Latest California Healthline Stories
Groups Calling for Pause in Transition
Children’s advocates last week called for a pause in the transition of kids from the Healthy Families program to Medi-Cal managed care. At a legislative hearing Thursday, advocates said the state had promised a relatively seamless transition of 860,000 children to managed care, but that gaps in coverage have already occurred — with the more-difficult phases of the transition yet to come.
The outcry was prompted, in part, when the families of an estimated 207 children who were receiving autism services through the Healthy Families program recently were told their coverage had to be stopped because of the state’s Healthy Families transition.
“From the beginning, we’ve heard assurances that there would be no loss in coverage for children, but we’re seeing it now,” said Serena Kirk, senior policy associate at Children’s Defense Fund California. She said the state’s monitoring effort isn’t working as well as it should be because it didn’t deal with the problems of these 200 families until they’d already been refused services.
Palliative Care Key Part of Berkeley Forum’s Prescription
Heath care organizations in Northern California are in step with a recent report from the Berkeley Forum suggesting that improvements in palliative care could help California save $110 billion over the next decade.
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.
Should Calif. Set Charity Minimum for Not-for-Profit Hospitals?
We asked legislators, stakeholders and consumer advocates to weigh in on a bill before the state Legislature calling for the state to establish a minimum amount of charity care for private, tax-exempt not-for-profit hospitals.
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.”
Immigrant Health Care: Many Not Eligible for Medicaid Expansion
A study finds that a significant portion of low-income individuals in states like California and Texas would not be helped by a potential Medicaid expansion because of their immigration status. The states are assessing other avenues of coverage.
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.
Changes Set Stage for ‘Shakeout’ of Medical Suppliers, Services
Experts predict changes in contracting practices might shrink the number of businesses supplying medical products and services in California by as much as 50% over the next few years.