Costs that Affect You

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Blue Shield says it’s capping profits
The Sacramento Bee

In what it called a “bold move” to cut health care costs, Blue Shield of California said Tuesday [June 7, 2011] it will cap profits at 2 percent of revenue and pump any extra cash back into credits for customers, funding to care providers and grant awards to nonprofits that provide health care to poor Californians.

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There are limits to how much a doctor or hospital may charge for medical records
Los Angeles Times

How do I find the best nursing home for my mom? Can I fight hospital charges that seem wrong? There are so many details to keep track of when trying to get good healthcare it can be enough to make the savviest among us throw up our hands.

That’s the reason for this new column, Health 411. Write to us if you find yourself with some health-related head-scratcher (contact information is at the end of the article) and we’ll try our best to guide you. No, we can’t take on your insurance company when it’s refusing to pay for a brand-name drug, and we don’t “know a guy” who can go after the doctor who botched your nose job and still charged you a fortune for it. But we can talk to the experts and tell you where to go or what steps to take to get the help you need.

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High-Speed telemedicine network gaining steam in California
Government Technology

SACRAMENTO, Calif. — Rural health-care providers will soon have their own broadband network for the practice of telemedicine in California, according to Christine Martin, executive director of the California Telemedicine & eHealth Center (CTEC).

Martin gave an update on the status of telehealth in California on Tuesday, May 10, at Government Technology Conference West 2011, an annual gathering of state IT officials and employees. The conference is hosted by e.Republic Inc., Government Technology magazine’s parent company.

Martin revealed that 300 rural sites will be on a secure, high-speed medical grade network by the end of 2011, as part of the California Telehealth Network’s Rural Health Care Pilot Program. Potentially more than 850 rural sites will be able to use the network. Telehealth and telemedicine are terms used interchangeably to refer to clinical care provided to a patient from a distance, using live video conferencing or digital imagery.

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Medicare patients aren’t taking advantage of some newly free tests
Kaiser Health News (KHN)

This story was done in collaboration with KHN’s partner The Washington Post.

Despite tough economic times, there are some things the government can’t give away.

Starting this year, seniors enrolled in Medicare no longer have to pay for more than a dozen tests and other services to help prevent or control cancer and other costly and debilitating diseases. These benefits, which also include an annual wellness exam, are part of the new federal health-care law.

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Electronic medical records poised to cut costs, improve patient care
Los Angeles Times

Jennifer Gomez sat at her doctor’s office in Evanston after her appointment, waiting for a handwritten prescription. Minutes later, her doctor wondered why Gomez was still in the office.

What the 20-year-old Loyola University Chicago student didn’t know was that not only had the prescription been sent to the pharmacy, it also was ready to be filled.

“The prescription was at my pharmacy before I even walked out of the office, because everything is computerized,” Gomez said of her experience at a clinic run by NorthShore University HealthSystem. “I was surprised, expecting to wait.”

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Stanislaus Indigent health plan is changed
The Modesto Bee

More than 1,200 poor adults in Stanislaus County will pay more for county-sponsored health care — perhaps $105,000 more combined in a given year, leaders decided Tuesday [April 5, 2011].

But other changes in indigent health eligibility could save money for some low-income people in other categories while costing the county $300,000 more per year, according to a report.

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Many don’t take prescriptions because of cost
Los Angeles Times

NEW YORK (Reuters Health) – A significant portion of people - perhaps as many as one in five – don’t take drugs a doctor has prescribed because they can’t pay for them, according to a new survey of people visiting an emergency room.

“I think this is a wake-up call,” study author Dr. Karin Rhodes of the University of Pennsylvania told Reuters Health.

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Drugmakers hike prices of meds facing generic competition
AARP

Prices have soared for some popular brand-name drugs widely used by older men and women — medications whose patents are close to expiring. Why? Manufacturers tend to hike the prices of those drugs in the year or so before they lose their exclusive marketing rights, according to two new reports.

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Nurses to play a greater role in healthcare
Los Angeles Times

Savinh Pouv wears a white coat, treats patients and is considered a primary care provider at the Los Angeles County clinic where she works — but she is not a doctor.

That does not matter to Maria Avalos. What matters, the 55 year-old homemaker said, is that when she comes to the Long Beach clinic to get treated for her diabetes, she always sees Pouv, a nurse practitioner.

“Before, they sent me from one to another,” doctor, Avalos said during a visit last week. “I like her —she checks me well, she has my records, she checks my medications and changes them if I need.”

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Brown signs big budget cuts measures
Contra Costa Times

SACRAMENTO — Amid ongoing talks with Republicans over his tax extension proposal, Gov. Jerry Brown on Thursday [March 24, 2011] signed 13 measures trimming $11.2 billion from the state’s $26.6 billion deficit.

Among what he called budget solutions, $8.2 billion are considered actual spending reductions, while the rest were funding shifts and internal loans.

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Franchise jumps on growing demand for urgent care centers
San Diego Union-Tribune

One of the latest concepts in delivering health care has come to San Diego County.

Doctors Express, the only for-profit national urgent care franchise in the country, has opened two offices in San Diego County since November [2010].

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Some seniors are in for sticker shock on drug premiums
KHN (Kaiser Health News)

The Obama administration often touts the health-law provision that over the next decade will close the unpopular “doughnut hole” — a gap in Medicare prescription drug coverage.

But officials rarely cite another provision, one that might cause sticker shock among some seniors.

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California taxes parents who add adult children to workplace health policies
The Sacramento Bee

Thousands of California parents leaped at the chance to provide health coverage to their grown and uninsured children when a provision in the federal health care law took effect last fall.

Now some of those parents, such as Barry Demant of Folsom, are finding a hidden cost to the new benefit: a bigger tax bill.

A loophole in California’s tax law requires the state to levy income taxes on the premiums employers pay to provide health insurance to the non-dependent children of their workers.

Last fall (2010), Demant added his unemployed 25-year-old daughter to his compa

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Blue Shield seeks rate hikes up to 59% for individuals
Los Angeles Times

Another big California health insurer has stunned individual policyholders with huge rate increases — this time it’s Blue Shield of California seeking cumulative hikes of as much as 59% for tens of thousands of customers March 1.

Blue Shield’s action comes less than a year after Anthem Blue Cross tried and failed to raise rates as much as 39% for about 700,000 California customers.

San Francisco-based Blue Shield said the increases were the result of fast-rising healthcare costs and other expenses resulting from new healthcare laws.

“We raise rates only when absolute

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Regular checkups could save CA billions, prevent hospital stays
The Sacramento Bee

Any doctor can tell you that an ounce of prevention is worth a pound of cure.

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Insurers may have to justify big premium hikes
Los Angeles Times

WASHINGTON — Moving to restrain skyrocketing health insurance premiums, the Obama administration is proposing new rules requiring insurers to justify increases of more than 10 percent a year in 2011.

At the same time, administration officials are planning to step up federal review of premiums if state regulators cannot adequately protect consumers, a move cheered by many leading consumer advocates.

“Ultimately, we know that the bright light of sunshine convinces more insurers to think twice and check their math before submitting large rate hikes,” Secretary of Health and Human Services Kathleen Sebelius said Tuesday (Dec. 21, 2010) announcing the proposed regulation, authorized by the new healthcare law. “This is our latest step to put consumers back in charge of their own health care.”

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New Law’s Health Insurance Regulations Could Mean Rebates For Consumers
Kaiser Health News (KHN)

Millions of Americans might be eligible for rebates starting in 2012 under regulations released Monday, Nov. 22, 2010, detailing the health care law’s requirement that insurers spend at least 80 percent of their revenue on direct medical care.

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Common Surgeries and Charges Comparison

The Office of Statewide Health Planning and Development provides an online tool where you can view and compare the median charge per stay and average length of stay for scheduled elective inpatient procedures.

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Federal COBRA and Cal-COBRA
Consolidated Omnibus Reconciliation Act

If you lose the health insurance you had through your employer, you may be able to continue that coverage for a limited period time under Federal COBRA or Cal-COBRA. Contact your plan administrator to see if you qualify for COBRA or Cal-COBRA continuation coverage.

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