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End-of-Life Choices

Trends in end-of-life care show that not only does the care given vary widely from region to region and hospital to hospital, but also patients often don't get the care they prefer. What can be done?

Care Management Puzzle

Chronic diseases and the cost of care are rising. Are disease management programs improving outcomes for patients with complex, chronic conditions?

No Middleman

Under the "direct primary care" model, patients pay a monthly fee for basic medical services. Learn about the history and current landscape of physician practices offering this arrangement.

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04/10/2013

CMS To Distribute up to $54M in Grants for ACA Exchange Navigators

CMS is accepting grant applications from individuals and organizations seeking to serve as navigators in the Affordable Care Act's federally run and partnership health insurance exchanges. The agency said it expects to distribute up to $54 million total. Modern Healthcare et al.

04/09/2013

Some Calif. Women Denied Breast Pumps Despite ACA

Beginning on Jan. 1, the Affordable Care Act required health insurers to provide nursing mothers with breast pumps, but the law does not specify the type of pump health plans must provide or for how long women qualify after giving birth. Some California women have had their requests for breast pumps denied by their health plans. HealthyCal.

04/09/2013

States Worried About Lack of Time To Test Health Plan Exchanges

Some state officials are concerned that there is not enough time to test their health insurance exchanges before enrollment begins on Oct. 1. The head of Washington state's exchange said the program will be a "work in progress." Modern Healthcare, USA Today.

04/05/2013

CalPERS Audits Health Plans To Find Ineligible Dependents

CalPERS is auditing health plans to ensure that the 733,000 dependents receiving coverage through CalPERS are eligible for such benefits. CalPERS research found that 4% to 8% of dependents on employer-sponsored health plans in others states were ineligible. CalPERS could save more than $1,300 for removing each ineligible dependent from the health plan. Capitol Public Radio's "KXJZ News."

04/04/2013

UC-Riverside Medical School Nabs $3M Grant From Kaiser

On Wednesday, the UC-Riverside School of Medicine announced that it received a two-year, $3 million grant from Kaiser Permanente Southern California. The grant will be used to fund outreach efforts and scholarships for eight of its 50 incoming students. UC-Riverside's medical school is slated to open this fall. Riverside Press-Enterprise.

04/03/2013

Loophole Could Allow Insurers To Avoid ACA Mandates Through 2014

To avoid new Affordable Care Act requirements, some insurers plan to let members renew their current coverage through the end of 2014. However, Kaiser Permanente has said it will not renew policies beyond Jan. 1, 2014, in California and in most other states. Los Angeles Times.

04/03/2013

Report Cites CMS for Poor Oversight of Health Plan Comparison Portal

A report from HHS' Office of Inspector General finds that CMS does not adequately oversee the "Plan Finder" website that it established to help consumers find coverage prior to the launch of the Affordable Care Act's health insurance exchanges. Modern Healthcare, CQ HealthBeat.

04/02/2013

Vermont Is First State To Post Certain Health Plan Rates Under ACA

Vermont has published proposed rates from two health plans serving residents who will purchase individual coverage through the state's health insurance exchange. Vermont is the first state to post such information as required by the Affordable Care Act. AP/Boston Globe et al.

03/27/2013

Health Insurers To Pay More for Medical Claims Under ACA, Report Says

A Society of Actuaries report predicts that health insurers will pay about 32% more for medical claims under the Affordable Care Act, which could lead to premium hikes for consumers. Covered California officials described the report as "misleading." AP/U-T San Diego et al.

03/26/2013

Gold Coast Health Plan OKs Consulting Contract Extension

On Monday, the Ventura County Medi-Cal Managed Care Commission voted 5-3 to approve a 90-day contract extension for an executive services firm to help Gold Coast Health Plan -- an HMO-style alternative for certain Medi-Cal beneficiaries -- address financial and staffing issues. Some commissioners raised concern about the cost of the contract extension. Ventura County Star.

03/26/2013

Michigan, Department of Justice Drop Lawsuit Against BCBS of Mich.

The Department of Justice and the state of Michigan have discontinued their antitrust lawsuit against Blue Cross Blue Shield of Michigan. DOJ said that a new state law banning a controversial contracting practice makes the suit unnecessary. Modern Healthcare, Wall Street Journal.

03/18/2013

Concord Selected To Run Call Center for Health Exchange

After reaching a deal with local unions, the Contra Costa County Board of Supervisors voted to select Concord as the site of a call center for the California health benefit exchange. Meanwhile, a Contra Costa Times editorial criticized the "last-minute" deal, noting that hours before the vote, "there was still no publicly available financial analysis telling supervisors and Contra Costa taxpayers what risk they would be taking on." Contra Costa Times, San Ramon Express.

03/18/2013

Lawmakers Argue Over ACA's Effect on Young Adults' Health Premiums

Last week, GOP members of a House subcommittee argued that provisions of the Affordable Care Act would lead to health insurance premium hikes for young adults in the individual and small-group markets. Democrats said that such claims are overblown. The Hill's "Healthwatch" et al.

03/18/2013

Stakeholders Await Draft of Health Exchange Application

Stakeholders are awaiting the release of a draft version of the application for California's health benefit exchange. Sam Karp -- vice president of the California HealthCare Foundation -- said the state should strive to provide a consumer-friendly process for enrolling in the exchange. KQED's "State of Health."

03/13/2013

Editorial Stumps for Bill To Block Excessive Rate Hikes

A San Jose Mercury News editorial argues that Congress should pass a bill by California Sen. Dianne Feinstein that would grant the HHS secretary the "power to examine health insurance premiums and deny unjustified or excessive rate hikes," which continues to be a problem in California and 16 other states that lack such authority. The editorial adds that if Congress does not pass Feinstein's bill, "Californians should protect their own interests with a ballot proposition planned for 2014." San Jose Mercury News.

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