California Healthcare News Nov 30, 2015

California Healthcare News

  • Paid news articleIn Brief: DMHC Awards Health Plans, Medical Groups; Kaiser Tops Equity Index

    Nov 19, 2015 By Payers & Providers Staff


  • UCSF Launches New Dementia Center

    Will be Operated in Conjunction With Irish Researchers

    Nov 19, 2015 By Anna Gorman


    UC San Francisco and the University of Dublin announced Monday the launch of an institute aimed at helping developing countries learn more about dementia and cope with the burden it places on patients, families and caregivers.

    The Global Brain Health Institute, which will be housed both in San Francisco and Dublin, will train 600 neuroscientists, policymakers, economists and others over 15 years in an effort to help developing countries better understand dementia, as well as how to delay and prevent it. The institute plans to focus initially on countries in Latin America and the Southern Mediterranean region.

  • Paid news articleKaiser Suggests Dialing Back On Chest Scans

    Says Lung Nodules Often Over-Diagnosed

    Nov 19, 2015 By Ron Shinkman


    Kaiser Permanente is tentatively suggesting patients who undergo computerized chest tomographies be warned by their physicians that identifying nodules in the lungs is often a common result, and that doctors themselves should reconsider their use of the procedure.

    The recommendation was made by a key Kaiser physician and researcher after data from its Southern California division concluded that the number of patients who have been identified to have had lung nodules skyrocketed in recent years.

  • Paid news articleState Sees Big Drop In HIV Diagnoses

    But Many Californians Still Unaware They Are Uninfected

    Nov 19, 2015 By Ron Shinkman


    Although much progress has been made in combatting the HIV and the AIDS virus over the past couple of decades, many infected Californians remain undiagnosed – putting them at risk for unknowingly infecting others, public health officials said this week.

    At a press briefing held Wednesday by the California Department of Public Health, officials said that the number of state residents newly diagnosed with HIV each year has dropped dramatically, from 13,000 at the height of the AIDS epidemic in the late 1980s and early 1990s to 4,712 in 2013.

  • Paid news articleIn Brief: Mentally Ill Less Likely To Receive Diabetes Screenings; Hospital Breastfeeding Rates Rise

    Nov 12, 2015 By Payers & Providers Staff


  • Paid news articleAV Hospital Farms Out Management

    Three-Year Contract is Awarded to Alecto Healthcare

    Nov 12, 2015 By Ron Shinkman


    A for-profit hospital company headed by the former top executive of Prime Healthcare Services has been selected to manage one of the state's largest district hospitals.

    A divided Antelope Valley Hospital board of directors voted 3-2 on Nov. 4 to have Irvine-based Alecto Healthcare Services take over management of the 422-bed Antelope Valley Hospital in Lancaster.

  • Big-Time Increase In Seven-Figure Pay

    66 Execs At Three Largest Systems Earn Over $1M a Year

    Nov 12, 2015 By Ron Shinkman


    As healthcare costs continue to spiral upward, so do the salaries of California's most senior not-for-profit hospital managers, according to a Payers & Providers preliminary analysis of tax return data.

    A total of 66 senior executives with the state's three largest not-for-profit hospital systems -- Sutter Health, Dignity Health and Kaiser Permanente -- received compensation of more than $1 million in 2013, the most recent year for which such data is available. That is up from 52 in 2011, the last year Payers & Providers conducted a compensation survey -- an increase of nearly 30%.

  • Paid news articleIn Brief: Kaiser Buys Stake In Stockton Hospital; California Gets Above-Average Marks On Pre-Term Births

    Nov 5, 2015 By Payers & Providers Staff


  • Paid news articleExchange Makes Enrollment Push

    Covered California Launches Bus Tour, New Ad Campaign

    Nov 5, 2015 By Payers & Providers Staff


    Open enrollment has begun this week for Covered California, and the health insurance exchange has launched a revamped ad campaign and a statewide bus tour.

  • Bridge To Reform Waiver Extended

    But Funding is Whittled Down Dramatically in Negotiations

    Nov 5, 2015 By Anna Gorman


    California and the federal government agreed in concept last Saturday on a $6.2-billion deal to reform the Medicaid program and to help pay for care of the low-income population.

    The largest share of the funds – nearly $3.3 billion – is aimed at helping public hospitals improve the safety and quality of patient care. The plan, in the form of a Medicaid waiver, also provides money to cover the uninsured and create pilot programs to keep high-need populations out of emergency rooms.

  • Paid news articleCA Blues Fined For Big Network Snafus

    DMHC Penalizes Anthem, Blue Shield For Directory Errors

    Nov 5, 2015 By Ron Shinkman


    The Department of Managed Health Care (DMHC) has levied significant fines against Blue Shield of California and Anthem Blue Cross of California for furnishing inaccurate provider directories to its enrollees who signed up through the state health insurance exchange in 2013.

    Blue Shield of California was fined $350,000, while Anthem Blue Cross was fined $250,000. Blue Shield received a larger fine because it apparently did not cooperate with the DMHC in its investigation of the matter, the Los Angeles Times reported earlier this week.

  • Paid news articleState Has Huge Drop In Uninsured Kids

    Study Credits ACA For Dramatic Decrease in Numbers

    Oct 29, 2015 By Payers & Providers Staff


    California provided insurance to more than 176,000 additional children last year -- the single biggest increase in the nation, according to a study by the Georgetown University's Center for Children and Families.

  • Paid news articleIn Brief: Anthem Settles Class Action Suit; Scores of Hospitals Receive High Grades From Leapfrog

    Oct 29, 2015 By Payers & Providers Staff


  • Paid news articleCDPH Holds Rare Vaccination Study

    Supports Pertussis Shots For Expectant Mothers

    Oct 29, 2015 By Payers & Providers Staff


    As more state residents eschew vaccinations out of fear of harming their children, the California Department of Public Health conducted a rare study regarding the results of vaccinating against whooping cough/pertussis.

    CDPH officials examined the records of 690 newborns in California who suffered from pertussis.

  • Paid news articleBig Stumble For State’s Hottest Startup

    Promise to Remake Lab Business Elusive For Theranos

    Oct 29, 2015 By Ron Shinkman


    Little more than a week ago, Theranos was California's hottest healthcare startup. Now it is on the hot seat.

    The Palo Alto-based Theranos was poised to transform the laboratory business with a proprietary technology aimed at all but eliminating the practice of using needles to draw blood, and doing so at a fraction of the cost of standalone and hospital labs.

  • Paid news articleIn Brief: Jones Says Aetna's Rate Increase Is Unreasonable; CMA Installs Inland Empire Physician As President

    Oct 22, 2015 By Payers & Providers Staff


  • Paid news articlePrime Continues Its Acquisition Spree

    Foundation Arm Purchases Hospital in Eastern Ohio

    Oct 22, 2015 By Payers & Providers Staff


    The Prime Healthcare hospital chain has continued its expansion outside of California with an entrance into the eastern Ohio market.

  • Paid news articleDMHC Fines SF Health Plan $30,000

    Conservatorship Also Removed From Alameda Alliance

    Oct 22, 2015 By Ron Shinkman


    The Department of Managed Health Care (DMHC) has issued a $30,000 fine against the San Francisco Community Health Authority (SFCHA) for mishandling payments of provider claims.

    The SFCHA operates the San Francisco Health Plan, which provides Medi-Cal managed care coverage to low-income residents of San Francisco.

  • Paid news articleFull Hospital Quake Compliance Nears

    OSHPD Says More Than 90% of Facilities Meet Guidelines

    Oct 22, 2015 By Ron Shinkman


    California's hospitals have made huge strides in updating their infrastructure to be compliant with seismic regulations, data released last week show.

    According to figures issued by the Office of Statewide Health Planning and Development (OSHD), nearly 91 percent of the 2,976 acute care hospital-operated buildings are now seismically compliant.

  • Paid news articleIn Brief: Covered California Has 2 Million Enrollees To Date; Kaiser Links HIV To Higher Cancer Rates

    Oct 15, 2015 By Payers & Providers Staff


  • Paid news articleNursing Facility Fined $75K By CDPH

    Allowed Patient to Develop Unchecked Gangrene in Foot

    Oct 15, 2015 By Payers & Providers Staff


    The California Department of Public Health (CDPH) has cited OakPark Healthcare in the Tujunga are of Los Angeles and fined it $75,000 for neglecting a patient who eventually died as a result.

  • Paid news articleHospitals Have Varied C-Section Rates

    Leapfrog Group Says Many Fail to Lower Their Numbers

    Oct 15, 2015 By Ron Shinkman


    California hospitals are slightly below the target set by a national quality initiative to reduce the rates of Caesarean sections, but the rates still vary widely, according to the data self-reported to the Leapfrog Group.

    The Washington, D.C.-baed Leapfrog had set a goal of reducing the national C-section rate to 23.9%, noting that overuse of the practice exposed too many women to unnecessary abdominal surgery.

  • Paid news articleBlue Shield Agrees To Limit Premiums

    Quietly Enters Into Agreement With Insurance Regulator

    Oct 15, 2015 By Ron Shinkman


    Under unprecedented pressure from the Department of Managed Health Care, Blue Shield of California will revisit some of its actuarial data for setting premiums for its individual, family and small group policies, and will forego at least one premium increase next year.

    The San Francisco-based insurer quietly agreed to an extensive order issued by the DMHC on Oct. 5.

  • Paid news articleIn Brief: UCSD Study Says Vaping Companies Lure Underage Users; Hospital Work Break Waiver Signed Into Law

    Oct 8, 2015 By Payers & Providers Staff


  • A New Chapter: Martin Luther King Medical Center Reopens

    The Payers & Providers Podcast Explores The Hospital's Past And Future

    Oct 8, 2015


    The Payers & Providers Podcast explores the recent reopening of South Los Angeles' Martin Luther King Community Hospital. Editor Ron Shinkman first discusses the hospital's troubled history while being operated by the Los Angeles County Department of Health Services. The podcast includes a visit to the remade campus, interviews with members of the community and gets the take of a key consultant to the hospital's rebirth and a close observer of its past.

  • Paid news articleAssisted Suicide Bill Signed Into Law

    Poll Shows Strong Support For Measure Clergy Opposes

    Oct 8, 2015 By Payers & Providers Staff


    Gov. Jerry Brown signed into law this week a bill that makes physician-assisted suicide legal in California under strict guidelines.

  • Paid news articleUCSF Receives $9.75M NIH Grant

    Money Will be Used For Mobile Health Test Platform

    Oct 8, 2015 By Payers & Providers Staff


    UC San Francisco has received a $9.75 million grant from the National Institutes of Health to create a platform that will allow researchers to conduct mobile health research in a more efficient manner.

  • Paid news articleCDPH Fines Nine Hospitals $915,100

    Facilities Penalized For Breaches of Patient Health Data

    Oct 8, 2015 By Ron Shinkman


    The California Department of Public Health (CDPH) has levied penalties and fines against nine hospitals totaling $915,100 for breaching state patient confidentiality laws.

    The penalties, which ranged from $2,500 to $250,000, were for incidents that occurred between 2011 and 2013. All of the incidents involved employees who were either negligent handling records or deliberately violated rules for the purpose of obtaining personal or workplace information.

  • Paid news articleIn Brief: Los Angeles County Will Merge Three Health Agencies; Statewide Smoking Rate Continues to Drop

    Oct 1, 2015 By Payers & Providers Staff


  • Paid news articleL.A. Center of Bad Ambulance Billings

    OIG Says it’s National Leader in Questionable Charges

    Oct 1, 2015 By Payers & Providers Staff


    Is Los Angeles the fraudulent ambulance capital of the United States?

    That was suggested in a new report by the U.S. Department of Health and Human Services Office of the Inspector General (OIG). The agency recently audited ambulance transports billed to the Medicare Part B program during the first half of 2012.

  • Paid news articleCommunity Clinics Lack Dental Care

    New Study Says California Lags Nationwide Average

    Sep 30, 2015 By Payers & Providers Staff


    Providing dental services at community health centers is a good way to improve oral health among low-income Californians, but few such providers are configured in this manner.

    That was the conclusion of the UCLA Center for Health Policy of Research, which surveyed 886 community health centers statewide.

  • Paid news articleCalifornia Begins Transition To ICD-10

    Many Players Are Ready, With Medi-Cal Big Exception

    Oct 1, 2015 By Ron Shinkman


    California's healthcare enterprises officially transitioned to the ICD-10 system as of today, implementing one of the biggest shifts in the way patient care is coded and billed in decades.

    It remains to be seen whether there will be any glitches with the transition, which vastly expands the number of codes for medical incidents and care. For the moment, the state's Medi-Cal program will be sitting out the ICD-10 transition.

  • Paid news articleIn Brief: Molina Purchases Mental Health Services Provider; Dignity Health Reports FY 2015 Earnings

    Sep 24, 2015 By Payers & Providers Staff


  • Paid news articleAG Harris Sued Over Daughters Deal

    Prime Healthcare Claims She Colluded With Labor Union

    Sep 24, 2015 By Payers & Providers Staff


    Although Prime Healthcare walked away earlier this year from a deal to acquire the Daughters of Charity Health system, it has yet to let go.

    The Ontario-based Prime has sued California Attorney General Kamala Harris, claiming she entered into a scheme with the Service Employees International Union-United Healthcare Workers West to ensure Prime would not be able to acquire the six-hospital Daughters of Charity chain. The suit was filed on Monday in U.S. District Court in Los Angeles.

  • Paid news articleState's Stroke Mortality Rates Decrease

    Hospitals Report Slight Downtick For 2012-13 Period

    Sep 24, 2015 By Payers & Providers Staff


    Thousands of Californians suffer ischemic strokes every year, and their chances or survival depend on fairly quick interventions in the hospital setting.

    According to new data from the Office of Statewide Health Planning and Development, the state's hospitals fared slightly better in treating ischemic stroke victims between January 2012 and November 2013 than in the prior 2011-12 period.

  • Paid news articleState Launches Cost Comparison Site

    While Data Rich, It Lacks Specific Prices For Procedures

    Sep 24, 2015 By Ron Shinkman


    The California Department of Insurance has teamed up with Consumer Reports and the UC San Francisco to launch a new consumer-oriented website for patients to obtain cost information about the care they receive.

    The website, California Healthcare Compare, aggregates quality data from the Integrated Healthcare Association, a variety of health insurers and other parties. The site, which was funded by a $3.9 million federal grant under the Affordable Care Act, provides a range of what an insured patient would pay for more than 100 different procedures by 22 different geographic regions, and rates individual providers on quality and outcomes on a five-point scale. Officials said that the website covers about 75% of the care paid for by insurers and patients in California.

  • Paid news articleIn Brief: Numbers Of Uninsured Dropped; CDPH Warns On Measles

    Sep 17, 2015 By Payers & Providers Staff


  • Paid news articleHealth Plans Respond To Wildfires

    They Make Network Rule Changes, Will Pay For Drugs

    Sep 16, 2015 By Payers & Providers Staff


    The wildfires currently raging north of Sacramento and in the San Diego area have caused some disruption to healthcare delivery, prompting some of the state's insurers to suspend some of its rules and offer to replace medications and equipment that may have been damaged.

    The Valley Fire in the Napa Valley region has burned 67,000 acres as of Wednesday and destroyed nearly 600 homes. In Fresno County, the Lake fire has burned more than 200 square miles.

  • Paid news articleDMHC Fines Blue Shield $140,000

    Citations Related to The Handling of Enrollee Grievances

    Sep 16, 2015 By Payers & Providers Staff


    The Department of Managed Health Care has levied a total of $140,000 in fines against Blue Shield of California for mishandling enrollee grievances.

    The fines were related to numerous incidents that occurred between 2011 and 2013.

  • Paid news articleAV Hospital Sues Los Angeles County

    Claims it is Being Shorted on Special Trauma Funding

    Sep 17, 2015 By Ron Shinkman


    One of California's largest district hospitals has filed a lawsuit against Los Angeles County, claiming it has been denied millions of dollars of special property tax money to help operate its trauma care center.

    The suit, filed by Antelope Valley Hospital in Los Angeles County Superior Court, claims that the $1 million a year it is receiving in public tax funds is insufficient for the job. Instead, the 420-bed facility wants $10 million a year, and another $100 million in back payments.

  • Paid news articleKaiser Beefs Up Mental Health Services

    Says it Has Hired Hundreds of Therapists to Fill Gaps

    Sep 17, 2015 By Ron Shinkman


    Under fire from both regulators and consumers for not providing enough mental health services, Kaiser Permanente this week has disclosed it has hired hundreds of professionals to address those needs in the past several years.

    According to Kaiser, it has boosted the ranks of mental health therapists in California by 45%, the equivalent of 497 additional mental health therapists, including 411 staff hires and another 86 positions filled through joint ventures with therapists in private practice outside of the Kaiser system. Altogether, it has nearly 1,600 therapists statewide.

  • Paid news articleIn Brief: Brown Signs AED Legislation Into Law; CDPH Gets $3.7M Opioid Grant

    Sep 10, 2015 By Payers & Providers Staff


  • Paid news articleCedars-Sinai Acquires Marina Del Rey

    Part of System’s Plan to Expand Into L.A.’s South Bay

    Sep 10, 2015 By Payers & Providers Staff


    Cedars-Sinai Medical Center has expanded its services into the South Bay area of Los Angeles with the acquisition of Marina Del Rey Hospital.

    Marina Del Rey hospital had previously been operated by a for-profit company, CFHS Holdings, which in turn was operated by Westridge Capital, an L.A.-based investment firm.

  • Paid news articleHospital Midwives Reduce C-Sections

    Marin General Study Also Points to Dedicated OBGYNs

    Sep 9, 2015 By Payers & Providers Staff


    Expecant mothers with private insurance are significantly less likely to undergo Cesarean sections if their care includes midwives and obstetrician coverage.

    That was the conclusion of researchers at UC San Francisco Medical Center and Marin General Hospital.

  • Paid news articleIPA Troubles Lead To Big Plan Fines

    $120K in Penalties Related to Accountable Health Care

    Sep 10, 2015 By Ron Shinkman


    The Department of Managed Health Care has issued $120,000 in fines to five separate health plans in connection to a 2012 incident where the Accountable Health Care IPA was using a non-physician to make medical treatment decisions.

    Molina Healthcare, Health Net, L.A. Care Health Plan and Anthem Blue Cross of California had been ordered to stop using Accountable Care’s utilization review services after the incident, when it was discovered that the son of Accountable Care’s CEO was making decisions to approve or deny medical care to their enrollees

  • Paid news articleMany Elderly Can’t Afford Healthcare

    State’s ‘Hidden Poor’ Often Don’t Qualify For Assistance

    Sep 10, 2015 By Ron Shinkman


    A large swath of California's senior citizens are between a financial rock and hard place, earning not enough to cover their basic needs but too much to qualify for badly needed government assistance, according to a new study by UCLA researchers.

    The study, which was unertaken by the UCLA Center for Health Policy Research, paints an unsettling picture suggesting that many older Californians will not be able to afford the healthcare services they will need as they age.

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