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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.

Long-Term Care

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05/08/2013

Opinion: Extend Fair Pay Rules to Home Care Workers

In a HealthyCal opinion piece, Dorie Seavey -- policy research director for the Paraprofessional Healthcare Institute -- and Eileen Boris -- chair of the Department of Feminist Studies at UC- Santa Barbara -- argue in favor of a proposed rule by the Obama administration to extend federal minimum wage and overtime rules to about 500,000 California home care works and nearly two million workers nationwide. They conclude that providing such protections "under the Fair Labor Standards Act would help make home care a respected occupation -- and ensure the stable, skilled home care workforce necessary to support growing numbers of Californians who, despite functional limitations, wish to live in their own homes and communities." HealthyCal.

05/01/2013

Proposal Would Raise Medicare Payments for Hospice Care Services

A new proposed rule from CMS would raise Medicare payment rates for hospices by 1.1% for fiscal year 2014. The proposal comes amid a rise in CMS spending on hospice care and an increase in Medicare enrollees' use of hospice services. Modern Healthcare, CQ HealthBeat.

04/17/2013

S.D. Health Systems: Block Skilled Nursing Medi-Cal Cut

San Diego County-based Palomar Health and Sharp Healthcare have announced their support for a bill that would stop a retroactive cut to Medi-Cal reimbursements for hospital-based skilled nursing services. Sharp and Palomar are the only two health systems in the county that operate skilled nursing homes. U-T San Diego.

04/11/2013

Leaders Push To Exempt Skilled Nursing From 10% Medi-Cal Cut

Yesterday, lawmakers, hospitals and labor unions held a rally to stump for a bill that would exempt hospital-based skilled nursing facilities from a retroactive 10% cut to Medi-Cal reimbursements. Sacramento Business Journal, Capital Public Radio's "KXJZ News."

04/10/2013

Online Insurance Brokers Eye Potential ACA Windfall

Online insurance brokers want consumers to use their websites to purchase health plans under the Affordable Care Act. In March, HHS approved partnerships between states and online insurance brokers but set strict standards on the information that the private websites must display. However, consumer advocates warn that the brokers might undermine the ACA by heavily promoting plans that pay a larger commission. Washington Post's "Wonkblog."

04/04/2013

Study: Number of People With Dementia, Cost of Care To Increase

A study published Wednesday in the New England Journal of Medicine finds that the number of U.S. residents with dementia is expected to more than double by 2040. According to the study, the cost of caring for U.S. residents with dementia is expected to reach as much as $511 billion by 2040. New York Times et al.

03/29/2013

Demand for Calif. Home Care Workers High, but Pay Low

Demand for home care workers is increasing, as many older adults choose to stay in their homes for as long as possible. However, the wages for home care workers in California are far below the 2009 federal poverty level, according to the Paraprofessional Healthcare Institute. HealthyCal.

03/26/2013

New Murrieta Nursing Home Unit Fills Post-Acute Care Gap

Murrieta officials say the addition of a new 46-bed unit at County Villa Murrieta, a skilled nursing facility, has helped address a shortage of medical services and post-acute care in the area. Facility officials said a goal of the new post-acute care unit is to boost pain management and recovery for patients who have had procedures in local surgery centers. U-T San Diego.

03/25/2013

Lincoln Nursing Facility Cited, Fined in Patient's Death

On Friday, the California Department of Public Health issued a $100,000 fine and a "Class AA" citation -- the most serious citation possible -- against Lincoln Meadows Care Center after an investigation found that the facility overmedicated a stroke patient who later died. Plum Healthcare -- the current owner of Lincoln Meadows -- declined to comment on the citation.  Sacramento Bee.

03/22/2013

Medicare Studies Cost of Long-Term Acute Care in Santa Cruz County

Officials in California are seeking to learn why long-term acute care spending in Santa Cruz County is significantly lower than in other U.S. counties. They are working with county officials to assess whether the region's practices could be replicated nationwide. HealthyCal.

03/18/2013

S.D. Hospice To Relocate All Patients by End of Month

Last week, a lawyer for San Diego Hospice -- which filed for bankruptcy protection last month amid a federal probe into its care delivery practices -- said the facility's nearly 1,000 patients would be relocated to new care providers by the end of the month. The announcement came during a court hearing as part of the hospice's bankruptcy proceedings. U-T San Diego.

03/11/2013

Editorial: CalPERS' Long-Term Care Promise Was 'Reckless'

A Sacramento Bee editorial argues that "early buyers of CalPERS' more expansive long-term care policies" have good reason to "feel burned" after the recent approval of a plan to raise premiums for such policies by 85%. According to the editorial, "While there was no guarantee, CalPERS created an expectation that the cost of this extraordinary benefit would remain flat forever." It adds, "It was a reckless promise." Sacramento Bee.

03/04/2013

Bankruptcy Judge: San Diego Hospice Can Pay Employees

On Friday, a state bankruptcy judge said that San Diego Hospice could make retroactive and future payroll payments. The hospice -- which filed for bankruptcy protection last month amid a federal probe into its care delivery practices -- said that employees might quit if they do not receive the payments. U-T San Diego.

03/04/2013

Opinion Piece Criticizes Media Coverage of CalPERS Rate Hike

In a Sacramento Bee opinion piece, Ann Boynton -- deputy executive officer for benefit programs, policy and planning at CalPERS -- argues that California's "media appear to be pandering to the sensational … when it comes to their coverage of premium increases in the CalPERS long-term care program." She writes, "What is missing in media coverage is that at the same time the board also approved new alternative benefit plans that give CalPERS [long-term care] policyholders options for relief from the financial impact of the 2015 rate increase." Sacramento Bee.

02/28/2013

Policyholders Say That CalPERS Misled Them on Long-Term Care Rates

CalPERS' long-term care policyholders are criticizing a new premium increase, saying they were promised when purchasing the plans that rates would not increase. However, marketing materials noted that rates could be changed through actions by the CalPERS Board. Sacramento Bee's "The State Worker."

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