Under unprecedented pressure from the Department of Managed Health Care, Blue Shield of California will revisit some of its actuarial data for setting premiums for its individual, family and small group policies, and will forego at least one premium increase next year.
The San Francisco-based insurer quietly agreed to an extensive order issued by the DMHC on Oct. 5.
Archived California Healthcare News
Hospitals Have Varied C-Section Rates
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Oct 14, 2015
California hospitals are slightly below the target set by a national quality initiative to reduce the rates of Caesarean sections, but the rates still vary widely, according to the data self-reported to the Leapfrog Group.
The Washington, D.C.-baed Leapfrog had set a goal of reducing the national C-section rate to 23.9%, noting that overuse of the practice exposed too many women to unnecessary abdominal surgery.
Nursing Facility Fined $75K By CDPH
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Oct 14, 2015
The California Department of Public Health (CDPH) has cited OakPark Healthcare in the Tujunga are of Los Angeles and fined it $75,000 for neglecting a patient who eventually died as a result.
In Brief: Covered California Has 2 Million Enrollees To Date; Kaiser Links HIV To Higher Cancer Rates
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Oct 14, 2015
Covered California Says 2 Million Have Enrolled Through Exchange
The Covered California health insurance exchange has reported that more than 2 million state residents have enrolled since 2013.
KanCare Administrators Held Fundraiser For Lawmakers
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Oct 12, 2015
One of the three companies that administer KanCare, Kansas\' Medicaid managed care program, co-hosted a fundraiser last week for Republican members of the Senate Public Health and Welfare Committee, opening a new chapter in the state’s move to privatized Medicaid.
The three managed care organizations the state contracted with in 2012 receive nearly all their revenue in Kansas from state and federal tax dollars.
Hospitals Tackle Urban Poverty
Free
Oct 12, 2015
As a child, Bishop Douglas Miles heard the warnings about vans trolling East Baltimore streets, snatching up young African-Americans for medical experiments at nearby Johns Hopkins Hospital.
Whether there was any truth behind those stories—Hopkins has always denied them—hardly mattered. The mythology lived on and, combined with the hospital’s very real development decisions, contributed to a persistent view of Hopkins as an imperious, menacing presence amid the largely poor and African-American neighborhoods surrounding it.
Express Scripts Won\'t Take Role In Lowering Price of New Cholesterol Drugs
Free
Oct 12, 2015
The nation’s largest pharmacy benefit manager said last week it’s not going to try to bring down costs by forcing the makers of two pricey new cholesterol drugs to compete against each other, as it successfully did this year with expensive hepatitis C treatments.
Instead, St. Louis-based Express Scripts said it will control spending by aggressively managing which patients get the injectable medications. The firm also said it won some discounts from the treatments’ estimated $14,000 annual list price.
CDPH Fines Nine Hospitals $915,100
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Oct 7, 2015
The California Department of Public Health (CDPH) has levied penalties and fines against nine hospitals totaling $915,100 for breaching state patient confidentiality laws.
The penalties, which ranged from $2,500 to $250,000, were for incidents that occurred between 2011 and 2013. All of the incidents involved employees who were either negligent handling records or deliberately violated rules for the purpose of obtaining personal or workplace information.
UCSF Receives $9.75M NIH Grant
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Oct 7, 2015
UC San Francisco has received a $9.75 million grant from the National Institutes of Health to create a platform that will allow researchers to conduct mobile health research in a more efficient manner.
Assisted Suicide Bill Signed Into Law
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Oct 7, 2015
Gov. Jerry Brown signed into law this week a bill that makes physician-assisted suicide legal in California under strict guidelines.
A New Chapter: Martin Luther King Medical Center Reopens
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Oct 7, 2015
The Payers & Providers Podcast explores the recent reopening of South Los Angeles\' Martin Luther King Community Hospital. Editor Ron Shinkman first discusses the hospital\'s troubled history while being operated by the Los Angeles County Department of Health Services. The podcast includes a visit to the remade campus, interviews with members of the community and gets the take of a key consultant to the hospital\'s rebirth and a close observer of its past.
In Brief: UCSD Study Says Vaping Companies Lure Underage Users; Hospital Work Break Waiver Signed Into Law
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Oct 7, 2015
UCSD: Vaping Companies Engage In Overly Aggressive Marketing Tactics
A new study by researchers at UC San Diego have concluded that purveyors of so-called vapor or electronic cigarettes engage in aggressive marketing tactics that often ensnare underage users.
Some States Pushing For Medicaid Work Requirement
Free
Oct 5, 2015
If Arizona gets its way, its able-bodied, low-income adults will face the toughest requirements in the country to receive healthcare coverage through Medicaid.
Most of those Medicaid recipients, and new applicants, would have to have a job, be looking for one or be in job training to qualify for the joint federal-state program for the poor. They would have to contribute their own money to health savings accounts, which they could tap into only if they met work requirements or engaged in certain types of healthy behavior, such as completing wellness physical exams or participating in smoking cessation classes. And most recipients would be limited to just five years of coverage as adults.
Value-Based Purchasing Doesn\'t Improve Quality
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Oct 5, 2015
Medicare’s quality incentive program for hospitals, which provides bonuses and penalties based on performance, has not led to demonstrated improvements in its first three years, according to a federal report released last Thursday.
ICD-10 Creates A Cascade Of New Codes
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Oct 5, 2015
If you’re struck by an orca, sucked into a jet engine, or having relationship problems with your in-laws, fear not: Your doctor now has a medical diagnosis code for that.
Today U.S. doctors, hospitals and health insurers must start using the ICD-10, a vast new set of alphanumeric codes for describing diseases and injuries in unprecedented detail.
California Begins Transition To ICD-10
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Sep 30, 2015
California\'s healthcare enterprises officially transitioned to the ICD-10 system as of today, implementing one of the biggest shifts in the way patient care is coded and billed in decades.
It remains to be seen whether there will be any glitches with the transition, which vastly expands the number of codes for medical incidents and care. For the moment, the state\'s Medi-Cal program will be sitting out the ICD-10 transition.
L.A. Center of Bad Ambulance Billings
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Sep 30, 2015
Is Los Angeles the fraudulent ambulance capital of the United States?
That was suggested in a new report by the U.S. Department of Health and Human Services Office of the Inspector General (OIG). The agency recently audited ambulance transports billed to the Medicare Part B program during the first half of 2012.
In Brief: Los Angeles County Will Merge Three Health Agencies; Statewide Smoking Rate Continues to Drop
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Sep 30, 2015
Los Angeles County Will Merge Three Health Agencies
The Los Angeles County Board of Supervisors voted 4-0 earlier this week to merge three departments that provide different healthcare services into a single entity in order to streamline care delivery.
Community Clinics Lack Dental Care
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Sep 29, 2015
Providing dental services at community health centers is a good way to improve oral health among low-income Californians, but few such providers are configured in this manner.
That was the conclusion of the UCLA Center for Health Policy of Research, which surveyed 886 community health centers statewide.
Prescribing Statins To Elderly Raises Concerns
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Sep 28, 2015
Many doctors are choosing a better-safe-than-sorry approach to heading off heart trouble in very elderly patients.
Inexpensive statin drugs are given to millions of people to reduce cholesterol, even many who do not show signs of heart disease. But a recent study has found that seniors with no history of heart trouble are now nearly four times more likely – from 9 percent to 34 percent – to get those drugs than they were in 1999.
