California Healthcare News

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Hospitals Buy Up Medical Practices, Pushing Up Healthcare Prices Premium Content
Sep 14, 2017

When Sarah Azad, M.D., followed her mother into the field of obstetrics eight years ago, she thought she’d be in private practice for the rest of her career. At the time, independent practices abounded in Silicon Valley.

            “From the time we were young, my mom’s patients loved her. She was a part of their lives. That’s just always how I’ve seen medical care,” she said.

Business Practices of Tenet-Owned Health Plan Leads to $80,000 Fine From DMHC Premium Content
Sep 14, 2017

The Department of Managed Health Care has fined a Cypress-based insurance carrier $80,000 for failure to meet tangible net equity requirements for nearly two years.

Kaiser Appoints Dean Of Medical School Premium Content
Sep 14, 2017

Kaiser Permanente has appointed Mark A. Schuster, M.D. as the founding dean and chief executive officer of its medical school. The facility will open in Pasadena in 2019.

CDPH Cites 10 Hospitals, Fines Them $618,000 Premium Content
Sep 7, 2017

The California Department of Public Health has issued administrative penalties and fines to 10 hospitals statewide for medical errors that were connected to the deaths of five patients and  placed the lives of the other patients in immediate jeopardy. The accompanying fines totaled more than $618,000.

            The penalties and fines were as follows:

California Bucking New Exchange Enrollment Rules Premium Content
Sep 7, 2017

California and several other states will exempt themselves this year from a new Trump administration rule that cuts in half the amount of time consumers have to buy individual health insurance under the Affordable Care Act.
            In California, lawmakers are contemplating legislation that would circumvent the rule in future years, too.

UCSF: Millions of ER Visits Annually Are Unnecessary Premium Content
Sep 7, 2017

A wide-ranging study by researchers at UC San Francisco has concluded that nearly 2 million visits to U.S. hospital emergency rooms each year are unnecessary.

            The study found that almost 14 million ER visits over a seven-year period in the U.S. led to patients being discharged without any care being rendered. That’s out of about 424 million ER visits examined nationwide between 2005 and 2011, using data from the National Hospital Ambulatory Medical Care Survey.

CMA Blasts Trump’s Decision On DACA Premium Content
Sep 7, 2017

The California Medical Association has blasted a decision by President Donald Trump to rescind the Obama administration’s Deferred Action for Childhood Arrivals program. It essentially placed holds on taking action against some 800,000 undocumented immigrants who were brought to the U.S. as children.

In Brief: Kaiser Permanente Develops Tool To Identify High-Risk Diabetes Patients Premium Content
Aug 24, 2017

Oakland-based Kaiser Permanente has developed a new tool intended to identify diabetes patients at greatest risk of developing precipitous drops in blood sugar levels.

The condition, known as severe hypogylcemia, can lead to emergency situations where patients quickly loose consciousness. About 100,000 emergency room visits per year nationwide are connected to the condition. It is often tied to diabetic patients taking medication to control their blood sugar who skip a meal or engage in intense exercise.

In Brief: CDPH Fines Kindred Nursing Home Facility $100,000 Premium Content
Aug 24, 2017

The CDPH found that Care Center of Rossmoor in Walnut Creek had improperly replaced a patient’s tracheostomy tube, causing air to flow underneath the patient’s skin. An investigation determined that the patient was improperly placed prior to the replacement of tube. The patient was elevated by about 30 degrees in their bed, when they should have been laying flat. The incorrectly placed tube led to oxygen deprivation in the patient, aggravated by the fact that staff failed to use an oral bag mask to try and improve oxygenation. The patient died about four hours later.

Partial Anthem Pullout Leaves Consumers With Few Options Premium Content
Aug 24, 2017

For about 60,000 Covered California customers, choosing a health plan next year will be easier, and possibly more painful, than ever: There will be only one insurer left in their communities after Anthem Blue Cross of California pulls out of much of the state’s individual market.

That means they could lose doctors they trust, or pay higher premiums.

Covered California Moves To Steady Market Nerves Premium Content
Aug 24, 2017

With the Trump administration still telegraphing uncertainty about its intentions toward funding cost subsidies under the Affordable Care Act, the Covered California health insurance exchange, citing what it called a “time of unprecedented uncertainty,” has taken steps to ensure that its enrollees are not rocked with unexpected costs as it nears the crucial open enrollment period for 2018.

Health Net Fined For Denying Transgender Coverage Premium Content
Aug 17, 2017

The Department of Managed Health Care has fined Woodland Hills-based Health Net $200,000 for its apparent refusal to cover gender reassignment surgeries and related benefits for its enrollees.

            The administrative penalty and fine is the first ever levied by the DMHC against a health plan for rejecting such coverage wholesale, and is the largest such fine associated with disputes over gender dysphoria treatments.

RVs Deliver Mental Health Services To Rural Areas Premium Content
Aug 17, 2017

Ana Magaña has struggled with schizophrenia for more than 30 years, and she even landed in the hospital a couple of years ago after she stopped taking her medications.

When the Woodlake resident was discharged, she received additional support.

But she didn’t get it by traveling 15 miles to the closest county mental health clinic, in Visalia. The clinic came to her.

Magaña, 74, was treated in one of Tulare County’s two mobile mental health units, custom-made recreational vehicles that serve isolated adults in rural areas.

Blue Shield Claims Significant Drop In Opioids Use Premium Content
Aug 17, 2017

San Francisco-based Blue Shield of California has claimed a significant reduction in opioid use among its enrollees who are prescribed the medications other than to mitigate cancer pain.

            According to data from Blue Shield’s narcotic safety initiative, overall opioid consumption has been cut by 32%. That includes a 46.8% reduction in the number of enrollees receiving high doses of the medication, and a 17.8% reduction in the average dose of opioids for long-time users of the drug, typically to address chronic pain issues.

Trump Administration Says It Will Make August CSR Payments Premium Content
Aug 17, 2017

The Trump administration said it would make cost sharing reduction payments to health plans this month, just days after a Congressional Budget Office (CBO) report concluded that halting the payments would cause both health insurance premiums and the federal deficit to skyrocket.

Medi-Cal Covering Meals For Some Sicker Enrollees Premium Content
Aug 10, 2017

Federico Guzmán moved from Mexico to San Francisco in 1992, fleeing anti-gay sentiment and searching for AIDS treatment.

            He couldn’t find a job and sometimes went hungry until friends introduced him to Project Open Hand, a nonprofit organization that began serving free, nutritious meals to HIV patients in 1985.

            The people there “were like angels from the sky,” said Guzmán, 50, who went home from his first visit with vegetables, eggs, bread and beans. He continues to receive medically tailored meals from the group.

FQHCs Play Key Roles In Healthcare Delivery Premium Content
Aug 10, 2017

Federally qualified health centers (FQHCs) are providing critical deliveries of healthcare services to the poorest patients in both California and elsewhere. But their funding is often on a precipice, particularly with ongoing uncertainties surrounding the Affordable Care Act.

            That’s the conclusion of UCLA researchers, which delved into the importance of FQHCs in a report released last week.

DMHC Fines Kaiser $30,000 For Data Breach Premium Content
Aug 10, 2017

The Department of Managed Health Care has fined Kaiser Foundation Health Plan $30,000 for an Internet glitch that led to the exposure of confidential patient information.

Union Moves To Place Dialysis Measure On 2018 Ballot Premium Content
Aug 10, 2017

The Service Employees International Union/United Healthcare West has announced plans to put on the November 2018 ballot a measure that would more closely regulate the state’s 570 dialysis clinics.

            According to the proposed measure, called the Kidney Dialysis Protection Act, clinics would undergo annual inspections, require mandatory staffing ratios and place caps on charges for dialysis care. Its text was recently submitted to the state attorney general’s office for review.

Covered California Keeps 2018 Rates Mostly Stable Premium Content
Aug 3, 2017

Covered California announced this week 2018 premium hikes lower than a year ago on average, as well as a containment plan should the Trump administration carry out its multiple threats to end cost-sharing subsidies for lower-income enrollees.

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