A new study in the journal Health Affairs discovered that the vast majority of hospitals in the United States with the highest markups in comparison to allowable Medicare charges are for-profit facilities.
Archived California Healthcare News
In Brief: Stanford Links Reflux Medicine To Heart Attack Risk; COPE Launches Care Coordination Effort
Premium Content
Jun 10, 2015
Stanford Links Reflux Medicine To Greater Heart Attack Risk
A new study by the Stanford University School of Medicine has linked the use of a popular medication to control acid reflux with a greater risk of heart attacks.
Push Is On To Improve Home Care Workers\' Wages, Benefits
Free
Jun 8, 2015
People working in one of the fastest growing professions in America aren’t well paid. Many of them don’t get health or retirement benefits. And federal minimum wage and overtime protections still don’t apply to them.
Despite the low wages and odd hours, 2 million Americans are home care workers, helping to dress, feed, and bathe the elderly and disabled within their homes. They are in high demand: The U.S. population is aging, and more seniors want to stay in their homes instead of moving to nursing homes.
Health Plans Try To Predict Preventable Readmissions
Free
Jun 8, 2015
John Iovine finally went home in April 2014, after several months in a rehab facility.
And this point in patients’ recovery — when they’ve been discharged and have to sink or swim on their own — is the stage that everyone in the health system is paying special attention to right now. For too long, too many people like John Iovine would take a dive at this stage and end up back in the hospital again.
The industry calls these returns to the hospital preventable readmissions, and they are a huge drain on finances, costing Medicare alone $15 billion annually. That’s why Medicare launched an initiative a few years ago that penalizes hospitals that see too many patients readmitted too soon. And in turn, that spurred many hospitals to pay more attention to the problem.
Kansas Health Insurers Seek Big Exchange Rate Increases For 2016
Free
Jun 8, 2015
Two of the three companies that sell individual-market policies for Kansans on the federally administered health insurance marketplace are proposing significant premium increases for 2016.
Rate increases proposed by Blue Cross and Blue Shield of Kansas, the state’s largest insurer, range from 35% to 39%. Aetna and Coventry Health Co., which merged in 2013, requested rate increases of 20% to 35%.
DMHC Fines Anthem Blue Cross $1.5 Million
Premium Content
Jun 3, 2015
The Department of Managed Health Care has levied a $1.5 million fine against Anthem Blue Cross of California for failing to pay for prenatal tests a state agency performed for tens of thousands of its enrollees, records show.
Breast Cancer Test Guidance Lacking
Premium Content
Jun 3, 2015
A significant proportion of California women – particularly African-Americans and Latinas – receive hazy or no actionable advice on how to proceed when they are diagnosed with early stage breast cancer, according to a new study led by UCLA researchers.
The sticking point is primarily over a molecular laboratory test to determine if their form of breast cancer is likely to return in the future, which can help tailor treatments such as chemotherapy regimens for the best outcomes.
In Brief: Study Urges More In-Person Enrollment Options For Poor Californians; HealthCare Partners Saved $1.8M Through Anthem ACO Collaboration
Premium Content
Jun 3, 2015
Study Urges More In-Person Enrollment Options For Poor Californians
A new study by a not-for-profit group that examined the state’s minority and lower-income residents urged more in-person options for that group to obtain health insurance.
OSHPD Adopts Emergency Water Curbs
Premium Content
Jun 2, 2015
The Office of Statewide Health Planning and Development (OSHPD) has issued new regulations to hospitals intended to conserve water.
Insurance Rate Hikes In Missouri To Undergo Independent Review
Free
Jun 1, 2015
A Missouri consumer advocacy group plans to take on the tedious task of reviewing health insurance rates with the goal of identifying and challenging hefty price hikes.
Missouri is one of the few states that does not allow its insurance regulators to review and approve health plan prices before they can be sold. As a result, local health advocates are planning for the first time to conduct that review themselves.
Kansas Hospitals Could Lose Sales Tax Exemption
Free
Jun 1, 2015
Kansas hospitals were surprised by a plan that surfaced late last week to solve the state budget crisis by ending a sales tax exemption for some nonprofit organizations.
The Senate voted down the plan 30-9 after several hours of debate. But with the state facing a budget gap of nearly $800 million and the Legislature looking for $400 million in new taxes, there’s a chance lawmakers could take another look at it.
eHealth Hit Hard By State Exchanges
Free
Jun 1, 2015
The Affordable Care Act was expected to be a boon for eHealth Inc., the nation’s largest online health insurance broker. After all, the law required most Americans to have coverage, provided government assistance to afford it and allowed Internet brokers to sell Obamacare policies.
Blue Wolf Leading Pack For Daughters
Premium Content
May 27, 2015
As the Daughters of Charity Health System tries to forge a path forward after a months-long saga to sell itself off to a for-profit operator fell through, a New York-based private equity firm appears to be its likeliest savior.
Multiple sources have told Payers & Providers that Blue Wolf Capital Partners LLC is the leading candidate to acquire the Los Altos-based Daughters of Charity. The hospital system, which operates six acute care facilities in and around Los Angeles and San Jose, would likely remain a not-for-profit entity if it accepted Blue Wolf’s offer, though few specific details of its proposal were available.
CDPH Fines 12 Hospitals $750,000
Premium Content
May 27, 2015
The California Department of Public Health has levied administrative penalties and $750,000 in fines against 12 hospitals for lapses in care that either endangered, injured or killed patients.
In Brief: State’s Minorities Less Likely To Receive Colon Cancer Screening Advice; Covered California Imposes Specialty Drug Cost Caps
Premium Content
May 27, 2015
State’s Minorities Less Likely To Receive Colon Cancer Screening Advice
A new study by researchers at the UCLA David Geffen School of Medicine and Cedars-Sinai Medical Center has concluded that minorities may be getting short shrifted on advice for colon cancer screening.
Medicaid Expansion Key To Cutting Uninsured Rates Among Middle-Aged Adults
Free
May 25, 2015
The health law’s expansion of Medicaid coverage to adults with incomes over the poverty line was key to reducing the uninsured rate among 50- to 64-year-olds from nearly 12% to 8% in 2014, according to a new analysis.
“Clearly most of the gains in coverage were in Medicaid or non-group coverage,†said study co-author Jane Sung, a senior strategic policy adviser at the AARP Public Policy Institute, which conducted the study with the Urban Institute.
Elder Abuse Likely Endemic In United States
Free
May 25, 2015
We know that victims of elder abuse tend to be socially isolated, physically weakened and struggling to maintain their independence. They are reliant on family, friends or caregivers who violate their trust.
What we don’t know, because elder abuse is underreported, is how big the problem really is.
Kansas Medicaid Expansion May Be Forced To A Vote
Free
May 25, 2015
A Senate committee last week learned that a bill proposing that the state collect a 3.5% fee on health insurance policies sold to Kansans on the federal government’s online marketplace could be used to force a vote on Medicaid expansion.
“I want to know if Senate Bill 309 could be a vehicle for Medicaid expansion,†Sen. Laura Kelly, a Topeka Democrat, asked in the final minutes of the Senate Ways and Means Committee hearing.
When It Comes To Hospital Bills, This Company Puts Its Foot Down
Free
May 18, 2015
In the late 1990s you could have taken what hospitals charged to administer inpatient chemotherapy and bought a Ford Escort econobox. Today average chemo charges (not even counting the price of the anti-cancer drugs) are enough to pay for a Lexus GX sport-utility vehicle, government data show.
Hospital prices have risen nearly three times as much as overall inflation since Ronald Reagan was president. Health payers have tried HMOs, accountable care organizations and other innovations to control them, with little effect.
Mental Health Respite Centers Can Cut Hospital Costs
Free
May 18, 2015
It is a busy Friday afternoon. Staff members check in guests at the front desk. Other employees lead visitors on tours of the upstairs bedrooms, or field calls from people considering future stays. Aromas of garlic and roasted chicken seep out of the kitchen.
Community Access is not a bed and breakfast, although it feels that way when you walk through its unmarked door off Second Avenue on Manhattan’s Lower East Side. Also known as Parachute NYC, this quiet seven-bedroom facility is one of four publicly funded mental health centers in New York City (located in Manhattan, Brooklyn, Queens and the Bronx) that provide an alternative to hospital stays for people on the verge of a mental health crisis.
