State roundup: Bumpy managed care transition in Calif.

Jul 2 2012

A selection of health policy stories from California, Wisconsin, Massachusetts and Minnesota.

Los Angeles Times: California Patients Struggle To Transition To Managed Care System
One year ago, California began moving certain Medi-Cal patients into a managed health care system with the goal of saving money while better coordinating treatment. But for some of these low-income seniors and disabled patients, the transition has been anything but smooth, forcing severely ill patients to give up their doctors, delay treatment and travel long distances for specialty care (Gorman, 7/2).

Milwaukee Journal Sentinel: State Hopes To Erase Growing Deficit For Health Programs Nearly Doubles
A shortfall in state health care programs has nearly doubled -- to $372.3 million -- in the past three months, but state officials believe they can eliminate it by next summer, the head of the state Department of Health Services said Friday. Health Services Secretary Dennis Smith said in a letter to legislative leaders the potential deficit was rising because Gov. Scott Walker and lawmakers in March eliminated an enrollment cap on the Family Care program they had put in place last year. Family Care provides services to help the elderly and disabled stay in their homes or other community settings rather than enter nursing homes (Marley, 6/29).

Boston Globe: Can House Calls Cut Health Costs?
[Daniel] Oates is a Boston Medical Center geriatrician who makes house calls, part of a cadre of physicians nationwide who serve a growing need of homebound seniors. He believes home visits provide more personalized, consistent care to people who might not otherwise see a doctor and can prevent hospitalizations or delay a move to a nursing home. Now the Centers for Medicare & Medicaid Services, in a program created under the newly-affirmed Affordable Care Act, is looking at the Boston program and 15 others to see whether they also can save money. Advocates hope the results will persuade more doctors to begin seeing patients at home (Conaboy, 7/1).

Boston Globe: Control Of Costs A Test For Health Overhaul
Just as the health care overhaul in Massachusetts is widely accepted as the model for the national bill upheld as constitutional Thursday by the U.S. Supreme Court, it is also seen by many as a model and a caution for the necessary sequel to much broader insurance coverage: cost control. Bringing almost everyone under the umbrella of health insurance is considered by advocates of the 2006 Massachusetts law, and of President Obama's 2010 plan, as the essential precondition for reining in medical expenses. All consumers, employers, hospitals, and insurers now abruptly, with the law's implementation, have a major stake in that goal (Jan and Kowalczyk, 7/1).

Sacramento Bee: Final California Budget Deal Wasn't All About Saving Money
Advocates across the spectrum wondered what Brown's motivation was for eliminating Healthy Families. They said it couldn't have been about the money, because $13 million this year and $73 million in future years don't amount to much in the face of multibillion-dollar deficits. "From a macro budget point of view, it's really a small amount of savings," said Anthony Wright, executive director of Health Access California, after the deal was struck. "This does more harm to the health system and children's health than it saves you money for state budget." Matosantos said Brown saw no reason to have 880,000 Healthy Families children served by a separate program from the 3.8 million children in Medi-Cal. "We think it makes more sense for kids and for program efficiency," she said. "Which means having the kids served in the Medi-Cal program, and not having 40 percent of (Healthy Families) kids move back and forth between one program and the other" (Yamamura, 6/1).

Minnesota Public Radio: Minn. Prepares For Wave Of Alzheimer's Cases
Minnesota's population of Alzheimer's patients is expected to double over the next 30 years, to 200,000 people. According to the Alzheimer's Association, by age 65, 1 in 8 people has the disease. Among people over 85, nearly half have it. One of Minnesota's main goals is to identify the disease much earlier so patients can get better care and their families can make smarter financial decisions. Another is to provide more support to overwhelmed caregivers, so patients can live with their families for as long as possible (Benson, 7/2).