State Highlights: La. Targets Docs Who Steer Patients Into Some Managed Care Plans
A selection of health policy stories from South Carolina, Louisiana, Texas, Kansas, Missouri, Colorado and California.
The Associated Press: Director: Medicaid Spending In S.C. Less Than Projected
South Carolina's Medicaid director says his agency is on track to spend about $250 million less this fiscal year than allotted in the state budget. Director Tony Keck told a Senate panel on Wednesday the Department of Health and Human Services is projected to spend $6.2 billion in state and federal money (Adcox, 12/4).
Modern Healthcare: La. Rule Targets Docs Steering Patients Into Certain Managed-Care Plans
Regulators in Louisiana are attempting to crack down on a perceived pattern of physicians inappropriately steering patients into particular Medicaid managed-care plans. Doctors caught exerting such influence could be booted from the program or asked to return payments for services they provided, and they face up to $5,000 in fines, according to an emergency rule effective Dec. 1 (Dickson, 12/4).
The Texas Tribune: State Gets Federal OK To Boost Medicaid Payments
A year after Texas was slated to increase Medicaid payments to primary care physicians under the Affordable Care Act, the state has received federal approval to implement the change. Although the ACA required states to increase payments to primary care physicians in 2013, the federal government did not approve the state's plan to implement the rate increases until recently (Aaronson and Luthra, 12/4).
Kaiser Health News: Kansas Advocates For Developmentally Disabled Oppose Giving Medicaid Insurers Full Responsibility
Aldona and Pat Carney call their son, Neil, "a 24-7 kid." He's profoundly autistic, severely mentally retarded and attends a special school. He has tried to eat light bulbs and charcoal briquettes and can be aggressive, sometimes scratching people near him. Neil, 18, who walks with a limp and carries around a grey sock that calms him, lives in a beige single-family home with a professional caregiver who's known him for years. The house is equipped with cameras to track his movements and a backyard swing he loves to ride (Bergal, 12/5).
St. Louis Beacon: Many Concerns -- And Some Hope -- In Health Data On Blacks In The Region
Sherrill Jackson is a 21-year breast cancer survivor. Shermane Winters-Wofford is a two-time stroke victim. Isadore Wayne and Mellve Shahid are coping successfully with prostate cancer. All four are known less for their adverse health experiences than for sending uplifting messages to black communities, dispelling myths about their illnesses and encouraging people to take advantage of medical screenings and other programs that can save lives (Joiner, 12/4).
Health Policy Solutions (a Colo. news service): Health Detectives Use House Calls, 'Hotspotting' To Cut Costs
Bridges to Care is an experiment that’s part of the trend in health care called "hotspotting." Dr. Jeffrey Brenner, a family physician working in one of the poorest communities in the U.S., Camden, N.J., pioneered the concept when he found that 1 percent of people there were racking up 30 percent of health costs. … Brenner looked for "hotspots" or outliers in vast amounts of data -- the sickest people who were costing the most. Then he did the unthinkable. Instead of trying to cut off these complex patients, Brenner gave them more, better-tailored care (Kerwin McCrimmon, 12/4).
California Healthline: State, Stakeholders Work To Renew Community-Based Adult Services
California health officials and stakeholders yesterday gathered in Sacramento to lay out a path to renew the Community-Based Adult Services program, which must be renewed by May 2014 or it will expire in August 2014. The wide-ranging meeting touched on dozens of facets of care for the frail population but also managed to skip over one of the central issues of the waiver renewal -- the state requirement that all CBAS centers shift to not-for-profit status. "That's one of the standards of participation, and will be included in the next meeting," said Denise Peach, chief of the CBAS branch of the state Department of Aging (Gorn, 12/4).