- California Healthline Original Stories 2
- Obamacare Premiums In California May Rise 8 Percent Next Year, State Predicts
- Gross! Anti-Cig Stories Make For Powerful No Smoking Campaign
- Covered California & The Health Law 2
- Patients Insured By Covered California Find Mistakes Hard To Resolve
- Is Obamacare Failing To Meet The Needs Of The Underinsured?
- Health IT 1
- 'Help Us Find Others Like Tess': Families, Patients With Rare Disorders Unlocking The Power Of Social Media
- Around California 1
- With New Ronald McDonald Facility, Families Will Be Able To Stay Near Critically Ill Children
Latest From California Healthline:
The projected increase in premiums is expected to draw national attention in an election year -- especially from foes of the Affordable Care Act. (Chad Terhune, 5/11)
But reaching Spanish speakers might take some extra effort. (Jocelyn Wiener, 5/11)
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Summaries Of The News:
When things go wrong, consumers find that they are bounced between the state exchange and their insurer, and that small problems can be exacerbated by more errors. In other Covered California news, premiums are projected to rise 8 percent in 2017.
The San Francisco Chronicle:
When Covered California Goes Wrong, Insureds Get The Runaround
When it comes to signing up customers, Covered California has been a success. But when it comes to serving customers, the independent public agency — now in its third year of helping individuals and small businesses get federally subsidized or free health insurance — still has growing pains. While the insurance marketplace works for most enrollees, a single mistake can set off an avalanche of errors that blocks coverage or generates inaccurate tax forms. When customers try to get problems fixed, some say, they get bounced from Covered California to their health insurer and back again. Even when all three parties get on a call together and come up with a solution, the fix doesn’t get made — or doesn’t stay fixed. (Pender and Colliver, 5/8)
Obamacare Premiums In California May Rise 8 Percent Next Year, State Predicts
California’s health insurance exchange estimates that its Obamacare premiums may rise 8 percent on average next year, which would end two consecutive years of more modest 4 percent increases. The projected rate increase in California, included in the exchange’s proposed annual budget, comes amid growing nationwide concern about insurers seeking double-digit premium hikes in the health law’s insurance marketplaces. Any increases in California, a closely watched state in the health law rollout, are sure to draw intense scrutiny during a presidential election. Republicans are quick to seize on rate hikes as further proof that President Obama’s signature law isn’t doing enough to hold down health care costs for the average consumer. (Terhune, 5/11)
The Auburn Journal offers a two-part series examining the impact of the Affordable Care Act on uninsured or lower-income residents in the region.
Uncovered California: Despite Insurance, Some Left Without Care
Charlene Sanborn loved being a mother to her three boys, and when they were grown she loved being a grandmother to their children. She would drop everything to babysit her grandchildren. In fact, she loved everybody’s children. When her boys were growing up in Placerville, the Sanborn house was the place to crash after school and on the weekends. Later, when she worked as a teacher’s aide, she went home and told her family stories of the cute things the kids had said and done that day. Growing up, the Sanborns had a lot of love, but they didn’t have much money, so their mom had gone without health insurance most of her life — until the Affordable Care Act went into effect in January, 2014, and along with so many other Californians she was able to enroll in Medi-Cal for the first time. (Caspers, 5/9)
Uncovered California: Emergency Rooms See Increased Numbers After Affordable Care Act
Emergency rooms are still swamped in Placer County and beyond. Many visits are from people who have insurance for the first time. Some say patients continue to use the ER because it’s where they’ve always gone; others say patients turn to ERs when doctors are too busy or too far away, and the pain is too great. When the Affordable Care Act was passed, one of its goals was to move non-urgent patients out of the ER, but a nation-wide study shows ER visits have either increased or stayed the same since January, 2014. (Caspers, 5/10)
The bill responds to complaints that businesses face a barrage of lawsuits over minor ADA violations that don't impede access for people with disabilities.
The Associated Press:
California Governor Signs Bill Giving Time For ADA Fixes
Gov. Jerry Brown is backing legislation that could cut the number of lawsuits against businesses over technical violations of the Americans with Disabilities Act. The Democratic governor announced Tuesday that he signed SB269. The measure gives businesses with fewer than 50 employees time to fix violations after they're pointed out, among other protections. Republican Assemblywoman Kristin Olsen of Riverbank says business owners shouldn't spend time fighting "predatory lawsuits." (5/10)
In responding to the trend, the Sacramento-based hospital group's business is transforming from inpatient to outpatient care. News outlets also report on regional hospital news from San Bernardino, San Francisco and Sonoma County.
Sutter Health Wrestles With Increasing Costs As Admissions Remain Flat
Sutter Health continued to see rapid growth in outpatient visits last year, while admissions remained flat. Those trends, along with rising expenses across the board, led to a pinched operating margin for the 25-hospital system.The Sacramento, Calif.-based hospital group reported an operating surplus of $287 million on nearly $11 billion in operating revenue for the year ended Dec. 31. In comparison, it saw an operating surplus of $419 million on $10.2 billion in operating revenue in the previous year.Its operating margin declined to 2.6% from last year's 4.1%,Salary and benefit costs increased 8.8% year over year, purchased services were up 11.2% and supply costs grew 11.7%.Like many of its peers, Sutter Health's business is transforming from inpatient to outpatient care. (Kutscher, 5/10)
Dignity Health’s Top Nursing Executive Visits San Bernardino Hospitals
Page West, the chief nursing executive officer of 39 Dignity Health Hospitals, visited St. Bernardine Medical Center on Tuesday afternoon as part of the non-profit hospital chain’s celebration of Nurses and Hospitals Week. The purpose of the visit is to show “an appreciation from a nurse to a nurse,” said West, who is based in San Francisco, and spent many years as a hospital nurse in the Dignity system. (Steinberg, 5/10)
The San Francisco Business Times:
Sneak Peek: New CPMC Hospital Hits Latest Milestone
California Pacific Medical Center's new $2.1 billion, 274-bed hospital at Geary and Van Ness is 40 percent of the way to its 2018 construction finish line, according to officials at Sutter Health's flagship hospital in the region. (Rauber, 5/10)
The Press Democrat:
Hospital Union Decries Staffing At Memorial And Petaluma Valley
The National Union of Healthcare Workers, which represents about 800 medical workers at Santa Rosa Memorial and Petaluma Valley hospitals, has released a scathing report that accused the two Sonoma County facilities of poor patient care caused by inadequate staffing. (Espinoza, 5/10)
A tsunami of workers’ compensation claims began to overwhelm Suzie Kim's family business -- and her suspicions of fraud were confirmed as criminal charges began piling up against some medical providers who treated her workers.
With Workers’ Compensation Fraud Comes Soaring Insurance Costs
Suzie Kim had a hunch that something was wrong. Janitors from her Los Angeles cleaning company flocked to many of the same medical providers for work injuries over and over again. The work is undeniably hard on the body. But as 20, 40 and then more than 80 work-injury cases stacked up at the company with 350 janitors, they began to take a toll on the family business. Sky-high medical bills led to sky-high workers’ compensation insurance rates. ... Employers like Kim are paying the price for what prosecutors throughout California describe as more than a $1 billion in medical fraud plaguing the state workers’ compensation system. (Jewett, 5/10)
Patients and their families are turning online to not only find people who share in their diagnosis, but also for help in getting one.
Through Social Media, Family Connects To Rare Diagnosis – And Hope
If you are suffering from an illness fewer than a dozen people in the world are known to have, getting a proper diagnosis can start to feel like a hunt for something that doesn’t exist. That’s the position one family found themselves in before they turned to social media in search of an answer, managing to discover in one day an answer that had eluded doctors for years. (Snow, 5/10)
The expansion, which broke ground almost two years ago, will make the Ronald McDonald House at Stanford, near Lucile Packard Children's Hospital, one of the largest of the 357 Ronald McDonald Houses in the world.
The Mercury News:
Ronald McDonald House At Stanford Opens New Facility To Serve More Families In Need
After years of planning, the Ronald McDonald House at Stanford opened a new facility on Tuesday that more than doubles the number of private rooms available to families who have traveled outside their communities to access medical treatment for their critically ill children at Lucile Packard Children's Hospital at Stanford. (Seipel, 5/10)
In other health care news from across the state —
The San Diego Union-Tribune:
Report: Improvement In Child Well-Being
By most measures, the health, safety and well-being of children and families in San Diego County improved in 2015, compared to previous years, but some problems have gotten worse, according to a new report by the nonprofit Children’s Initiative. (Cook, 5/10)
The East Bay Times:
Pleasanton: New Low-Income Health Clinic Opens
Low-income and uninsured patient care provider Axis Community Health has opened a new clinic that will allow it to increase the number of Tri-Valley residents it serves to 20,000 from its current 12,000 at the group's other two clinics. (Kilduff, 5/10)
The Desert Sun:
Zika Virus: What The Coachella Valley Needs To Know
With the tragic cases of Zika virus in South and Central America drawing worldwide attention, Coachella Valley residents are naturally wondering if an outbreak is heading our way. The good news is that we are fine, at least for now. Here's how things are shaking out. (Newkirk, 5/10)
The Bakersfield Californian:
Supervisors Put A Lid On Pot Dispensaries
Kern County supervisors voted unanimously Tuesday to put a temporary moratorium on new medical marijuana shops in unincorporated areas, giving them time to develop permanent policy. (Burger, 5/10)
The Sacramento Bee:
Lodi Oncologist, Wife Pay $300,000 To Settle Chemo Drug Claim
A Lodi oncologist and his wife, who was his office administrator, have paid the United States $300,000 to settle allegations that they billed Medicare for chemotherapy drugs purchased from an unlicensed foreign distributor, acting U.S. Attorney Phillip Talbert announced Monday. Federal prosecutors allege that, between October 2010 and May 2011, Dr. John F. Kiraly III and Rene Kiraly billed and received reimbursement from Medicare, the government-funded health care insurance for seniors, for the drugs in violation of the False Claims Act. (Walsh, 5/9)
As Hillary Clinton looks to wrap up the Democratic presidential primary, she is floating the idea of a Medicare buy-in option for those in their 50s.
The New York Times:
Hillary Clinton Takes A Step To The Left On Health Care
For months during the Democratic presidential nominating contest, Hillary Clinton has resisted calls from Senator Bernie Sanders to back a single-payer health system, arguing that the fight for government-run health care was a wrenching legislative battle that had already been lost. But as she tries to clinch the nomination, Mrs. Clinton is moving to the left on health care and this week took a significant step in her opponent’s direction, suggesting she would like to give people the option to buy into Medicare. (Rappeport and Sanger-Katz, 5/10)
The Wall Street Journal:
Hillary Clinton Says She’s Weighing Medicare For 50-Year-Olds
Hillary Clinton has spent months berating rival Bernie Sanders for proposing a single-payer, government-run health-care plan, sticking to her more modest proposals aimed at lowering costs and saying she has no interest in another nasty legislative battle over health care. Now, as she tries to close out her primary contest against the Vermont senator, she is floating a new idea: allowing people as young as 50 to buy into Medicare, the health plan that serves those ages 65 and up. (Meckler, 5/10)
But experts say, although value-based deals have increased in number, they remain limited in scope and may not put a huge dent in drug spending.
The Wall Street Journal:
Health Insurers Push To Tie Drug Prices To Outcomes
Health insurer Cigna Corp. will get extra price discounts from drugmakers if new cholesterol medications don’t help patients as much as expected, a significant step in a broader push to tie the cost of drugs to how well they work. Such “value-based” deals are becoming more common as rising costs spur customers to demand assurances they are getting what they pay for. U.S. prescription spending rose 12% to nearly $425 billion in 2015, following a 13% increase in 2014, according to research firm IMS Health. Cigna is set to announce on Wednesday that it is the first insurer to reach value-based contracts for an entire new class of cholesterol drugs: Praluent, which is co-marketed by Sanofi SA and Regeneron Pharmaceuticals Inc., and Amgen Inc.’s Repatha are the only two cholesterol-lowering drugs known as PCSK9 inhibitors currently on the U.S. market. (Loftus and Wilde Mathews, 5/11)
If Prince died from opioids, he follows a dangerous pattern that is a growing frustration for first responders: saving a life only to lose it shortly after to another overdose.
The Wall Street Journal:
Prince’s Death Spotlights Overdose Antidote Dilemma
Prince’s death last month from a possible opioid overdose highlights the challenge for health officials using the overdose-reversal medication naloxone: getting people saved from overdoses into addiction treatment. Six days before he died, the 57-year-old musician overdosed on the painkiller Percocet while on a flight, forcing the plane to make an emergency landing in Moline, Ill., a law-enforcement official said. Hospital staff revived him with a dose of naloxone, also known as Narcan. ... Across the country, public health officials are embracing naloxone as a key life-saving tool in the opioid crisis. (Kamp and Campo-Flores, 5/11)