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Tag Archives: Patient Access
$2 cigarette tax hike: Doctors and hospitals fight tobacco industry
http://www.sacbee.com/news/politics-government/capitol-alert/article101382077.html
Doctors have long argued that low reimbursement rates are undermining the Medi-Cal system. While more Californians are seeking treatment, the state hasn’t done enough to increase funding to provide care, Corcoran said. Reimbursement rates are not up to par with the cost of practice, making it difficult for physicians to accept Medi-Cal patients, he said.
“It is a broken system,” Corcoran said. “Physicians want to be able to take care of patients. There’s not a lack of desire or a lack of willingness. It’s whether you can actually sustain a practice for all of your patients and provide that level of care that areas need and deserve.”
Medi-Cal is expected to balloon to 14.1 million patients in the current budget year, nearly double the number of Californians using the government-funded health care program four years ago, according to the state. Officials attribute the increase to the federal health care overhaul that expanded subsidized insurance. With a shortage of Medi-Cal doctors, advocates say patients in rural areas and other pockets of the state lack adequate access to care.
During budget talks, the Brown administration has pushed back against the need for rate increases. The administration pointed out that struggling providers can request reimbursement in full and questioned whether higher rates will result in better care.
Uncovered California: Why Millions Have Fallen Into Health Care Gaps
Uncovered California: Why Millions Have Fallen Into Health Care Gaps
“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: Community College Students’ Quest for Mental Health Services
Uncovered California: Community College Students’ Quest for Mental Health Services
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.
Without Medicaid expansion, Texas hospitals left holding the bag
http://www.fiercehealthcare.com/finance/without-medicaid-expansion-texas-hospitals-left-holding-bag
Should Texas ever decide to expand Medicaid eligibility under the Affordable Care Act, its hospitals would be spared about $358 million a year in costs tied to uncompensated care, a new study has found.
The research was conducted by the Florida-based consulting firm Health Management Associates on behalf of the Texas Health and Human Services Commission, The Dallas Morning News has reported. The report was not immediately available online.
If Medicaid were expanded, about 9 percent of the approximately $4 billion a year Texas’ hospitals spend on uncompensated care could be saved, the newspaper reported. Health Management Associates (HMA) predicted about 668,000 Texans out of the 1.1 million eligible for Medicaid coverage would enroll if eligibility were expanded.
But, quoting the report, the newspaper said that Texas lawmakers are not inclined to expand Medicaid anytime soon.
Hospitals more likely to admit children with private insurance
New research shows hospitals are more likely to admit children with private insurance over those with publicly funded plans, particularly during times when there are limited inpatient beds, an indication that reimbursement rates play a role in how hospitals manage pediatric patients in the emergency room.
Researchers from the National Bureau of Economic Research studied billing patterns for children in New Jersey that visited an emergency room between 2006 and 2012. The economists found that children with Medicaid or Children’s Health Insurance Program that presented to the ER with flu symptoms were 10 percent less likely to be hospitalized than those with private plans, according to the Washington Post. During peak flu season, when there was a shortage of inpatient beds, children between 2 and 10 years old on Medicaid and CHIP were 20 percent less likely to be admitted.
Is UC Davis Medical Center Skimping On Care For The Poor?
For at least 20 years, Leslie Love relied on the UC Davis Medical Center’s hospital and clinics for her health care. Her children and grandchildren went to the same doctors there.
“They cared about me,” said Love, a 57-year-old teacher’s assistant who lives near the academic medical center, which is located in Sacramento. “There’s people there that I can trust.”
But that trust was recently broken: Love has been fighting for follow-up care since her knee surgery at UC Davis in 2014. Love’s current Medi-Cal managed care plan, Health Net, ended its contract with the UC Davis Health System in January 2015. As a result, Love could no longer see the physicians there who had treated her knee.
The pullout, which affected an estimated 3,700 patients at the time, means that Health Net’s now nearly 123,000 Medi-Cal managed care enrollees in Sacramento County can no longer seek primary care at UC Davis.
Ever since, tension has been building over what some critics say is limited access for Medi-Cal patients at UC Davis’ health clinics.
Because it is financed partly by state taxpayers, the UC Davis Health System — like all University of California hospitals and clinics — is considered a public institution with a mandate to care for the poor.
That’s why some patients and their advocates are frustrated. They say UC Davis is not fulfilling its mission as a public hospital because the health system generally no longer accepts primary care patients covered by Medi-Cal managed care contracts. Medi-Cal patients still can receive specialized and emergency room care, as well as in-hospital stays.
A state-by-state breakdown of 71 rural hospital closures
More than 70 rural hospitals have closed since 2010 — and many more may be headed down the same path.
Rural hospitals are facing a myriad of financial challenges, and those in states that have not expanded Medicaid are feeling the most financial pressure. Sixty-three percent of hospitals vulnerable to closure are in states that have not expanded Medicaid, according to a report from iVantage Health Analytics, a firm that compiles a hospital strength index based on data about financial stability, patients and quality indicators.
Here are 25 states that have closed at least one rural hospital since 2010, according to research from the North Carolina Rural Health Research Program. For the purposes of its analysis, the NCRHRP defined a hospital closure as the cessation in the provision of inpatient services. Although all of the facilities listed below no longer provide inpatient care, many of them still offer services, including outpatient care, imaging, emergency care, urgent care, primary care or skilled nursing and rehabilitation services.
How rural healthcare organizations are faring in non-Medicaid expansion states.
Hospitals in rural areas of the country are feeling a sharp financial pinch in states that have not expanded their Medicaid programs under the Patient Protection and Affordable Care Act.
Community hospitals in rural counties of Tennessee, one of the states that have opted not to embrace Medicaid expansion, are facing financial pressure that could be relieved if more of their low-resource patients had Medicaid coverage. “In our health systems, they manage it. They have figured it out. Where it’s really hitting is our rural hospitals,” says Craig Becker, president of the Tennessee Hospital Association. “We’ve lost six rural hospitals in the last year, and we’re going to lose another one this year.”
In economically disadvantaged Tennessee communities, many nonelderly adults are either reliant on Medicaid for their health coverage or fall into the “self-pay” category, Becker says. “We only get about 5% of payment for self-pay patients.”
Medicaid is a public form of medical insurance jointly funded by the states and the federal government. Under the PPACA, states can expand their Medicaid programs with federal financial assistance to include all adults in families with incomes below 138% of the federal poverty level.
C-suite feels ripple effect from Medicaid expansion, study says
http://www.healthcarefinancenews.com/news/c-suite-feels-ripple-effect-medicaid-expansion-study-says
Medicaid expansion is making a difference as to whether hospitals are investing in clinics, new equipment and hiring new staff, or looking at the status quo and layoffs, according to a recent report by Georgetown University Health Policy Institute.
Hospitals in Medicaid expansion states have realized a drop in uncompensated care; an increase in institutional financial security; new community efforts to integrate and improve care; and innovative programs to expand access to specialists, according to the study.
CEOs who head hospitals in both expansion and non-expansion states said they saw a drop in uninsured rates in expansion states that was not as dramatic in non-expansion states.
This has translated to a decline in uninsured patient stays by close to 40 percent. Non expansion states reported a decline of 2.9 percent.
HENRY KOTULA 