Latest California Healthline Stories
Tale of Two Exchanges Shifting Gears in California
In keeping with its traditional role as the front-runner in health care trends, California surged ahead with plans for two health exchanges — one for insurance and one for information. In some ways, the state now is shifting from sprint mode to a long-distance strategy.
Four Rules and Regs Health Policy Experts Can’t Wait To Read
Health policy experts list the upcoming rules and regulations that have the potential to shape the industry, such as proposals to implement health reform provisions like state health insurance exchanges and accountable care organizations.
Unsolved Mystery: Could Secret Shoppers Have Helped Reform Law?
The Obama administration’s plan to use mystery shoppers to gauge physician wait times was abruptly killed on Tuesday. Health policy experts sleuth out why the program met its sudden end and whether it will hurt health reform implementation.
California Running Out of Health Care Providers
Study after study on work force issues in California all come to the same conclusion: There are not enough doctors, nurses and allied health providers to meet projected need. On top of that, those providers are not distributed evenly across the state. But what can be done about it?
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?
Grant Moved Up To Get IT Dollars
Kim Belshé’s committee-of-one turned out to be extremely efficient.
It is a daunting task, applying for a federal establishment grant for the California Health Benefit Exchange — it lays out the direction and scope of the entire exchange, so the board’s plan was to complete it in September. That was complicated slightly by the fact that Belshé was the only board member on the committee supervising the grant application.
It became clear, however, that some of the work needed to get started — particularly the health information technology work — which means it needs federal cash sooner rather than later. So the exchange board announced at last week’s meeting that it is applying for the grant now, with final approval of that grant being sought at next month’s board meeting.
Changing the Way Hospitals Do Business
One of the tenets of health care reform is to provide incentives to raise quality, improve outcomes and lower costs.
That idea is what’s behind about $3.3 billion in federal incentives dangled in front of public hospitals in California as part of the Medicaid waiver deal completed late last year. A new policy brief from the California Association of Public Hospitals details some of those changes.
The deal in the waiver agreement — the Delivery System Reform Incentive Program — is a pay-for-performance initiative for 21 public hospitals in California. That change in performance is measured by meeting a myriad of different milestones.
Are Legal Challenges to Reform Actually Making it Stronger?
Opponents of health reform rushed to challenge the law in court — but the flurry of anti-overhaul cases may have helped the government build its own case to defend it. Lawyers explain the Obama administration’s rare approach to the unprecedented legal battle.
Insurers Flip the Script: Making Sense of Givebacks
Blue Shield of California pledged to cap its income. Aetna requested to cut its premiums in Connecticut. The moves aren’t unprecedented. But will they set a precedent?
Health Reform Legislation Regularly Assailed
Last week’s deadline to get legislation through the Assembly and Senate saw a number of big-ticket health care proposals make their way through the Legislature — including one bill to regulate rate hikes by health insurers, and another to launch a new kind of basic health care insurance program in California.
Many of the health-related proposals — especially ones that had anything to do with meeting federal guidelines for implementation of the federal health reform law in 2014 — met with resistance, skepticism and sometimes derision.