Latest California Healthline Stories
Medi-Cal Reimbursement Tops Policy List
The California Medical Association gathered in Sacramento last weekend, and the new CMA president came up with his own variation on the real estate agent motto:
It’s about funding, funding, funding.
“We would like to see physicians be able to maintain a viable practice, first and foremost,” new CMA president James Hinsdale said. “Physicians are being squeezed by Medicare, and squeezed by Medicaid [and by California’s Medicaid program, Medi-Cal].”
Spotting a Unicorn: ACOs Inch Closer to Reality
More health care providers are entering into arrangements to create “accountable care organizations,” but these emerging alliances face legal questions because regulators have yet to define ACOs. Potential answers, and several milestones, lie ahead for the model.
Post-Mortem on Physician Hiring Bills
A pilot program that has allowed some direct hiring of physicians in rural areas of California apparently generated a lot of interest in Sacramento. Three different bills were introduced to expand the scope of that pilot program, and all three of those bills failed.
In California, hospitals are not allowed to employ physicians directly, in order to maintain a kind of firewall between hospital administrators and the health care providers who make medical decisions.
But there is also a shortage of primary care physicians in rural areas of the state, so some medical centers were granted an exception to the no-direct-hiring rule, so that they could hire on their own doctor for their own facility. Many hospital administrators felt that suspension of the rule gave them a competitive hiring advantage.
Fresno Clinic May Help Prevent Physician Burnout
The Tzu Chi clinic in Fresno, where the goal is to “treat the poor and teach the rich,” helps rejuvenate volunteer physicians, who say prolonged visits with patients remind them why they “got into medicine.”
Doc Shortage Made Worse by Low Participation in Medi-Cal
California faces two related problems about to get worse: not enough family practice physicians and not enough physicians treating Medi-Cal patients. We asked stakeholders how California should deal with these two shortages.
The Decision Turf Between Care Providers and Patients
There has been a shift in medicine toward involving patients more in decisions about their own health. In an article in today’s Journal of the American Medical Association, a California physician explains how that outwardly time-consuming process could not only make patients happier with their care, but might actually save time for care providers.
Time is short for physicians, especially these days. And that’s one of the reasons the patient-doctor dynamic shifted from one extreme to another, according to Alexander Kon, who has been a pediatric intensive care physician at UC Davis (though he is soon taking his talents to San Diego, to the Naval Medical Center there).
About two decades ago, Kon said, many physicians embraced a new model of care, where the doctor provides information and leaves the final decision about treatment options up to the patient. Which is both good and bad, he said.
Primary Docs Centerpiece of Reform, but Where Are They?
Health care reform may help alleviate shortage of primary care physicians, but it will take major shifts in medical training and procedures, experts say.
Recruiting, Training More Health Care Workers
There is a dearth of health care providers in California, and the demand for more highly skilled health workers will only increase when national health care reform goes into effect. That’s the word from Tom Riley, legislative advocate for the California Academy of Family Physicians, speaking at a Senate Health Committee hearing last week.
“We think the time has come for this to be front and center in the health care debate, the workforce issue,” Riley said. “This is a terribly important thing for us to be addressing.”
The proposed law, AB 2551 by Assembly member Ed Hernandez (D-West Covina), would establish the Health Workforce Development Council, a task force charged with tackling how to recruit and train a new segment of the health care workforce.
Will ACOs Be A-OK? Model Stirs Hopes, Questions
Accountable care organizations, or ACOs, are the most-discussed acronym-cum-health care payment model since HMOs. As providers across the nation rush to adopt the concept, is California poised to be a leader?
Ombudsman Program Tries to Follow Money
California’s long-term ombudsman program, a volunteer network governed by a state agency, is designed to represent and advocate for people in nursing homes and senior housing. In many cases, it’s the only forum seniors have to voice complaints and concerns about their living situations — which makes it an extremely popular program among seniors.
Right now, the state’s ombudsman program may be beloved, but it’s a beloved orphan.
Last year, the $3.8 million program was cut, and then lawmakers later restored almost half of it — $1.6 million. But now, even that temporary funding is gone, and officials have been scrounging to come up with enough money to keep the Long-Term Care Ombudsman Program going.