state data.

The report finds that inpatient costs at 275 hospitals statewide could be reduced by 25%, yielding the $10 billion in savings among patients covered by Medicare, Medicaid and private health insurance.

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Study: Teen obesity surgery benefits last at least 3 years
San Francisco Chronicle

The largest, longest study of teen obesity surgery shows huge weight loss and health gains can last at least three years, and many say it’s worth the risks. “I feel awesome. It’s like a new life,” said Miranda Taylor, a Cincinnati nursing student in the study who had surgery when she was 16 and weighed 265 pounds. She lost more than 100 pounds, along with severe depression, pre-diabetes and an obesity-related hormonal condition.

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Vaccine for cervical cancer may also help men

Evidence is mounting that the HPV vaccine is also effective in preventing other HPV-related cancers, including those of the head and neck. Although most people who get HPV do not develop cancer, rates of HPV-related head and neck cancers are dramatically rising for men aged 40 to 50, according to Dr. Maura L. Gillison, the Jeg Coughlin Chair of Cancer Research at the Ohio State University Comprehensive Cancer Center. When Gillison recently gave a presentation showing the increasing rate of HPV-related head and neck cancer among men, her audience was shocked.

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Pfizer expands income eligibility to its free drug program
Modern Healthcare

Pharmaceutical giant Pfizer said Thursday that it would double the income threshold for patients to be eligible for financial assistance in response to an increasing number of consumers finding it difficult to afford their prescription medicines.The change would allow single patients earning up to four times the federal poverty level, or $47,080, or a family of four with household income of up to $97,000 to receive more than 40 different drugs for free through its RxPathways program.The company said there’s been a shift in who requests financial help over the past year.

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Rivals Kaiser and Dignity team up to jointly own hospital
Modern Healthcare

Kaiser Permanente and Dignity Health will jointly own St. Joseph’s Medical Center in Stockton, Calif., the two companies announced this week. Kaiser, an eight-state healthcare organization based in Oakland, will buy a 20% stake in the hospital now owned by San Francisco-based Dignity Health. Dignity Health, a 21-state health system, will own 80% of the hospital, according to a Kaiser press release announcing the deal. Kaiser declined to disclose the value of its investment. St.

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UCSD needs 700 volunteers for cancer study
San Diego Union-Tribune

UC San Diego researchers are looking for 700 county residents to participate in a new study that aims to examine the link between neighborhoods and cancer.

Led by Dr. Jacqueline Kerr, an associate professor in the university’s Department of Family Medicine and Public Health, the study will explore whether people who live in neighborhoods with better access to healthy food and safe recreation score lower on measures, such as insulin resistance and inflammation, that increase cancer risk.

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Mother Lode benefits from growth in medical specialists
Calaveras Enterprise

Despite stagnant population growth in the past decade, demand for health care has been growing in the Mother Lode as the population ages and changes in federal law expand the number of people with health insurance.

One significant impact of that growth in demand has been an increase in the number and variety of medical specialists available to serve the population here.

Mark Twain Medical Center in San Andreas boasts more than 130 staff members.

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Pilot telemedicine program brings doctors to patients

Imagine being able to get checked out by your doctor without even leaving home.

The time has come, and it is a pilot program at the VA San Diego Healthcare System. You would never know Charles Rowland was living on the streets at one point.

He was dressed to kill during his telemedicine appointment on Thursday.

The Air Force veteran likes to look and feel his best.

He got an infection following a pedicure.

Dr. Nilesh Shah asked him how he was doing over the computer screen.