States that resisted the ACA face the biggest hurdles in 2017

http://www.fiercehealthcare.com/payer/states-resisted-aca-face-biggest-hurdles-2017?utm_medium=nl&utm_source=internal&mrkid=959610&mkt_tok=eyJpIjoiWmpJMlpEZzFZbVV3WXpSaSIsInQiOiI0dCs1NW9kd0ord0VnTUpDWkgzcUp6VmpOV09JNUpldnBqcTh3eUJNTithQUs5QWc0N1JBbjJRYWZmRVJRN216MjNHQ2tFNGhrQWNON2NwR0dLSkdiVTZTSGxDVEZkNVwvejNoRitlVFpGblU9In0%3D

Document titled "Patient Protection and Affordable Care Act"Document titled "Patient Protection and Affordable Care Act"

States that are set to experience reduced competition in their health insurance exchanges also appear to be the ones that were unwilling to lay the groundwork to create a robust marketplace.

The issues that many states are now facing regarding consumer choice and premium pricingwere predicated by resistance from Republican politicians, who failed to expand Medicaid or conduct the necessary outreach to enroll healthy individuals into marketplace plans, according to the Los Angeles Times. In fact, eight of the nine states that have the fewest plan options next year refused to expand Medicaid and failed to engage in outreach.

“It’s the same basic lesson I tell my kids,” Joel Ario, a former insurance commissioner in Oregon and Pennsylvania, told the newspaper. “If you put the work into something, you will get results. If you just sit on the sidelines and complain, you shouldn’t be surprised if things don’t work out.”

Uncovered California: Why Millions Have Fallen Into Health Care Gaps

Uncovered California: Why Millions Have Fallen Into Health Care Gaps

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“Right now, I have a medicine sitting at Wal-Mart pharmacy that I can’t purchase till payday,” Jacqueline, a 55-year-old San Diegan told me during a telephone interview in mid-April. She asked that her last name not be used for this story. “I’ll go without, eight or nine days till payday. It’s for my high cholesterol.”

Five years after the Affordable Care Act became law, and more than three years after California began moving aggressively to implement its provisions, upwards of three million Californians remain without health care coverage; and millions more, like Jacqueline, have basic coverage but continue to be grievously under-insured.This is the story of how so many Californians continue to fall through the ACA’s cracks.

“Uncovered California” is a three-part series of stories and videos examining how the Golden State is trying to fill holes in its health care coverage. Sasha Abramsky’s articles look at working people who are falling through coverage cracks, and at what’s being done to help community college students gain access to mental health services. Debra Varnado reports on efforts to expand the role of nurse practitioners to increase medical services for low-income Californians.

Uncovered California: What’s Holding Back Nurse Practitioners?

Uncovered California: What’s Holding Back Nurse Practitioners?

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Nurse practitioners, or NPs, are registered nurses with “advanced clinical training at the master’s and doctoral levels, providingprimary, acute and specialty health care services,” according to the American Association of Nurse Practitioners. Most NPs (55 percent) specialize in family care and in adult gerontology (nearly 21 percent). A significant number provide acute, pediatric, neonatal, women’s and psychiatric health care services.

According to a 2014 study published in Nursing Outlook, nurse practitioners are significantly more likely than primary care physicians to “practice in urban and rural areas, provide care in a wider range of community settings and treat Medicaid recipients and other vulnerable populations.”

“Uncovered California”is a three-part series of stories and videos examining how the Golden State is trying to fill holes in its health care coverage. Sasha Abramsky’s articles look at working people who are falling through coverage cracks, and at what’s being done to help community college students gain access to mental health services. Debra Varnado reports on efforts to expand the role of nurse practitioners to increase medical services for low-income Californians.

 

Uncovered California: Community College Students’ Quest for Mental Health Services

Uncovered California: Community College Students’ Quest for Mental Health Services

Mental Health infographic

On April 19, 35-year-old Sacramento City College student Rachel Wilson testified before the state Assembly’s higher education committee. A survivor of sexual assault and multiple suicide attempts, she described the lack of mental health support services available to her at school. Wilson was followed by an American River College professor, whose own son had killed himself while studying at a community college. The professor talked about three students who had recently committed suicide at her school, and of the lack of mental health services to help troubled individuals. When faculty members saw someone in crisis, she said, they were instructed to call campus police and have them take the student away.

“Mental illness is not a crime,” she told legislators. Then she repeated it: “Mental illness is not a crime.”

 Both women wanted the legislators to support Kevin McCarty’s (D-Sacramento) Assembly Bill 2017, which would significantly expand mental health services across California’s vast community college system.

Roughly two million Californians attend classes in one or another of the 113 community campuses dotted around the state. Surveys suggest that somewhere in the region of one in four of these students will experience a diagnosable mental health problem at some point, but approximately 40 percent of them won’t seek timely help. And too often, the institutions at which they study won’t be proactive in linking them up with vital services. As a result, they go untreated.

“Uncovered California” is a three-part series of stories and videos examining how the Golden State is trying to fill holes in its health care coverage. Sasha Abramsky’s articles look at working people who are falling through coverage cracks, and at what’s being done to help community college students gain access to mental health services. Debra Varnado reports on efforts to expand the role of nurse practitioners to increase medical services for low-income Californians.

Mylan’s CEO A Villain? Depends On Your Preferred Brand Of Capitalism

http://healthaffairs.org/blog/2016/09/06/mylans-ceo-a-villain-depends-on-your-preferred-brand-of-capitalism/

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Different Flavors Of Capitalism

As usual, the answer is a clear “No” and “Yes,” and resolving the question raises much deeper issues than one executive’s personal culpability. The answer depends on what definition of capitalism one deems appropriate. As the European economist André Sapir has noted, there are actually four distinct brands of capitalism in the Western economy, of which the version practiced in the United States and some other Anglo-Saxon countries—sometimes also referred to as “savage capitalism”—is but one.

The clearest version of raw Anglo Saxon capitalism, and one quoted widely to this day, was offered by the late Nobel Laureate economist Milton Friedman in his classic book “Capitalism and Freedom.” There he proposed that the one and only social obligation to society that the CEO of an investor-owned, for-profit company is “to maximize its profits while engaging in ‘open and free competition without deception and fraud.’” (Quoted in Thomas Carson’s “Friedman’s Theory of Corporate Social Responsibility.”) On that view, any corporate action that is legal is ipso facto ethical.

Ms. Bresch can argue that with her aggressive pricing policy on EpiPen she was merely owning up to this doctrine of Anglo-Saxon capitalism. Her board of directors may or may not have known about that policy with regard to this particular product, one of many the company sells. Here Ms. Bresch also can point out that she is in good company in the drug industry. Many drug companies beyond the poster-boys for what is now decried as “price gouging”—Valeant Pharmaceuticals International and Turing Pharmaceuticals—have adopted raw Anglo-Saxon capitalism as the intellectual foundation for their pricing policies by steadily raising prices on long existing drugs, year after year, or even quarter after quarter.

Is the CQO Position Needed?

http://www.healthleadersmedia.com/quality/cqo-position-needed?spMailingID=9476343&spUserID=MTMyMzQyMDQxMTkyS0&spJobID=1000559816&spReportId=MTAwMDU1OTgxNgS2

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In a healthcare system’s most mature state, everyone owns quality,” says Baylor Scott & White Health’s chief quality officer. So if everyone owns quality, why have a CQO?

As Healthcare Changes, So Must its CEOs, CFOs, COOs…

http://www.healthleadersmedia.com/leadership/healthcare-changes-so-must-its-ceos-cfos-coos%E2%80%A6

Image result for CEO, COO, CFO

To keep up with big changes in how healthcare is administered, financed, and organized, top leaders are finding a need for new talents and organizational structures.