Latest California Healthline Stories
Cal eConnect Set to Absorb CaleRx Consortium
The proposed marshalling of e-forces between Cal eConnect and the CaleRx Consortium has moved forward, and after yesterday’s meeting of Cal eConnect’s advisory group, it looks even more likely that some kind of merger will take place.
“E-prescribing is one of the high priorities for us,” Mark Elson of Cal eConnect said. “We’ve been in discussion with the California E-Prescribing Consortium about consolidating our activities in e-prescribing, and that discussion has been positive. We are now in a position to basically adopt the E-Prescribing Consortium into Cal eConnect.”
Elson said it will soon be presented to the eConnect board, though probably not in time for its next board meeting on Friday. CaleRx members meet on Tuesday.
Dozens of Bills Down, Dozens To Go
There will be cake.
That’s the celebratory reaction from health care advocates and many legislators in Sacramento — and literally, there will be a large table of cake at a community center in Sacramento today, where lawmakers and policy professionals will gather to toast what the national health care reform law has already brought to California, and what it’s about to bring.
“Our findings are that, in just one year, hundreds of thousands of Californians are directly getting benefits under the new law,” according to Anthony Wright, executive director of Health Access California, which issued a report yesterday summarizing the impact of the federal Affordable Care Act on California.
Making Budget Pill Easier To Swallow
If you were to say last week’s California State Legislature trailer bills on health care were pulling a large load, you might be accused of putting the cart before the horse. The cart, in this case, is orchestrating cuts and ways to preserve health care programs before voting on the final state budget, which — to carry the analogy — would be the horse.
Having been approved by both houses and ready for Gov. Jerry Brown’s (D) signature, the Senate and Assembly budget proposals include enough money for the state In-Home Supportive Services program to remain in operation, helping to keep aged, blind and disabled persons living at home instead of being institutionalized.
Part of the fiscal maneuvering to keep the program alive is a little-talked-about provision — the Medication Dispensing Pilot Project slated to launch July 1.
What About Docs’ Side of Drug Kickbacks?
Insurance Commissioner Dave Jones’ pursuit of a whistle-blower lawsuit against Bristol-Myers Squibb, which allegedly offered kickbacks to physicians to increase its drug sales in California, raises a related question: What about all those physicians — 15,000 gifts have been reported between 1999 and 2005 — who took the bait?
That bait includes sports tickets, expensive meals, all-expense paid trips and honoraria for speakers who sometimes didn’t even show up.
While a code of conduct for physicians is not written in stone, the American Medical Association’s policies usually hold weight with its members. In essence, AMA’s guidelines say that individual gifts of minimal value are permissible as long as the gifts are related to the physician’s work. We’re talking pens and notepads. No gifts should be accepted if there are strings attached, according to AMA. In other words, don’t accept gifts in return for prescribing a manufacturer’s drugs.
When California’s Managed Risk Medical Insurance Board decided to create a state-run, pre-existing condition insurance plan in October, 2010 instead of using the “federal fallback” program, it didn’t mean complete autonomy for California officials.
The high-risk insurance program is funded through 2013 by a $761 million allotment from the federal government and federal officials have some guidelines about how that money is spent.
To entice more enrollees, the federal HHS lowered premiums on the pre-existing condition plans in states using the federal fall-back program. HHS requested that all plans, including state-sponsored ones, create a new child-only age band, moving it from birth to 14-years-old to include children up to 18. Secondly, HHS reinterpreted the payment plans for subscribers in each of the nation’s PCIP — or pre-existing condition insurance plan — regions.
Blue Shield’s Rate Motives Explained
Could Blue Shield of California’s motivation for making an about face on its proposed May 1 rate increase have anything to do with California’s new Health Benefits Exchange, slated to launch in 2014?
Blue Shield officials say no.
However, whether intended or not, the decision probably won’t hurt the company’s relationship with the state’s Department of Insurance. Legislation creating California’s new exchange grants the state insurance commissioner authority to recommend insurers to the exchange based on the equity of their rate increases.
Blue Shield officials said retreating from the proposed rate hikes will allow the company to more freely address issues causing medical costs to rise.
Fearer Ready To Get To Work on Benefit Exchange Board
Paul Fearer, senior executive vice president and director of human resources for Union Bank in San Francisco, brings a rich background in health care purchasing to the penultimate seat on the California Health Benefit Exchange board. Now he and his three colleagues are waiting for the fifth and final appointee so the board can set policy in motion in preparation for the exchange’s start-up in 2014.
He joins California Health and Human Services Secretary Diana Dooley, former California HHS Secretary Kim Belshé and former Schwarzenegger administration chief of staff Susan Kennedy on the exchange board.
“We may look at different ways to reach solutions, but we are aligned in our mission to achieve affordable, quality and accessible health care,” Fearer said.
Regional Meetings Focus on Work Force Shortages
By the time the California Office of Statewide Health Planning and Development completes a series of regional focus groups, it should have a good handle on creating a robust health care work force. The 10th meeting is scheduled this week in Ontario.
Regional leaders have been charged with offering suggestions on training, recruiting and retaining quality health care workers, while buttressing the impact of reform.
The Patient Protection and Affordable Care Act is bolstering efforts to increase the work force through a variety of provisions addressing the primary care system.
Mental Health Comes Up $1.4 Billion Short
According to a study just released by National Alliance on Mental Illness, California spent $587 million fewer dollars on mental health services than it did two years ago.
Add in the $861 million in redirection of Prop. 63 funds in the proposed new budget, and you’re looking at a total loss of roughly $1.4 billion in mental health funding. But losses can be dealt with, as long as they’re not perpetual budget drains, according to Pat Ryan, executive director of the California Mental Health Directors Association.
“It’s very scary,” Ryan said. “We have pointed out, the amount of money they’re estimating to pay for services [in the new budget restructuring] is already starting out less than we know it costs to provide those services.”
It Pays To Adopt Electronic Health Records
Providers throughout California are about to get a significant amount of help in establishing their electronic health record systems, according to Raul Ramirez, chief of the state’s Office of Health IT.
“Our hope is to launch the incentive program on April 1,” he said. “We’ve been in contact with CMS (federal Centers for Medicare and Medicaid Services), and we expect feedback any time now.”
If the launch goes as planned, providers could start seeing incentive payments starting in May, Ramirez said.