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"disqusTitle": "Billions in Medicaid Funding at Risk as California, Feds Debate",
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"content": "\u003cp>California risks losing billions in health care dollars if the state and federal governments can’t agree this week on a plan to fund reforms of the Medicaid program, hospital officials and experts said.\u003c/p>\n\u003cp>Public hospitals throughout the state are counting on the $7.25 billion in state and federal funds to treat large numbers of low-income and uninsured patients. The plan, known as a Medicaid waiver, also would allow the state to continue improving the efficiency, safety and quality of its Medicaid program, called Medi-Cal.\u003c/p>\n\u003cp>About a third of all Californians are enrolled in Medi-Cal -- 12.5 million people. The current waiver, which took effect in 2010, expires on Oct. 31, though the federal government can grant an extension while negotiations over the plan continue.\u003c/p>\n\u003cp>[contextly_sidebar id=\"a5pZ22plFG1s4mvtWAOUCrTWG4OLpJXL\"]“It is critically important to us,” said Susan Ehrlich, CEO of San Mateo Medical Center, one of the state’s public hospital and clinic systems. “It is a very large percentage of the overall revenue that we rely on, and we don’t have other ways to make it up.”\u003c/p>\n\u003cp>Ehrlich is one of about a dozen public and University of California hospital leaders who traveled to Washington this week to make their case for the waiver to members of Congress and administration officials.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Erica Murray, CEO of the California Association of Public Hospitals, said one of the sticking points is how long an important provision of the waiver would last, with the state proposing five years and the federal government offering only three. The provision would pay for changes in how public hospitals deliver care, she said.\u003c/p>\n\u003cp>“Three years is not enough,” she said. “We need five years of support and incentive to achieve the goals of where the public systems need to be to stay competitive in their local marketplaces.”\u003c/p>\n\u003cp>Disagreements also exist over how hospitals should be paid to care for uninsured patients. The state wants to have the flexibility to use the money for more primary and preventive care rather than just to pay for emergency room visits and hospitalizations.\u003c/p>\n\u003cp>The state and the federal government have been negotiating since March, when California submitted a plan called “\u003ca href=\"http://www.dhcs.ca.gov/provgovpart/Pages/WaiverRenewal.aspx\" target=\"_blank\">Medi-Cal 2020\u003c/a>.” The plan also includes money to improve dental health programs, to expand the number of providers treating Medi-Cal patients and to start pilot projects addressing social problems of high-need patients.\u003c/p>\n\u003cp>State Department of Health Care Services Director Jennifer Kent said this week that the state needs the waiver to keep public hospitals financially stable so they can continue implementing reforms enacted under the Affordable Care Act. State officials are working toward a resolution and are trying to meet the deadline, Kent said.\u003c/p>\n\u003cp>“Everyone knows this is important,” Kent said. “It just boils down to getting the details worked out. I think we will get there.”\u003c/p>\n\u003cp>A spokesman for the Centers for Medicare & Medicaid Services declined to comment on the ongoing negotiations, but said extensions have been granted in other states.\u003c/p>\n\u003cp>Public hospitals have every right to be concerned about how the discussions are going, but there is always a lot of back and forth in Medicaid waiver negotiations, said Robin Rudowitz, associate director of the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured. “Given the amount of money, I can’t imagine that anyone is going to walk away from the table,” she said.\u003c/p>\n\u003cp>Waivers allow states to make exceptions to the usual Medicaid rules. Under the expiring Medicaid waiver, known as the “Bridge to Reform,” California enrolled about 650,000 uninsured residents in free county-based health coverage until they were able to enroll in Medi-Cal through the Affordable Care Act. The state also transitioned many of its Medi-Cal beneficiaries into managed care.\u003c/p>\n\u003cp>In addition, public hospitals revamped their programs — and created new ones — to improve the health and safety of their patients and to cut costs. For example, they began tracking patients with certain diseases, pairing patients with health coaches and making more weekend appointments for primary care.\u003c/p>\n\u003cp>Now public hospitals say they need money to continue implementing the reforms. The new waiver also would increase the number of hospitals that can access funds.\u003c/p>\n\u003cp>San Mateo Medical Center used the money to cut wait time for primary care appointments, screen diabetic patients for depression and reduce deaths by sepsis. Kern Medical Center reduced pressure ulcers among hospitalized patients and helped obese children lose weight.\u003c/p>\n\u003cp>[contextly_sidebar id=\"iB9CYD3FkXcoqHTBmSs0dLf7lgJv3VwT\"]UCLA Health System developed a program to help train physicians from Latin America so they could begin working in in high-need areas. The university’s health system also improved diabetic patients’ adherence to instructions on taking medication.\u003c/p>\n\u003cp>Santiago Muñoz, UCLA Health System’s chief strategy officer, said that his institution relies on it to help pay for expensive care to children with complex illnesses.\u003c/p>\n\u003cp>“We’re providing a lot of care to Medicaid kids,” said Munoz, who was among those who traveled to Washington this week to push for the waiver. “A lot of this highly specialized care is only available at academic or teaching hospitals.”\u003c/p>\n\u003cp>Without the new waiver, public hospitals will be in a “precarious situation,” said Christina Ghaly, deputy director for strategy and operations for the L.A. County Department of Health Services.\u003c/p>\n\u003cp>Through the waiver, the county’s public hospitals and clinics received about $2 billion in federal funding over the past five years, were able to assign more than 400,000 patients to primary care teams and better integrate physical and mental health services.\u003c/p>\n\u003cp>The goal of the Medicaid waiver, she said, is to shift more care from inpatient to outpatient settings and to get to the bottom of why some patients continue to seek high-cost treatment.\u003c/p>\n\u003cp>“When a person ends up in the emergency department 50 times because they are homeless, you can continue seeing them in the emergency department … or you can address the root cause of their homelessness,” she said.\u003c/p>\n\u003cp>The state’s low Medi-Cal reimbursement rate doesn’t fully cover care for the low-income population, providers said. And even though the Affordable Care Act expanded Medi-Cal, Ghaly said there are still millions of uninsured patients — and public hospitals are disproportionately responsible for their care.\u003c/p>\n\u003cp>“There has to be a deal,” Ghaly said. “If we aren’t able to close that gap … there would be some very difficult decisions.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Anna Gorman is a reporter with \u003c/em>\u003ca href=\"http://khn.org/\">\u003cem>Kaiser Health News\u003c/em>\u003c/a>\u003cem>, a nonprofit news organization covering health care policy and politics. It is an editorially independent program of the \u003c/em>\u003ca href=\"http://www.kff.org/\">\u003cstrong>\u003cem>Kaiser Family Foundation\u003c/em>\u003c/strong>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Erica Murray, CEO of the California Association of Public Hospitals, said one of the sticking points is how long an important provision of the waiver would last, with the state proposing five years and the federal government offering only three. The provision would pay for changes in how public hospitals deliver care, she said.\u003c/p>\n\u003cp>“Three years is not enough,” she said. “We need five years of support and incentive to achieve the goals of where the public systems need to be to stay competitive in their local marketplaces.”\u003c/p>\n\u003cp>Disagreements also exist over how hospitals should be paid to care for uninsured patients. The state wants to have the flexibility to use the money for more primary and preventive care rather than just to pay for emergency room visits and hospitalizations.\u003c/p>\n\u003cp>The state and the federal government have been negotiating since March, when California submitted a plan called “\u003ca href=\"http://www.dhcs.ca.gov/provgovpart/Pages/WaiverRenewal.aspx\" target=\"_blank\">Medi-Cal 2020\u003c/a>.” The plan also includes money to improve dental health programs, to expand the number of providers treating Medi-Cal patients and to start pilot projects addressing social problems of high-need patients.\u003c/p>\n\u003cp>State Department of Health Care Services Director Jennifer Kent said this week that the state needs the waiver to keep public hospitals financially stable so they can continue implementing reforms enacted under the Affordable Care Act. State officials are working toward a resolution and are trying to meet the deadline, Kent said.\u003c/p>\n\u003cp>“Everyone knows this is important,” Kent said. “It just boils down to getting the details worked out. I think we will get there.”\u003c/p>\n\u003cp>A spokesman for the Centers for Medicare & Medicaid Services declined to comment on the ongoing negotiations, but said extensions have been granted in other states.\u003c/p>\n\u003cp>Public hospitals have every right to be concerned about how the discussions are going, but there is always a lot of back and forth in Medicaid waiver negotiations, said Robin Rudowitz, associate director of the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured. “Given the amount of money, I can’t imagine that anyone is going to walk away from the table,” she said.\u003c/p>\n\u003cp>Waivers allow states to make exceptions to the usual Medicaid rules. Under the expiring Medicaid waiver, known as the “Bridge to Reform,” California enrolled about 650,000 uninsured residents in free county-based health coverage until they were able to enroll in Medi-Cal through the Affordable Care Act. The state also transitioned many of its Medi-Cal beneficiaries into managed care.\u003c/p>\n\u003cp>In addition, public hospitals revamped their programs — and created new ones — to improve the health and safety of their patients and to cut costs. For example, they began tracking patients with certain diseases, pairing patients with health coaches and making more weekend appointments for primary care.\u003c/p>\n\u003cp>Now public hospitals say they need money to continue implementing the reforms. The new waiver also would increase the number of hospitals that can access funds.\u003c/p>\n\u003cp>San Mateo Medical Center used the money to cut wait time for primary care appointments, screen diabetic patients for depression and reduce deaths by sepsis. Kern Medical Center reduced pressure ulcers among hospitalized patients and helped obese children lose weight.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>UCLA Health System developed a program to help train physicians from Latin America so they could begin working in in high-need areas. The university’s health system also improved diabetic patients’ adherence to instructions on taking medication.\u003c/p>\n\u003cp>Santiago Muñoz, UCLA Health System’s chief strategy officer, said that his institution relies on it to help pay for expensive care to children with complex illnesses.\u003c/p>\n\u003cp>“We’re providing a lot of care to Medicaid kids,” said Munoz, who was among those who traveled to Washington this week to push for the waiver. “A lot of this highly specialized care is only available at academic or teaching hospitals.”\u003c/p>\n\u003cp>Without the new waiver, public hospitals will be in a “precarious situation,” said Christina Ghaly, deputy director for strategy and operations for the L.A. County Department of Health Services.\u003c/p>\n\u003cp>Through the waiver, the county’s public hospitals and clinics received about $2 billion in federal funding over the past five years, were able to assign more than 400,000 patients to primary care teams and better integrate physical and mental health services.\u003c/p>\n\u003cp>The goal of the Medicaid waiver, she said, is to shift more care from inpatient to outpatient settings and to get to the bottom of why some patients continue to seek high-cost treatment.\u003c/p>\n\u003cp>“When a person ends up in the emergency department 50 times because they are homeless, you can continue seeing them in the emergency department … or you can address the root cause of their homelessness,” she said.\u003c/p>\n\u003cp>The state’s low Medi-Cal reimbursement rate doesn’t fully cover care for the low-income population, providers said. And even though the Affordable Care Act expanded Medi-Cal, Ghaly said there are still millions of uninsured patients — and public hospitals are disproportionately responsible for their care.\u003c/p>\n\u003cp>“There has to be a deal,” Ghaly said. “If we aren’t able to close that gap … there would be some very difficult decisions.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
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"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
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"possible": {
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"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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},
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"tagline": "Art is where you find it",
"info": "Rightnowish digs into life in the Bay Area right now… ish. Journalist Pendarvis Harshaw takes us to galleries painted on the sides of liquor stores in West Oakland. We'll dance in warehouses in the Bayview, make smoothies with kids in South Berkeley, and listen to classical music in a 1984 Cutlass Supreme in Richmond. Every week, Pen talks to movers and shakers about how the Bay Area shapes what they create, and how they shape the place we call home.",
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"title": "Snap Judgment",
"tagline": "Real stories with killer beats",
"info": "The Snap Judgment radio show and podcast mixes real stories with killer beats to produce cinematic, dramatic radio. Snap's musical brand of storytelling dares listeners to see the world through the eyes of another. This is storytelling... with a BEAT!! Snap first aired on public radio stations nationwide in July 2010. Today, Snap Judgment airs on over 450 public radio stations and is brought to the airwaves by KQED & PRX.",
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},
"soldout": {
"id": "soldout",
"title": "SOLD OUT: Rethinking Housing in America",
"tagline": "A new future for housing",
"info": "Sold Out: Rethinking Housing in America",
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