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Medi-Cal & Medicare Underfunding

Overview

Chronic Under-Funding of Medi-Cal and Medicare

California’s 430 hospitals and health systems are shouldering the financial burden of the government’s responsibility to provide care for some of our most vulnerable patients – seniors, the disabled, children and the under-insured.

News article

Don’t Take the ‘Medi’ Out of Medicaid

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Medicaid is in desperate financial trouble. The states know it. Hospitals know it. Doctors know it. And as each group cuts back on services to try to save money, increasingly patients know it, too.

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Rural Medical Providers Say Medi-Cal Cuts Will Slash Skilled-Nursing Care

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Hospital officials in California’s rural counties say the latest round of cuts to Medi-Cal could leave thousands of the state’s neediest people without access to medical care.

Report

Calif. Hospital Association Urges Court To Block Medi-Cal Cuts

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The California Hospital Association has petitioned a federal court to prevent certain Medi-Cal reimbursement cuts from taking effect, KPBS News reports. Medi-Cal is California’s Medicaid program.

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State Budget May Push Kern Valley Hospital to the Brink

Kern Valley Hospital and other hospitals like it could become another casualty in the country’s worst economic downturn since the Great Depression.

The Budget Act of 2011, signed by Governor Brown on March 24, includes a reduction to Medi-Cal reimbursement rates for SNFs that are distinct parts of hospitals. Medi-Cal rates for these facilities will be reduced another 10 percent – rates that were applicable in the 2008-09 rate year. 

News article

Medi-Cal Cuts May Affect 70,000 North State Patients
Official Says Hospital May Have to Close

Health care officials say a recent 10 percent cut in Medi-Cal reimbursements for doctors treating low-income patients portends a bleak future for about 70,000 north state residents already struggling to find someone to treat them.

News article

Report: Medi-Cal Cuts Could Harm Millions of California Residents

Medi-Cal cuts could create risks for millions of Californians who depend on the program for treatment of chronic or terminal health conditions, according to a new report, Kaiser Health News’ “Capsules” reports.

Article

Governmental Underpayments, Regulations Combine with Medical Advances to Drive Rising Hospital Costs

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California ranks 51st nationally in Medicaid payments to health care providers per enrollee.

The spotlight is shining on health care costs. It’s an issue that generates newspaper headlines and debate among business leaders, policymakers and consumers. But for all of the arguments — and accusations — that emanate from this discussion, the facts are more complex than the dialogue often reflects.

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Health Care Pawn in Government Debates

There has been a lot of talk and media attention about the federal deficit and the raising or freezing of our national debt ceiling. If Congress does not agree on a plan going forward by Dec. 23, the Defense Department and health care delivery – doctors and hospitals – will pay a significant price.

News article

Mayers Official Protests Pending Cuts

Mayers Memorial Hospital District CEO Matt Rees (Fall River Mills, Calif.)  made a case to health care regulators in Washington, D.C., to stop impending budget cuts that would force him to close the hospital’s birthing center and move 30 infirm and elderly patients far away from loved ones. Rees, along with a delegation from the California Hospital Association, protested pending state cuts to Medi-Cal that would reduce his hospital’s budget by $1.4 million.

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A Primer on Medicare, Medicaid and Social Security

Medicare is a health insurance program managed by the U.S. government for people 65 or older and for younger people with certain disabilities.  Medicaid – Medi-Cal in California - is a joint federal-state health program for certain categories of people with lower incomes such as children, pregnant women and those with disabilities.

News article

Rule Would Discourage States’ Cutting Medicaid Payments to Providers

Faced with huge financial problems, many states have frozen or reduced Medicaid (Medi-Cal) payments to health care providers, and governors of both parties have proposed additional cuts this year. Medicaid recipients and health care providers have sued state officials to block such cuts, and one case, from California, is pending in the United States Supreme Court. 

News article

As Economy Stumbles, Medi-Cal Costs Climb

Medi-Cal is California’s version of the nationally implemented Medicaid program and it provides more than 7.7 million low-income families, children, and elderly, and disabled Californians will health care and other vital human resources. Costs for the program are split by the federal and state governments, with a total price tag of about $53 billion this year. 

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State Budget: Brown’s Medi-cal Plan Questioned

Medi-Cal is California’s version of Medicaid, a $50 billion government health care program for the state’s 7 million low-income, elderly and handicapped residents.

Recipients would cover $5 of the cost for their doctor, clinic and dental visits under Brown’s plan. Pharmacy services would cost between $3 and $5, depending on availability of low-cost, preferred drugs. If approved by the Legislature, the copayments would save the state an estimated $294 million in 2011-12, according to projections.
 

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$10-billion Medicaid Plan Approved for California

The Obama administration decision will help modernize and expand the health insurance program for the poor, possibly covering hundreds of thousands more residents over the next five years.

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More Funding for Medi-Cal, But Are There Enough Doctors?

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California counties could soon have more money to put towards caring for the uninsured — about $10 billion more, as federal matching funds for the state’s Medi-Cal program. But finding enough providers to deliver care could be the challenge. 

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Cost of Care Exceeds Funding of Medicare and Medi-Cal Programs

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California’s 430 community hospitals and health systems provide care to every patient who needs it whether or not they have insurance. While hospitals focus on caring for their patients, they face significant financial challenges caused by the inadequate payments from two government-sponsored programs: Medicare and Medi-Cal. Medicare and Medi-Cal combined provide coverage to 11 million people in California, including seniors, the disabled, children and the underinsured.

Article

Doc Shortage Made Worse by Low Participation in Medi-Cal

California faces two intertwining problems about to get more acute: not enough family practice physicians and not enough physicians treating Medi-Cal patients. How should California deal with these two shortages?

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Medi-Cal Rate Freeze Worries Health Care Providers

Hospitals and physicians are bracing for possible Medi-Cal reductions as the state budget is once again on life support and could remain that way for months.

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Assembly Passage of Bill That Would Bring Doctors to Underserved Communities Applauded by Health and Social Justice Leaders

Citing a federal government estimate that more than 3 million Californians cannot find doctors who will provide them essential medical care, health care and social justice advocates challenge the Senate to show the same level of compassion and leadership demonstrated by yesterday’s passage of SB 726 (Ashburn) on the Assembly Floor.

“Speaker John Perez and members of the State Assembly listened to the desperate concerns of Californians who lack basic access to healthcare. By voting in support of SB 726, which will allow facilities in rural and federally designated health professional shortage areas to hire a limited number of doctors, the Assembly has acted to ease the escalating doctor shortages that are plaguing lower income and rural communities,” said Tom Petersen, director of government relations for the Association of California Healthcare Districts.

Report

Medicaid (Medi-Cal) Coverage and Spending in Health Reform

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The Patient Protection and Affordable Care Act (PPACA) expands Medicaid to nearly all individuals under age 65 with incomes up to 133 percent of the federal poverty line (FPL) which will extend coverage to large numbers of the nation’s uninsured population, especially adults. However, the ultimate reach of the program will depend heavily on both federal and state actions to implement the new law.

Study

Copay Increase Yields Fewer Visits to Doctors, More to Hospitals

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Higher Medicare copays, sometimes just a few dollars more, led to fewer doctors visits and to more and longer hospital stays, a large new study reveals.

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