California Healthcare News May 25, 2015

California Healthcare News

  • Paid news articleIn Brief: Sharp, Scripps Join HIE; UCSF Links Depression To Stroke Risk

    May 14, 2015 By Payers & Providers Staff


  • Hoag Reduces C-Sections Dramatically

    Widespread Planning Leads to Systematic Changes

    May 14, 2015 By Anna Gorman


    Hoag Memorial Hospital Presbyterian, one of the largest and most respected facilities in Orange County, needed to move quickly.

    A big insurer had warned that its maternity costs were too high and it might be cut from the plan’s network. The reason? Too many cesarean sections.

  • Paid news articleCovered California Unveils 2016 Budget

    Significant Cuts Reflect Lower-Than-Projected Enrollments

    May 14, 2015 By Ron Shinkman


    California’s state health insurance exchange proposed a modest 2016 budget that includes reductions in both spending and enrollment projections.

    The Covered California budget included a spending plan for $332.9 million in fiscal 2015-16, down from $390.6 million. Spending forecasts are expected to be pared down further in 2016-17, until they reach a steady state of $300 million a year in fiscal 2018.

  • Paid news articleUCSF Promotes Trauma-Based Primary Care Model; California Receives Significant Grants To Build Community Health Centers

    May 7, 2015


  • Paid news articleDMHC Fines Western Dental $110,000

    Includes Penalty For Underreporting Enrollees to Agency

    May 7, 2015 By Ron Shinkman


    The Department of Managed Health Care has fined the Orange-based Western Dental Services dental insurance plan $110,000 for failing to pay its providers in a timely manner and for neglecting to pay the regulator a special assessment, records show.

    The DMHC dinged Western Dental $80,000 because it failed in the first quarter of 2013 to report enrollees who received services from its provider network.

  • Paid news articleJapanese-Americans: Aging Template?

    Their Demographics in California Are Tempting to Study

    May 7, 2015 By Payers & Providers Staff


    The proportion of older Japanese-Americans is far larger than any other ethnic group in the United States, making them a good study cohort to determin how the rest of the country will handle aging in the future, according to UCLA researchers.

    A recently released study by the UCLA Center for Health Policy Research concluded that nearly a quarter of Japanese-Americans are over the age of 65, twice the populace at large. However, over the next 35 years, the proportion of the U.S. population over 65 will match the current numbers of Japanese-Americans – meaning the former group could provide a glimpse of what is in store for older Americans down the line.

  • Paid news article2015 Fines For Data Breaches Top $1M

    Many Involve Employees Surreptitiously Looking up Data

    May 7, 2015 By Ron Shinkman


    The California Department of Public Health has fined six hospitals and two other healthcare providers more than $1.1 million so far this year for breaches of confidential patient information.

    Records show the breaches are typically the result of patient data that was not properly secured either being lost or stolen, or employees inappropriately accessing patient records, often of family members or acquaintances. Health privacy experts say such types of breaches are common.

  • Paid news articleIn Brief: 5,000 Nurses Set To Strike Statewide; PAMF, UnitedHealthcare Create ACO; Sutter Donates $500K For Nepal Recovery Effort

    Apr 30, 2015 By Payers & Providers Staff


  • Paid news articleMedi-Cal Expansion, ER Usage Linked

    OSHPD Data Helps Put ACA Reforms in Stark Relief

    Apr 29, 2015 By Ron Shinkman


    When a patient shows up at a California emergency room, the likelihood that they are enrolled in the Medi-Cal program has skyrocketed, new state data shows.

    According to the information from the Office of Statewide Health Planning and Development, ER visitors who identified as Medi-Cal patients rose some 50% from 2013 to last year, from just under 800,000 in the first quarter of 2013 to 1.16 million during the fourth quarter of 2014.

  • Paid news articleLGBT-Sensitive Physicians Still A Rarity

    Few Academic Medical Practices Provide Referrals,Training

    Apr 29, 2015 By Ron Shinkman


    When Allison L. Diamant, M.D., an adjunct professor at the UCLA Geffen School of Medicine, began practicing medicine in the 1990s, there was still a lot of apprehension among lesbians, gays and transgender patients about disclosing their sexual or gender orientations to physicians.

    Some 20 years later, with same sex marriage legal in a majority of states and transgender characters in two popular television shows, a lot of attitudes have changed. But according to Diamant, members of the LGBT community still have issues accessing providers sensitive to their needs.

  • Paid news articleSeton Medical Center Fined $100,000

    Cited For Death of Patient at Its Skilled Nursing Facility

    Apr 30, 2015 By Payers & Providers Staff


    The skilled nursing facility at Seton Medical Center in Daly City has been fined $100,000 by the California Department of Public Health for a November 2014 incident that led to the suffocation of a patient.

    The patient, a female with a history of pneumonia and profound swallowing problems, had had a permanent tracheostomy not long after she was admitted in January 2014.

  • Paid news articleIn Brief: L.A. Care Accepting Cash Payments For Premiums; State's Residents Say They Face Treatment Barriers Over Psychological Care

    Apr 23, 2015 By Payers & Providers Staff


  • Paid news articleCDPH Says Measles Outbreak Is Over

    But Agency Cautions it Could Return in The Future

    Apr 23, 2015 By Payers & Providers Staff


    The California Department of Public Health has announced that the outbreak of measles that began late last fall has concluded, but warned that cases could flare anew.

  • Paid news articleDMHC Fines Anthem Blue Cross $57,500

    Agency Cites Plan Over Seven Separate Incidents

    Apr 23, 2015 By Payers & Providers Staff


    The Department of Managed Health Care has fined Anthem Blue Cross of California $57,500 in connection with what the agency says were seven incidents where it violated state regulations, primarily involving how it handles enrollee grievances.

  • Paid news articleDaughters Of Charity Slashes Jobs

    Cost-Cutting in Response to Prime Deal Falling Through

    Apr 23, 2015 By Ron Shinkman


    Just weeks after a proposed acquisition of its hospitals by Prime Healthcare Services fell through, the Daughters of Charity Health System cut hundreds of jobs throughout the organization as a cost-cutting measure, it acknowledged on Wednesday.

    Altogether, 4% of Daughters of Charity’s workforce was laid off, the Los Altos Hills-based not-for-profit announced in a statement. That represents some 280 employees, with cuts coming throughout the organization.

  • Paid news articleJones Slams Anthem Over Latest Hike

    Says 8.7% Average Increase For 170,000 Enrollees Unjustified

    Apr 23, 2015 By Ron Shinkman


    California Insurance Commissioner Dave Jones on Wednesday denounced a proposed rate increase on individual policyholders by Anthem Blue Cross of California, calling it unreasonable and unjustified.

    The rate increase was for some 170,000 enrollees with PPO plans that were “grandfathered” in under the Affordable Care Act. The increase, which Jones said Anthem enacted on April 1, averaged 8.7%, with some older policyholders seeing increases as high as 24.9%.

  • Paid news articleIn Brief: Kaiser Says Patient Data Breaches On The Rise; SGR Repeal Moves Closer To Reality

    Apr 16, 2015 By Payers & Providers Staff


  • Paid news articleCalifornians Want More Time With Docs

    New Foundation Survey Says Some Have Access Issues

    Apr 16, 2015 By Payers & Providers Staff


    Enrollees in the Medi-Cal program said they were more likely to have issues finding a physician to provide care than Californians with other forms of insurance.

  • Paid news articleKaiser Finds Autism-Diabetes Link

    Study Pins Blame on Gestational Form of Disease

    Apr 16, 2015 By Payers & Providers Staff


    The causes of autism in children has been speculated on as incidences of the disorder continue to rise, but Kaiser Permanente has apparently linked to to gestational diabetes in expectant mothers.

    Gestational diabetes is a fairly common condition in expectant mothers, occurring about 9% of the time, based on data from the Centers for Disease Control and Prevention.

  • Paid news articleJones Critical Of Proposed Drug Costs

    Says Covered California Is Setting Patient Caps Too High

    Apr 16, 2015 By Ron Shinkman


    Insurance Commissioner Dave Jones has been highly critical of a plan issued by the Covered California insurance exchange to cap the patient co-payments for pricey specialty drugs.

    The proposal issued by Covered California would place caps on co-payments ranging from $200 to $500, depending on what level plan they are enrolled in. However, those enrollees in the lowest-cost Bronze plan would pay a co-payment capped at $500 per month per specialty drug. Jones said on Wednesday that was unreasonable.

  • Paid news articleHospital May Sue Over Trauma Funding

    Antelope Valley Facility Chafes Over Measure B Allocation

    Apr 16, 2015 By Ron Shinkman


    Antelope Valley Hospital received a designation as a level two trauma center in 2010. The number of trauma patients it treats today is about 30% higher than five years ago.

    But the 420-bed hospital, located 60 miles northeast of Los Angeles in Lancaster, has received the same supplementary trauma funding from Los Angeles County every year: about $1.3 million.

  • Paid news articleIn Brief: Covered California Signs Up 18,000 During Special Enrollment;

    Apr 9, 2015 By Payers & Providers Staff


  • Paid news articleBlue Shield Fined $45,000 By DMHC

    Sums Tied to Five Different Citations From Agency

    Apr 9, 2015 By Payers & Providers Staff


    Blue Shield of California was fined $45,000 by the Department of Managed Health Care last month for five separate violations of the Knox-Keene Act, records show.

  • Paid news articlePBGH Turns Focus To Spinal Surgeries

    Wants to Cut Costs For Often Controversial Procedure

    Apr 8, 2015 By Ron Shinkman


    The Pacific Business Group on Health (PBGH), one of the state's biggest group purchasers, has expanded a value-based purchasing program to include spinal surgeries.

    The procedure – which has drawn controversy because of its costs and criticisms in some quarters because it is thought to be overutilized – is being added to PBGH's Employers Centers of Excellence Network.

  • Paid news articleMany State Mortality Indicators Improve

    But Alzheimer’s And Other Categories Lagging Behind

    Apr 9, 2015 By Payers & Providers Staff


  • Paid news articleA Big Gap In Breast Cancer Testing

    Access to Specialized Assay Dictated by Income, Race

    Apr 9, 2015 By Ron Shinkman


    A new study by UCLA researchers concludes that income plays a significant role for women seeking front-line diagnostic screenings to help treat their breast cancers.

    The study, which focused on more than 1,800 breast cancer patients in 31 states, showed a distinct division by income and race among women who have access to the latest testing, known as gene expression profiling.

  • In Brief: UCSF, John Muir Collaborate On Integrated Care System; CDPH Launches Campaign Against E-Cigarettes

    Apr 2, 2015 By Payers & Providers Staff


  • Ill Doctors Join Right-To-Die Lawsuit

    Say Patients Are Being Deprived Of Quality of Life

    Apr 2, 2015 By Anna Gorman


    Dan Swangard, M.D., knows what death looks like.

    As a physician, he has seen patients die in hospitals, hooked to morphine drips and overcome with anxiety. He has watched dying drag on for weeks or months as terrified relatives stand by helplessly.

    Swangard was diagnosed in 2013 with a rare form of metastatic cancer.

  • Paid news articleKaiser Reduces Potential Opioid Abuse

    Some Forms of Prescriptions Are Slashed Dramatically

    Apr 2, 2015 By Ron Shinkman


    Kaiser Permanente's efforts to reduce the number of opioid prescriptions being written by its providers have paid significant dividends.

    Over the past three years, Kaiser's Southern California division has been able to drastically reduce the number of prescriptions dispensed that provide large large doses of the medication, as well as switch the vast majority of recipients to generic equivalents. Both changes are key to deterring abuse of the prescription drugs, officials say.

  • Paid news articleIn Brief: CDPH Fines L.A. Nursing Home $80,000; Death With Dignity Bill Moves Through Committee

    Mar 26, 2015 By Payers & Providers Staff


  • Paid news articleMedical Group Admits Balance Billing

    DMHC Settlement Includes Collection Process Reforms

    Mar 25, 2015 By Ron Shinkman


    A San Diego-area group of emergency room physicians has reached a settlement with the Department of Managed Health Care regarding the balance billing of hundreds of patients they treated.

    Under the terms of the agreement with the agency, the Emergency Services Medical Corp. (ESMC) of Solano Beach has agreed to stop balance billing patients, and has also filed a plan of correction with the agency.

  • Paid news articleKaiser Enhances Medication Adherence

    Study Says Mail Order Meds, Low Co-Payments Help

    Mar 25, 2015 By Payers & Providers Staff


    When older patients receive longer-lived prescriptions, have lower out-of-pocket costs and access to mail order pharmaceuticals, they're more likely to adhere to regimens to treat chronic illnesses, Kaiser Permanente researchers have concluded.

  • Paid news articleInsurance Execs Show Subsidy Worries

    Topic Was Dominant at Los Angeles Broker Conference

    Mar 25, 2015 By Ron Shinkman


    King v. Burwell is on the brains of health insurance executives.

    The case was an ongoing topic of conversation at Wednesday's annual Keenan Summit in Los Angeles, which is sponsored by Keenan, Torrance-based large group insurance broker. The two-day conference is held in both Oakland and L.A. on consecutive days.

  • In Brief: SecondOpinionExpert Launches Mobile Platform, Seeks Patients; UCLA Reports Huge Cost Variation In Treating Enlarged Prostates

    Mar 19, 2015 By Payers & Providers Staff


  • Paid news articleBlue Shield Loses State Tax Exemption

    Franchise Tax Board Quietly Revoked Status Last Year

    Mar 19, 2015 By Payers & Providers Staff


    In a stunning blow to one of the state’s largest insurers, the California Franchise Tax Board has stripped Blue Shield of California’s tax exemption as a not-for-profit organization.

    The revocation, first reported on Wednesday by the Los Angeles Times, came after years of criticism against the San Francisco-based insurer. The exemption was apparently revoked last August, and Blue Shield was ordered to file tax returns beginning with the 2013 calendar year.

  • Paid news articleHeroin Overdoses Challenge Hospitals

    Caseloads Have Nearly Doubled Over The Past Decade

    Mar 19, 2015 By Ron Shinkman


    California's hospitals have seen a dramatic spike over the last decade in the number of patients being treated for heroin overdoses.

    New data released by the Office of Statewide Planning and Development (OSHPD) shows a nearly doubling in the number of patients overdosing on heroin being treated at hospital emergency rooms or admitted as inpatients between 2005 and the first half of last year. The numbers tend to confirm national numbers released by the U.S. Centers for Disease Control and Prevention earlier this month, and tend to suggest an epidemic of hard drug use by whites in relatively affluent parts of the state.

  • Paid news articleIn Brief: Health Net Launches Palliative Care Programs; Sutter HMO Expands

    Mar 12, 2015 By Payers & Providers Staff


  • Paid news articleKitchen Initiative Promotes Health

    Scripps Mercy, Rady Join Forces on Community Benefit

    Mar 12, 2015 By Payers & Providers Staff


    Two San Diego hospitals have collaborated on creating an unusual community health benefit: Communal meals.

    Scripps Mercy Hospital and Rady Children's Hospital have created what is known as the “Teaching Kitchen,” a program intended to educate low-income residents of the San Diego area regarding better food and lifestyle choices.

  • Latino, Black Insurance Enrollment Up

    But Numbers Still Lagging California’s Overall Average

    Mar 12, 2015 By Anna Gorman


    The percentage of Latinos and African Americans who signed up for subsidized health coverage through California’s insurance exchange increased modestly during the second annual open enrollment period, officials announced last week.

    About 37% of subsidized enrollees are Latino, up from 31% during the first enrollment period ending in March 2014, according to data released by the Covered California health insurance exchange. About 4% are African American, up from 3% last year. Those numbers include only those enrollees eligible for subsidies who responded to questions about their race or ethnicity.

  • Paid news articlePrime Passes On Daughters of Charity

    Declares That Conditions Attached to Sale Are Too Onerous

    Mar 12, 2015 By Ron Shinkman


    California Attorney General Kamala Harris said yes. But Prime Healthcare said no. And the fate of six hospitals in and around San Jose and Los Angeles hang in the balance.

    After months of negotiations and often raucous pronunciations by those opposed to the deal, Ontario-based Prime Healthcare Services passed up on the chance to acquire the hospitals operated by Daughters of Charity Health System earlier this week, claiming the conditions attached to closing the transaction were too onerous.

  • Paid news articleIn Brief: Cedars-Sinai Reports Cases Of CRE Linked To Duodenoscope; CalOptima Launches New Network

    Mar 5, 2015 By Payers & Providers Staff


  • Paid news articleAuditor Blasts CDPH In New Report

    Says That Agency Has Failed to Implement Reforms

    Mar 5, 2015 By Payers & Providers Staff


    A report released this week by the California Auditor has levied severe criticism against the state Department of Public Health (CDPH), claiming the agency has failed to implement reforms it recommended more than two years ago.

  • Paid news articleIntegrated Care Addresses Racial Gaps

    Stanford Study Says It Fixes Big Colon Cancer Issue

    Mar 5, 2015 By Payers & Providers Staff


    A new study by Stanford University researchers strongly suggests that a holistic integrated care model can overcome significant ethnic disparities in treating colon cancer patients.

    The study, which examined 30,000 colon cancer patients in California, concluded that there was no differences in mortality rates when care delivered within an integrated care model, such as what is provided by Oakland-based Kaiser Permanente.

  • Paid news articleMLK Hospital Finally Poised To Reopen

    Latest Incarnation’s Mission is Much More Modest in Scale

    Mar 5, 2015 By Ron Shinkman


    Is “Killer King” dead?

    That is the sincere hope of the management of Martin Luther King Jr. Community Medical Center as it reopens in a matter of weeks.

    The hospital was closed by the Los Angeles County Department of Health Services in August 2007 after a series of serious lapses in patient care. They included horribly botched surgeries, critically ill patients whose vital sign monitors were ignored by nurses and a woman left to die writhing on the floor of the emergency room as janitorial staff cleaned around her.

  • Paid news articleIn Brief: UCLA's Feinberg Stepping Down; Anthem Breach Impacted 13.5 Million Californians

    Feb 26, 2015 By Payers & Providers Staff


  • Paid news articleHarris Okays Daughters Hospital Deal

    Prime Reviews Options on Strict Conditions

    Feb 26, 2015 By Payers & Providers Staff


    California Attorney General Kamala Harris has approved a bid by Ontario-based Prime Healthcare Services' to acquire the six-hospital Daughters of Charity healthcare system for $843 million, but it remains unclear if the for-profit operator will go through with the deal.

    Harris proposed stricter conditions than originally proposed by the parties to ensure that levels of care would be preserved and pension obligations to Daughters' 7,800 employees are maintained.

  • Paid news articleAnother Slam On Kaiser Psych Services

    DMHC Says Insurer Has Yet to Fix All Its Access Issues

    Feb 26, 2015 By Payers & Providers Staff


    The Department of Managed Health Care issued a mixed interim report on Kaiser Foundation Health Plan's move toward improving access to mental health services, concluding that the Oakland-based insurer has fixed two deficiencies but that two others have yet to be fully addressed.

    According to the survey that was released on Feb. 24, the DMHC concluded that Kaiser had fixed deficiencies in regards to capturing and tracking data to determine if mental health services were being delivered in a timely fashion under California law. It also concluded that Kaiser had fixed the methodology issues regarding how it tracks and reports timely access to services.

  • Paid news articleState’s Uninsured Reduced Up To 40%

    UCLA, State Data Say 2.7 Million Got Coverage Last Year

    Feb 25, 2015 By Ron Shinkman


    With the U.S. Supreme Court scheduled to hear oral arguments next month in a case that could directly impact how easily individual Americans are able to obtain health insurance, a new study by researchers at UCLA demonstrate how unstable the insurance situation had been in California until last year.

    According to the data by the UCLA Center for Health Policy Research, in 2013 more than one in eight Californians under the age of 65 had gone without health insurance for more than a year.


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