California Healthcare News

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Kaiser Third Quarter Results Free
Nov 21, 2017

For the third quarter ending Sept. 30, 2017, Kaiser Permanente reported combined operating revenues of $18.3 billion. Operating income was $850 million and non-operating income was $408 million in the third quarter. Net income for the third quarter was $1.3 billion. Capital spending was $773 million in the third quarter. 

California Medi-Cal Managed Care Enrollment Free
Nov 17, 2017

California total Medi-Cal managed care enrollment as of September 2017 was 10,729,234. This reflects a reduction of 40,041 enrollees from the previous month, a gain of 263,456 enrollees from one year ago (9/16) and a gain of 862,050 enrollees from two years ago (9/15).


Source: California Department if Health Care Services


Anthem Blue Cross Slapped With $5 Million Fine Premium Content
Nov 16, 2017

Concluding that Anthem Blue Cross of California’s grievance system has been systematically defective for more than a decade, the Department of Managed Health Care (DMHC) has levied a $5 million fine against the insurer, saying that hundreds of enrollees in recent years have been denied an appropriate avenue to settle disputes about their care and who should pay for it.

CMS May Move To Add Work Requirements To Medicaid Eligibility Premium Content
Nov 16, 2017

vision for the state-federal program in two appearances last week, saying her new course give states wide latitude over eligibility and benefits.

            In a speech Nov. 7 to state Medicaid directors, Verma said the program needs to give people “hope that they can achieve a better future for themselves and their families, hope that they can one day break the chains of generational poverty and no longer need public assistance.”

            She has noted other government assistance programs such as food stamps, have similar requirements.

Flu Shot Rate Among Hospital Workers Continues To Rise Premium Content
Nov 16, 2017

A new report by the California Department of Public Health indicated a slight rise in the proportion of hospital workers who received flu shots during the most recent flu season, which ran from October 2016 through March of this year.

Physician Practice Management Firm SynerMed Plans To Shut Down Premium Content
Nov 16, 2017

SynerMed, a company that manages physician practices serving hundreds of thousands of Medicaid and Medicare patients across California, is planning to shut down amid scrutiny from state regulators and health insurers.

            The company’s chief executive, James Mason, notified employees in an internal email Nov. 6, obtained by Kaiser Health News, that audits by health plans found “several system and control failures within medical management and other departments.”

Average California Individual Short-Term Health Insurance Costs Free
Nov 14, 2017

A new e-Health study released data on costs and shopping trends among short-term health insurance shoppers at for the period between the 2017 and 2018 open enrollment periods, and found the average California short term monthly individual premiums were $187 ($109 nationally) and family premiums were $496 ($264 nationally.) The average California annual individual deductible was $4,246 ($4,608 nationally) and the family deductible as $10,638 ($8,785 nationally.)     

Medicaid Health Plans Cleaning Up In California Premium Content
Nov 9, 2017

Medicaid is rarely associated with getting rich. The patients are poor, the budgets tight and payments to doctors often paltry.

            But some insurance companies are reaping spectacular profits off the taxpayer-funded program in California, even when the state finds their patient care is subpar.

Community Medical Center Long Beach Says It Will Discontinue Inpatient Services Premium Content
Nov 9, 2017

Another hospital in California is slated to close its inpatient services due to pending deadlines to make seismic upgrades.

C-Section Rates Cut In California Premium Content
Nov 9, 2017

A campaign to reduce the use of Cesarean sections in California is bearing some fruit.

            According to an article recently published on the Health Affairs blog, the rate of first-time C-sections occurring at the end of low-risk pregnancies in California dropped from 28.3% in 2015 to 25.5% during the first half of 2017, a reduction of about 10%. The statewide C-section rate also dropped from 26.5% to 25.1%, a reduction of about 4%.

California Premature Birth Rate at 8.6% Free
Nov 9, 2017

According to the just released March of Dimes 2017 Premature Birth Report Card, California had a Preterm Birth Rate of 8.6% in 2016, with a Grade B, compared to the overall national rate of 9.8% with a grade of C. 

California Medicare Advantage and PDP Enrollment - October 2017 Free
Nov 9, 2017

As of October 2017, 5,840,008 Californians are eligible for Medicare, with 2,394,995 enrolled in Medicare Advantage (41.0%, compared to 11.2% nationally.) 2,243,335 are enrolled in Prescription Drug Plans (38.4% compared to 44.6% nationally.)     
Source: Monthly Enrollment by State, October 2017, CMS    

Transgenders in California Struggle With Mental Health Issues Premium Content
Nov 2, 2017

California’s transgender population is more likely to attempt suicide, have suicidal thoughts or have mental health issues interfere with their ability to get through the day, according to new data from the UCLA Center for Health Policy Research.

Latino ACA Enrollment Now Up In Air Premium Content
Nov 2, 2017

Latinos, who just a year ago were highly sought customers for the Affordable Care Act’s marketplace plans may not get the same hard sell this year.

            The Trump administration’s laissez-faire approach toward the upcoming enrollment period for the health law’s insurance marketplaces could reverse advances made in the number of Latinos with coverage, fear navigators and community activists.

DMHC Fines Kaiser $205,000 Premium Content
Nov 2, 2017

The California Department of Managed Health Care has fined Kaiser Foundation Health Plan $190,000 for improper responses to enrollee grievances, records show.

OPA Releases Annual Health Plan Report Cards Premium Content
Nov 2, 2017

California’s Office of the Patient Advocate (OPA) has released its annual health plan report cards, and Kaiser Foundation Health Plan again received the top scores. The report cards measure the state’s 10 largest HMOs and six largest PPOs.

            The Oakland-based Kaiser was the only plan rated “excellent” (four out of four stars) by patients in Northern and Southern California for the quality of the care received. It received three stars (“good”) for patient experience in both regions.

Covered California Offers Reassurance As Open Enrollment Kicks Off Premium Content
Nov 2, 2017

The Covered California health insurance exchange has announced that consumers who do not qualify for premium subsidies will pay an average of $115 per month less for coverage in 2018 than this year due to what the organizations calls a “healthy risk mix.” Open enrollment began on Wednesday.

Nine Medi-Cal Coverage Fast Facts Free
Oct 30, 2017

1. Medi-Cal covers nearly 13.5 million Californians
2. Nearly 1 in 3 Californians have Medi-Cal coverage
3. Medi-Cal covers 1 in 2 of births in the state
4. Medi-Cal covers nearly 49% of California kids under age 12
5. 62% of Medi-Cal enrollees are families with children
6. Medi-Cal covers more than 1 on 5 of Age 65+ Californians
7, Medi-Cal covers nearly 3 in 5 nursing facility residents
8. Medi-Cal covers 1 in 2 disabled Californians
9. More than 2 in 3 Medi-Cal adults are in the labor force

California Medicare Advantage and PDP Enrollment - October 2017 Free
Oct 30, 2017

As of October 2017, 5,840,008 Californians are eligible for Medicare, with 2,394,995 enrolled in Medicare Advantage (41.0%, compared to 11.2% nationally.) 2,243,335 are enrolled in Prescription Drug Plans (38.4% compared to 44.6% nationally.)

Source: Monthly Enrollment by State, October 2017, CMS



California Hospital Systems Move To House Homeless Premium Content
Oct 25, 2017

During the five years Tony Price roamed the streets and dozed in doorways, the emergency rooms of Sacramento’s hospitals were a regular place for him to sleep off a hard day’s drinking.

            “A lot of times I would pass out, and then I’d wake up in the hospital,” said Price, 50.

            About two or three times a month, he would show up at a local emergency department. Sometimes doctors hydrated him with intravenous fluids and sent him on his way. Other times, they kept him a night or two.