Latest California Healthline Stories
Hits Keep Coming for Mental Health Community in California
Cuts in funding for two years running. Redirection of $861 million. Major shift of responsibility away from the state and onto the counties. Can all of that actually result in more efficient and integrated mental health care?
Dozens of Bills Down, Dozens To Go
There will be cake.
That’s the celebratory reaction from health care advocates and many legislators in Sacramento — and literally, there will be a large table of cake at a community center in Sacramento today, where lawmakers and policy professionals will gather to toast what the national health care reform law has already brought to California, and what it’s about to bring.
“Our findings are that, in just one year, hundreds of thousands of Californians are directly getting benefits under the new law,” according to Anthony Wright, executive director of Health Access California, which issued a report yesterday summarizing the impact of the federal Affordable Care Act on California.
Overlooked but Not Forgotten: Three Lesser-Known Reforms
The first anniversary of the federal health care law is drawing attention to its major changes. Here are three under-the-radar reforms that also will shape health care practice.
Suzanne Delbanco of Catalyst for Payment Reform Discusses Ideas on Paying for Care
Suzanne Delbanco, executive director of Catalyst for Payment Reform, spoke with California Healthline about a growing movement to improve the delivery of care by transforming health care payment structures across the U.S.
Making Budget Pill Easier To Swallow
If you were to say last week’s California State Legislature trailer bills on health care were pulling a large load, you might be accused of putting the cart before the horse. The cart, in this case, is orchestrating cuts and ways to preserve health care programs before voting on the final state budget, which — to carry the analogy — would be the horse.
Having been approved by both houses and ready for Gov. Jerry Brown’s (D) signature, the Senate and Assembly budget proposals include enough money for the state In-Home Supportive Services program to remain in operation, helping to keep aged, blind and disabled persons living at home instead of being institutionalized.
Part of the fiscal maneuvering to keep the program alive is a little-talked-about provision — the Medication Dispensing Pilot Project slated to launch July 1.
What About Docs’ Side of Drug Kickbacks?
Insurance Commissioner Dave Jones’ pursuit of a whistle-blower lawsuit against Bristol-Myers Squibb, which allegedly offered kickbacks to physicians to increase its drug sales in California, raises a related question: What about all those physicians — 15,000 gifts have been reported between 1999 and 2005 — who took the bait?
That bait includes sports tickets, expensive meals, all-expense paid trips and honoraria for speakers who sometimes didn’t even show up.
While a code of conduct for physicians is not written in stone, the American Medical Association’s policies usually hold weight with its members. In essence, AMA’s guidelines say that individual gifts of minimal value are permissible as long as the gifts are related to the physician’s work. We’re talking pens and notepads. No gifts should be accepted if there are strings attached, according to AMA. In other words, don’t accept gifts in return for prescribing a manufacturer’s drugs.
How Can California Exchange Minimize ‘Churning’?
We asked experts and stakeholders to suggest strategies in the building and operation of California’s new health insurance exchange that would minimize beneficiaries’ moving in and out of coverage — known as “churning.”
When California’s Managed Risk Medical Insurance Board decided to create a state-run, pre-existing condition insurance plan in October, 2010 instead of using the “federal fallback” program, it didn’t mean complete autonomy for California officials.
The high-risk insurance program is funded through 2013 by a $761 million allotment from the federal government and federal officials have some guidelines about how that money is spent.
To entice more enrollees, the federal HHS lowered premiums on the pre-existing condition plans in states using the federal fall-back program. HHS requested that all plans, including state-sponsored ones, create a new child-only age band, moving it from birth to 14-years-old to include children up to 18. Secondly, HHS reinterpreted the payment plans for subscribers in each of the nation’s PCIP — or pre-existing condition insurance plan — regions.
Blue Shield’s Rate Motives Explained
Could Blue Shield of California’s motivation for making an about face on its proposed May 1 rate increase have anything to do with California’s new Health Benefits Exchange, slated to launch in 2014?
Blue Shield officials say no.
However, whether intended or not, the decision probably won’t hurt the company’s relationship with the state’s Department of Insurance. Legislation creating California’s new exchange grants the state insurance commissioner authority to recommend insurers to the exchange based on the equity of their rate increases.
Blue Shield officials said retreating from the proposed rate hikes will allow the company to more freely address issues causing medical costs to rise.
Riverside County Working on Public Health Medical Home
The Riverside County Public Health Department is planning a patient-centered medical home system at its primary care clinics. Expected to increase efficiency and access, the new system will take about two years to install.