Medi-Cal Provider Rate Cuts Approved
| October 31, 2011 | Posted by Ashley Cohen under Blog |
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Despite already having some of the lowest Medi-Cal reimbursements in the country, the feds recently approved an additional 10% cut to many providers’ Medi-Cal reimbursements (including physicians, dentists, clinics, pharmacies, and most nursing homes). Reimbursements could be as low as $11 after the cuts. The Medi-Cal program costs California $14… more
Infant Mortality Reaches New Low in California
| October 28, 2011 | Posted by Ashley Cohen under Blog |
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Infant mortality in California fell to a new low of 4.9 deaths per 1,000 births in 2009. This beat the previous low that was reached in 2006 with five deaths per 1,000 births. Public health officials think that a possible reason might be better health choices being made by pregnant… more
Policywood: Entertainment Meets Education
| October 26, 2011 | Posted by Ashley Cohen under Blog |
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If you haven’t seen the movie John Q, I highly recommend it. I stumbled upon it on HBO last night while I was complaining about the lack of good TV on Tuesday nights. The 2002 movie stars Denzel Washington as John Q. Archibald, a low-income father whose son is diagnosed… more
Designing the Exchange’s IT System
| October 25, 2011 | Posted by Ashley Cohen under Blog |
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Perhaps the most challenging task in creating the California Health Benefit Exchange is developing the IT infrastructure. The Exchange is faced with never-before-attempted requirements in developing a system that is both complex and user-friendly. The system must be able to interface with other entities, such as county systems, the IRS… more
October Exchange Board Meeting: Strategic Visioning, NPRM Comments, and Design Options
| October 24, 2011 | Posted by Ashley Cohen under Blog |
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On Friday, the California Health Benefit Exchange held its monthly meeting in Sacramento (agenda). This was the first meeting in which Peter Lee was the Executive Director of the Exchange. Diana Dooley, on behalf of the Board and participants, thanked Pat Powers for all of her work leading up to… more
Final ACO Regulations Released
| October 20, 2011 | Posted by Ashley Cohen under Blog |
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Earlier today, HHS released the final regulations for Medicare Accountable Care Organizations. Back in March, a proposed rule was released for stakeholder review. HHS received more than 1,300 comments on the proposed rule asking to increase incentives, streamline the Shared Savings Program, and extending the benefits to a broader range… more
Implementing California’s Small Business Health Exchange
| October 17, 2011 | Posted by Ashley Cohen under Blog |
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On Friday, Small Business Majority hosted its first in a series of forums on implementing California’s small business exchange called “Providing Excellent Insurance at an Appealing Rate.” The panel, moderated by Micah Weinberg of the Bay Area Council, included Terry Gardiner (VP, Policy & Strategy, Small Business Majority), Shawn Nowicki… more
The (Official) End of the CLASS Act
| October 14, 2011 | Posted by Ashley Cohen under Blog |
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Today, the White House announced they are officially pulling the plug on the CLASS Act, a voluntary long-term care insurance program included in ACA. Under the Act, those who participate would receive a minimum of $50/day to fund needed long-term services. Over the past few months, there have been many… more
Blue Shield Provides Refunds to Consumers
| October 13, 2011 | Posted by Ashley Cohen under Blog |
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In June 2011, Blue Shield pledge to limit its profits to 2% of revenue. Based on 2011 earnings, Blue Shield announced that they would be returning $295M to consumers in the form of premium credits. Individual policyholders will be credited an average of $135, mid-large group policyholders (51+ employees) will… more
Defining the Essential Health Benefits
| October 11, 2011 | Posted by Ashley Cohen under Blog |
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ACA requires HHS to develop a set of “essential health benefits” (EHB). Plans in Exchange (in addition to certain plans outside the Exchange) must offer these benefits to consumers as a bare minimum. HHS recently asked the Institute of Medicine (IOM) to assist with developing criteria to determine these benefits.… more
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