Latest California Healthline Stories
Insurers Must Pay Rebates, Cover Women’s Services
Nearly two million California consumers and small business owners will get money back on their health insurance premiums this month because of new federal and state statutes requiring insurers to use at least 80% of their premium dollars for patient care. For employers with more than 51 covered employers, the threshold is 85%. Insurers will return almost $74 million in California.
Another Affordable Care Act requirement goes into effect today ensuring women receive eight types of preventive and diagnostic care in their health coverage, including breastfeeding support services.
The California rebate average of about $65 per person might not be much individually, but it could mean quite a bit to small-business employers, according to Anthony Wright, executive director of Health Access California.
Diane Meier of the Center to Advance Palliative Care Talks About Treating Critically Ill Patients
In part two of a two-part report, Diane Meier — professor of geriatrics and palliative medicine at Mount Sinai School of Medicine and director of the Center to Advance Palliative Care — spoke with California Healthline about how her experience treating critically ill patients led her to become an advocate for palliative care and other approaches that focus on the needs of patients and families.
Breaking Down the Three Health Reforms Taking Effect Today
Defenders of the Affordable Care Act can point to a pair of reforms taking effect today that offer immediate benefits. Meanwhile, Oregon moves forward with its own transformative health care pilot.
DHCS Director Douglas Rejects Another Judicial Decision
Toby Douglas, director of the Department of Health Care Services, has rejected another proposed decision by an administrative law judge over an appeal of eligibility for the Community Based Adult Services program. According to stakeholders, it is the first rejection based on eligibility criteria.
Douglas earlier had rejected — or “alternated” as it’s known in the appeals system — two other proposed decisions based on the legal question of whether the department had the right to reverse face-to-face assessments of eligibility by nurses. After a Department of Social Services administrative law judge issued a proposed decision that DHCS did not have that right, Douglas disagreed, and rejected those proposed decisions.
In a more recent case, Douglas rejected an appeal based not just on the singular legal question but on the merits of the individual case, according to Elissa Gershon, a Disability Rights California attorney.
Access, Clinic Finances, ED Overuse All Major Concerns for CMA
With health care reform and the state’s cutbacks and reorganization of its health care system, the practice of medicine in California is about to undergo major changes. California Medical Association officials have serious concerns about some of those changes.
“Yes, we are in a budget crunch, and yes, money is tight,” said Doug Brosnan, an emergency department physician and a member of the CMA’s board of trustees. “But there is suffering. Patients are suffering because they lack access to basic services.”
Brosnan was part of a group of CMA officials who met with reporters on Friday in Sacramento to talk about California’s recent spate of budget cuts to health programs and the outlook for reform after the Supreme Court’s decision to uphold most of the Affordable Care Act. CMA officials said they are concerned about the state’s efforts to reorganize existing services — such as the duals demonstration project, or the shift of 873,000 children from the Healthy Families program to Medi-Cal managed care.
Reform Talk Moving From Rhetoric to Bottom Line in Business Community
A new report based on a statewide “listening tour” indicates small business owners in the state are eager to move beyond political and legal wrangling and start figuring out what health reform will mean for the bottom line.
Governor Signs Veteran-Benefit Bill
It was a bill that had no organized opposition, and passed through every committee without a single “nay” vote.
The governor added his approval Tuesday to that overwhelming support, signing AB 1869 by Assembly Speaker John Pérez (D-Los Angeles) into law.
The legislation affects approximately 130,000 veterans who remain uninsured despite possibly being eligible for federal Veterans Affairs health benefits, according to a Senate analysis of California Health Interview Survey data compiled by UCLA.
‘Where You Live Matters’ to Your Health
Health care numbers are interesting to Angela Russell but they only become important when you remember what they represent, Russell said.
“Data rankings are a starting point, not an endpoint, and the key is using that information to take action,” Russell said. “You have to remember, this data is alive. It represents families and individuals and communities.”
Russell is the engagement lead for the County Health Rankings and Roadmaps program at the University of Wisconsin Population Health Institute. Yesterday, she was in the Capitol Building to talk about using federal and state health care data to make policy changes at the local level. The event was part of a California Health Policy Forum briefing called: “Health Rankings for Communities Across California: Using Data To Improve Population Health.” The event was funded in part by California HealthCare Foundation, which publishes California Healthline.
Direct Messaging Called Major Advance in State’s HIE Effort
The health information technology community got a chance to see direct messaging — a new way to move information between providers who use different electronic health record systems — in action last week at a two-day conference.
Diane Meier of the Center to Advance Palliative Care Talks About Goals of Treatment Approach
In part one of a two-part report, Diane Meier — professor of geriatrics and palliative medicine at Mt. Sinai School of Medicine and director of the Center to Advance Palliative Care — spoke with California Healthline about the definition of palliative medicine and how it encompasses more than hospice care.