Latest California Healthline Stories
State Laying Foundation for Duals Conversion
The state’s Department of Health Care Services released a series of draft papers this week, outlining some of the concerns and aims of its planned conversion program, which will eventually offer managed care choices to dual eligibles — those Californians who are eligible to receive both Medi-Cal and Medicare benefits.
The latest paper, released yesterday and expected to be posted on the DHCS website today, looks at the possible scope of that transition and finds it could include many more than the 150,000 people originally estimated for the conversion program.
“There are 370,000 duals in Los Angeles County alone,” according to Peter Harbage of Harbage Consulting, who worked on the papers. “There are another 250,000 in the next four largest counties. The paper opens the conversation on that point, as well as on other key issues.”
Extra Year of Operation for PCIP?
A big topic at yesterday’s meeting of the Managed Risk Medical Insurance Board (MRMIB) was the agency’s interaction with the state’s Health Benefit Exchange.
Programs MRMIB administers will eventually disappear, absorbed by the introduction of health care reform and the Exchange in 2014. That is fine with the board members at MRMIB, but they gently raised the idea yesterday that programs such as the Pre-existing Condition Insurance Plan might be continued for a year.
“This population will migrate to the Exchange, and that’s what we want,” board member Richard Figueroa said. “But also, we do have some things to offer, in terms of what we’ve learned about running a transparent process, the single rules engine, and how to get people into these programs and keep them there.”
Getting Business Involved in Health Discussion
Big decisions are being made in health care, many of them affecting California businesses, but the business community won’t have much say in those decisions if leaders don’t step up and participate in defining the future of the health care landscape.
That’s one of the points in a report due out today from the Bay Area Council. The report, “Road Map to a High Value Health System,” analyzes the sources of rising health care costs in California and outlines choices to lower those costs.
“The broader business community and organizations representing the business community have run the gamut from hostile to disengaged,” according to report author Micah Weinberg. “Our message is, if we don’t participate in this process, we’re going to get something we don’t like. So we wanted to make sure businesses get involved.”
Many Opt Out of State’s ADHC Plan
In August, a letter and application packet went out to about 26,000 people in the adult day health care system, a program slated for elimination as a Medi-Cal benefit on Dec. 1.
Beneficiaries were asked to choose between three options: They could sign up for one of the managed care options; they could send in a form to opt out of those plans; or they could do nothing, and would be automatically enrolled.
The results are in: Of those 26,068 patients, 654 chose a managed care plan, and another 10,297 people did nothing and were automatically enrolled in a managed care plan. The majority — 15,117 people — chose to remain in their fee-for-service plans.
Health Care Reform for Small Businesses
The number one key to success for small businesses in the state’s Health Benefit Exchange is choice, according to several presenters at a panel discussion last week in Sacramento.
“You have to have choice, that’s the big thing,” Bill Wehrle of Kaiser Permanente said. “If you don’t have choice, people won’t sign up.”
Wehrle was part of a forum addressing the needs of small businesses in California, and what the state’s exchange needs to do to woo both small-business owners and their employees.
WIC Program May Drop 110,000 in California
The federal government is preparing to cut $1.5 trillion over 10 years from its budget. Under some proposals or in the event automatic reductions are triggered if no compromise solution is reached, cuts could affect health care services for low-income individuals.
Reductions in the U.S. Department of Agriculture’s Women, Infants and Children program would mean fewer services for California kids, according to Laurie True, executive director of the California WIC Association.
“We would have to take people off the program,” True said. “We haven’t had to take people off this program for many, many years and we think it’s unacceptable.”
State Appeals Ruling on Disability Funding
In May, a federal judge issued an injunction to halt the state’s freeze on funding for programs for the developmentally disabled.
Yesterday, California attorneys were back in court, this time at the 9th Circuit U.S. Court of Appeals in Pasadena, to ask that the May decision be overturned.
Craig Cannizzo, who argued the case on behalf of individuals with developmental disabilities, said this case has far-reaching implications because the state did not get permission from CMS for the rate freeze.
Legislative Hearing Frames Looming Impact of Federal Cuts
Edwin Park was not exactly a ray of sunshine.
The policy expert from Washington, D.C., testified recently at an Assembly budget subcommittee hearing in Sacramento on the effects of impending federal budget cuts to California.
“The major Medicaid proposals [being considered] would substantially shift cost to the states,” Park said. “Some Medicare savings would also shift cost to the states. And states like California will have to compensate for these cuts.”
Health Reform, LGBT, Telehealth Bills Signed
More than two dozen bills directly related to health care were signed into law over the weekend by Gov. Jerry Brown (D).
Despite some initial opposition from the Health Benefit Exchange board, the governor signed AB 1296 by Susan Bonilla (D-Martinez), a measure that creates the Health Care Reform Eligibility, Enrollment and Retention Planning Act. It requires state Health and Human Services officials to set up standardized forms and procedures to apply for or renew eligibility and enrollment in state subsidy programs.
It’s part of the no-wrong-door approach to streamline enrollment in Medi-Cal, the Health Benefit Exchange and other state assistance programs.
Process Opens To Get Federal EHR Incentive Money
For Raul Ramirez, it has been a long time coming.
“This is a big day for providers, for the state. This is a big day for California,” Ramirez said.
Ramirez, chief of the Department of Health Care Services’ Office of Health Information Technology, was talking about this week’s initial processing of applications for up to $1.4 billion in federal funds for the state’s electronic health record incentive program.