Anthem Blue Cross of California misled “millions of enrollees†about whether their doctors and hospitals were participating in its new plans, and failed to disclose that many policies wouldn’t cover care outside its approved network, according to a class action lawsuit filed earlier this month.
As a result, many consumers have been left on the hook for thousands of dollars in medical bills, and have been unable to see their longtime doctors, alleges the suit by Santa Monica-based advocacy group Consumer Watchdog.
Archived California Healthcare News
In Brief: Social Services Posts Data On LTC Facilities; CDPH Warns Of Telephone Scam
Free
Jul 15, 2014
Department Of Social Services Posts Citation Data On Long-Term Care Facilities
The California Department of Social Services has launched a redesigned website that includes much deeper data regarding the state's long-term care facilities.
Few mentally ill can find jobs
Free
Jul 14, 2014
Employment rates for people with a serious mental illness are dismally low and getting worse, according to a report from the National Alliance on Mental Illness. Just 17.8 percent of people receiving public mental health services were employed in 2012 – down from 23 percent in 2003.
That’s an unemployment rate of more than 80%.
Kansas, Michigan Asked To Fix Medicaid Glitches
Free
Jul 14, 2014
Federal officials have asked six states, including Kansas and Michigan, to submit plans for resolving issues that appear to be delaying the processes to determine Medicaid eligibility, primarily for pregnant women, children and people with disabilities.
Letters were sent to each state’s Medicaid director on June 27.
First Essential Provider List Released
Premium Content
Jul 9, 2014
Some purchasers of healthcare insurance via Covered California may have had issues with the provider networks of the health plans they selected, but the exchange itself is putting the finishing touches on a list of essential providers available to a large number of enrollees.
Known as essential community providers, or ECPs, the list was mandated under the Affordable Care Act as a way to address disparities in care based on income, geography and other demographics. It is intended to ensure that people who have become newly insured under the ACA are able to remain with the community providers after they obtain coverage.
HealthCare Partners Gets Falling Grant
Premium Content
Jul 9, 2014
Torrance-based HealthCare Partners is one of 10 providers nationwide participating in an initiative to reduce falls among elderly patients.
The initiative, organized by the National Institute of Health\'s aging division and the Patient-Centered Outcomes Research Institute, will spend at least $30 million over the next five years to try and reduce the number of falls among older patients. HealthCare Partners, which was selected in part because it has gathered extensive patient fall data through its electronic medical records system, is the only participant from California.
CDPH: STDs On The Rise In California
Free
Jul 9, 2014
The rates of certain types of sexually transmitted diseases rose substantially in California last year, according to data from the Department of Public Health.
Kaiser Opens New Oakland Hospital
Free
Jul 9, 2014
Kaiser Permanente has opened up its state-of-the art new hospital and medical offices in Oakland, a project that came with a hefty total pricetag of $1.3 billion.
In Brief: DMHC, Blue Shield Disclose Data Breach; Kaiser Links HIV To Stroke Risk
Free
Jul 9, 2014
DMHC, Blue Shield Disclose Breach Of Provider Data
Blue Shield of California and the Department of Managed Health Care were involved in a data breach involving the Social Security numbers of about 18,000 physicians and other healthcare providers.
Uncertainty On How Supreme Court Will Move On Future Contraception Cases
Free
Jul 7, 2014
The U.S. Supreme Court’s opinion last week holding that some for-profit firms do not have to provide women the contraceptive coverage required under the Affordable Care Act if they have religious objections addressed only half of the ongoing legal battle over the birth control mandate.
But those on both sides of the issue think the court’s majority may have telegraphed which way it could rule when one of those other cases reaches the justices.
Supreme Court\'s Recent Healthcare Labor Ruling In Illinois Casts Doubts Elsewhere
Free
Jul 7, 2014
The U.S. Supreme Court’s recent ruling in a case brought by home healthcare aides in Illinois casts doubt on labor agreements between such workers and state governments in nine other states.
It also closes off—or at least complicates—one of labor’s clearest paths to reversing a decades-long trend of declining ranks and shrinking clout.
States Retooling Medicaid Long-Term Care Programs
Free
Jul 7, 2014
Three years after the demise of the long-term care piece of the Affordable Care Act, some states are retooling their Medicaid programs to maximize the number of people who can get care at home and minimize the number who have to become poor to receive help.
They also are trying to save state dollars. Medicaid is a joint state-federal program, and long-term care for the elderly is putting an ever greater burden on state budgets: Total Medicaid spending for long-term services rose from $113 billion in 2007 to nearly $140 billion in 2012.
Tri-State Area: If You Can Make It Here, You Can Make Out Pretty Well
Free
Jul 2, 2014
Healthcare Compensation News will devote a large part of each issue to healthcare payment data and trends in various regions of the United States, with a focus on not-for-profit hospitals.
Why hospitals? Because they pose complex financial questions seen in few other facets of healthcare delivery.
An Introduction To Healthcare Compensation News
Free
Jul 2, 2014
Everyone wants to know what everyone else is paid.
That could be a good enough reason on its own to launch Healthcare Compensation News. However, there are far more compelling reasons to begin a monthly publication following the sector\'s pay practices.
What Some C-Suite Executives Earn
Free
Jul 2, 2014
What Some C-Suite Executives Earn
Tri-State Hospital Chief Operating Officer Average Total Compensation:
$416,036
Median Total Compensation:
The Perk File
Free
Jul 2, 2014
The Internal Revenue Service recently began requiring not-for-profit entities to disclose any specific perks given to their top executives as part of their compensation or to help conduct business. Here\'s a breakdown for the Tri-State CEOs, as well as their costs when available.
Labor Union Agrees To Drop Voter Initiative To Cap Hospital CEO Pay
Free
Jul 2, 2014
A ballot initiative that would have capped what not-for-profit hospitals in California could pay its executives was officially shelved by its sponsor in lieu of a closer alliance with the state\'s leading hospital lobby.
The Service Employees International Union-Healthcare Workers West had been gathering signatures for the initiative to place it on November\'s ballot. It would have capped hospital executive pay at $475,000 a year. That\'s significantly higher than the average base compensation for hospital executives in California, which is more than $500,000 per year, and approaches $750,000 when bonuses and other additional pay is factored in.
Health Care Service CEO Pay Took Hit
Free
Jul 2, 2014
Last year was an off one financially for Chicago-based Health Care Service Corp., which operates Blues plans in five states. The pay of their top executives took a hit as a result.
Chief Executive Officer Patricia Hemingway Hall had a total compensation package last year of $11.2 million, down 30% from the $16 million she took home in 2012, according to data from the Illinois Department of Insurance.
Pending Pharmacy Bill Creates Friction
Premium Content
Jun 25, 2014
A bill in the state Legislature that would allow health plan enrollees to opt-out of mandatory mail-order prescription drug plans has raised the ire of a lobbying group for that sector, claiming it would lead to Californians forfeiting nearly $2 billion a year in cost savings next year.
The bill, AB 2418, is in hearings in front of the Senate Health Committee this week after being passed by the Assembly 75-1 late last month. Authored by Susan Bonilla, D-Concord, it would allow any enrollee in a health plan that mandates mail-ordered prescriptions to be able to opt out starting in 2016.
Can Hospitals Make More With Less?
Premium Content
Jun 25, 2014
Low cost hospitals in California generate less revenue than higher-cost facilities, but they tend to be more profitable.
That\'s the conclusion of Cleverley & Associates, an Ohio-based hospital consulting firm that surveyed 74 non-teaching hospitals in California with annual revenue of between $100 million and $300 million per year. Cleverley\'s firm used 2012 Medicare cost reports from the Centers for Medicare & Medicaid Services and data from the Office of Statewide Health Planning and Development, among other sources.