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UnitedHealthcare Delays Change to Sepsis Review Policy Following CHA Advocacy

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In a May 3 letter to CHA, UnitedHealthcare (UHC) announced it will temporarily suspend implementation of its new sepsis review policy in California until Nov. 1. The delay — a result of CHA’s advocacy on the issue — is intended to allow additional time to work through administrative and other issues that are unique to the California market, in particular due to California hospitals’ prevalent use of full-risk, capitated, delegated network arrangements.

CHA Advocacy Alert on Patient Protection Bill Urges Removal of Unnecessary Default Payment Rate

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Yesterday, CHA issued an Advocacy Alert on Assembly Bill 1611 (Chiu, D-San Francisco), which would protect patients from balance billing for emergency services. CHA supports the elements of the bill that would protect patients. However, the bill as currently written would also impose a default out-of-network reimbursement rate that will ultimately incentivize health insurance companies to avoid contracting with hospitals, driving reimbursement rates below the cost of care. CHA remains opposed to this bill unless it is amended to remove the default rate.

290,000 Reasons to Celebrate

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This week — May 6-12 — marks National Nurses Week, a time to honor, celebrate, and elevate nurses. Throughout the week, hospitals across the state will be honoring and thanking the nurses who help us provide care to Californians who need it.

Private Health Insurance Organizations Shouldn’t Dictate Quality of Care

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Health insurance companies are standing in the way of many patients receiving affordable, quality healthcare. Insurance companies have been denying patient claims for medical care, all while increasing monthly premiums for most Americans. Many of the nation’s largest healthcare payers are private “for-profit” companies that are focused on generating profits through the healthcare system. Through a rigorous approval/denial system, health insurance companies can dictate the type care patients receive.

A Millennial Doctor’s Experience with Industrial Medicine

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A survey of 200 physicians under the age of 35 showed that 56% reported unhappiness with the current state of medicine. That number didn’t seem surprising to me at first. I was not particularly “happy” at the time of reading this survey either.

I’ve aspired to become an oncologist for as long as I can remember. In oncology, despite my inability to cure, I can always try to heal. I form connections with patients and their families as they embark on a journey that is quite often their last. I learn from my patients as much as, and at times more than, they learn from me.

But all of this is overshadowed by a sense of heaviness that I frequently encounter as I enter the clinic room. That sense of heaviness hits when a patient tells me of the time when they were placed on a “brief hold” for more than half an hour in order to reach someone to get a prescription refilled or reschedule an appointment. Or when their insurance refused to cover the drug that I had prescribed to them. It is when I hear that clinic visits or treatments are not scheduled due to insurance authorization delays. Or when I’m asked about the cost of drugs and end up having to explain how nobody really knows.

Bernie Sanders: Medicare for All will save Americans from health care crisis

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Today in America, we have more than 27 million people without any health insurance. Millions more who have employer-based insurance are being fleeced by skyrocketing premiums and prescription drug prices, and they are often thrown off those private plans when they change or lose jobs.

This is great for the 64 health care CEOs who were paid $1.7 billion in 2017. But this is an economic and medical emergency for millions of Americans. The good news is that we have a very straightforward solution that draws from our own country’s past success: We can guarantee health care as a right to all by expanding Medicare, the most popular and successful program in American history.

Reminder: CAHHS Volunteer Services Hosts Education and Networking Events

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Don’t forget to register for the California Association of Hospitals and Health Systems (CAHHS) Volunteer Services upcoming “mini-conferences,” which feature selected speakers and topics from our 2019 California Hospital Volunteer Leadership Conference. The Northern California meeting is August 15, 2019 at NorthBay Healthcare Green Valley Administration Center. The Southern California meeting is August 16, 2019 at Los Angeles Chamber of Commerce. Please share this information with your volunteers and staff. 

Mini-conferences offer participants the opportunity to:

Review the information shared at the February 2019 conference.
Learn more about the upcoming volunteer impact questionnaire.
Network with professionals, peers and other volunteer leaders, many of whom are new to their positions.

Topics include:

How technology transforms the future of health care.
How volunteer resources support the patient experience, retail, and community.
Processes to support the volunteer workforce. 
How to engage volunteers more effectively and demonstrate their impact. 

2019 California Hospital Volunteer Leadership Conference

Click here to review the February 2019 conference program including educational materials/sessions, photos, sponsors and events.

Register Today

Click desired location link below for more information and to register.

Northern California | August 15, 2019 | NorthBay Healthcare Green Valley Administration Center, Fairfield 

Southern California | August 16, 2019 | Los Angeles Area Chamber of Commerce, Los Angeles

CHA Issues Summaries of IRF, SNF, Hospice PPS Proposed Rules

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CHA has issued three summaries, prepared by Health Policy Alternatives, of federal fiscal year 2020 prospective payment system (PPS) proposed rules recently released by the Centers for Medicare & Medicaid Services: the inpatient rehabilitation facility (IRF) PPS, the skilled-nursing facility (SNF) PPS, and the hospice PPS.

Comments on the  IRF rule are due June 17, and comments on the SNF and hospice rules are due June 18. CHA reminds members to register for an upcoming member forum that will address key provisions of the SNF and IRF proposed rules.

CHA Provides Update on EEO-1 Reporting Obligations

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On April 23, CHA reported that the Equal Employment Opportunity Commission’s (EEOC) revised data reporting requirements could result in a directive for employers to submit EEO-1 pay data for 2017 and 2018 as soon as May 31. However, on April 25 the U.S. District Court for the District of Columbia ruled that the EEOC may have until Sept. 30 to collect that data. 

Webinars Begin Next Week on New Opioid Safety Designation for Hospitals

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Cal Hospital Compare, a nonprofit performance reporting initiative, will launch an opioid safety designation program for hospitals later this month, intended to accelerate improvement and recognize California hospitals’ efforts to combat the opioid epidemic. A series of five no-cost webinars — the first to be held May 9 at 11 a.m. (PT) – will explain a self-assessment tool integral to the new designation, and will feature peer-to-peer learning on a variety of safe opioid practices.