Latest California Healthline Stories
Promise, Peril of Duals Program
Advocates see potential for improvement but also are concerned about consumer protections in the transition of roughly 1.1 million Californians into Medi-Cal managed care. The state is launching a managed care pilot project for beneficiaries who are dually eligible for Medicare and Medi-Cal, California’s Medicaid program.
“This is really a critical moment in time for dual-eligibles and represents an amazing time to improve care for duals,” said Kevin Prindiville, deputy director of the National Senior Citizens Law Center office in Oakland. “But it’s also a time to be very careful and cautious about how we proceed to move forward.”
Prindiville, one of several speakers at an informational forum last month, said California is still negotiating with CMS officials, so some of the details of the plan are still uncertain.
California Cities Gear Up To Vote on Ballot Initiatives To Tax Sugar-Sweetened Beverages
El Monte Planning Commissioner Art Barrios, Chuck Finnie of the Community Coalition Against Beverage Taxes, El Monte Mayor Andre Quintero and Richmond City Council member Jeff Ritterman spoke with California Healthline about local ballot measures that tax sugar-sweetened beverages.
The Calif. Pilot That Could Prove ACOs Work
After several years of anticipation, early-stage accountable care organizations are beginning to report initial results. Leaders of a Sacramento-based pilot say they have demonstrated clear savings — and the model is replicable.
Oversight Commission: ‘Descriptions Incomplete’
A state oversight commission found little to no substance in reports of programmatic misconduct in its initial report released yesterday on concerns raised over compliance with Mental Health Services Act program in California.
“Basically, in the programs that were mentioned, the descriptions of those programs were incomplete,” said Jennifer Whitney, chief of communications for the Mental Health Services Oversight and Accountability Commission. “And that painted a very different picture of the programs.”
Several recent news reports questioned 13 different programmatic elements that supposedly used MHSA funds for such things as yoga classes and a sweat lodge.
Tuberculosis Added to Screening List
Legislators have worked on a number of bills this session related to immunizations. On Friday, Gov. Jerry Brown (D) signed one of them into law.
SB 659 by state Sen. Gloria Negrete McLeod (D-Chino) requires tuberculosis screening to be included on the state’s immunization registry. That will help health officials coordinate TB immunization efforts, Negrete McLeod said, because parents now won’t need to prove immunization with their yellow-card record.
“By allowing these results to be included in the state registry,” she said, “parents will have an easier time demonstrating compliance with the requirements of local school districts.”
Pilot Program Helps Kids With Severe Diagnoses, Saves Money
A UCLA study showed a high level of patient and family satisfaction with a pilot program that takes a palliative approach to care for children with severe illnesses. The program also produced significant savings for the state, according to the study.
$4.6 Million Grant for Consumer Assistance
The Department of Managed Health Care recently received a $4.6 million federal grant to fund its consumer assistance program to help answer questions from California consumers about health coverage.
“This will enable us to reach and assist more Californians who are struggling with health coverage questions,” said Marta Green, deputy director for communications and planning at DMHC.
“The focus of the grant is on consumer assistance for Californians,” Green said, “and in particular to help seniors and people with disabilities, who have more specific needs.”
To get an idea of why health care reform is so important, said Pam Kehaly, president of Anthem Blue Cross, you have to understand how much it costs.
“The issue today is how to restrain the rising cost of health care while delivering high-quality care,” Kehaly said at a policy roundtable discussion in Sacramento yesterday. “Last year, that was a $2.7 trillion expenditure. We throw these numbers around, but it’s hard to understand the magnitude of what we’re talking about. But if you sat at your dining room table tomorrow morning and turned over dollar bills, one after the other, it would take you 92 years to reach $2.7 trillion.”
Or put another way, Kehaly said, the cost of health care is about $8,400 for every American every year. “That means, for a family of four, it’s pretty much like buying a new car every year,” Kehaly said. “The amount of the economy of France — that is, how much France and the French people spend on everything — that’s how much we spend on health care.”
Primary Care Direct Model: ‘Neither Insurance nor Health Plan’
Accessible, high-quality primary care is a mantra of the Affordable Care Act, which promotes the development of patient-centered medical homes and accountable care organizations. A new direct primary care model attempting to deliver all of those things is being vetted in California, albeit slowly.
California First State to Get Funding for Seniors, Disabled Program
Federal health care reform includes a state plan option to provide home- and community-based services designed to keep seniors and persons with disabilities living at and keep them out of institutional care. States taking up that option receive a 6% increase in federal matching payments.
Yesterday, California received federal approval to change its State Plan Amendment, opening the door to begin claiming Community First Choice federal funding.
The change is worth $573 million to California over two years, according to state officials.