You can relax. This is not a story about how much exercise you should be getting. (Although just writing that line made me get up off my chair and take full advantage of my stand-up desk.)
Instead, it’s a story about the power of asking — and measuring. Kaiser Permanente ran a pilot program at four of its 15 medical centers in Northern California and reported Thursday that patients who were asked about exercise lost slightly more weight than patients who weren’t.
Disclaimer: we’re not talking big amounts. Overweight patients in the pilot group lost 0.2 pounds more than those not in in the program. Patients with diabetes had a 0.1 percent greater decline in their blood sugar levels — known as the A1C test. These are not big numbers individually, but the study points to something bigger — the power of an organized system to improve patients’ health. Continue reading
(Justin Sullivan/Getty Images)
Over at the New York Times, Elisabeth Rosenthal continues her terrific series on the high cost of health care in America. Tuesday’s installment is a deeply-reported look into the murky world of hospital prices, where a “stitch tops $500,” says the headline.
The lowest-cost silver-tier plan costs 26 percent more in Alameda County vs. Orange County.
But it’s where Rosenthal sets most of her reporting that makes the story a must-read for anyone in the Bay Area. She profiles patients receiving care at California Pacific Medical Center, a Sutter Health hospital — and her piece indirectly brings up the question of higher health insurance premiums here.
These higher premiums were made evident when Covered California released its plans for all the 19 “rating regions” of the state. In Alameda County, for example, the “silver tier” premiums for a 40-year-old range from $317 to $365. In Orange County, the range is $252 to $290 and Kaiser coming in at a high of $332. In other words, the lowest-cost silver-tier plan is 26 percent more expensive in Alameda County vs. Orange County.
Glenn Melnick, a health economist at USC, is quoted throughout the Times piece, and I called him Tuesday morning to talk about this NorCal vs. SoCal difference. “I would say that hospital prices represent a disproportionate share of that differential,” he said, and added that premiums are higher in the Bay Area even after accounting for the higher cost of living here. Continue reading
By Dan Diamond, California Healthline
Search Covered California’s website, and you’ll find a list of 33 “frequently asked questions.”
The 33rd and final question — below questions like “Why should I buy health insurance?” and “I’m pregnant and do not have insurance. What health coverage is available for me?” — is this one: “Will patients be able to keep their same doctor when they purchase health insurance through Covered California?”
The question may be last on Covered California’s list, but it’s top-of-mind for many consumers. About one million Californians, and millions of other Americans, are losing their health plans through the individual market and turning to Obamacare’s new insurance exchanges to shop for replacement coverage. And in many cases, it’s still unclear if the family doctor will be coming with them.
The Mechanics Behind Narrow Networks Continue reading
So maybe that headline needs a bit of clarification: This new research has to do with postmenopausal women and their levels of estrogen. (Still, if you’re a pre-menopausal woman, you should read this, too. Men, if you know any women, please read on.)
After a woman goes through menopause, her estrogen levels drop. This study, led by a Stanford School of Medicine researcher, was the first to look at associations between estrogen decline and cognition — both in women who went through menopause more recently (less than 6 years) and longer ago (more than 10 years). The research team wanted to know if the time from menopause made a difference in cognitive ability. And so we return to the headline: They found no connection.
“There were no differences between women close to the time of menopause and further from the time of menopause,” said Stanford neurologist Victor Henderson, lead author of the study. The women were given a battery of neurological tests, not just “a short screening instrument,” the authors wrote. Continue reading
Jane Bradford and her family will save more than $400 a month on premiums, she says. (Photo Courtesy of Bradford Family)
By Stephanie O’Neill, KPCC and Kaiser Health News
Barbara Neff of Santa Monica is one of the roughly 1 million Californians who recently got word that their health insurance coverage would be expiring soon. The canceled plans sparked a political firestorm as people realized President Barack Obama’s promise – “If you like your plan, you can keep it” — didn’t apply to everyone.
But Neff, a 46-year-old self-employed writer, isn’t outraged. She’s relieved. Even though she makes too much money to receive a subsidy to buy insurance under the Affordable Care Act, the policy cancellation was good news for her.
Neff says she’s been stuck in a bad plan because treatment for a back problem years ago red-flagged her with a preexisting condition.
“The deductible has ranged anywhere from $3,000 to as high as $5,000, which means I have to spend that much each year before the insurance even kicks in,” she says. “I was rejected [from a more affordable policy] because I’d had a bout of sciatica five years previously that has never returned.” Continue reading
Some Californians whose policies have been canceled are finding relief in a surprising place: from insurance companies that aren’t offering plans on the Covered California marketplace.
Earlier this year, Aetna announced it would bow out of the state’s individual market — effective Dec. 31. Cigna is staying, but is not offering any products on the exchange. Right now, both companies are accepting new customers into pre-ACA plans. Aetna plans are available to Costco members only until Dec. 15; Cigna is offering pre-ACA plans through Dec. 23.
Anne Gonzales, a Covered California spokeswoman, confirmed that a carrier not offering plans on Covered California “could offer a non-compliant plan through 12/31/2013 but it would need to become compliant when it renews next year.” So, consumers can enroll now, but when the policy comes up for renewal in 12 months, the plans would need to come into compliance with the ACA — and premiums would almost certainly go up.
Jason Andrew, CEO of Stone Meadow Benefits in Redwood City, says he has “tons of letters on my desk” from clients who have received notice that their policies were canceled. The policies they have been offered are “all more expensive and not as good of coverage,” he says. Continue reading
Screenshot from CoveredCA.com, the website of Covered California.
After long discussion, the board of Covered California, the state’s health insurance marketplace, voted unanimously Thursday to stay the course and phase out plans that do not comply with the Affordable Care Act by Dec. 31.
The board’s decision comes a week after President Obama said states should consider allowing consumers whose plans were canceled to renew them through 2014. Dave Jones, California’s insurance commissioner, said he agreed with the president’s request.
But ultimately the authority to permit renewals rested with the board –- because of the contracts insurers have with Covered California. The board weighed whether to release carriers from the provision requiring them to phase out plans that do not have the benefits required by the ACA.
The board had three options before it: permit no renewals; permit consumers to renew through Mar. 31, 2014; or permit renewals through Dec. 31, 2014. In a detailed analysis (definitely worth a read), Leesa Tori, senior advisor to Covered California laid out the pros and cons of each, but there was no clear best option. “If we (allow extensions), are we making more of a mess or are we actually helping?” she said. Continue reading
Sharon Wilson, 53, picks up her weekly allotment of produce from the AIDS Project of the East Bay. Wilson, who has HIV, says without help, she couldn’t afford to buy fresh vegetables. (Angela Hart/KQED)
By Angela Hart
Several times each week, Sharon Wilson, a 53-year-old HIV-positive retired caregiver, takes an hour-long bus ride from her Berkeley home to her clinic in downtown Oakland. Wilson doesn’t mind making the trip, because she says the care she has received there since her diagnosis has saved her life.
Wilson says multiple chronic diseases, including HIV, have made it impossible for her to work. Ensuing financial struggles make managing her disease increasingly difficult.
“I can’t afford healthy food and all the medications I need to take,” Wilson said as she described her strict antiretroviral drug regimen. “It’s not easy to learn a new way of living. I take a handful of pills when I wake up in the morning, a handful of pills with lunch, and another handful before I go to bed.”
For people like Wilson, the AIDS Project of the East Bay — one of Alameda County’s six HIV specialty clinics — is a place of refuge. There, Wilson has received primary care for her HIV and specialty care since 2006. She’s been referred to Oakland’s Highland Hospital multiple times to treat other chronic conditions, including congestive heart failure and arthritis. Continue reading
A prescription label for the cholesterol-lowering drug Lipitor, a brand name statin medicine. (Tim Boyle/Getty Images)
Last Monday two major groups released a set of new guidelines designed to lower cholesterol. Now, it appears a major component of the guidelines — an online risk calculator — may be flawed, the New York Times reports.
Since the publication of the guidelines, two Harvard Medical School professors “evaluated the guidelines using three large studies that involved thousands of people and continued for at least a decade,” the Times reported. They knew the patients’ health status at the start and then they looked to see how many had had a heart attack or stroke in the next decade. How accurate was the new calculator in predicting risk? From the Times:
The answer was that the calculator overpredicted risk by 75 to 150 percent, depending on the population. A man whose risk was 4 percent, for example, might show up as having an 8 percent risk. With a 4 percent risk, he would not warrant treatment — the guidelines that say treatment is advised for those with at least a 7.5 percent risk and that treatment can be considered for those whose risk is 5 percent.
By Anna Gorman, Kaiser Health News
California has mistakenly sent letters to 246,000 low-income residents, warning they may need to find new doctors next year under the state’s newly expanded Medicaid program.
The error frustrated counties and community health centers which have repeatedly assured patients they can keep their providers when the Affordable Care Act takes effect in 2014. The patients are part of the state’s “bridge to reform” program, which was designed to cover uninsured, poor Californians until they became eligible for Medi-Cal, the state’s version of Medicaid.
Bridge to reform launched in 2011 and more than 600,000 people across the state enrolled in county-based health coverage. Many people formed relationships with doctors and started seeking regular care. But county and clinic administrators said the incorrect information in the mailing this month has put the counties’ efforts in jeopardy.
The mix-up occurred as people are scrambling to figure out how the health law impacts them, and as private policy holders have been receiving letters canceling their insurance plans. Continue reading