Latest Morning Briefing Stories
Health Care May Play Part in California Political Makeover
With retirements on both sides of the aisle, new congressional districts and new voting rules, California’s political makeup is headed for change in both Washington, D.C., and Sacramento. A couple of health care issues — a controversial Medicare plan in Congress and a state ballot proposal to regulate health insurance premiums — could play a part in how those changes happen.
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.
Four Resolutions We Hope Lawmakers Will Keep This Year
The Republicans have promised a replacement for the health reform law. The Democrats had planned a payment advisory panel. Both parties want a “doc fix.” Will this be the year lawmakers stick to their promises?
Politics Have Always Been Part of Policy — but Have We Hit a New Low?
Berwick’s out. Overruling the FDA is in. A flurry of recent headlines recall another moment when politics and health policy collided and set the nation on a new course.
How To Protect Seniors During Duals Conversion?
Yesterday’s stakeholder meeting to help plan the duals conversion pilots was partially notable for what it was not.
It was not rancorous, it was not loud and the discussion went relatively smoothly for the Department of Health Care Services, compared with last week’s grilling of DHCS over the smaller conversion of SPDs (seniors and persons with disabilities) to managed care.
“Hearing the issues here today is very important for us,” Melanie Bella of CMS said at the end of the meeting. “A couple of things we said were non-negotiable here are stakeholder involvement, meaningful stakeholder involvement and consumer protections.”
Mandatory Enrollment Draws Attention From Legislators
The state wants to move fee-for-service Medi-Cal beneficiaries who are seniors and persons with disabilities into managed care plans. At the same time, the state is in the initial stages of launching a demonstration project to eventually move up to 1.1 million dual eligibles — those eligible for both Medicare and Medi-Cal benefits — into managed care.
Today in Sacramento, those two significant efforts get some legislative oversight. The Senate and Assembly health committees are holding a joint hearing on how those two efforts will be conducted.
“We want the health care system to be more efficient, but without sacrificing patient care,” Assembly member Bill Monning (D-Carmel) said. “The objective [of both efforts] is to improve patient care. So this is an opportunity to have some transparency for the public and some oversight.”
What a Waste: Why We Can’t Rein In Extra Health Spending
Don Berwick took a parting shot at the waste in the U.S. health system as he stepped down at CMS, reinvigorating a question as old as Medicare: Why isn’t our system more efficient?
Dual Eligibles a Tricky Population To Manage
The state Department of Health Care Services wants to integrate care for about 1.1 million dual eligibles in California — people eligible for both Medicare and Medi-Cal services — by moving them to managed care plans.
“These two insurance programs don’t necessarily work well together,” according to Neal Adams, deputy director of the California Institute for Mental Health. “The benefit design is not equal across all platforms.”
Adams was part of a stakeholder summit convened last week by DHCS to discuss the dual eligible demonstration project. It was the first of three stakeholder meetings this month. Others are scheduled Dec. 12 in San Francisco and Dec. 15 in Los Angeles.
Medicare Physicians Nervously Await Yearly ‘Doc Fix’
In the wake of the congressional debt panel’s failure to come up with long-range budget solutions, California physicians are nervously awaiting the annual holiday tradition of a temporary “doc fix” to adjust the equation that determines how much they’ll get paid for treating Medicare beneficiaries.
Three Meetings To Address Duals Conversion
This week, the state begins a series of stakeholder meetings across California, all looking at different aspects of the ambitious task of converting more than one million people who receive both Medicare and Medi-Cal benefits — known as dual eligibles — to a more comprehensive model of care.
According to Peter Harbage, who has been leading the information-gathering component of the effort, this is an important month in the process. Now that the first wave of input has been solicited, the three meetings scheduled for December can dive deeper into the details.
“The main goal is to talk about the design of the duals demonstration project, so the state can get a better understanding what people believe the challenges and opportunities are, and what consumer protections need to be done,” Harbage said.