http://www.lahealthaction.org/index.php/library/index en vcalderon@lahealthaction.org Copyright 2012 2012-05-16T22:04:34-08:00 http://lahealthaction.org/index.php/library/full_entry/3957/ Report providing the 2012 Milliman Medical Index measurements of 14 American cities, including Los Angeles, on total cost of healthcare for a typical family of four covered by a preferred provider plan (PPO). The report finds that family healthcare spending in 2012 reached a new high averaging $20,728, a cost roughly equivalent to that of a basic mid-size sedan. The report provides scenarios detailing potential outcomes of the Supreme Court ruling on ACA and how the different rulings may effect future PPO payments for Americans. Health Insurance and Coverage Programs, Employment-based Health Insurance, Health Care Reform and Expansion, Health Care Financing, Costs of Health Care 2012-05-16T20:56:33-08:00 http://lahealthaction.org/index.php/library/full_entry/3952/ Report providing a funding breakdown of Health and Human Service programs as proposed in the 2012-13 May budget revision by Governor Brown. State Budget, Health Insurance and Coverage Programs, Public Health Insurance Coverage Programs, Health Care Reform and Expansion, Health Care Financing, Costs of Health Care 2012-05-14T18:08:26-08:00 http://lahealthaction.org/index.php/library/full_entry/3947/ Memorandum to the Board of Supervisors providing a recommended budget for the County of Los Angeles FY 2012-13. The memorandum provides a breakdown of the drastic changes taking place in the Department of Health Services' and Medi-Cal revenue streams as a result of the 1115 Waiver, particularly with the Healthy Way LA (HWLA) Matched program, the transition of SPDs into Medi-Cal managed care, the transfer of the Office of Managed Care's lines of business to L.A. Care and the State's transfer of various programs to the County. Health Insurance and Coverage Programs, Public Health Insurance Coverage Programs, Health Care Reform and Expansion, Health Care Financing, Costs of Health Care, Section 1115 Medicaid Waiver 2012-04-17T21:03:35-08:00 http://lahealthaction.org/index.php/library/full_entry/3831/ Memorandum to the Board of Supervisors providing information regarding the Governor's FY 2012-13 proposed State Budget and potential impacts on L.A. County including details on promoting coordinated care and enhancing the quality of home-based and community services for dual eligibles, Healthy Families shift to Medi-Cal, and other pertinent budgetary information related to the Department of Health Services, Mental Health and Public Social Services. State Budget, Health Insurance and Coverage Programs, Health Care Reform and Expansion, Health Care Financing, Costs of Health Care, Medi-Cal Redesign 2012-01-10T19:39:59-08:00 http://lahealthaction.org/index.php/library/full_entry/3811/ Memorandum from the L.A. County CEO to the Board of Supervisors providing an update on the triggered budget reductions and the estimated county impact. As a result of the $2.2 billion State General Fund revenue shortfall, $980.8 million of the triggered reductions outlined in the FY 2011-12 State Budget will be enacted beginning January 1, 2012 with an overall L.A. County impact of $380,000. The Medi-Cal Managed Care Plan will have a reduction of $8.6 million statewide with L.A. County's Department of Health Services receiving a loss of $1.0 million in FY 2011-12. State Budget, Health Insurance and Coverage Programs, Public Health Insurance Coverage Programs, Health Care Financing, Costs of Health Care 2011-12-15T23:20:14-08:00 http://lahealthaction.org/index.php/library/full_entry/3804/ Policy brief presenting findings from a yearlong study that closely followed a small but typical set of older Californians with disabilities who depend on fragile arrangements of paid public programs and unpaid help to live safely and independently at home. Data shows declines in health status and other personal circumstances among aging Californians have been exacerbated by recent reductions in public support, and will be made even worse by significant additional cuts that are pending. Policy recommendations include consolidating long-term care programs and enhancing support for caregivers. Health Insurance and Coverage Programs, Public Health Insurance Coverage Programs, Health Care Financing, Costs of Health Care, Health Status and Issues, Vulnerable Populations and Health Disparities 2011-12-08T18:29:39-08:00 http://lahealthaction.org/index.php/library/full_entry/3803/ Report providing a detailed discussion of baseline health spending by state of residence (per capita personal health care spending, per enrollee Medicare spending, and per enrollee Medicaid spending) in 2009, over the last decade (1998–2009), as well as the differential regional and state impacts of the recent recession. Data shows that California's healthcare spending per person is among lowest in U.S. with a total spending by insurers, government agencies and individuals amounting to $6,238 per resident in 2009, well below the national average of $6,815. Health Insurance and Coverage Programs, Public Health Insurance Coverage Programs, Outreach, Enrollment, Retention and Utilization, Health Care Financing, Costs of Health Care 2011-12-08T18:20:51-08:00 http://lahealthaction.org/index.php/library/full_entry/3761/ Memorandum from L.A. County DHS to the Board of Supervisors requesting delegated authority to execute an agreement to structure the long-term financial relationship with L.A. Care and to provide for the orderly transfer for health plan operations from the Community Health Plan (CHP) to L.A. Care effective on date of approval through December 31, 2021. Health Insurance and Coverage Programs, Public Health Insurance Coverage Programs, Outreach, Enrollment, Retention and Utilization, Health Care Reform and Expansion, Health Care Financing, Costs of Health Care, Section 1115 Medicaid Waiver 2011-11-08T22:07:57-08:00 http://lahealthaction.org/index.php/library/full_entry/3760/ Memorandum from L.A. County DHS to the Board of Supervisors requesting delegated authority for contractual actions necessary to transfer the In-Home Supportive Services (IHSS) Health Care Plan product line to L.A. Care, as the next stage of the policy direction approved by the Board to transition the Community Health Plan (CHP) staff to serve as the Medical Service Organization (MSO) function for DHS, concentrate DHS resources on being the key provider of health care for Medi-Cal and uninsured populations in L.A. County, and transition all lines of business from the CHP to L.A. Care to assume all health plan functions. Health Insurance and Coverage Programs, Public Health Insurance Coverage Programs, Outreach, Enrollment, Retention and Utilization, Health Care Reform and Expansion, Health Care Financing, Costs of Health Care 2011-11-08T21:38:50-08:00 http://lahealthaction.org/index.php/library/full_entry/3719/ Memorandum from the L.A. County Department of Public Health (DPH) to the Board of Supervisors following up on the Board approved DPH recommendation to prepare the execute sole-source agreements with certified and/or licensed alcohol and drug providers for Assembly Bill 109 under the Public Safety Realignment Act. This memorandum contains a list of the agencies that will be funded at $1 million for FY 2011-12. State Budget, Health Care Delivery Systems, Health Care Financing, Costs of Health Care, Health Status and Issues 2011-10-12T18:13:12-08:00 http://lahealthaction.org/index.php/library/full_entry/3698/ Report analyzing data that shows elderly Hispanic and Medicaid patients accounted for 1% and 15%, respectively, of the patient population at the best hospitals, while at the worst hospitals, these groups represented 4% and 23% of the patients. Report's findings have important implications for Medicare’s forthcoming value-based purchasing program. The worst institutions in particular will have to improve on both costs and quality to avoid incurring financial penalties and exacerbating disparities in care. Health Insurance and Coverage Programs, Public Health Insurance Coverage Programs, Health Care Reform and Expansion, Health Care Financing, Costs of Health Care 2011-10-06T17:36:25-08:00 http://lahealthaction.org/index.php/library/full_entry/3691/ Report examining how changes in the way federally qualified health centers (FQHCs) are financed could support the transformation of these critical safety-net providers into high performing patient-centered medical homes. Based on their findings, the authors make preliminary recommendations to encourage health centers to serve as patient- and community-centered medical homes including 1) establishing recommended standards for patient- and community-centered medical homes that apply to FQHCs; 2) structuring payment incentives to promote medical homes; 3) including FQHCs in state Medicaid medical or health home projects; adapting payment approaches, including adding monthly case management fees; and 4) encouraging the Health Resources and Services Administration to use quality-of-care measures in making funding decisions. Health Insurance and Coverage Programs, Public Health Insurance Coverage Programs, Health Care Reform and Expansion, Health Care Delivery Systems, Ambulatory Care, Health Care Financing, Costs of Health Care 2011-10-03T20:43:29-08:00 http://lahealthaction.org/index.php/library/full_entry/3673/ Memorandum from L.A. County DHS to the Board of Supervisors proposing a reduction in the PSIP reimbursement rate from 18% to 12% for all outstanding claims for FY 2010-11, and reduce the rate for FY 2011-12 to 14% of the Official County Fee Schedule (OCFS) due to the FY 2009-10 State Budget funding reductions to the PSIP, the continued increase in claim volume, and a slight increase in payment per claim. Continuing reimbursement at the current 18% of OCFS would result in a projected shortfall of $1.2 million for FY 2010-11 and $3.3M for FY 2011-12. If there is a significant decrease in the number of PSIP claims, and a significant funding balance remains after all claims are paid at reduced rates, a supplemental payment may be made, not to exceed 35% of OCFS. State Budget, Health Insurance and Coverage Programs, Outreach, Enrollment, Retention and Utilization, Health Care Financing, Costs of Health Care, Health Status and Issues, Vulnerable Populations and Health Disparities 2011-09-20T18:08:35-08:00 http://lahealthaction.org/index.php/library/full_entry/3764/ Report on estimated federal savings associated with care coordination models for Medicare and Medicaid dual eligibles. As of 2010, over 9 million individuals were eligible for both Medicare and Medicaid. Dual eligibles are among the most expensive and chronically ill of all patients with per capita spending among dual eligibles exceeding $20,000 per year. Report shows team-based care models working with severely chronically ill patients have been shown to reduce hospitalizations and readmissions, and cut down on rates of nursing home admissions demonstrating the potential for team based care to improve quality and lower spending through improved care coordination and transitions of care. Health Insurance and Coverage Programs, Public Health Insurance Coverage Programs, Health Care Reform and Expansion, Health Care Delivery Systems, Hospitals, Health Care Financing, Costs of Health Care, Health Status and Issues, Chronic Conditions 2011-09-01T18:39:41-08:00 http://lahealthaction.org/index.php/library/full_entry/3604/ Memorandum providing an update on legislation regarding the extension of hospital provider fee (SB 335) and health care coverage for behavioral treatment for individuals with autism (SB 770). SB 335 (Hernandez and Steinberg) would extend the existing hospital provider fee through December 31, 2013. All funds received by public and private hospitals must be used to draw down federal funds for hospital services in the Medi-Cal program. The measure also would establish the Low Income Health Program (LIHP) Medicaid Expansion Out-of-Network Emergency Care Services Fund. SB 770 (Steinberg and Evans) would required health care service plan contracts and health insurance policies to provide coverage for behavioral treatment and other prescribed intervention therapies for individuals with autism. Health Insurance and Coverage Programs, Outreach, Enrollment, Retention and Utilization, Health Care Reform and Expansion, Health Care Delivery Systems, Hospitals, Health Care Financing, Costs of Health Care, Section 1115 Medicaid Waiver 2011-08-25T19:46:13-08:00 http://lahealthaction.org/index.php/library/full_entry/3577/ Policy brief examining how premiums for individual health insurance differ around the nation, finding that premiums can vary substantially from state to state. The average per-person premium in 2010 ranged in cost from approximately $136 per month in Alabama to more than $400 per month in Vermont and Massachusetts. The average across all states was $215 per member per month. California's average premium was $157 per month. Health Insurance and Coverage Programs, Health Care Financing, Costs of Health Care 2011-08-09T18:14:10-08:00 http://lahealthaction.org/index.php/library/full_entry/3521/ Policy brief summarizing the major provisions of a rule proposed by the Centers for Medicare and Medicaid Services that would set forth state requirements for ensuring access to care in state Medicaid programs. It would apply to fee-for-service Medicaid, but not to Medicaid managed care programs. Under the proposed rule, state Medicaid agencies would have to review access to a subset of Medicaid-covered services every year, and review access to every Medicaid-covered service at least once every five years. State Budget, Health Insurance and Coverage Programs, Public Health Insurance Coverage Programs, Health Care Financing, Costs of Health Care 2011-07-26T17:49:00-08:00 http://lahealthaction.org/index.php/library/full_entry/3513/ Letter urging federal legislators to reject the $100 billion in proposed Medicaid cuts, which will undermine patients’ well-being, severely limit access to quality care and coverage, accelerate job loss and adversely impact economic recovery in California. State Budget, Health Insurance and Coverage Programs, Public Health Insurance Coverage Programs, Health Care Reform and Expansion, Health Care Delivery Systems, Health Care Financing, Costs of Health Care 2011-07-25T21:41:40-08:00 http://lahealthaction.org/index.php/library/full_entry/3512/ Letter urging President Obama, Congressional leadership and key federal officials to reject two federal Medicaid proposals under discussion in the FY 2012 budget: 1) Reducing the overall matching rate for Medicaid and the Children’s Health Insurance Program (CHIP) and 2) Limiting or eliminating Medicaid provider taxes, both of which would cause harm to L.A. County's health care safety net. State Budget, Health Insurance and Coverage Programs, Public Health Insurance Coverage Programs, Health Care Reform and Expansion, Health Care Delivery Systems, Health Care Financing, Costs of Health Care, Section 1115 Medicaid Waiver 2011-07-19T21:36:19-08:00 http://lahealthaction.org/index.php/library/full_entry/3489/ Report on Oregon's 2008 Medicaid expansion program, which provided 10,000 out of 90,000 low-income adults coverage through a lottery system, which provided the first randomized controlled study of insuring previously uninsured adults. Therefore, it may offer some important clues to the likely impact of the Affordable Care Act. This ongoing study found that Medicaid coverage in Oregon increased individuals' health care access and use of services, lowered out-of-pocket costs, reduced medical debt, and improved self-reported health and well being. Health Insurance and Coverage Programs, Public Health Insurance Coverage Programs, Health Care Reform and Expansion, Health Care Financing, Costs of Health Care 2011-07-14T19:57:09-08:00