Latest Morning Briefing Stories
Hearing Focuses on Children’s Dental Care
Assembly member Richard Pan (D-Sacramento) knew the subject was a little out of the ken of the workforce committee, but that it was too important to be ignored.
“One of principles in looking at whether we have an adequate workforce is to make sure we can take care of our patients,” Pan said. “We need to take care of the oral health needs of children, and that depends, in part, on availability of coverage, and payment for those services.”
Pan, chairman of the Assembly Select Committee on Health Care Workforce and Access to Care, presided over a recent hearing on children’s oral health in Sacramento County.
Legislature Examines Duals Transition
Toby Douglas took a good amount of heat last Wednesday at an Assembly joint hearing of the committee on Aging and Long-Term Care and the Budget subcommittee on Health and Human Services.
Douglas — director of the state Department of Health Care Services — with a full array of budget cuts, program transitions and agency reorganization on his plate, has been making presentations and fielding questions at a number of legislative hearings recently. None of them has been a cakewalk, but this hearing was a little more barbed than most.
Complaints and concerns ranged from a perceived lack of choice to worry over rapid-fire changes.
More People May Be Eligible for Adult Day Services
There was a glimmer of good news for the 35,000 adult day health care Medi-Cal patients in California. It looks like a much higher percentage of them than previously estimated will be eligible to receive the new benefit called Community Based Adult Services.
Department of Health Care Services Director Toby Douglas originally said he expected about 50% of current ADHC patients to qualify for the new program. ADHC will be eliminated as a Medi-Cal benefit on Mar. 31 and the CBAS program starts Apr. 1.
Now it looks like 70% to 80% of those receiving the ADHC benefit will qualify for CBAS, according to Catherine Blakemore, executive director of Disability Rights California, which is monitoring the state’s assessment and placement of ADHC patients.
From Supreme Court to Appeals Court
Yesterday’s decision by the U.S. Supreme Court had a ripple effect in California, influencing a number of lawsuits in the state over health care cuts.
Four lawsuits have been filed over the 10% Medi-Cal provider rate cuts, and in all four cases, a federal judge has issued a temporary injunction blocking those cuts. In another court case, an injunction halted 20% trigger cuts to Californians receiving In-Home Supportive Services.
All of those cases were waiting to see what the Supreme Court would decide in Douglas v. Independent Living Center of Southern California. Yesterday’s decision to send that case back to the Ninth Circuit Court of Appeals was a huge victory for patient rights’ groups, according to Melinda Bird, a Disability Rights California attorney.
Can Health Equity Be a Moneymaker?
Sometimes the right thing might also be the financially beneficial thing.
Physician groups are gathering today in Sacramento for a conference on disparities in health care related to race, language and geography. This time, the debate is not just about the moral imperative to promote equity in health care, but also about the clinical and financial impetus to make that move.
“The thing that has changed, as more people are brought into systems of care with accountability, health organizations are going to be looking at avoidable cost as well as avoidable risk,” according to Wells Shoemaker, medical director of the California Association of Physician Groups, which organized the conference.”It’s sort of the low-hanging fruit when you’re looking for avoidable costs.”
Getting a Head Start on Medi-Cal Expansion
For a program no one’s really heard of, this one is pretty successful.
Counties started enrolling people into the Low-Income Health Program in July 2011, and four months later (at the most recent count in November) about 260,000 Californians were enrolled in it, according to Linda Leu, a health care policy analyst with Health Access California.
“It is a really great opportunity for those who are low-income, and who have been left out of programs like Medicaid [or, in California, Medi-Cal],” Leu said.
And with an acronym like LIHP, the perfect time to publicize the program is on Valentine’s Day, she said.
Study: Uninsured Face Similar Debt as Medi-Cal Beneficiaries
More Californians are borrowing money to pay for health care services — and two-thirds of them have medical insurance, according to a new study by the UCLA Center for Health Policy Research.
“When you think you’re insured, you still end up paying a percentage and that adds up, into thousands of dollars,” report author Shana Alex Lavarreda said. “So having insurance doesn’t mean you will have things paid for.”
Another surprising finding, Lavarreda said, is that uninsured Californians face a similar medical debt level to those who have insurance through Medi-Cal.
It May Be Time ‘To Take the Pain’ on Medicaid
New Kaiser Family Foundation data illustrate the rise in Medicaid enrollment and lawmakers’ continuing struggle to control costs. Budget battles in Washington state, not Washington, D.C., may show the future of the program: stark efforts to slow utilization.
Medical Transport Lawsuit Gets Federal Injunction
A federal judge issued a preliminary injunction Wednesday to halt a 10% Medi-Cal provider reimbursement cut to medical transportation services.
It was the third time the state has lost in court on this issue. State officials said the state will appeal. Preliminary injunction rulings at the end of December halted cuts in hospital and pharmacy services. Another lawsuit, brought by the California Medical Association and other providers, is still pending.
Marat Sheynkman, executive director of the California Medical Transportation Association, which filed the suit that triggered Wednesday’s ruling, said the 10% Medi-Cal reimbursement cut would have hit medical transport providers particularly hard.
What’s Best Enrollment Process for Dual Eligibles?
State officials face a key decision in orchestrating a shift into managed care for more than one million Californians who are beneficiaries of both Medicare and Medi-Cal: How to enroll people in the new plans. We asked stakeholders and experts to discuss pros and cons of various enrollment options.