Latest California Healthline Stories
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.”
For Mentally Ill, Home Is Where the Health Home Pilot Is
Which grant was buried in the week’s news? Rhode Island won a big award for its health insurance exchange efforts, but a second CMS announcement — that the Ocean State was approved for a Health Home Medicaid project — could have major implications for mental health care.
Dueling Polls Offer Alternative Reform Opinions
Two polls released last week offered conflicting views of public opinion on health care reform. Coming in the same week the Supreme Court announced it would hear reform arguments, the polls also raise a couple of questions: How much influence does public opinion have on the Supreme Court? And vice versa?
Design Element the First Step Toward No-Wrong-Door
California took an important first step toward implementation of the Health Benefit Exchange last week when it unveiled the initial design for enrolling Californians and determining their eligibility in 2014.
The initial design of the project, called Enroll UX 2014 (UX stands for “user experience”), was presented to the Health Benefit Exchange board by project director Terri Shaw.
“We have teams from 11 states participating in the process,” Shaw said. “The objectives are two-fold — to develop a first-class user experience, and to ensure retention of consumers.”
Premium Hikes Report May Be Kindling for California Initiative
Premiums for employer-based health insurance increased by 50% nationally in the seven years before passage of the Affordable Care Act, according to a new report from the Commonwealth Fund. The report comes at the start of a statewide campaign for a ballot measure to give California authority over health insurance rate hikes.
Healthy San Francisco’s Lessons for National Health Reform
It has an employer mandate. It has improved access to care. It has survived a Supreme Court challenge. So, why aren’t national health policy leaders paying more attention to Healthy San Francisco?
Five Key Lines in the Circuit Court Rulings on Reform
Questions about the Affordable Care Act’s constitutionality took center stage again this week, as a fourth appeals court rendered its decision and the Supreme Court prepares to conference on whether to take the case.
New Cost Tool Aims To Boost Pay-for-Performance Model of Care
In an effort to measure value in health care transactions, the Integrated Healthcare Association is introducing a “Total Cost of Care” metric to be used in its pay-for-performance program. IHA hopes the new tool will speed up improvements in clinical quality by providing financial incentives to physicians.