Latest California Healthline Stories
Dealing with Continual, Constant Cuts
“Well, I have to tell you, I’m looking forward to getting paid again.”
That’s the summary reaction to passage of the state budget from Dave Jones, CEO of Mountain Valleys Health Centers up north in rural Lassen County.
“We are all relieved to have a budget,” he said.
Legislature Approves Waiver Bills for Medi-Cal
Flying under the budget radar this week were two bills that frame a major restructuring of the Medi-Cal system in California.
The two bills represent about $10 billion in federal dollars coming to California. The waiver is actually negotiated between state and federal officials, and that negotiation is ongoing and due to be wrapped up by the end of this month.
But an official stamp of approval from the Legislature is an important step to eliminate confusion and ambiguity over the new ways Medi-Cal will run, and to limit lawsuits over wording in those new Medi-Cal rules.
Medi-Cal Reimbursement Tops Policy List
The California Medical Association gathered in Sacramento last weekend, and the new CMA president came up with his own variation on the real estate agent motto:
It’s about funding, funding, funding.
“We would like to see physicians be able to maintain a viable practice, first and foremost,” new CMA president James Hinsdale said. “Physicians are being squeezed by Medicare, and squeezed by Medicaid [and by California’s Medicaid program, Medi-Cal].”
At a recent panel discussion in Sacramento, the information came fast and furious — all of it on health information technology.
There was a lot to talk about. The state’s Regional Expansion Centers, the California Telehealth Network, Cal eConnect and the Beacon community in San Diego are all examples of major projects to bring electronic medical record systems to the computers of physicians across the state.
“The vast majority of the country does not have the management and financial infrastructure to implement electronic medical record systems,” David Lansky, the president and CEO of Pacific Business Group on Health, said. “And starting next year, the federal government is going to be spending substantial money to providers who can show they’re using electronic medical record technology.”
Waiver, Medical Home Bills Linger on Agenda
The Legislature, expected to reconvene soon to pass the budget, will also deal with some legislative leftovers.
Two bills relating to the Medicaid waiver are expected to be approved in both houses.
The fate of a another bill dealing with medical homes is harder to predict.
Can Health Care Reform Rein in Costs?
One of the main goals of health care reform — lowering the cost of care — was a major focal point last week at a policy forum in San Francisco hosted by the New America Foundation.
“There are a huge set of provisions in [the national health reform law] that are already working to make coverage more affordable,” Herb Schultz, regional director of the U.S. Department of Health and Human Services, said. “The truth is, it’s not a 2014 thing,” Schultz said. “There are a heck of a lot of things happening in 2010 and 2011.”
Schultz pointed to the recent enactment of provisions to extend dependent health care coverage to age 26, and the elimination of pre-existing conditions as a basis for denying coverage to children under 19. In the past, taxpayers generally paid for treating those uninsured people, he said, rather than insurers.
“Everyone thinks that January 2014 is years away,” California HHS Director Kim Belshé said. “But 2014 is tomorrow.”
Belshé is referring to setting up the California Health Benefit Exchange, now that the governor signed two exchange bills into law yesterday.
The exchange has to be operational three years from its inception, on Jan. 1, 2014 — but that’s the blink of an eye for a project of this scope and importance, Belshé said.
State Officials Anxious for Word on Medicaid Waiver
At the bimonthly stakeholders’ meeting for the Medicaid waiver yesterday, all eyes turned to the front of the room, where David Maxwell-Jolly was about to speak.
Maxwell-Jolly is the director of the state Department of Health Care Services, and he had just been asked about the status of negotiations with CMS over California’s $10 billion Medicaid waiver. The state, facing a deadline of Oct. 31 to come to final agreement on the waiver, is stuck in idle until the federal agency comes up with a draft of what it likes and doesn’t like about California’s plan.
“We don’t have a draft at this point.” Maxwell-Jolly said. “Any day now, we should be getting it.”
The biggest of many decisons the governor faces this week involves creation of the California health care benefits exchange, and no one seems to know which way he’ll go on it.
One of the factors that has fueled the push toward a possible veto of the bill is a report that has many Capitol staffers hopping mad. It was written by Mike Genest, Gov. Schwarzenegger’s former director of the Department of Finance, and it was commissioned by the California Chamber of Commerce, one of the more vocal opponents of the exchange.
According to multiple sources, some of whom requested anonymity, the report promulgates several major fallacies about the power and scope of the proposed benefits exchange:
Powerful Move To Short-Circuit the Exchange
The biggest and most ground-breaking piece of the California health care reform puzzle might just stay in the box.
The health care benefits exchange that would be created if the governor signs two bills (AB 1602 and SB 900) that were approved by the Legislature would be similar to an exchange set up in Massachusetts, but would be the first of its kind in the nation established to conform to the national health care reform law.
The governor has been getting a big push from Anthem Blue Cross and the California Chamber of Commerce to veto those bills, according to government officials and health care advocates.