Latest California Healthline Stories
Timeline Delineates Duals Project Tasks
The state Department of Health Care Services has released a timeline of deadlines and target dates for its Coordinated Care Initiative, also known as the duals demonstration project.
Eventually, the duals project hopes to move about one million Californians dually eligible for Medi-Cal and Medicare benefits into Medi-Cal managed care plans. The idea, state officials have said, is to provide better, more integrated care by pooling the funding sources from two disparate programs. Coordinated care could provide stronger case management, offer needed services and save state and federal dollars.
The pilot program in eight counties, beginning in March, 2013, will serve about 700,000 of the state’s dual eligibles.
DHCS Rejects Judge’s Opinion on Adult Services Eligibility
An administrative law judge from the Department of Social Services issued an opinion that the Department of Health Care Services does not have the legal authority in two cases to deny eligibility for the Community Based Adult Services program. That opinion was rejected in an alternate decision issued Wednesday by DHCS director Toby Douglas.
The appeals process, contained at this point within the state Health and Human Services Agency, is overseen by DSS, which submits its findings to Douglas, who has final word on appeals decisions.
One of the two potential beneficiaries whose coverage was denied by the state provided California Healthline with the 10-page document containing the judge’s ruling and the state’s overruling of it.
Future of Health IT on Display at Gathering
The future of health care depends on the present of health information technology.
That was the take-home message yesterday, during the first day of a two-day conference on the progress and promise of health IT in California. The gathering is called “Connecting California to Improve Patient Care in 2012: Practical Solutions for Health Information Exchange and Quality Analytics.” That mouthful was nothing compared to the arcane and complex conversation during the first of a two-day conference in Rohnert Park. The conference concludes today.
“We are using data to improve people’s health care,” said Linette Scott, chief medical information officer for the state Department of Health Care Services. Scott said the success of state health care projects, like the duals demonstration project (also known as the Coordinated Care Initiative), for instance, depends on the successful development of information technology.
Moving ‘Almost a Million Children’ to Medi-Cal
The Managed Risk Medical Insurance Board, which oversees the state’s Healthy Families program, yesterday took a long look at the first outline of a plan to facilitate the state-ordered shift of an estimated 873,000 children enrolled in the HF program to Medi-Cal managed care.
The conclusion was, the current time frame to make such a big change is too tight, said Janette Casillas, executive director of MRMIB.
“In this transition, it is not just an administrative process to move almost a million children,” Casillas told the board yesterday. “Whenever a child is disenrolled [in the Healthy Families program], there are seven different IT transactions to make, for example. There are three separate transactions to update meds.”
Task Force Starts with Population Health
When you’re trying to take on reformation of the complex and arcane system of health care in California, where do you even begin?
At population health, apparently.
The state’s recently formed “Let’s Get Healthy California” task force convened yesterday for the first of four scheduled webinars. The meetings are part of the task force’s plan to eventually organize the unruly health care system in California by creating a priority list and action plan for what needs to be done, according to Diana Dooley, Secretary of Health and Human Services.
Appeal Decisions Due From DHCS
The Department of Health Care Services will issue a decision this week on the first “test case” appeal hearings to decide eligibility for the new Community-Based Adult Services program, according to DHCS officials.
The first appeal hearings were held May 30. After judges submit rulings to the state, the DHCS director has 30 days to decide whether or not the department accepts those rulings.
“We have received under 20 decisions [from judges] so far,” said Norman Williams, deputy director of public affairs for DHCS. “The first one was on or around June 18, and they’ve been on a flow basis since then.”
Important Bills on Horizon for CMA
The California Medical Association, which keeps an eye on all health-related legislation in California, last week released its “Hot List” of proposed health care bills in the next legislative session.
“Given that health care reform continues to be such a big concern, access to care for patients is going to be a big one,” said Molly Weedn, director of media relations for CMA. “And we’re looking at a lot of public health issues this year, like childhood obesity, for instance.”
There are 30 pieces of proposed legislation on this year’s Hot List, including nine bills sponsored by CMA.
Similar Procedures, Different Prices at California Hospitals
The cost of many hospital services varies widely across the state — with some facilities charging two or three times as much for a similar procedure, according to a report released yesterday by the California Public Interest Research Group.
Higher cost at one hospital doesn’t necessarily mean higher quality, according to Pedro Morillas, CalPIRG’s legislative director.
“Just because a specific hospital charges an arm and a leg doesn’t mean you’ll get better care there,” Morillas said. “Cost is not a corollary for better quality.”
Rural Clinics Hope DHCS Email Will Turn Tide in Medi-Cal Benefits Lawsuit
The Department of Health Care Services has been accused of withholding information in a court case — information that has the potential to change the reimbursement status of rural health centers and federally qualified health centers in California, according to court documents filed Monday in the U.S. Court of Appeals Ninth Circuit by the California Association of Rural Health Clinics.
Officials from DHCS could not comment on the lawsuit, according to Norman Williams, deputy director of public affairs for DHCS.
“As this matter is in active litigation, DHCS will provide its response to CARHC’s recent motion in an upcoming court filing,” Williams said.
Capitol Reacts to Budget, Reform Ruling
Health care issues took center stage in California for the past month — first, when budget pushback focused on health-related programs, and more recently, when the Supreme Court took a stand on legality of the federal health care reform law.
Here’s a taste of what California had to say about it all, culled from interviews, releases and a variety of media outlets: