Latest California Healthline Stories
Quality Ratings Offered in Medicare Enrollment Window
Open enrollment for Medicare starts at the end of next week. This week, the federal government launched its online service to help people make Medicare decisions. This year, ther service offers a little something extra, according to David Sayen, the regional administrator for CMS.
“This enrollment period is different,” Sayen said. “For the first time, we’re rewarding quality.”
Medicare Advantage plans now will be rated for quality of care. Part D prescription drug plans will continue to be rated for quality.
Health 2.0 Conference Focuses on Patient-Centered Technology To Promote Wellness
Jonathan Attwood of Zamzee, Stephen Downs of the Robert Wood Johnson Foundation, Chris Hewett of Mindbloom, National Coordinator for Health Information Technology Farzad Mostashari and Christine Robins of BodyMedia spoke with California Healthline about new consumer-focused health innovations.
How Long Can We Avoid Long-Term Care?
At a conference in Sacramento last week, advocates kept calling it a crisis in care in California — and at the same time acknowledging that citizens’ and policymakers’ eyes seem to glaze over whenever the subject of long-term care comes up.
Given the huge swell of about-to-be-seniors who will need care in California, it’s certainly an important subject. One of the touchstones of the conference was that the long-term care world needs a new, less scary way of framing the issue — it needs to develop a new language.
Because it can be so difficult to engage Californians on the subject, the legislative infrastructure has not yet been fully set up. According to Diana Dooley, secretary of the Health and Human Services Agency, there is a lot of room right now for input on the subject.
UC-Riverside, UC-Merced Turn to New Models for Med Schools
In response to state budget cuts and emerging trends in medical education, UC-Riverside and UC-Merced are seeking new ways to fund their medical school programs and train students. Both universities are developing new partnerships and new teaching models to circumvent the daunting economic climate.
UC-Davis Wins Emergency Services Lawsuit
The courts have sided with UC-Davis Medical Center, ruling this week that Sacramento County must pay for emergency services for indigent patients.
Superior Court Judge Lloyd Connelly said the county has a responsibility to pay for indigent care, whether the county contracts with a specific provider of those emergency services or not.
“The judge rejected every defense the county had to not pay us,” UC-Davis attorney David Levine said. “He conclusively confirmed that they owe us money, and they have to pay us.”
Budget Cuts Could Put Developmentally Disabled ‘in Danger’
Yesterday, The Arc of California filed a lawsuit in U.S. District Court in Fresno, saying that state officials have violated federal law by shortchanging programs for people with developmental disabilities.
The Arc, a national advocacy organization that began in 1953 as NARC — the National Association for Retarded Children — changed its name to The Arc in 1992.
“We want to stop the state from violating federal law, with both their direct and indirect payments,” according to lead attorney Bill McLaughlin.
Data Take Center Stage at Health 2.0 Conference
As efforts to get consumers actively involved in health information technology mature, the focus at the Fifth Annual Health 2.0 Conference in San Francisco showed an evolutionary shift away from getting the conversation started and toward deciding what to talk about.
Legislative Hearing Looks at Rural Health
The list of rural health issues is a long one, according to Steve Barrow of the California State Rural Health Association. But it can be summed up by one statistic, he said.
“In the rural areas, we have 30% of the state’s Medi-Cal patients, and we have 10% of the state’s population,” Barrow said.
Barrow was one of the presenters at a recent bipartisan legislative hearing on rural health issues, presided over by Assembly members Alyson Huber (D-El Dorado Hills) and Linda Halderman (R-Fresno).
Our Sidneys: The Six Key Studies That Shook Up the Summer
With a nod to David Brooks’ annual awards in the New York Times, “Road to Reform” highlights our own Sidney Awards, named for Kaiser Permanente’s co-founder. Here are six major health policy studies that changed the course of conversation this summer.
Misreporting of Health Billing Down
Bruce Lim was pretty happy. He’s the deputy director in charge of audits and investigations for the Department of Health Care Services. A biannual review of potential fraud in fee-for-service medical billing found that — across the board — there were far fewer financial red flags than in the past.
“Bottom line, the trend lines are very favorable,” Lim said. “The total potential exposure to errors and to potential fraud has decreased. If you look at the positive numbers, 94.5% were billed and paid appropriately, that’s extremely positive.”
The outlier, Lim said, was the adult day health care program, which he said had trouble making sure patients fit “medical necessity” criteria.