Latest California Healthline Stories
Putting Prime Interest in Primary Care
Kelly Pfeifer, who recently took over as the medical director for the San Francisco Health Plan, knows the problems of medical economics all too well.
“We’ve been spending lots of money for health care and not getting a lot for it,” Pfeifer said at a forum in Sacramento put on by the Center for Health Improvement. “We’ve been paying for volume, not quality, and that’s what we get.”
Pfeifer also said she knows a few solutions for medicine’s troubles. “I do have hope that we can get out of this mess,” she said. “The answer is to invest in primary care.” Pfeifer had several examples of primary care innovations that have shown promise.
Study Out Next Week on Continuous Coverage
In a study to be released Thursday, a UCLA researcher drew some interesting conclusions about the impact of California’s 12-month continuous Medicaid eligibility policy on continuity of care.
Shana Lavarreda, Director of Health Insurance Studies at UCLA’s Center for Health Policy Research, just completed a study funded by SHARE (the State Health Access Reform Evaluation, a program of the Robert Wood Johnson Foundation). It tracked where children received care in 2000 and 2001, to measure the effect of the continuous care policy implemented in 2000.
First, she said, one finding really surprised her: “One big finding was that there were still half a million children in California who had discontinuous coverage,” Lavarreda said. “With the huge surge in coverage [after the continuous coverage policy went into effect], we thought children would be covered and remain covered — but you still had kids that were on and off the program.”
Policy Brief Tackles Waiver Policy
A policy brief issued this week summarizes the many facets and programs of the recent federal Medicaid waiver agreement — including one program that few people know about, and which could have a profound effect on public hospitals in California.
“It’s a very exciting and critical element of the waiver,” according to Melissa Stafford Jones, president and CEO of the California Association of Public Hospitals and Health Systems.
“It embodies the principles of health care reform into a system that’s smarter and provides more coordinated care,” Stafford Jones said. “It really puts California at the leading edge of that national effort.”
A Time of Adversity and Opportunity
It’s an unusual time to be Secretary of all things health care in California.
On the one hand, Diana Dooley will take over the Department of Health and Human Services at a time when budget cuts have already worn the public safety net down to spider-web thinness.
And she arrives with a new budget deficit looming that could gut many existing health care and service programs. In fact, outgoing Governor Schwarzenegger asked lawmakers to cut more than $1 billion from Medi-Cal and the Healthy Families programs, and to eliminate the $1.4 billion CalWORKS program altogether.
Proposal Sends Shiver Through Health Agencies
The budget proposed by the governor yesterday, which includes deep cuts to health care programs in California, is unlikely to be passed in its current form, political experts said.
Legislators have made it clear that they most likely will wait for incoming Governor Jerry Brown to take office in January before taking on the latest budget shortfall. And legislative leaders have expressed support for health and human service programs: from contributing an amicus brief last week to a lawsuit that would reverse cuts in mental health programs, to lobbying for repeal of Schwarzenegger’s line-item vetoes last month of many human services programs.
But whether or not any of the proposed budget cuts happen, the latest budget reduction plan is a huge red flag to health care advocates.
Governor Transition Might Hinder Grant
The new governor takes office on Jan. 3 — but that would be too late for California to apply for a large federal innovation grant, according to a number of health care advocate groups.
“We’re in this lull period,” Lucien Wulsin of the Insure the Uninsured Project said, “with the outgoing Schwarzenegger administration and the incoming Brown, there’s this whole handoff thing.”
And since the innovation grant application has to go in by Dec. 23, Wulsin said that’s a little worrisome.
How California’s Health Care Landscape Is Shifting
At a panel discussion in Sacramento yesterday, the line of the day belonged to Louise McCarthy, head of governmental affairs for the Community Clinic Association of Los Angeles County.
The phrase “elephant in the room” kept coming up throughout the discussion, and usually it referred to some health care money owed and not being paid by the state.
“It’s not an elephant in the room we’re dealing with,” McCarthy said. “It’s more of a pachyderm party right now.”
Changing Health Care Role for California’s Businesses?
It’s an alarming lead statistic in a report out this week: About 20% of working Californians don’t get health care insurance through their employer.
What that means is that it’s not just the unemployed and disabled who are struggling to find health care coverage. It’s also a large number of people with jobs.
But will any of that change under the pending national health care reform law? Businesses with fewer than 50 employees won’t be required to provide health insurance. So will state lawmakers need to enact some kind of legislation to address it?
State of Nursing in the State of California
The National Summit on Advancing Health through Nursing was held in Washington, D.C., yesterday to officially launch a report called The Future of Nursing: Leading Change, Advancing Health. It listed the developments that need to happen in nursing during health care reform.
“This is the first day of the future of nursing,” Risa Lavizzo-Mourey, President and CEO of the Robert Wood Johnson Foundation, said at yesterday’s summit. “This is the day when we fill the critical piece of the health care picture. We are here not to reform but to transform how care is delivered.”
Donna Dolinar is on the board of the California chapter of the American Nursing Association, and she was at the D.C. conference.
Going From No-Show to Showing Teeth
It was two weeks ago that the California Department of Managed Health Care was a sort of agency-non-grata at a legislative oversight hearing. The Assembly budget subcommittee hearing was targeted at the DMHC’s perceived lack of response to complaints that the insurance industry was short-changing emergency departments across the state.
When the DMHC didn’t show up to that oversight hearing, it prompted a fair share of derision and antipathy — and it confirmed emergency department officials’ fears that the agency was ignoring their complaints.
Yesterday, the agency showed that it has been listening, by levying nearly $5 million in fines on seven health care insurers.