Latest California Healthline Stories
States Hurting, But Outlook Still Bright
Economist James Glassman knew it sounded funny. While he was speaking at the annual Health Care Forecast Conference at UC Irvine last week, the California Legislature was in the process of cutting another $12 billion out of its budget — half of that from health-related programs.
But the current bad news in health care and gloomy economic prognostications will not continue, he said.
“In my mind,” Glassman said, “you have to balance what you’re hearing with what’s happening in the market. If it really was so dire, for instance, the bond market would be a disaster.”
Two Health IT Groups Join Forces
It seems like a natural fit. Cal eConnect was formed to promote and coordinate electronic health record use in California, and the California E-Prescribing Consortium (CaleRx) is trying to get providers to electronically connect with pharmacists.
Those two processes are inextricably linked, keeping EHRs and prescribing electronically. It’s all in the name of reshaping the health care delivery system, and providing better care at a lower cost.
Yesterday was the first time the two groups officially established an ongoing collaboration, in a joint workgroup meeting. How exactly that collaboration will develop is still being discussed, but everyone seemed to agree on one thing: It’s a good idea to join forces.
Will California Keep Adult Day Health?
Senior advocates are hoping a hearing at the end of last week was a turning point for the Adult Day Health Care program. It is slated to be eliminated as part of Governor Brown’s proposed budget — but since one committee recommended keeping it while another committee urged its elimination, the fate of the ADHC program has come down to the joint conference committee.
The committee is scheduled to meet every day this week to work out all budget discrepancies, including a decision on what to do with the ADHC program. But it was the meeting at the end of last week that gave a flare of hope to advocates.
“By the time I went home that day, I had the first sense of some hope,” Lydia Missaelides of the California Association for Adult Day Services said. “And that’s all I can ask for right now.”
Seniors Make Statewide Effort To Rescue Adult Day Services
It’s a big week for the Adult Day Health Care program. A budget subcommittee in the Senate recently recommended shutting it down, while an Assembly subcommittee suggested keeping an amended version of it.
The joint Budget Conference Committee discussing that discrepancy got a little more input than expected yesterday.
Gov. Jerry Brown (D) made an appearance at the start of the hearing. His message was vigorous and straightforward:
$500 Million in Medicare Underpayments in California?
A California attorney has filed a class action lawsuit, saying that Medicare knowingly underpaid physicians in 10 counties in California, as well as dozens of counties in 32 other states. The suit alleges $500 million in underpayments in California, and a total of $3.2 billion throughout the nation.
“Medicare has acknowledged that certain counties are being underpaid, according to standards they set back in 1996,” according to attorney Dario de Ghetaldi, of the Corey, Luzaich, Pliska, de Ghetaldi & Nastari law firm. “It’s a problem they’ve created, and it’s a problem they’ve allowed to continue to exist.”
San Diego County physicians lead the nation in Medicare underpayment, Ghetaldi said.
More Seniors Means Greater Elder Abuse
Assembly member Mariko Yamada (D-Davis) cited an interesting statistic during a legislative session on elder abuse yesterday: “We have 10,000 people a day who are turning 65 in this country,” Yamada said.
California has a higher percentage of seniors than other states, she said. “So,” she added, “that means the silver tsunami is here.”
With the increasing numbers of seniors comes an equally increasing need to do something about elder abuse, Assembly member Tom Ammiano (D-San Francisco) said.
Future Uncertain for Adult Day Health Care Services
The verdict is in, and it looks like almost all proposed health services budget cuts have been approved by the budget subcommittees. The biggest dun came at Medi-Cal’s expense — it was cut by $1.5 billion, primarily from lowering the provider reimbursement rate for Medi-Cal by 10%, and by raising rates for patient co-payments.
The largest elements of the new budget plan also call for $1.2 billion to be axed from CalWorks, primarily by shortening the length of time people can be eligible for it, and shifting $1 billion of Prop. 10 money to Medi-Cal.
But one major piece of the health cuts remains undecided.
Physicians Are Insurance Consumers, Too
Since taking office less than two months ago, Insurance Commissioner Dave Jones has made it clear he wants to protect consumers from insurers — and he made moves to get the authority to curb excessive insurance rate hikes and enforce new federal medical loss ratios.
Jones still doesn’t have the rate-regulation authority he said the California Department of Insurance needs, but he does have the enforcement power to go after insurers who don’t meet medical loss ratio standards.
Now Jones’ office is targeting a new type of insurance: medical malpractice.
Every two years, the UCLA Center for Health Policy Research conducts an extensive survey — with a county-by-county breakdown of income, ethnicity and health indicators of Californians.
The California Health Interview Survey (CHIS) is the nation’s largest state survey. Yesterday, the center released its 2009 data, one day after issuing its first policy brief on the data, which looked at the recent rise in how many people will be eligible for Medi-Cal and under national health care reform.
That kind of information is vital in crafting the state’s health policies, according to E. Richard Brown, director of UCLA’s CHPR.
About 3 Million New Medi-Cal Enrollees?
The number of Californians who will be eligible to participate in the federal health care coverage expansion in 2014 is higher than previously thought, according to a new study from the UCLA Center for Health Policy Research, based on data from the 2009 California Health Interview Survey.
About 4.7 million people will be eligible for the new coverage options, and about 3 million of those people qualify for Medi-Cal, according to Shana Alex Lavarreda, lead author of the UCLA policy brief.
“We were surprised by the number of people eligible for Medi-Cal, about 3 million, under the federal expansion,” Lavarreda said.