As a Senior Peer Advocate in well-heeled Santa Clara County –
home to many Silicon Valley fortunes – Donna L. Weisblatt shared
this shocking observation about the region’s hidden underbelly:
“The number of people bringing in less than $1,000 a month and
needing to find housing.”
Denial runs deep among Californians when they think about growing
old: nearly four in ten told pollsters in a recent survey that
aging is something they “would rather not think about.” But for
many, that better change, because most people are going to need
some form of long-term care as they age, and few are prepared for
California has taken the idea of managed care for low-income
seniors and people with disabilities to a whole new level. Under
an agreement with the Obama Administration announced last week,
the state will begin shifting both medical care and long-term
supports and services to managed care companies in just seven
Watch this closely. You may be looking at the future.
Many California residents gave their HMO plans good or excellent
scores for providing health care but assigned lower scores for
the plans’ access to care, according to a statewide report
card from the state Office of the Patient Advocate, the
Ventura County Star reports.
Report Card Details
The annual report card scores HMO and PPO insurance plans that
cover a total of 16 million California residents (Kisken,
Ventura County Star, 3/27).
It ranks health plans depending on how well they meet 40 quality
measures (Kleffman, Contra Costa Times, 3/28).
HEALTH PLANS AND MEDICAL GROUPS DEMONSTRATE IMPROVED CARE FOR
CHILDREN, BUT SHOW MIXED RESULTS IN PREVENTING AND MANAGING
COSTLYAND DEBILITATING CHRONIC DISEASES FOR ADULTS
SACRAMENTO – The Office of the Patient Advocate (OPA) released
the 2013 Report Cards today on a redesigned, consumer-friendly
and, for the first time, as a mobile app for iPhone and iPad. The
Website and app make it easy for consumers to review quality
ratings on more than 40 clinical care measures for the state’s 10
largest commercial Health Maintenance Organizations (HMO), six
largest commercial Preferred Provider Organizations (PPO), and
209 medical groups.
The state needs to be extremely careful with the children being
phased out of the Healthy Families program because they’re in
danger of losing access to care and services if that transition
doesn’t go smoothly, according to a new issue brief from the
Lucile Packard Foundation for Children’s Health, based in Palo
The issue brief follows on the heels of last week’s release of a
study on the level of care and services provided to children with
chronic illnesses, a study which ranked California near the
bottom of the nation in several categories, including access to
“E-visits” to the doctor? According to a U.S. study, they
may be just as effective as in-person office visits for
uncomplicated ailments such as sinus infections and urinary tract
infections – and much cheaper.
For e-visits, patients fill out online forms about their symptoms
and a doctor or nurse gets back to them within a few hours with
In the study, which appeared in the journal JAMA Internal
Medicine, the main difference between e-visits and office visits
was that patients who received their care online were prescribed
more antibiotics, a finding that could be concerning but is hard
to interpret on its own, the researchers said.
Whether you are going to the hospital for an outpatient procedure
or whether you will be admitted to the hospital for medical
illness or surgical procedure, there are certain things you must
know and certain things you must do in order to ensure that your
reasonable expectations will be met.
You must become informed about the terms and limits of your
health insurance policy. See if the fees you are being charged
can be negotiated ahead of time. If you do not know the terms and
limits of your policy, you will not know the financial field upon
which you are playing, and the end result may be significantly
displeasing to you.
Do not be afraid to ask questions of your doctor. By
accepting you as a patient he or she has made a contract with you
to provide you with the best possible care. This means that the
doctor must make time to answer your questions. On the other
hand, you must realize that doctors do not have much time in
today’s medical environment owing to the system under which they
currently work. Therefore, prepare a list of questions for the
doctor each day, and set a time during the course of the day that
you and the doctor can meet so that these questions can be
answered. If possible, e-mail the questions to your doctor before
Effective June 27, 2010, all California doctors are required to
notify their patients that they are licensed by the Medical Board
of California and provide the Medical Board’s contact
information. This notice may either be prominently posted in the
doctor’s office, or it may be in the form of a written statement
that is given to the patient. The written notification must
include the Medical Board of California’s telephone number and
Web site. Consumers can contact the Medical Board to check on a
doctor’s license status or to file a complaint.
Look for doctors and office staff who speak your family’s
language, or ask for an interpreter if you need one to talk to
your doctor or your child’s doctor. Certified medical
interpreters are trained to translate health information
correctly. They must keep your information private.
Beginning January 17, 2011, a new timely access regulation will
go into effect in California that rquires HMO doctors to see
patients with non-urgent care needs within 10 business days of
the patient’s request for an appointment. For requests to see a
specialist, patients must be seen within 15 business days of the
request. Patients seeking urgent care that does not require prior
authorization must be seen within 48 hours (96 hours for urgent
care iif it requires prior authorization). Visit
Timely Access to Care to learn more about this new
Some hospitals provide better care than others. Visit
CalHospitalCompare.org, a service of the California
Healthcare Foundation, to view ratings of quality of
care, patient experience and safety measures for hospitals
in your area.
Visit the California Office of the Patient Advocate Web
site to learn how health insurance plans rate on the quality
of care their members receive, as well as how medical
groups, their doctors and other providers rate on the care
Overeating, lack of health insurance access and comparatively
high poverty are among the many reasons why Americans are less
healthy and die younger than people in other wealthy countries, a
report requested by the U.S. government showed on Wednesday
[January 9, 2013].
The United States spends more per person on healthcare than any
other nation but lags on many important health measures amid
higher rates of obesity and heart disease and worse infant
mortality rates than other rich countries.
Even healthy people worry about the quality of care they can
expect to receive when they become ill. Will a cancerous tumor be
spotted early enough? Will hospital staff move fast enough to
save my life? What is the worried-looking doctor scribbling in my
Health-care innovations aren’t limited to drugs and devices.
Experts increasingly are adopting new ways to treat patients that
studies show are better at healing the sick, preventing disease,
improving patients’ quality of life and lowering costs. Here are
10 innovations that took root in 2012 and are changing the care
patients will get in 2013.
Ask Me 3™ is a patient education program created by
the National Patient Safety
Foundation® to help promote discussions between you and
your healthcare providers to ultimately improve your health
outcomes. Here are a few simple questions you should
ask your healthcare professional at your next visit.
What is my main problem?
What do I need to do?
Why is it important for me to do this?
And now that you have asked the questions, it is important for
you to continue the discussion so that you have a good
understanding of the answers to your questions.
We invite you to click on the links below for more detail and
additional helpful tips to help you take charge of your health.
California is among the states that scored highest for hospital
care related to conditions and treatments commonly linked to
mortality, according to a report released by Healthgrades, USA
Partnership HealthPlan of California, a health insurer covering
roughly 200,000 Medi-Cal beneficiaries in six Northern California
counties, has decided to offer the optional benefit of palliative
care to its members.
“It’s part of health care, and part of life,” said Richard
Fleming, the regional medical director for PHP. “That’s why we’re
arranging for greater availability of palliative care.