Latest California Healthline Stories
Five Things To Watch in Health Care in 2013
If 2012 was a high-wire political act, and 2014 will bring a rush of implementation, will next year be an intermission or sprint for health care? Here are five indicators to watch in the coming months.
Time Running Out To Opt Back In to Adult Day Program
About 4,400 frail and elderly Californians who qualified for Community Based Adult Services opted out of the managed care program to remain in traditional fee-for-service care. Less than three weeks remain for them to change their minds.
On Dec. 31, the state Easy-Way-Back program will close, and those “opt-outs” who declined Medi-Cal managed care will officially forfeit their CBAS benefits, according to Norman Williams, director of public affairs for the Department of Health Care Services.
The opt-outs — or the providers who are advising them to opt out — may be operating on false assumptions, Williams said in a written statement.
Forum Explores Dealing with Chronic Care Under ACA
Chronic health conditions remain one of the contributing factors to financial and utilization strain on the health care system, and there are a number of steps that can be taken to address them, according to a panel of experts that met recently in San Jose.
The forum, called “Chronic Disease: A Common Sense Approach to Solving Complex Health Issues,” was held Nov. 27 and hosted by the Partnership to Fight Chronic Disease. The moderator, Ken Thorpe, chairman of the partnership, said dealing with chronic conditions may be the most important health care concern of our time.
“We all know the prevalence of obesity has doubled since the early 1980s, and that doubling of obesity accounts for about 10% of health costs in this country,” Thorpe said. “Because the rise in prevalence of obesity has contributed to the rise in diabetes, as well as hyperlipidemia, hypertension and other related chronic health conditions.”
Northern California Addresses Safety-Net Challenges
Anticipating an influx of newly insured residents in 2014 when the Affordable Care Act fully takes effect, Northern California clinics are recruiting new primary care physicians and considering how to best use mid-level providers.
Call for MLR Regulation Gets Mixed Reaction
The Commonwealth Fund on Wednesday released a study on the federal medical-loss ratio rule, which concluded that regulation may need to be introduced to maximize the effect of the MLR.
“In future years, the MLR rule may need to be coupled with regulatory pressure in order for any further reductions in administrative costs to be reflected in reduced premium rates,” the study said.
That squares with the opinion from the state insurance commissioner, but the medical insurance industry does not agree.
Duals Project Edges Closer to Completion
More than 300 people attended a Department of Health Care Services seminar yesterday offering details of the duals demonstration project, also known as the Coordinated Care Initiative.
The department recently released several reports, including a draft of the care coordination and long-term services and supports readiness standards. Those guidelines are a big step toward the state’s readiness plan it eventually will need to submit to CMS, said Jane Ogle, deputy director of DHCS, at yesterday’s seminar.
The state released a summary of some of the significant details in the reports:
Report Urges Exchanges To Help Consumers Make Right Choices
When Covered California opens for business in 2014, one of the first and most important tasks will be to get people to sign up for the right coverage — a simple but crucial step in making the health benefit exchange a success, according to a new report released this week.
At-Home Nursing Services Rules Challenged
A lawsuit filed yesterday urges state health officials to alter California’s limit on adult at-home nursing services.
The limit doesn’t make sense, the Disability Rights California lawsuit said, because a higher limit would allow some beneficiaries to remain home, which would cost the state less than the price of institutionalization.
DHCS officials said the department has a policy of not commenting on pending litigation.
Will Firms Cut Jobs — or Benefits — Under ACA? Weighing the Evidence
Questions continue to swirl about the Affordable Care Act’s effect on employment and health coverage, with critics suggesting that the law will lead to more part-time hiring and supporters arguing that the concerns are overblown.
How Will Consumers Choose Exchange Coverage?
The Pacific Business Group on Health yesterday released the third and final installment of its comprehensive report on how to ensure that the people joining a health benefit exchange end up with the plan that works best for them.
“The whole notion of the Affordable Care Act and the establishment of the exchange is to improve the overall health care marketplace,” said Ted von Glahn, a senior director at PBGH, a not-for-profit business coalition focused on health care issues.
“If you don’t get it right when people are making those choices,” von Glahn said, “that would defeat the whole purpose of it.”