Latest California Healthline Stories
Healthy Families Savings Goes from $13M to $137K
At a legislative hearing yesterday, state officials said the estimates for savings have been reduced for the Healthy Families transition to Medi-Cal managed care.
According to the Legislative Analyst’s Office, the original estimated general fund savings for the Healthy Families transition was $13.1 million in 2012-13. The estimate has shrunk to $137,000. Savings for next fiscal year — 2013-14 — were estimated at $52 million and that estimate has been revised to $43 million.
Scott Ogus, who represented the Department of Finance at yesterday’s hearing, said there were several factors contributing to the revision. Delays in implementation by the Department of Health Care Services led to caseload changes. DHCS officials have said the department slowed down some of the early phases of the transition so children would have less disruption in continuity of care.
Five Bills Pass Health Committee
The state Senate Committee on Health yesterday approved two bills designed to help alleviate California’s shortage of physicians and nurses in underserved parts of the state.
The committee also approved three other bills.
The provider bills, SB 20 and SB 271 both authored by Sen. Ed Hernandez (D-West Covina), sailed through the health committee on 9-0 votes.
Public Involvement in Managed Care Licensing?
Thirteen bills came before the Assembly Committee on Health yesterday and all 13 were approved, but not all them got a red-carpet reception.
One of the bills that stirred up opposition from health plans was a proposal by Assembly member Roger Dickinson (D-Sacramento) to open the managed care licensing process to public scrutiny and input.
“We know that millions more Californians will attain coverage under the Affordable Care Act, along with millions more in the impending Medi-Cal expansion, and [the effort] to move current enrollees in Healthy Families and other programs into Medi-Cal managed care,” Dickinson said, “making it an opportune time to apply for managed care licensure.”
Spring Recess Gives Way to Spring Work
The California Legislature yesterday returned to work after a 10-day spring recess. A small mountain of bills is in front of lawmakers who have until May 31 to pass bills off the floor.
Health care legislation up for discussion includes:
Mobile App Highlights Patient Advocate Site
Ratings of health plans’ performance put together by the state Office of the Patient Advocate and newly displayed on its website are now accessible by mobile application.
“This is the first app of this type nationally,” said OPA director Amy Krause. “We hope this makes quality an important part of every doctor visit.”
At the heart of what makes the mobile app worthwhile, Krause said, is the rating system itself, which is based on information provided by the Department of Insurance. Patients can compare performance and quality factors among HMOs, PPOs and medical groups in California, both overall and within specific categories, such as how plans’ providers handle diabetes prevention and treatment.
New Survey Offers First Data on Managed Care Shift
A survey released yesterday revealed strengths and weaknesses in the state’s 2011 transition of about 172,000 seniors and persons with disabilities into Medi-Cal managed care plans.
Two-thirds of the responding beneficiaries said their care was the same or better than it had been before the transition but the survey raised concerns on several fronts, most notably a lower level of notification and communication, according to Carrie Graham, assistant director of research at Health Research for Action at UC-Berkeley School of Public Health. Health Research for Action conducted the survey in partnership with the California HealthCare Foundation, which publishes California Healthline.
The survey reached 1,521 Medi-Cal-only respondents who transitioned into managed care between June 2011 and April 2012. Graham said there was a 59% response rate to the survey.
Duals Demonstration Gets Green Light
CMS and California health officials yesterday announced they agree on a framework for the launch of the duals demonstration project starting as soon as October.
About 456,000 Californians who are dually eligible for Medicare and Medi-Cal coverage in the eight demonstration counties will be qualified to participate in the duals project.
State officials announced yesterday the project will be launched under the name Cal MediConnect.
Access at Issue in Provider Cut
A new Assembly bill would exempt one type of skilled-nursing provider from state-imposed Medi-Cal reimbursement cuts. The 10% reduction is being challenged in federal court and has not taken effect.
The new bill, AB 900 by Assembly member Luis Alejo (D-Salinas), would exempt hospital-based, acute-care skilled nursing facilities from the cut. Other providers could be included in the legislation, but so far the bill deals only one kind of provider.
Hospital-based skilled-nursing facilities were singled out because the cuts will affect them more than other Medi-Cal providers, according to Jan Emerson-Shea, vice president of external affairs for the California Hospital Association.
Concern Over Retroactive Medi-Cal Cut
State lawmakers last week got a reply to their long-held question about a 10% Medi-Cal provider reimbursement rate reduction — and they didn’t much like the answer.
At an Assembly budget subcommittee hearing last week, the testimony turned to what would happen if a federal appeals court rules in favor of the state’s effort to cut Medi-Cal reimbursement rates to providers by 10%.
Assembly member Holly Mitchell (D-Los Angeles) asked the director of the Department of Health Care Services, Toby Douglas, a question that has haunted provider groups facing the large rate reduction.
Committee Votes to Remove Limits on Coverage for UC Students
The Assembly Committee on Health last week voted to halt caps on health care coverage for some UC students. Currently, coverage for the roughly 135,000 students covered by UC plans runs out at $400,000, which can be catastrophic to students who develop rare and severe conditions, such as brain cancer.
“We want to make sure that UC students receive the same reforms as are in the Affordable Care Act,” said Assembly member Richard Pan (D-Sacramento), author of AB 314, which passed the Assembly Committee on Health last week by a 13-4 vote. Under the Affordable Care Act, caps on care cost have been removed.
“We want to ensure, if [UC students] get a serious illness like cancer, they’re not left without care,” Pan said.