Latest California Healthline Stories
Pitfalls and Promise of Converting California’s Dual Eligibles
The state would like to move “dual eligibles” — Californians who receive both Medicare and Medi-Cal benefits — into managed care plans. State officials say the move would save money and improve care, but it’s a big and complicated task.
Reform’s Unanswered Question: To Trim or Transform Medicare?
More cuts to Medicare are looming, just months after the Affordable Care Act sliced billions in program spending. Whether the new changes will be sweeping or merely substantive remains to be seen.
Accounting for the ACO Backlash by Recounting DRG Fight
All kinds of health care stakeholders seem to agree: CMS’ proposed ACOs are profoundly disagreeable. But is this criticism truly new or just providers’ traditional resistance to federal efforts to overhaul health care payment?
Medicare’s Old Age Problem Is New Again
Is 67 the new 65? Republicans have again proposed hiking Medicare’s eligibility age as a gambit to extend program solvency. Some have championed the plan, but many policy analysts — and much of the public — are resisting the idea.
Paul Ryan’s Radical Plan To Reform Medicare not so Radical
While Republicans’ plan to transform Medicare into a voucher program is being hailed as groundbreaking, the model has been floated for decades. Here’s a look back at the history of Medicare vouchers — and what makes Ryan’s plan different.
Suzanne Delbanco of Catalyst for Payment Reform Discusses Ideas on Paying for Care
Suzanne Delbanco, executive director of Catalyst for Payment Reform, spoke with California Healthline about a growing movement to improve the delivery of care by transforming health care payment structures across the U.S.
$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.
Ripple Effect Might Hit Non-Medicare Patients
The poll numbers were not good. About 67% of physicians in America said they’ll likely see fewer Medicare patients, and well over half of American physicians said they intend to cut administrative or clinical staff, if the roughly 30% cut in Medicare reimbursement goes through at the end of this year.
That’s according to a national report this week from the Medical Group Management Association.
“I think you’d find similar answers in California,” Andrew LaMar of the California Medical Association said. “Physicians will be in tough financial straits if they have to take a 30% cut in Medicare. And it will have a huge effect on access to care in California.”
The long fight that is national health care reform has had one large skirmish that netted about $3 billion in reimbursement money for California.
That’s the word from the California Hospital Association (CHA), and it is the driving reason behind giving its annual Health Care Hero award to a Congressman from California, Rep. Dennis Cardoza (D-Merced).
“It’s an award to individuals who have done a particularly heroic job in health care,” Jan Emerson of the CHA said. “He played a key role in ensuring that $3 billion that was slated to go to other hospitals in other states, instead stayed in California.”
How Reform Could Affect Four Key Populations
A health policy expert explores how the national health reform would affect four groups of U.S. residents. While younger workers are poised to benefit, Medicare beneficiaries may feel cuts.