Latest California Healthline Stories
‘Road Map’ Lays Out Details for Building Exchange
The Children’s Partnership “blueprint for reform” released this week marks an important milestone in the formation of California’s Health Benefit Exchange, according to Kristen Golden Testa, health director of the Children’s Partnership.
“The [Health Benefit] Exchange board did a lot of work on the visioning process, figuring out what they wanted the exchange to be like,” Golden Testa said. “This offers a road map to get to a lot of the visioning pieces.”
The report was released in draft form to the exchange board in December, and some of the detail laid out in the report may have helped board staff develop that RFP, Golden Testa said.
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?
Exchange Board Has One Meeting To Consider HHS List
Just before the most recent California Health Benefit Exchange board meeting, the federal Health and Human Services agency released its list of proposed essential health benefits. Aimed at ensuring that health plans in individual and small group markets offer a minimum of coverage — both inside and outside of health benefit exchanges — the HHS proposed list is scheduled to take effect in 2014.
Board members got a quick briefing on the proposed requirements, since comments on them are due at the end of January. That leaves the board with one more meeting — on Jan. 17 — to approve comments on those benefit requirements, according to Peter Lee, executive director of the board.
“It’s something we didn’t expect to see,” Lee said. “We didn’t know it was coming.”
New Year, New Deals? Breaking Down Health Plan, Doctor Alliances
Is California driving the next health care earthquake? A striking batch of insurers and physician groups are teaming up — and shaking up the industry — with the Golden State at the epicenter.
State Pilot Prompts Children’s Hospital To Form ACO
The California Department of Health Care Services has chosen Rady Children’s Hospital in San Diego to manage the care of medically vulnerable children via a newly formed accountable care organization, hoping for better care coordination and cost savings.
Five Health Care Issues To Watch in 2012
Mark your calendars: A slew of ACA-related payment reforms, health IT changes and health insurance exchange updates will debut next year — even as constitutional questions over the law come to an end. (Maybe.)
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.
Clashing Views of Transition for Seniors, Disabled
Either the state’s transition to managed care is going great, or it’s a confusing mess.
That would depend on who’s talking. At a joint oversight hearing last week, convened by the Senate and the Assembly committees on health, government officials outlined a generally positive picture for the effort to move Medi-Cal seniors and people with disabilities (SPDs) from Medi-Cal fee-for-service to managed care.
“The transition of seniors and people with disabilities into managed care is part of the triple mandate from [the federal] HHS,” according to Jane Ogle, deputy director at the Department of Health Care Services. “Better health, better quality and more cost-effective care.”
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?
California Leading Payment Reform Effort
Steve McDermott runs a physicians group, but it’s his role as patient that makes him an expert on payment reform, he said.
“I had hip replacement surgery and let me say, it is a wonderful thing,” McDermott said. “I went from a grumpy old man to, well, just an old man. But yeah, it probably saved my marriage.”
But a look at the bill could’ve sent him back over the line far past grumpy, if he didn’t have medical insurance. The cost of a hip replacement, he said, is out of whack. “The cost is about $70,000 — not including surgery,” McDermott said. “And the number of uninsured in California is at about 23%, and that’s just unacceptable. If the health care system is the number-one cause of bankruptcies in the state, that’s not good.”