Latest California Healthline Stories
CMS Meets Deadline for Approving Healthy Families Transition
Tight up against the end-of-year deadline, CMS officials on Dec. 31 granted approval of California’s plan to move 860,000 Healthy Families children into Medi-Cal managed care programs.
Federal officials asked for changes to the transition plan, including more frequent monitoring and evaluation of the transition to better ensure children are able to access primary care physicians under the new plan.
The first phase of the transition started Tuesday, Jan. 1.
San Diego Diabetes Program Working, Gaining Attention
Community-based diabetes treatment using low-cost, culturally focused interventions can lead to effective disease management, according to a series of studies of a long-running San Diego program. Project Dulce’s success and alignment with larger goals of the Affordable Care Act have attracted attention around the country.
Sonoma Center Facing State Sanctions
The California Department of Public Health took a major step this week toward decertifying and revoking the license of the intermediate care facility at Sonoma Developmental Center.
The Sonoma facility, which serves 290 people with intellectual disabilities, is expected to appeal the state action.
The original survey in July by the Department of Public Health found 57 deficiencies, and four instances of immediate jeopardy to residents. The facility had two three-month periods to correct those problems. According to CDPH officials, time is up.
State Plans Retroactive Payment Rate Hikes
The good news for primary care physicians is the federal program to raise Medicaid reimbursement rates starts Jan. 1.
The bad news is Medi-Cal providers in California may have to wait several months to retroactively receive the higher payment.
California health officials have to wait for federal approval of a state plan amendment, which will take time, said Norman Williams, deputy director of public affairs for the Department of Health Care Services.
Setting Priorities in Health Care Special Session and Beyond
We asked lawmakers and stakeholders to use post-election perspective to define priorities for both the state Legislature’s special session on health care next month and the legislative session that follows.
Healthy Families Set for January Transition
State health officials have made it clear that the first phase of the Healthy Families transition to Medi-Cal managed care will go on as scheduled, beginning Jan. 1. Children’s health advocates say they will do everything to support that effort while still keeping a careful eye on its progress.
The first phase of the transition will move about 415,000 children into Medi-Cal — almost half the 860,000 children enrolled in Healthy Families. The transition is dependent on federal approval by CMS within three weeks.
“We have said consistently that the state isn’t quite ready yet,” said Wendy Lazarus, the founder and co-president of The Children’s Partnership, a national not-for-profit children’s advocacy group based in Santa Monica. “So, yes, it would be good if CMS reached the same conclusion.”
California Hospitals Team Up on Disaster Plans, but Federal Budget Cuts Could Affect Efforts
Cheri Hummel of the California Hospital Association, Kurt Kainsinger of UCLA Healthcare System, Claudia Marroquin-Frometa of Centinela Hospital Medical Center and Lisa Schoenthal of the California Emergency Medical Services Authority spoke with California Healthline about how California hospitals are forming partnerships to strengthen their disaster preparedness plans.
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.”