Monthly Archives: May 2013

Want To Get People to Eat More Fresh Produce? Give Them A Little Money

By Marnette Federis

(Marnette Federis/KQED)

(Marnette Federis/KQED)

Collene Kraut says she never misses a chance to tell her 3-year-old daughter to eat vegetables and fruits. So when a farmers’ market launched in March, a block away from her home near San Diego, Kraut was eager to go.

“I don’t like it when people give my kid bad things to eat,” said Kraut. “I just want her to be healthy.”

Kraut receives funds from SNAP (formerly called food stamps), and she learned that she could use those funds at this new market. But Kraut learned about another new program while she was there, one that would help her stretch her dollars further. It’s called Fresh Fund, a grant-funded program which provides matching dollars specifically to purchase produce.

The program’s goal is to help low-income families buy accessible, affordable, nutritious produce.
That extra money is having an impact. Because of Fresh Fund, Kraut says she and other family members are now trying different varieties of fruits and vegetables. Kraut says she especially likes the different varieties of greens she finds, adding that they taste better than what she can buy at the supermarket.

“I brought some [greens] back for my dad, and he was eating it plain without salad dressing, he said it was good,” she recounts.

The Fresh Fund program helps families such as Kraut’s to stretch their food budgets so they have more room to shop for healthier food. The program’s goal is to help low-income families buy accessible, affordable, nutritious produce. Offering matching dollars for produce appears to influence people’s diets. Continue reading

Health Law Protected Young Adults From High Hospital Bills

By Sarah Varney, Kaiser Health News

Researchers report that the Affordable Care Act shifted $147 million from individuals -- or hospitals, in the form of uncompensated care -- to private insurance plans. (Indoloony/Flickr)

Researchers report that the Affordable Care Act shifted $147 million from individuals — or hospitals, in the form of uncompensated care — to private insurance plans. (Indoloony/Flickr)

Researchers at the RAND Corporation set out to find some hard data on one aspect of the health law: Does having medical insurance protect young adults from the financial ruin that often comes with a major injury or illness?

The quick answer: Yes, it does.

Since September 2010, the Affordable Care Act has allowed young adults to remain on their parents’ medical insurance until they turn 26, and an estimated 3.1 million young people have taken advantage of the new rule.

The RAND researchers looked at nearly a half a million visits young adults made to emergency departments around the country before and after the under-26 provision took effect.

“We looked at just the most serious conditions,” said Andrew Mulcahy, an associate policy researcher at the RAND Corporation. Mulcahy and his colleagues pored over actual hospital records for bone fractures, poison, traumatic brain injuries, and other incidents that would require an urgent trip to the hospital. Continue reading

Why California’s Obamacare Premiums Are Lower Than Expected

Dan Diamond, California Healthline

(Getty Images)

(Getty Images)

No Aetna. No United.

No Cedars-Sinai.

Covered California’s list of participating health care providers and insurers is out, and it’s possibly more notable for who isn’t partaking in the state’s new health insurance exchange rather than for who is.

The reasons for the big-name absences are manifold, ranging from payer strategy to high hospital prices to even accusations of gamesmanship. And they help explain the caution that — despite news that premiums will be far lower than expected — the exchange transition may be bumpier than some early, optimistic reports suggest.

Why Top Payers are Absent

According to representatives for Aetna, United and Cigna, the firms are sitting out California’s exchange because they’re taking a wait-and-see approach.

“We are simply taking the time to carefully evaluate and better understand how the exchanges will work to ensure we are best prepared to participate meaningfully in their development,” a United spokesperson told Chad Terhune at the Los Angeles Times. Continue reading

Insurers Balk at Some Rare Genetic Tests for Breast Cancer

By Michelle Andrews for Kaiser Health News and NPR

Angelina Jolie's decision to have a double mastectomy after genetic testing has prompted a discussion about which other tests should be covered. (Gage Skidmore/Flickr)

Angelina Jolie’s decision to have a double mastectomy after genetic testing has prompted a discussion about which other tests should be covered. (Gage Skidmore/Flickr)

When it comes to inherited genetic mutations that increase the risk of breast cancer, BRCA1 and BRCA2 get nearly all the attention.

Inherited mutations in these genes cause from 5 to 10 percent of breast cancers as well as up to 15 percent of ovarian cancers, according to the National Cancer Institute.

There are other, rarer genetic mutations that also predispose women to breast cancer.

Other genes besides BRCA1 and BRCA2 may have mutations that predispose a woman to breast cancer.
Health insurers that cover BRCA-related testing and treatment without a hitch sometimes balk at providing coverage in these other instances. The predictive value of some of those variations isn’t always as strong or clear-cut.

When Angelie Jolie said earlier this month that she’d tested positive for a particularly harmful BRCA1 mutation and had a double mastectomy to substantially reduce her risk of getting breast cancer, she didn’t mention her insurance coverage. Continue reading

Appeal Denied: Medi-Cal Rate Cuts Poised to Move Forward

By Judy Lin, Associated Press

A federal appeals court on Friday denied a second request by California doctors, pharmacists and hospitals seeking to undo the state’s 10 percent provider rate cut for treating the poor.

The 9th U.S. Circuit Court of Appeals denied an appeal from medical providers to rehear their case, which allows Gov. Jerry Brown to begin implementing the cuts retroactively. A three-judge panel had ruled against them in December on the grounds that trial courts cannot block the state from making cuts that were approved by the U.S. Department of Health and Human Services.

Health providers vowed they will continue to press lawmakers to restore the 10 percent reimbursement rate cut to the state’s Medicaid program, known as Medi-Cal. Continue reading

Young Adults Will Make or Break Obamacare in California

By Mina Kim, KQED

David Kim, brother of KQED health reporter Mina Kim, is 29-years-old and uninsured. (Mina Kim/KQED)

David Kim, brother of KQED health reporter Mina Kim, is 29-years-old and uninsured. He is considering whether to buy insurance on the health care marketplace if he doesn’t have employer-based coverage next year. (Mina Kim/KQED)

Most of us know someone who doesn’t have health insurance. In my case, it’s my little brother, David Kim.

David is 29-years-old and recently earned an advanced degree in international relations. He hasn’t been able to land a full-time job with health benefits. The two jobs he has now are temporary, and with such a precarious work situation, he just doesn’t think he can afford health insurance.

“I’m totally aware that if I get sick then I’m doomed financially,” Dave told me over a lunch break. “And maybe that’s not a very financially sound decision to make, but it is nonetheless a risk that, for the time being, I’m prepared to take.”

Young adults —18 to 34-year-olds — make up more than 40 percent of California’s uninsured, though they make up less than 30 percent of the population. And according to many health reform advocates, they’re the ones who could make or break Obamacare.

“If we get only sick people, and don’t get the young, healthy people into the insurance system, it’s going to mean premiums are much higher.” 
“The success of this law really does depend on getting young people insured, and frankly getting everyone insured,” said Larry Levitt, a health policy and insurance expert for the Kaiser Family Foundation.

In less than five months, a key piece of Obamacare will go live: state-based insurance marketplaces, called Covered California here. That means millions of Californians looking for coverage for themselves or their families will be able to go online and enroll in qualified health plans regardless of their medical history. Many will get help from federal subsidies. But if the exchange doesn’t enroll enough young, healthy people, insurers will have to hike everyone’s premiums. Continue reading

Calif’s Health Insurance Exchange Sets Plans, Premiums; No Apparent ‘Rate Shock’


(Joe Raedle/Getty Images)

Update: Aug. 7, 2013: Covered California announced Wednesday that 12 insurance companies have formally signed contracts with the agency to offer plans on the new marketplace. Since the initial announcement (below), one company, Ventura County Health Plan, has withdrawn from offering coverage on the marketplace. The following companies will offer plans on the marketplace, although not all companies will offer plans in every region of California:

·      Alameda Alliance for Health

·      Anthem Blue Cross of California

·      Blue Shield of California

·      Chinese Community Health Plan

·      Contra Costa Health Plan

·      Health Net

·      Kaiser Permanente

·      L.A. Care Health Plan

·      Molina Healthcare

·      Sharp Health Plan

·      Valley Health Plan

·      Western Health Advantage

Last week, Covered California announced tentative plans and premiums for its small business marketplace, also called SHOP.


The state’s health insurance exchange, Covered California, announced Thursday morning the plans and premiums that will be available to millions of Californians.

And what everyone wants to know is: how much will it cost. Experts had warned of “rate shock,” that premiums might skyrocket for all kinds of reasons. That has not happened.

Covered California says that individuals will pay an average premium of $321 per month for a “silver” plan. (More on silver plans below.) Many people will be eligible for subsidies to reduce that cost further.

Across the state, people who had been working toward this day seemed to heave a collective sigh of relief.

“This is a home run for consumers in every region of California,” said Peter Lee, executive director of Covered California, in a release to reporters. “Californians should be proud of how not only health plans in this state, but doctors, medical groups and hospitals have stepped up — creating a market that will allow millions of consumers to enroll in affordably priced products.”

Charles Bacchi, executive vice president with the California Association of Health Plans called it an “important day” and commended both insurance companies and providers for working together “to deliver quality, affordable health care. We couldn’t have done this without providers willing to join us to make the Affordable Care Act a success,” he said in a reference to provider groups working to keep rates low.

The plans on the exchange are required to offer a standard set of comprehensive benefits. It’s hard to compare premiums next year to what’s in place this year, since there is no standard set of benefits at present. Covered California chose as the best comparison the average premium for a small business plan. The rates in Covered California range from 2 percent above to 29 percent below that benchmark. Continue reading

Powerful Documentary Highlights ‘The Power of Two’

Every 10 minutes, someone’s name is added to a waiting list — a waiting list for a new kidney, heart, lung or other organ. And every day, about 18 people die waiting.

Starting today, San Francisco’s Link TV is screening a remarkable documentary, “The Power of Two.” Twin sisters with fatal cystic fibrosis each received a double lung transplant. In the clip below, they travel to the National Donor Memorial in Richmond, VA.”In a way it was like a pilgrimage to a Mecca,” says Ana, one of the twins. “Because this is the place where our country pays tribute to all the people who have said ‘yes’ to organ donation.”

You can watch the complete documentary online at LinkTV.

And, if you’re not already, you can sign up to be an organ donor.

More Single Boomers Share Homes — and Health Support

By Julie Rovner, NPR

Lorene Solivan moved into the "Golden Girls" house in October after seeing an ad on Craigslist. An event manager at a food company, Solivan says she often cooks dinner for the group. (Maggie Starbard/NPR)

Lorene Solivan moved into the “Golden Girls” house in October after seeing an ad on Craigslist. An event manager at a food company, Solivan says she often cooks dinner for the group. (Maggie Starbard/NPR)

Today more than 1 in every 3 baby boomers — that huge glut of people born between 1948 and 1964 — is unmarried. And those unmarried boomers are disproportionately women. As this vast generation rushes into retirement, there’s a growing concern among experts on aging: Who will take care of all these people when they’re too old to care for themselves?

It’s a question many of the experts take personally. “That is what scares me,” says Sara Rix, who works for the AARP Public Policy Institute, studying the economic prospects of women in the workforce. “Because I am one of those people,” she says, “and I do think about it.”

“Oh, I’ve got wonderful nieces and nephews,” Rix says, noting that’s what a lot of her boomer peers claim, too. “Well, in fact, they’ve got their families. They’ve got their in-laws. They’ve got their parents. And I don’t think it’s reasonable to expect much out of them.”

Kathleen Kelly, who runs the Family Caregiver Alliance and the National Center on Caregiving in San Francisco, says she’s seeing the same sort of concern in her social circle. “I’m in my 50s, and my friends are all talking about, ‘Could we all move in together? Could we buy an apartment building and all live together?’ There are all sorts of permutations of this conversation,” Kelly says. “But it really is something that people are thinking about, particularly women.”

And, because boomers are boomers, some are doing more than just thinking about it. Already, there’s a small but apparently growing movement of boomer women forming group houses with their single peers. Continue reading

Where You Live Affects What Kind of Surgery You’ll Have: Look It Up

(Getty Images)

(Getty Images)

Where you live matters. And in health care, it matters in all sorts of ways you might not think of immediately. If you’re having elective surgery, one of the major factors determining what kind of treatment you will receive depends on where you live, according to new research released Tuesday.

In health policy, “elective” does not necessarily mean cosmetic surgery. Treatments for early stage cancers are considered “elective” because there are a range of options. The California Healthcare Foundation (CHCF) has been following this issue in its “All Over the Map” project. Previously, the foundation has examined variation in heart procedures, joint replacement and c-sections. Tuesday the foundation added a detailed look at geographic variation in treatments for three more conditions: breast cancer, prostate cancer, and back and neck pain.

PIcking out eyebrow-raising numbers was no problem:

  • Men in Indio (Riverside County) receive brachytherapy, known commonly as radiation seeds, to treat prostate cancer at almost five times the statewide average.
  • Women in Healdsburg (Sonoma County) receive lumpectomy without radiation for early stage breast cancer at 270 percent of the statewide average.
  • People in Brawley (Imperial County) are nearly three times as likely to receive cervical fusion, where two vertebrae in the neck are fused together, for neck problems compared to statewide.

CHCF_AllOverTheMap_Banner2_200513_R1SingleLow rates are easy to find, too. To name just one: women in Lancaster, northeast of Los Angeles, with early stage breast cancer receive lumpectomy with radiation at just 26 percent of the statewide average.

The question is why. Maribeth Shannon with the foundation says the variation is “just puzzling to us.” She stressed that the statewide average is not necessarily the “right” rate, but the state average is an estimate that’s easy to use as a benchmark.

In its analysis, the foundation accounted and adjusted for a host of patient characteristics that might skew the numbers. Still, the broad variation is there. Shannon pointed out that it would be “unusual” that patients would differ so significantly in what treatments they wanted, simply according to where they lived.

“It’s much more likely,” Shannon said, “that physicians practicing in that area tend to rely on that course of treatment over others. … It does seem to be more the physician preference than the patient preference.” Continue reading