State highlights: Health insurance changes catch Detroit teachers off guard; United Healthcare cuts 500 Tenn. doctors from Medicare advantage network

Jul 17 2014

A selection of health policy stories from Michigan, Tennessee, California, Wisconsin, New York and North Carolina.

Detroit Free Press: Detroit Teachers Union Challenges Health Insurance Changes
Teachers union officials in Detroit say recent changes to medical insurance caught union members off guard and violate a collective-bargaining agreement. District officials say the new insurance plans, which take effect Aug. 1, are expected to save the financially troubled Detroit Public Schools more than $13 million annually. The changes were necessary and allowable under emergency manager law, a district spokeswoman said. The changes eliminate a more expensive Blue Cross Blue Shield PPO option and require members to sign up for one of two Health Alliance Plan HMO plans: One that requires people to use Henry Ford Health System doctors, or a more expensive premium plan that lets people chose any HAP provider (Zaniewski, 7/15).

The San Francisco Chronicle: S.F. Supervisors Pass Budget, Easily And Early
In a vote that was void of the controversy of last year, board members also unanimously approved 2015 health care rates for city workers, a package that will cut Kaiser members' rates by 2 percent, keep rates for Blue Shield static and reduce the rates for employees covered by the city self-funded plan by 18 percent. Supervisors in 2013 threatened to reject health care rates, saying Kaiser hadn't done enough to justify a 5.25 percent increase (Lagos, 7/15).

The Tennessean: United Cuts Providers For Medicare, Medicaid Patients
United [Healthcare]is cutting 500 Tennessee physicians from its Medicare Advantage network, and an additional, undisclosed amount from its TennCare product in 2014. According to the Tennessee Medical Association, these doctors were not cut because of performance issues or poor conduct, but unrelated network changes. United has made similar network changes in states besides Tennessee. United is not doing this out of the blue. Reimbursement rates for Medicare and Medicaid members are declining. Major insurance companies like United are looking for ways to keep costs down and to negotiate quality incentives with doctors (DuBois, 7/15).

The Milwaukee Journal Sentinel: Losses Mounting At Wheaton Franciscan-St. Joseph
A decline in the number of patients, combined with an increase in the percentage covered by government health programs, has resulted in huge losses at the Wheaton Franciscan-St. Joseph Campus and given the hospital little or no hope of breaking even in future years. The hospital is one of two that serve Milwaukee's lowest-income neighborhoods, and both now are consistently losing money. Wheaton Franciscan-St. Joseph, on the city's west side, is expected to post a loss of more than $30 million for the fiscal year that ended June 30, after losing $14.8 million in its 2013 fiscal year (Boulton, 7/15).

The New York Times: At NewYork-Presbyterian Hospital, Its Ex-C.E.O. Finds Lucrative Work
When Dr. Herbert Pardes retired as president and chief executive of NewYork-Presbyterian Hospital in 2011, the institution honored him at its annual "Cabaret" fund-raiser. More than 1,000 guests dined on wild mushroom soup catered by the restaurateur Danny Meyer and listened to Kelli O'Hara, a star of "South Pacific," serenade them with Rodgers and Hammerstein, Sondheim and Berlin. But there were more thanks to come. The next year, Dr. Pardes earned $5.6 million ... Three years after retirement, Dr. Pardes is still employed by the hospital (Hartocollis, 7/15).

Bloomberg: Sterilized Women Would Get Reparations Extension in N.C.
A Democratic legislator in North Carolina is fighting to give people forcibly sterilized by the state four decades ago more time to file for compensation under a 2013 law that gave them a year to come forward. Fewer than half the estimated 1,800 living sterilization victims, most of them poor, black women, filed claims by the June 30 deadline. The state is closing the door on the rest, a stance that undermines the first and only eugenics reparations in the U.S., said Representative Larry Hall, a 58-year-old who represents Durham. North Carolina's decision to pay sterilization victims, more than a decade in the making, exemplifies challenges faced by states trying to address their misdeeds of the past. In the U.S. South, legislators have resisted eugenics compensation for fear of setting a precedent for reparations for slavery and civil-rights violations (Newkirk, 7/16).