California Healthcare News

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California Medicaid, Medicare and Private Insurance 2001 vs 2014 Free
Feb 23, 2018




California Healthcare Coverage 2001 vs 2014:
Medicaid: 6.78 million in 2001; 11.505 million in 2014 - 69.7% increase
Medicare: 3.945 million in 2001; 5.746 million in 2014 - 45.7% increase
Private Insurance: 21.798 million in 2001; 31.834 million in 2014 - 46.0% increase






Big Payouts At Small Medi-Cal Insurer Premium Content
Feb 22, 2018

Norma Diaz and her husband, Joseph Garcia, have dedicated their careers to running a nonprofit health insurer that covers some of California’s neediest residents.

            For three decades, they have worked for a Medicaid managed-care plan, Community Health Group, serving nearly 300,000 poor and disabled patients in San Diego County under a state contract funded entirely by taxpayers. They’ve earned above-average ratings for patient care.

            And in the process, they’ve made millions of dollars.

California Startup Wants To Use Artificial Intelligence To Speed Stroke Treatments Premium Content
Feb 22, 2018


Could a Silicon Valley startup run by a British neurosurgeon dramatically speed up stroke treatment?

                That’s the proposition being put forward by, a San Francisco-based firm. Its chief executive officer, Chris Mansi, believes the use of artificial intelligence to rapidly analyze  CT scans of suspected stroke victims, will speed the process from initial presentation in a hospital to treatment.

DMHC Orders OC Surgeon To Stop Balance Billing Premium Content
Feb 22, 2018

The Department of Managed Health Care has issued a rare cease and desist order against an individual physician for the inappropriate balance billing of a patient.

Adventist Health Shifting More Than 1,000 Jobs To Cerner Premium Content
Feb 22, 2018

Roseville-based hospital system Adventist Health is shifting nearly 1,200 jobs to IT giant Cerner Corp. as part of a restructuring of its operations statewide.

            The Los Angeles Business Journal reported on the story last week, saying that 1,166 jobs were being shifted, with Cerner essentially taking on all of Adventist’s revenue cycle management and IT operations. The move is expected to save Adventist about $100 million a year.

Upcoming Shortage of California Behavioral Health Professionals Free
Feb 20, 2018




The UCSF HealthForce Center's recently released report tells us that:

 - California had over 80,000 licensed behavioral health professionals in 2016.
 - Forty-five percent of psychiatrists and 37% of psychologists are over age 60 years.
 - Demand forecasts based on current service utilization patterns indicate by 2028:
      California will have 41% fewer psychiatrists than needed; and
      11% fewer psychologists, LMFTs, LPCCs & LCSWs than needed.



Covered California Subsidized Plan Selections by Metal Tier Free
Feb 16, 2018

Covered California Open Enrollment Subsidized Plan Selections by Metal Tier were as follows for 2017 and 2018:

Covered California states that "among those who receive financial assistance, 15 percent of new consumers selected a Gold plan during open enrollment, over three times as many as the 4 percent that selected a Gold plan last year."





Surprising Revelation On Aetna Authorization Reviews Premium Content
Feb 15, 2018

Both of California’s health insurance regulators said they will investigate how Aetna Inc. makes coverage decisions, as the lawsuit of a California man who is suing the nation’s third-largest insurer for improper denial of care heads for opening arguments on Wednesday.

California’s Suburbs Have More Poor, Less Healthcare Premium Content
Feb 15, 2018

The promise of cheaper housing brought Shari Castaneda to Palmdale in northern Los Angeles County, about nine years ago. 

            The single mom with five kids had been struggling to pay the bills. “I kept hearing that the rent was a lot cheaper out here, so I moved,” she said.

Hospitals Want AG To Grant Break On Charity Care Obligations Premium Content
Feb 15, 2018

Four hospitals have petitioned California Attorney General Xavier Becerra for a big break on their mandated charity care obligations to patients.

California Medi-Cal Physician Supply and Reimbursement Free
Feb 13, 2018

Covered California added 423,484 new plan selections for just ended fifth annual open enrollment, including 50,000 people during the final three days. The new selections were a 3% increase over last year's open enrollment, However, renewals experienced a decline, yielding an overall decrease of -2.26% in total enrollment for 2017-2018 with a total of 1,521,525 enrollees. 

California Medi-Cal Physician Supply and Reimbursement Free
Feb 9, 2018


There were 39 Medi-Cal Physicians per 100,000 Medi-Cal Patients in 2015, which shrank from 59 per 100,000 in 2013. California reimburses Medi-Cal providers at 66% of the national Medicaid average, and California ranks among the bottom 2 states for Medicaid provider payment rate.






Source: 2018 California Children's Report Card, Children Now

Funding For Health Centers Remains Unresolved Premium Content
Feb 8, 2018

With lawmakers facing another deadline this week for legislation to keep the federal government open, one of the outstanding issues is long-term funding for a key healthcare program serving low-income people.

            The Community Health Center program helps provide care for 27 million people at nearly 10,000 nonprofit clinics nationwide, almost all of which are in poor rural and urban areas.

Older Californians Getting Shorted On Mental Health Premium Content
Feb 8, 2018

California is woefully lacking in coordinated mental healthcare services for its oldest residents, even as the state’s population continues to age rapidly.

DMHC Fines Aetna $45,000 Premium Content
Feb 8, 2018

The Department of Managed Health Care has fined Aetna Health of California $45,000 for the mismanagement of an enrollee’s grievance.

ACA Enrollments Down Slightly In 2017 Premium Content
Feb 8, 2018

New data from the National Academy for State Policy indicated 11.8 million Americans signed up for health coverage through state exchanges during the most recent enrollment period, a decline of 3.7% from 2016. That’s despite the Trump administration’s efforts at sabotaging the ACA by cutting the open enrollment period in half.

            The handful of states that run their own exchanges saw enrollments increase by 0.2%, while those states that opted to have the federal government run their exchange saw enrollments drop 5.3%.

California State Employee Retirement Health and Dental Benefit Liability Free
Feb 6, 2018


The current estimate for California state employee post-retirement total health and dental benefit liability is $91.5 billion, compared to last year's estimate of just under $77 billion, according to a new report from the state controller’s office. The estimated total reflects present-day dollars.





California HMO Penetration Rates Free
Feb 2, 2018

The overall HMO penetration rate for California is 59.2%, compared to 31.6% nationally. The California Commercial HMO penetration rate is 47.0% (12.8% U.S.); the Medicaid penetration rate is 77.7% (70.5% U.S.) and Medicare Advantage rate is 41.5% (32.4% U.S.)

Source: Kaiser Family Foundation State Health Facts

California’s Pregnant Women Warned On Marijuana Use Premium Content
Feb 1, 2018

Two-year-old Maverick Hawkins sits on a red, plastic car in his grandmother’s living room in the picturesque town of Nevada City, Calif., in the foothills of the Sierra Nevada. His playpal Delilah Smith, a fellow 2-year-old, snacks on hummus and cashews and delights over the sounds of her Princess Peppa Pig stuffie.

            It’s playtime for the kids of the provocatively named Facebook group “Pot smoking moms who cuss sometimes.”

CDPH Fines Two L.A. County Nursing Homes For Patient Deaths Premium Content
Feb 1, 2018

The California Department of Public Health has fined two nursing homes in Los Angeles and Torrance $100,000 apiece for causing the deaths of patients.