California Healthcare News

On orders from Congress, Medicare is easing up on its annual readmission penalties on hundreds of hospitals serving the most low-income residents, records released last week show.

For the seventh year, Medicare is punishing hospitals for having too many patients end up back in their care within a month. The government estimates the hospital industry will lose $566 million over a year. The penalties, an effort to encourage better care, are a signature effort of the Affordable Care Act.

The birth rate of California’s teenagers has continued its long decline, according to data from the California Department of Public Health (CDPH).

According to the data, the birth rate among Californians age 15 to 19 was 15.7 per 1,000 in 2016. That reflects an 11% decline from 2015, and is a record low, state officials said. The rate was 46.7 per 1,000 in 2000. Eighteen years ago, California’s teens gave birth more than 55,000 times. In 2016, little more than 21,000 births were recorded. In 2000, 895 children under the age of 15 gave birth; in 2016, it was 195.

A new Health Affairs study found that "in 41 highly concentrated California counties, the percentage of hospital-employed physicians increased from about 25% in 2010 to more than 40% in 2016...The national share of hospital-employed physicians increased from 30% to 48% from 2010 to 2016."

Source: Health Affairs

Tania Alvarado’s 13-year-old daughter doesn’t smile much anymore. She doesn’t want anyone to see her front teeth, which are so crowded they’re nearly growing atop one another. The crowding makes it painful to eat; it also embarrasses her.

“Am I going to get those braces this year?” the Los Angeles eighth-grader asks her mom, again and again.

Alvarado always answers her the same way: “It’s still not happening.”

Gov. Jerry Brown has signed into a law a bill that will require all hospitals in California to prepare vegan meals for patients on request.

Senate Bill 1138 mandates that hospitals offer “wholesome, plant-based meals of such variety as to meet the needs of patients in accordance with their physicians’ orders.” The bill also requires such offerings be made to California’s prisoners.

A new California Workers’ Compensation Institute study of California Workers Comp claims in 2016-2017 found that 43 percent of the claims had no overlapping prescriptions; 33 percent had two concurrent prescriptions; 20 percent had three to four concurrent prescriptions; while 4 percent had five or more concurrent prescriptions and were considered polypharmacy claims.

California’s expansion of Medicaid under the Affordable Care Act enabled many low-income HIV patients to get health insurance previously denied to them. Still, those with mental health needs, who had been receiving coordinated care through a separate federal program, suddenly faced gaps in treatment, payment disputes and doctors who had little understanding of life with HIV.

Even as the Affordable Care Act is potentially imperiled by a case being litigated in federal court in Fort Worth, Texas, California has benefitted the most of any state from its provisions, according to new data from the U.S. Census Bureau.

Overall, the uninsured rate in California dropped from 17.2% prior to the enactment of the ACA five years ago to 7.2% at the end of last year, according to the federal data.

Plans With Over 400,000 Enrollees:

- Anthem Blue Cross: 5.44
- Blue Shield of California: 5.42
- Health Net of California: 0.65
- Inland Empire Health Plan (IEHP): 0.14
- Kaiser Permanente: 0.45
- L.A. Care Health Plan: 0.22
- Molina Healthcare of California: 0.71
- UnitedHealthcare of California: 1.51
Avg For Plans With Enrollment Over 400,000: 1.91
Avg For Plan With Enrollment Under 400,000: 1.06