Costs that Affect You

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States are all over the map on health overhaul
San Francisco Chronicle

A list of states and their uninsured population, grouped according to the progress they have made in establishing health insurance exchanges, a linchpin for expanding coverage under President Barack Obama’s health care overhaul law.

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New group to set priorities for medical effectiveness research
Kaiser Health News

More than two years ago, studies found that injection of medical cement into compression fractures of the spine produced no better pain relief than “sham” injections.

Yet doctors continue to perform the $5,000-plus procedure and most insurers, including Medicare, still cover it.

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1% of U.S. residents accounting for 20% of total health spending
California Healthline

One percent of U.S. residents accounted for more than 20% of overall health care spending in 2009, according to a report by the Agency for Healthcare Research and Quality, HealthLeaders Media reports.

Further, just 5% of U.S.

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Health programs face significant cuts under Brown’s budget plan
California Healthline

On Thursday [January 4, 2012], Gov. Jerry Brown (D) released his budget proposal for the 2012-2013 fiscal year, the San Francisco Chronicle reports.

The $92.6 billion spending proposal includes deep cuts to health and human services programs.

The administration’s Department of Finance estimated that California will face a $9.2 billion shortfall in the next fiscal year. The Legislative Analyst’s Office had projected the state would face a nearly $13 billion deficit.

Brown initially planned to release the proposal next week.

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State Medicaid spending soars
Reuters

Spending by U.S. states on Medicaid, the healthcare program for the poor, soared last year and will likely continue growing despite measures to contain costs, according to a report released on Tuesday [December 13, 2011].

Total Medicaid spending, excluding administrative costs, likely reached $398.6 billion in fiscal 2011, which ended in June for most states. That was up 10.1 percent from the year before, when spending rose 6 percent, the National Association of State Budget Officers reported.

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Health law may accelerate growth in urgent care centers
Kaiser Health News

CAPITOL HEIGHTS, Md. — After Dwayne Duckenfield banged his right elbow working around the house on a recent Saturday, he grew worried when the swelling didn’t go down and the pain worsened.

Concerned he may have broken a bone, the project manager who lives in Washington, D.C., didn’t go to the nearest emergency room or wait until Monday to call his physician for an appointment. Like an increasing number of Americans looking for fast and affordable health care, he went to an urgent care facility.

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California’s healthcare spending per person among lowest in U.S.
Los Angeles Times

For more evidence that the Golden State has lost some of its luster, consider this news from the federal government: California spends less per person on healthcare than all but eight states.

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Health official takes parting shot at ‘waste’
The New York Times

WASHINGTON — The official in charge of Medicare and Medicaid for the last 17 months says that 20 percent to 30 percent of health spending is “waste” that yields no benefit to patients, and that some of the needless spending is a result of onerous, archaic regulations enforced by his agency.

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Higher copays seen for Medicare brand-name drugs
San Francisco Chronicle

With three weeks left for seniors to change their Medicare prescription plan for 2012, a study released Wednesday [November 16, 2011] finds that copays for brand-name drugs are going up — sharply in some cases.

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New study shows health insurance premium spikes in every state
The Washington Post

Premiums for employer-sponsored health insurance have risen faster than incomes in every state in the nation, according to a report released Thursday [November 10, 2011].

The analysis of federal data by the Commonwealth Fund, an independent research organization, shed new light on the state-by-state picture while essentially confirming a national trend, highlighted in other recent surveys of employer-sponsored insurance, of greater premiums for skimpier benefits.

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Proposed Fresno County health program too costly
The Fresno Bee

A Community Medical Centers proposal for a low-income health program in Fresno County would improve health care for the poor but would be too costly, a county analysis says.

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State Medicaid spending skyrockets
Kaiser Health News

The end of federal stimulus spending is going to mean nothing but pain for state Medicaid programs in fiscal 2012.

State Medicaid spending is projected to grow by an average of 29 percent in the budget year that began July 1, the biggest increase in the history of the federal-state health insurance program for the poor and disabled, according to a report released Thursday [October 27, 2011]

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$6.8 billion spent yearly on 12 unnecessary tests and treatments
Kaiser Health News

For many adults, a routine visit to a primary care physician might involve blood tests, a urinalysis, an electrocardiogram, maybe a bone density scan. Too often, however, these tests are inappropriate and they cost a bundle, according to a recent study,  not only for the health care system but also for individuals, who are increasingly footing more of the bill for their care.

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INLAND: Retail pharmacies take on provider role
The Press-Enterprise

Six free health screenings lured Vicki Masters to a Riverside Walgreens last week.

She was among almost a dozen people who waited to board the AARP/Walgreens Wellness Tour bus. Once inside the bus, medical technicians tested customers’ blood glucose, cholesterol, body mass index, waist circumference, blood pressure and bone density. The round of tests, valued at $100, took about five minutes.

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To ACO or not to ACO, that is the Bay Area question
San Francisco Business Times

Bay Area health care organizations that have been sitting on the fence may be more likely to explore starting an ACO, now that the feds have loosened rules and time lines, and enhanced financial incentives.

Accountable care organizations, a key part of President Barack Obama’s health reform package, are in effect an experimental Medicare pilot designed to control costs while improving quality, although other forms of ACOs are being explored outside that government framework.

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CMA urges federal officials to review Medi-Cal payment rates
California Healthline

The California Medical Association has requested that CMS assess whether California pays health care providers enough to guarantee adequate access to care for Medi-Cal beneficiaries, California Watch reports. Medi-Cal is California’s Medicaid program.

CMA also is involved in an effort urging federal officials to reject Gov.

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Assisted living, nursing home costs keep rising
Sacramento Business Journal

Nursing home, assisted living and adult day health care costs rose faster in the Sacramento region than they did nationwide over the last year, but the cost of home health aides stayed the same.

The national average for private room nursing home rates rose 4.4 percent to $239 per day in 2011 — or $87,235 annually — according to a new market survey released Tuesday by MetLife. Private room rates in assisted living centers rose 5.6 percent, to $41,724 annually.

Meanwhile, the average private room nursing home rate in the Sacramento region — defined as “rest of the state” outside Los Angeles, San Diego and San Francisco — rose 6.7 percent, to $272 per day or $99,280 annually. Rates rose 3.7 percent, to 48,720 annually for private rooms in assisted living centers in the Sacramento region.

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Insurers, employers offer incentives to promote healthful habits
Los Angeles Times

American Express Co. paid thousands of employees to exercise this summer, giving each $200 toward their healthcare expenses simply for walking 21/2 miles a day.

Health insurance giant Humana Inc. has begun offering camping gear, cameras and even hotel rooms in the Caribbean to customers who see the doctor and undergo tests for blood pressure and cholesterol.

And when the new year arrives, Blue Shield of California will introduce its new Blue Groove plan offering breaks of up to $500 on insurance premiums or healthcare costs to policyholders in the Sacramento area who fill out health questionnaires and get medical screenings.

Growing numbers of employers and insurance companies, stung by continued hikes in healthcare costs, are offering employees money and merchandise to lead healthier lives. Advocates of the approach are betting that preventive action will keep workers productive and hold down healthcare bills for expensive diseases like cancer and diabetes.

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Anthem pulls switch on Medicare Advantage subscribers
Los Angeles Times

A pair of letters to the health insurer’s California customers sparks confusion. Anthem, it turns out, is replacing its California Medicare Advantage plan with 13 regional variations that allow it to set premiums and benefits according to local conditions.

Consumers receive their fair share of sucker punches from big corporations. But this one’s a real beauty.

And it affects all California seniors with Medicare Advantage plans offered by Anthem Blue Cross.

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California telehealth law could cut costs by $1B, report concludes
California Healthline

California could achieve significant Medi-Cal cost savings by expanding telehealth services through legislation (AB 415) that Gov. Jerry Brown (D) signed into law earlier this month, according to a report prepared for the Center for Connected Health Policy, CMIO reports. Medi-Cal is California’s Medicaid program.

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