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"title": "KQED’s #PriceCheck Project Shows Steep Variation in Prices Paid by Health Insurers",
"headTitle": "Price Check | State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_19667\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf.jpg\">\u003cimg class=\"size-full wp-image-19667\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf.jpg\" alt=\"(Illustration: Andy Warner)\" width=\"640\" height=\"206\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf-400x129.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf-320x103.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Illustration: Andy Warner)\u003c/figcaption>\u003c/figure>\n\u003cp>Since June, KQED has been crowdsourcing health care prices.\u003c/p>\n\u003caside class=\"pullquote alignleft\">For starters, insurers paid from $128 to $694 for a screening mammogram. \u003c/aside>\n\u003cp>Why turn to crowdsourcing? Because health care prices are notoriously opaque. Negotiated rates between insurance companies and providers, both doctors and hospitals, are sealed tight, by contract. We know there’s variation, but comparing what one insurance company pays with another is virtually impossible.\u003c/p>\n\u003cp>So \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/06/23/kqed-launches-project-to-help-make-health-costs-transparent/\" href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/kqed-launches-project-to-help-make-health-costs-transparent/\" target=\"_blank\">we asked you,\u003c/a> the members of our community, to share what you paid.\u003c/p>\n\u003cp>Together with our collaborators \u003ca title=\"http://www.scpr.org/price-check\" href=\"http://www.scpr.org/price-check\" target=\"_blank\">KPCC in Los Angeles\u003c/a> and \u003ca title=\"http://clearhealthcosts.com\" href=\"http://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts.com\u003c/a>, a New York City startup dedicated to health cost transparency, we created a form to make it easy for people to share what they paid — and easy for consumers to see apples-to-apples comparisons of prices.\u003c!--more-->\u003c/p>\n\u003cp>First off, thank you! Hundreds of you shared what you paid for common health care procedures, and thousands more have searched our database, looking for concrete prices they can count on.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Today, we are also proud to report recognition from the medical community: the journal \u003ca title=\"http://archinte.jamanetwork.com/article.aspx?doi=10.1001/jamainternmed.2014.6793\" href=\"http://archinte.jamanetwork.com/article.aspx?doi=10.1001/jamainternmed.2014.6793\" target=\"_blank\">JAMA Internal Medicine invited me to write\u003c/a> a Viewpoint to inform doctors about PriceCheck findings. It was published Monday.\u003c/p>\n\u003cp>\u003cstrong>How PriceCheck Works\u003c/strong>\u003c/p>\n\u003cp>In PriceCheck we asked people to share prices for four common medical procedures: mammograms, lower-back MRIs, IUDs and diabetes test strips -- although plenty of people shared prices for other procedures, too. Our form can take virtually any share.\u003c/p>\n\u003cp>I described in JAMA Internal Medicine what happens next:\u003c/p>\n\u003cblockquote>\u003cp>“First, people enter the ‘charged' price. Next, people who do not have insurance and pay out of pocket enter the self-pay price. People with insurance can submit both what the insurer paid and their copay amount, if any. All shared costs are automatically fed into the database, which we pre-populated with cash prices for 30 to 35 ‘shoppable’ medical tests and procedures; these prices were collected by ClearHealthCosts.com.\"\u003c/p>\u003c/blockquote>\n\u003cp>We started with mammograms, because this test is done \u003ca title=\"http://www.fda.gov/Radiation-EmittingProducts/MammographyQualityStandardsActandProgram/FacilityScorecard/ucm113858.htm\" href=\"http://www.fda.gov/Radiation-EmittingProducts/MammographyQualityStandardsActandProgram/FacilityScorecard/ucm113858.htm\" target=\"_blank\">more than 38 million times a year\u003c/a> across the country. Since screening mammograms are a test that can be scheduled, women can, in theory, call around and select a facility based on price.\u003c/p>\n\u003cp>We thought we would find variation, and indeed we did.\u003c/p>\n\u003cp>Looking just at the San Francisco and Los Angeles metropolitan areas, we found that the variation in what insurers paid for screening mammograms ranged from $128 to $694.\u003c/p>\n\u003cp>Specifically in Los Angeles, our KPCC co-conspirator Rebecca Plevin\u003ca title=\"http://www.scpr.org/blogs/health/2014/07/21/17024/next-up-for-pricecheck-back-mri-s/\" href=\"http://www.scpr.org/blogs/health/2014/07/21/17024/next-up-for-pricecheck-back-mri-s/\" target=\"_blank\"> found one woman\u003c/a> whose insurer paid $600 more than the lowest-cost screening mammogram in Los Angeles. “I’m sure every woman who’s had a mammogram had the exact same experience I did,” this woman told Plevin. \"It was a friendly technician, but I don’t think that’s worth maybe $600 extra dollars.”\u003c/p>\n\u003caside class=\"pullquote alignright\">Read the \u003ca title=\"http://archinte.jamanetwork.com/article.aspx?doi=10.1001/jamainternmed.2014.6793\" href=\"http://archinte.jamanetwork.com/article.aspx?doi=10.1001/jamainternmed.2014.6793\" target=\"_blank\">JAMA Internal Medicine Viewpoint\u003c/a> about PriceCheck. \u003c/aside>\n\u003cp>In lower-back MRIs, we found that for \u003ca title=\"http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/cpt.page\" href=\"http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/cpt.page\" target=\"_blank\">CPT\u003c/a> code 72148, insurers paid from $467 to $1,567. But when looking beyond commercial insurers, we found even greater variation — from a low of $255 to a self-pay price of $6,221 at an academic medical center.\u003c/p>\n\u003cp>That $255 MRI was paid by Medicare — and was just a fraction of the $2,450 price the facility charged.\u003c/p>\n\u003cp>But the variation doesn’t stop there, as I described in JAMA Internal Medicine. Yet another person went to the same facility and was charged $603 for the same procedure, same CPT code. This patient had commercial insurance, but paid the entire amount out of pocket, the patient said in comments on our form, since “I had not yet met my deductible.”\u003c/p>\n\u003cp>For IUDs, women reported that prices insurers paid ranged from $440 to $1,230 (for both the device and insertion.)\u003c/p>\n\u003cp>We received very few formal submissions for diabetes test strips. But people shared their prices in comments on Facebook or blog posts. Culling from these informal shares, we found that cash prices for a box of 50 strips ranged from $9 to $88.\u003c/p>\n\u003cp>In \u003ca title=\"http://archinte.jamanetwork.com/article.aspx?articleid=1935928\" href=\"http://archinte.jamanetwork.com/article.aspx?articleid=1935928\" target=\"_blank\">an editorial\u003c/a>, JAMA Internal Medicine editor Rita Redberg, a UC San Francisco cardiologist, called PriceCheck \"bold\" and said that PriceCheck is starting to supply \"essential information\" about price information for common health care tests and procedures.\u003c/p>\n\u003cp>\u003cstrong>Why Price Matters\u003c/strong>\u003c/p>\n\u003cp>Until recently, consumers didn’t have much incentive to shop on price in health care. They might have paid only a manageable copay; insurance picked up the rest.\u003c/p>\n\u003cp>But today, many people have high-deductible health plans. So it might matter to you if the price your insurer negotiated at Facility A is hundreds of dollars more than at Facility B.\u003c/p>\n\u003cp>People told us in comments on stories we wrote and on Facebook of their frustration (“fury” might be a better word):\u003c/p>\n\u003cul>\n\u003cli>“High deductible so paid the whole thing and then found out I could have had it done for *HALF* the price only blocks away. My first foray into individual insurance and it s***ed. Need to shop around assuming can even get a price quote.”\u003c/li>\n\u003cli>“I was told the procedure was $1850. I have a $7500 deductible. So I talked to (an employee) who said if I paid upfront and agreed not to report he procedure to Blue Cross, that it would be $580.”\u003c/li>\n\u003cli>“How’s a civilian supposed to make sense of this?”\u003c/li>\n\u003c/ul>\n\u003cp>\u003cstrong>What About Quality?\u003c/strong>\u003c/p>\n\u003cp>We’ve received thoughtful and pointed questions on two fronts. First, many people ask about quality. Should people be shopping for health care procedures in the same way they shop for a computer or look for the best price on canned goods?\u003c/p>\n\u003cp>This is a reasonable question, but the problem is that cost and quality are unfortunately not connected in health care. There’s no evidence that getting the most expensive treatment or procedure will yield a better outcome. People are starting to wonder why they're paying dramatically more if that extra money isn't buying better health.\u003c/p>\n\u003cp>At PriceCheck, we believe that driving cost transparency helps drive quality discussions, too. \u003ca title=\"But thanks to a law enacted in October, Massachusetts health insurers now have to make all their prices public — in advance.\" href=\"But%20thanks%20to%20a%20law%20enacted%20in%20October,%20Massachusetts%20health%20insurers%20now%20have%20to%20make%20all%20their%20prices%20public%20%E2%80%94%20in%20advance.\" target=\"_blank\">A new law in Massachusetts\u003c/a> requires insurers to make their prices public, in advance. Patients can look up their own costs, based on their plan. Advocates are encouraging people to shop on price.\u003c/p>\n\u003cp>We also hear skepticism about the reliability of crowdsourced data. While I noted this important caveat in JAMA Internal Medicine, we are also firmly behind our community and the prices they share with us. Yes, these data are crowdsourced and as such may contain errors, I wrote, then added:\u003c/p>\n\u003cblockquote>\u003cp>“Yet people should be able to understand their medical bills and explanation of benefits statements. Some people who shared their prices provided contact information; we reached some of them to discuss their bills more fully.”\u003c/p>\u003c/blockquote>\n\u003cp>The PriceCheck form and database are open to you. Please visit and search our database for prices — or share what you paid. Help us make health costs transparent!\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/177363983\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19667\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf.jpg\">\u003cimg class=\"size-full wp-image-19667\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf.jpg\" alt=\"(Illustration: Andy Warner)\" width=\"640\" height=\"206\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf-400x129.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf-320x103.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Illustration: Andy Warner)\u003c/figcaption>\u003c/figure>\n\u003cp>Since June, KQED has been crowdsourcing health care prices.\u003c/p>\n\u003caside class=\"pullquote alignleft\">For starters, insurers paid from $128 to $694 for a screening mammogram. \u003c/aside>\n\u003cp>Why turn to crowdsourcing? Because health care prices are notoriously opaque. Negotiated rates between insurance companies and providers, both doctors and hospitals, are sealed tight, by contract. We know there’s variation, but comparing what one insurance company pays with another is virtually impossible.\u003c/p>\n\u003cp>So \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/06/23/kqed-launches-project-to-help-make-health-costs-transparent/\" href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/kqed-launches-project-to-help-make-health-costs-transparent/\" target=\"_blank\">we asked you,\u003c/a> the members of our community, to share what you paid.\u003c/p>\n\u003cp>Together with our collaborators \u003ca title=\"http://www.scpr.org/price-check\" href=\"http://www.scpr.org/price-check\" target=\"_blank\">KPCC in Los Angeles\u003c/a> and \u003ca title=\"http://clearhealthcosts.com\" href=\"http://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts.com\u003c/a>, a New York City startup dedicated to health cost transparency, we created a form to make it easy for people to share what they paid — and easy for consumers to see apples-to-apples comparisons of prices.\u003c!--more-->\u003c/p>\n\u003cp>First off, thank you! Hundreds of you shared what you paid for common health care procedures, and thousands more have searched our database, looking for concrete prices they can count on.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Today, we are also proud to report recognition from the medical community: the journal \u003ca title=\"http://archinte.jamanetwork.com/article.aspx?doi=10.1001/jamainternmed.2014.6793\" href=\"http://archinte.jamanetwork.com/article.aspx?doi=10.1001/jamainternmed.2014.6793\" target=\"_blank\">JAMA Internal Medicine invited me to write\u003c/a> a Viewpoint to inform doctors about PriceCheck findings. It was published Monday.\u003c/p>\n\u003cp>\u003cstrong>How PriceCheck Works\u003c/strong>\u003c/p>\n\u003cp>In PriceCheck we asked people to share prices for four common medical procedures: mammograms, lower-back MRIs, IUDs and diabetes test strips -- although plenty of people shared prices for other procedures, too. Our form can take virtually any share.\u003c/p>\n\u003cp>I described in JAMA Internal Medicine what happens next:\u003c/p>\n\u003cblockquote>\u003cp>“First, people enter the ‘charged' price. Next, people who do not have insurance and pay out of pocket enter the self-pay price. People with insurance can submit both what the insurer paid and their copay amount, if any. All shared costs are automatically fed into the database, which we pre-populated with cash prices for 30 to 35 ‘shoppable’ medical tests and procedures; these prices were collected by ClearHealthCosts.com.\"\u003c/p>\u003c/blockquote>\n\u003cp>We started with mammograms, because this test is done \u003ca title=\"http://www.fda.gov/Radiation-EmittingProducts/MammographyQualityStandardsActandProgram/FacilityScorecard/ucm113858.htm\" href=\"http://www.fda.gov/Radiation-EmittingProducts/MammographyQualityStandardsActandProgram/FacilityScorecard/ucm113858.htm\" target=\"_blank\">more than 38 million times a year\u003c/a> across the country. Since screening mammograms are a test that can be scheduled, women can, in theory, call around and select a facility based on price.\u003c/p>\n\u003cp>We thought we would find variation, and indeed we did.\u003c/p>\n\u003cp>Looking just at the San Francisco and Los Angeles metropolitan areas, we found that the variation in what insurers paid for screening mammograms ranged from $128 to $694.\u003c/p>\n\u003cp>Specifically in Los Angeles, our KPCC co-conspirator Rebecca Plevin\u003ca title=\"http://www.scpr.org/blogs/health/2014/07/21/17024/next-up-for-pricecheck-back-mri-s/\" href=\"http://www.scpr.org/blogs/health/2014/07/21/17024/next-up-for-pricecheck-back-mri-s/\" target=\"_blank\"> found one woman\u003c/a> whose insurer paid $600 more than the lowest-cost screening mammogram in Los Angeles. “I’m sure every woman who’s had a mammogram had the exact same experience I did,” this woman told Plevin. \"It was a friendly technician, but I don’t think that’s worth maybe $600 extra dollars.”\u003c/p>\n\u003caside class=\"pullquote alignright\">Read the \u003ca title=\"http://archinte.jamanetwork.com/article.aspx?doi=10.1001/jamainternmed.2014.6793\" href=\"http://archinte.jamanetwork.com/article.aspx?doi=10.1001/jamainternmed.2014.6793\" target=\"_blank\">JAMA Internal Medicine Viewpoint\u003c/a> about PriceCheck. \u003c/aside>\n\u003cp>In lower-back MRIs, we found that for \u003ca title=\"http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/cpt.page\" href=\"http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/cpt.page\" target=\"_blank\">CPT\u003c/a> code 72148, insurers paid from $467 to $1,567. But when looking beyond commercial insurers, we found even greater variation — from a low of $255 to a self-pay price of $6,221 at an academic medical center.\u003c/p>\n\u003cp>That $255 MRI was paid by Medicare — and was just a fraction of the $2,450 price the facility charged.\u003c/p>\n\u003cp>But the variation doesn’t stop there, as I described in JAMA Internal Medicine. Yet another person went to the same facility and was charged $603 for the same procedure, same CPT code. This patient had commercial insurance, but paid the entire amount out of pocket, the patient said in comments on our form, since “I had not yet met my deductible.”\u003c/p>\n\u003cp>For IUDs, women reported that prices insurers paid ranged from $440 to $1,230 (for both the device and insertion.)\u003c/p>\n\u003cp>We received very few formal submissions for diabetes test strips. But people shared their prices in comments on Facebook or blog posts. Culling from these informal shares, we found that cash prices for a box of 50 strips ranged from $9 to $88.\u003c/p>\n\u003cp>In \u003ca title=\"http://archinte.jamanetwork.com/article.aspx?articleid=1935928\" href=\"http://archinte.jamanetwork.com/article.aspx?articleid=1935928\" target=\"_blank\">an editorial\u003c/a>, JAMA Internal Medicine editor Rita Redberg, a UC San Francisco cardiologist, called PriceCheck \"bold\" and said that PriceCheck is starting to supply \"essential information\" about price information for common health care tests and procedures.\u003c/p>\n\u003cp>\u003cstrong>Why Price Matters\u003c/strong>\u003c/p>\n\u003cp>Until recently, consumers didn’t have much incentive to shop on price in health care. They might have paid only a manageable copay; insurance picked up the rest.\u003c/p>\n\u003cp>But today, many people have high-deductible health plans. So it might matter to you if the price your insurer negotiated at Facility A is hundreds of dollars more than at Facility B.\u003c/p>\n\u003cp>People told us in comments on stories we wrote and on Facebook of their frustration (“fury” might be a better word):\u003c/p>\n\u003cul>\n\u003cli>“High deductible so paid the whole thing and then found out I could have had it done for *HALF* the price only blocks away. My first foray into individual insurance and it s***ed. Need to shop around assuming can even get a price quote.”\u003c/li>\n\u003cli>“I was told the procedure was $1850. I have a $7500 deductible. So I talked to (an employee) who said if I paid upfront and agreed not to report he procedure to Blue Cross, that it would be $580.”\u003c/li>\n\u003cli>“How’s a civilian supposed to make sense of this?”\u003c/li>\n\u003c/ul>\n\u003cp>\u003cstrong>What About Quality?\u003c/strong>\u003c/p>\n\u003cp>We’ve received thoughtful and pointed questions on two fronts. First, many people ask about quality. Should people be shopping for health care procedures in the same way they shop for a computer or look for the best price on canned goods?\u003c/p>\n\u003cp>This is a reasonable question, but the problem is that cost and quality are unfortunately not connected in health care. There’s no evidence that getting the most expensive treatment or procedure will yield a better outcome. People are starting to wonder why they're paying dramatically more if that extra money isn't buying better health.\u003c/p>\n\u003cp>At PriceCheck, we believe that driving cost transparency helps drive quality discussions, too. \u003ca title=\"But thanks to a law enacted in October, Massachusetts health insurers now have to make all their prices public — in advance.\" href=\"But%20thanks%20to%20a%20law%20enacted%20in%20October,%20Massachusetts%20health%20insurers%20now%20have%20to%20make%20all%20their%20prices%20public%20%E2%80%94%20in%20advance.\" target=\"_blank\">A new law in Massachusetts\u003c/a> requires insurers to make their prices public, in advance. Patients can look up their own costs, based on their plan. Advocates are encouraging people to shop on price.\u003c/p>\n\u003cp>We also hear skepticism about the reliability of crowdsourced data. While I noted this important caveat in JAMA Internal Medicine, we are also firmly behind our community and the prices they share with us. Yes, these data are crowdsourced and as such may contain errors, I wrote, then added:\u003c/p>\n\u003cblockquote>\u003cp>“Yet people should be able to understand their medical bills and explanation of benefits statements. Some people who shared their prices provided contact information; we reached some of them to discuss their bills more fully.”\u003c/p>\u003c/blockquote>\n\u003cp>The PriceCheck form and database are open to you. Please visit and search our database for prices — or share what you paid. Help us make health costs transparent!\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Fresno Pilots Asthma Program Aimed at Tapping Investors for Funds",
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"content": "\u003cfigure id=\"attachment_22223\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/asthma-12A.jpg\">\u003cimg class=\"size-large wp-image-22223\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/asthma-12A-640x426.jpg\" alt=\"Maura Vasquez tells health educator Nunu Sixay during a home visit on Tuesday, September 9, 2014, that her son, Jovani Garcia-Vasquez, 6, has not visited the emergency room since learning that administering his medication more regularly could help alleviate his asthma symptoms (Heidi de Marco/KHN).\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">During a home visit Maura Vasquez (R) tells health educator Nunu Sixay that her son, Jovani, 6, has not been to the E.R. since learning that administering his medication more regularly could help alleviate his asthma. (Heidi de Marco/KHN).\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Anna Gorman\u003c/strong>, \u003ca title=\"http://kaiserhealthnews.org/news/the-latest-in-public-health-funding-tapping-investors/\" href=\"http://kaiserhealthnews.org/news/the-latest-in-public-health-funding-tapping-investors/\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>Inside her single-story home in the dry and dusty Central Valley, Dalia Mondragon scarcely sleeps. Several times a night, she tiptoes into her children’s rooms to make sure their chests are peacefully rising and falling.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Under the approach, investors fund a social impact bond; if a social program saves money -- investors make money.\u003c/aside>\n\u003cp>“I feel like any time they could stop breathing,” she says.\u003c/p>\n\u003cp>Mondragon and all four of her children have asthma -– a disease that has sent them to the hospital more times than she can count. So she is more than willing to open her home to Nunu Sixay, an asthma prevention worker trying to figure out what is triggering the attacks. On a recent visit, Sixay found some possible culprits: mold in the bathroom and aerosol furniture polish in the kitchen.\u003c/p>\n\u003cp>Sixay’s work visiting low-income families like the Mondragons is part of a public health experiment to help asthmatic children breathe easier and stay out of costly emergency rooms – with the aim of getting investors to pay for it.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The plan is to create a “social impact bond,” a contract in which Wall Street and other investors agree to support programs with goals such as taxpayer savings and improved health outcomes. If the programs can demonstrate with solid evidence that they have met those goals, the investors recoup their principal and get a return, typically from the government.\u003c/p>\n\u003cp>The asthma project is among the first to focus on improving health outcomes. But a rising number of “pay for success” projects are planned or underway around the nation, including in Ohio, Connecticut, South Carolina and Massachusetts. One seeks to expand early childhood education in Utah, for instance, and another to reduce homelessness in Colorado.\u003c/p>\n\u003cp>Typically, private investors or foundations provide at least a portion of the seed money. Bank of America Merrill Lynch, for instance, raised $13.5 million from its investors for a New York project aimed at reducing recidivism and increasing employment among former inmates. Depending on the outcomes, which must be evaluated by an independent third party, the government will repay the investors and provide a return. Generally, it is a slice of taxpayer savings, ranging from 5 to 12 percent of the original investment.\u003c/p>\n\u003cp>“We were all excited about the idea of a whole new form of impact investing,” said Kirstin Hill, a managing director in Merrill Lynch’s global wealth management business.\u003c/p>\n\u003cp>The bonds, which first were devised in England, appeal to investors who want to see part of their portfolio go toward what they see as a social good. “People with lots of money are anxious to invest at least a portion in things like this, especially if you give them a reasonable return,” said John Vogel, who teaches business administration at Dartmouth’s Tuck School of Business.\u003c/p>\n\u003cp>Critics, however, say it’s too early to see what impact the bonds will have, and question whether the effects can be accurately measured. Some are skeptical that many private firms will invest.\u003c/p>\n\u003cp>\u003cstrong>Growing The Pie\u003c/strong>\u003c/p>\n\u003cp>Organizations are looking for ways to “grow the pie of funding that is available to the social sector” rather than relying only on philanthropic and government funds, said Rick Brush, CEO of Collective Health. The Connecticut company is helping to organize the Fresno project with Social Finance, a Boston nonprofit that designs social impact bonds.\u003c/p>\n\u003cp>Nirav Shah, director of Social Finance, said numerous health programs have a significant impact on patients but are outside of clinical settings so aren’t typically reimbursed by insurers.\u003c/p>\n\u003cp>In the asthma program, for example, a social impact bond could pay for home renovations such as stripping out carpet or getting rid of mold.\u003c/p>\n\u003cp>The Fresno project is still in its pilot stage: Organizers won’t start reaching out to investors until late next year Funding from banks, individuals and foundations would enable the asthma prevention program to expand from about 200 children to 3,500, they said. In this case, the returns could come from either the state or insurers, Shah said.\u003c/p>\n\u003cp>The pilot program, which is funded by a grant of about $1 million from The California Endowment, is using claims data to track ER visits and measure the savings before turning to investors. The estimated savings per child is more than $7,700.\u003c/p>\n\u003cp>\u003cstrong>Taking It To Heart\u003c/strong>\u003c/p>\n\u003cp>In Fresno, asthma prevention workers ask parents to commit to three changes in the home to help prevent asthma attacks. Throughout the year, they follow up with in-person visits and phone calls. “The little knowledge we give them they really take it to heart,” Sixay said.\u003c/p>\n\u003cp>One recent day, Sixay stopped by the cramped house of 6-year-old Jovani Garcia-Vasquez. His mother, Maura Vasquez, said she used to rush her son to the hospital every time he had an asthma flare-up. She said that a doctor had advised her not to give the inhaler to her son because he could get addicted to Albuterol. “So I didn’t give it to him, hardly ever,” she said.\u003c/p>\n\u003cp>After learning from Sixay that the medication actually helps relieve the asthma symptoms, Vasquez began administering it more regularly. She said she hasn’t had to take him to the ER since.\u003c/p>\n\u003cp>“I didn’t know how to help him,” she said. “Now I know.”\u003c/p>\n\u003cp>Sixay sat down with Jovani and asked him to point to faces that showed how he felt. When she asked “How is your asthma today?” he pointed to a happy face.\u003c/p>\n\u003cp>Sixay, who works for the Central California Asthma Collaborative, said she is taking small steps toward solving a big problem. Fresno has one of the highest childhood asthma rates in California, with a fifth of children ages 5 to 17 affected. The county also has high rates of asthma-related pediatric emergency room visits and hospitalizations, paid for primarily by Medi-Cal, California’s public insurance program for poor people. All told, about $35 million is spent countywide per year for hospital costs for children with asthma, according to Collective Health and Social Finance.\u003c/p>\n\u003cp>The region has relatively poor air quality, said Vipul Jain, a professor at UC San Francisco and pulmonologist at Fresno’s Community Regional Medical Center. “It’s this recurrent, vicious glob [of bad air] that never lets them free,” he said. Poverty, lack of regular care and poor housing conditions also contribute to high hospitalization rates, he said.\u003c/p>\n\u003cp>Jain said home interventions can certainly help, but good self-management, disease education and clinical care also are needed. Otherwise, “it’s not realistic to expect a significant change,” he said.\u003c/p>\n\u003cp>The Fresno project is collaborating with Clinica Sierra Vista, a community health center in Fresno, which is providing ongoing medical care. Each day, the clinic’s doctors see asthmatic children like Jose Lomelli, 11.\u003c/p>\n\u003cp>On a recent September morning, Jose’s mother, Hopie Castro, took him to the doctor because he was coughing and using his inhaler every few hours and she worried he would have to go to the emergency room.\u003c/p>\n\u003cp>Jose missed about a fifth of the last school year because of asthma and has gone to the hospital more than 15 times in the past several years, Castro said.\u003c/p>\n\u003cp>Dr. Kami Jow listened to Jose breathe and confirmed that he was having an asthma attack. He prescribed steroids, and he corrected him on using his inhaler so the medicine would flow into his lungs.\u003c/p>\n\u003cp>“How do I know when to take him to the emergency room?” she asked.\u003c/p>\n\u003cp>“You’ll see him working really hard to breathe,” he said.\u003c/p>\n\u003cp>Jow said he often sees families who don’t know what leads to asthma attacks or how or when to use medication. Rarely, he said, does he have the time to educate them thoroughly about the disease.\u003c/p>\n\u003cp>That’s where workers like Sixay come in.\u003c/p>\n\u003cp>She sees a lot of progress but faces occasional setbacks. The Mondragons, for instance, had made improvements at home –- then recently got a kitten. It’s cute, she told the family, but not good for the airways.\u003c/p>\n\u003cp>“It’s a process,” she said. “They are not all going to change overnight.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Kaiser Health News (KHN) is 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>\u003cfigure id=\"attachment_22223\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/asthma-12A.jpg\">\u003cimg class=\"size-large wp-image-22223\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/asthma-12A-640x426.jpg\" alt=\"Maura Vasquez tells health educator Nunu Sixay during a home visit on Tuesday, September 9, 2014, that her son, Jovani Garcia-Vasquez, 6, has not visited the emergency room since learning that administering his medication more regularly could help alleviate his asthma symptoms (Heidi de Marco/KHN).\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">During a home visit Maura Vasquez (R) tells health educator Nunu Sixay that her son, Jovani, 6, has not been to the E.R. since learning that administering his medication more regularly could help alleviate his asthma. (Heidi de Marco/KHN).\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Anna Gorman\u003c/strong>, \u003ca title=\"http://kaiserhealthnews.org/news/the-latest-in-public-health-funding-tapping-investors/\" href=\"http://kaiserhealthnews.org/news/the-latest-in-public-health-funding-tapping-investors/\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>Inside her single-story home in the dry and dusty Central Valley, Dalia Mondragon scarcely sleeps. Several times a night, she tiptoes into her children’s rooms to make sure their chests are peacefully rising and falling.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Under the approach, investors fund a social impact bond; if a social program saves money -- investors make money.\u003c/aside>\n\u003cp>“I feel like any time they could stop breathing,” she says.\u003c/p>\n\u003cp>Mondragon and all four of her children have asthma -– a disease that has sent them to the hospital more times than she can count. So she is more than willing to open her home to Nunu Sixay, an asthma prevention worker trying to figure out what is triggering the attacks. On a recent visit, Sixay found some possible culprits: mold in the bathroom and aerosol furniture polish in the kitchen.\u003c/p>\n\u003cp>Sixay’s work visiting low-income families like the Mondragons is part of a public health experiment to help asthmatic children breathe easier and stay out of costly emergency rooms – with the aim of getting investors to pay for it.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The plan is to create a “social impact bond,” a contract in which Wall Street and other investors agree to support programs with goals such as taxpayer savings and improved health outcomes. If the programs can demonstrate with solid evidence that they have met those goals, the investors recoup their principal and get a return, typically from the government.\u003c/p>\n\u003cp>The asthma project is among the first to focus on improving health outcomes. But a rising number of “pay for success” projects are planned or underway around the nation, including in Ohio, Connecticut, South Carolina and Massachusetts. One seeks to expand early childhood education in Utah, for instance, and another to reduce homelessness in Colorado.\u003c/p>\n\u003cp>Typically, private investors or foundations provide at least a portion of the seed money. Bank of America Merrill Lynch, for instance, raised $13.5 million from its investors for a New York project aimed at reducing recidivism and increasing employment among former inmates. Depending on the outcomes, which must be evaluated by an independent third party, the government will repay the investors and provide a return. Generally, it is a slice of taxpayer savings, ranging from 5 to 12 percent of the original investment.\u003c/p>\n\u003cp>“We were all excited about the idea of a whole new form of impact investing,” said Kirstin Hill, a managing director in Merrill Lynch’s global wealth management business.\u003c/p>\n\u003cp>The bonds, which first were devised in England, appeal to investors who want to see part of their portfolio go toward what they see as a social good. “People with lots of money are anxious to invest at least a portion in things like this, especially if you give them a reasonable return,” said John Vogel, who teaches business administration at Dartmouth’s Tuck School of Business.\u003c/p>\n\u003cp>Critics, however, say it’s too early to see what impact the bonds will have, and question whether the effects can be accurately measured. Some are skeptical that many private firms will invest.\u003c/p>\n\u003cp>\u003cstrong>Growing The Pie\u003c/strong>\u003c/p>\n\u003cp>Organizations are looking for ways to “grow the pie of funding that is available to the social sector” rather than relying only on philanthropic and government funds, said Rick Brush, CEO of Collective Health. The Connecticut company is helping to organize the Fresno project with Social Finance, a Boston nonprofit that designs social impact bonds.\u003c/p>\n\u003cp>Nirav Shah, director of Social Finance, said numerous health programs have a significant impact on patients but are outside of clinical settings so aren’t typically reimbursed by insurers.\u003c/p>\n\u003cp>In the asthma program, for example, a social impact bond could pay for home renovations such as stripping out carpet or getting rid of mold.\u003c/p>\n\u003cp>The Fresno project is still in its pilot stage: Organizers won’t start reaching out to investors until late next year Funding from banks, individuals and foundations would enable the asthma prevention program to expand from about 200 children to 3,500, they said. In this case, the returns could come from either the state or insurers, Shah said.\u003c/p>\n\u003cp>The pilot program, which is funded by a grant of about $1 million from The California Endowment, is using claims data to track ER visits and measure the savings before turning to investors. The estimated savings per child is more than $7,700.\u003c/p>\n\u003cp>\u003cstrong>Taking It To Heart\u003c/strong>\u003c/p>\n\u003cp>In Fresno, asthma prevention workers ask parents to commit to three changes in the home to help prevent asthma attacks. Throughout the year, they follow up with in-person visits and phone calls. “The little knowledge we give them they really take it to heart,” Sixay said.\u003c/p>\n\u003cp>One recent day, Sixay stopped by the cramped house of 6-year-old Jovani Garcia-Vasquez. His mother, Maura Vasquez, said she used to rush her son to the hospital every time he had an asthma flare-up. She said that a doctor had advised her not to give the inhaler to her son because he could get addicted to Albuterol. “So I didn’t give it to him, hardly ever,” she said.\u003c/p>\n\u003cp>After learning from Sixay that the medication actually helps relieve the asthma symptoms, Vasquez began administering it more regularly. She said she hasn’t had to take him to the ER since.\u003c/p>\n\u003cp>“I didn’t know how to help him,” she said. “Now I know.”\u003c/p>\n\u003cp>Sixay sat down with Jovani and asked him to point to faces that showed how he felt. When she asked “How is your asthma today?” he pointed to a happy face.\u003c/p>\n\u003cp>Sixay, who works for the Central California Asthma Collaborative, said she is taking small steps toward solving a big problem. Fresno has one of the highest childhood asthma rates in California, with a fifth of children ages 5 to 17 affected. The county also has high rates of asthma-related pediatric emergency room visits and hospitalizations, paid for primarily by Medi-Cal, California’s public insurance program for poor people. All told, about $35 million is spent countywide per year for hospital costs for children with asthma, according to Collective Health and Social Finance.\u003c/p>\n\u003cp>The region has relatively poor air quality, said Vipul Jain, a professor at UC San Francisco and pulmonologist at Fresno’s Community Regional Medical Center. “It’s this recurrent, vicious glob [of bad air] that never lets them free,” he said. Poverty, lack of regular care and poor housing conditions also contribute to high hospitalization rates, he said.\u003c/p>\n\u003cp>Jain said home interventions can certainly help, but good self-management, disease education and clinical care also are needed. Otherwise, “it’s not realistic to expect a significant change,” he said.\u003c/p>\n\u003cp>The Fresno project is collaborating with Clinica Sierra Vista, a community health center in Fresno, which is providing ongoing medical care. Each day, the clinic’s doctors see asthmatic children like Jose Lomelli, 11.\u003c/p>\n\u003cp>On a recent September morning, Jose’s mother, Hopie Castro, took him to the doctor because he was coughing and using his inhaler every few hours and she worried he would have to go to the emergency room.\u003c/p>\n\u003cp>Jose missed about a fifth of the last school year because of asthma and has gone to the hospital more than 15 times in the past several years, Castro said.\u003c/p>\n\u003cp>Dr. Kami Jow listened to Jose breathe and confirmed that he was having an asthma attack. He prescribed steroids, and he corrected him on using his inhaler so the medicine would flow into his lungs.\u003c/p>\n\u003cp>“How do I know when to take him to the emergency room?” she asked.\u003c/p>\n\u003cp>“You’ll see him working really hard to breathe,” he said.\u003c/p>\n\u003cp>Jow said he often sees families who don’t know what leads to asthma attacks or how or when to use medication. Rarely, he said, does he have the time to educate them thoroughly about the disease.\u003c/p>\n\u003cp>That’s where workers like Sixay come in.\u003c/p>\n\u003cp>She sees a lot of progress but faces occasional setbacks. The Mondragons, for instance, had made improvements at home –- then recently got a kitten. It’s cute, she told the family, but not good for the airways.\u003c/p>\n\u003cp>“It’s a process,” she said. “They are not all going to change overnight.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Kaiser Health News (KHN) is 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\u003c/div>\u003c/p>",
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"content": "\u003cp>There’s a new scene at Richmond’s \u003ca href=\"http://pogopark.org/2013/07/21/elm-park-scale-model/\">Elm Playlot\u003c/a>, a half-acre renovated “pocket park” in the heart of the Iron Triangle, one of the city’s toughest neighborhoods.\u003c/p>\n\u003cp>Inside the park’s fence, kids are everywhere. Toddlers ride tricycles along brightly painted paths. Older kids patiently wait for a spin on the popular zip line. And teens gather in the center for a quick game of dodge ball.\u003c/p>\n\u003cp>This is a far cry from what the park used to look like just two years ago. The playground was littered with empty liquor bottles, gun shell casing and an occasional needle. Parents didn’t take their kids there.\u003c/p>\n\u003cp>“Nobody used to come in here and now people are here to take care of us,” says 10-year-old Jose Anaya while taking a break from running around the playground. “[Now] it makes me feel safe.”\u003c/p>\n\u003cp>His sister Dulce chimes in.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“The first time I walked by it, it was so amazing I couldn’t help myself,” she says. “The next day I came and seen all the exciting things that was here at Pogo Park. I got to meet some of my friends. I want to thank whoever made the Pogo Park and the workers who are here to help us.”\u003c/p>\n\u003cp>The siblings make a dash to the ice cream truck stopped in front of the park. They share ice cream before Dulce gives Jose a big push on the zip line.\u003c/p>\n\u003cp>“We have a lot of fun,” he says. \u003c/p>\n\u003cp>The park’s renovation is the brainchild of Toody Maher, a UC Berkeley alumna who previously helped launch the trendy Swatch watches on the West Coast.\u003c/p>\n\u003cp>The Richmond resident is the founder and executive director of \u003ca href=\"http://pogopark.org/\">Pogo Park\u003c/a>, the nonprofit that is renovating parks throughout Richmond. In 2007, she visited each of the city’s 56 parks, and it was the tiny “pocket parks,” like Elm Playlot, that captured her attention.\u003c/p>\n\u003cp>“When I first came to visit, every single house surrounding the park, but one, was boarded up,” Maher says. “You drive up and think, ‘Oh, this is a nice park.’ Then you get in and realize there is nowhere to sit, there’s no water fountains, there’s no bathroom.”\u003c/p>\n\u003cp>Maher used funds from her 401(K) as the initial investment. Since then, she’s managed to raise $8 million dollars from private and public sources.\u003c/p>\n\u003cp>“My whole life I’ve always dreamed, if I had a million dollars and I had all the time in the world, I would go and build like great little children’s parks and playgrounds,” she says, smiling.\u003c/p>\n\u003cp>But Maher knew she needed to gain the community’s trust, which was hard since the neighbors were fed up with broken promises.\u003c/p>\n\u003cp>“This is a neighborhood where, despite millions of dollars of investments and urban renewal projects, nothing works,” she says.\u003c/p>\n\u003cp>Maher decided to hire workers from the community to design, build and now manage their own park.\u003c/p>\n\u003cp>“I knocked on people’s doors that live around the neighborhood, and we worked for years to figure out what we wanted to build,” says Maher. “By empowering local residents to make the change themselves, it’s really been a transformative project for the whole neighborhood. It’s like a mini stimulus plan in the neighborhood because all these folks are getting jobs and training.”\u003c/p>\n\u003cp>One of those employees is Karina Guadalupe. She’s worked for Pogo Park since 2008.\u003c/p>\n\u003cp>“Before the park, people knew they had someone living next to them, but it really wasn’t a sense of community,” says Guadalupe. “Now the neighbors know each other, they look after each other’s kids and it’s a place to come meet each other and feel safe and comfortable.”\u003c/p>\n\u003cp>She’s not the only one who has noticed the change.\u003c/p>\n\u003cp>“We live here and are really invested in this,” says Doris Mason, a longtime Richmond resident who works the afternoon shift at the park. “Every day, I wake up I know I’m making a difference, so I don’t mind coming to work.”\u003c/p>\n\u003cp>She says Elm Playlot has changed the whole atmosphere of the neighborhood.\u003c/p>\n\u003cp>“You can look around and you can see the kids, you know, they’re just happy,” Mason says. “There’s no play structure; they’re creating their own type of play.”\u003c/p>\n\u003cp>Maher is already working on renovating two other Richmond parks and has plans for many more.\u003c/p>\n\u003cp>“There are thousands of inner-city parks all over the country that are just lying there — unused, dormant, uninspired — and all you have to do is transform it into a Pogo Park,” Maher says. She adds, “All I set out to do was just build a far-out, fantastic, great children’s park. It’s such a great feeling; it’s indescribable to see a dream come true.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Elm Playlot, Pogo Park’s first renovation, is at Eighth Street and Elm Avenue in Richmond.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>There’s a new scene at Richmond’s \u003ca href=\"http://pogopark.org/2013/07/21/elm-park-scale-model/\">Elm Playlot\u003c/a>, a half-acre renovated “pocket park” in the heart of the Iron Triangle, one of the city’s toughest neighborhoods.\u003c/p>\n\u003cp>Inside the park’s fence, kids are everywhere. Toddlers ride tricycles along brightly painted paths. Older kids patiently wait for a spin on the popular zip line. And teens gather in the center for a quick game of dodge ball.\u003c/p>\n\u003cp>This is a far cry from what the park used to look like just two years ago. The playground was littered with empty liquor bottles, gun shell casing and an occasional needle. Parents didn’t take their kids there.\u003c/p>\n\u003cp>“Nobody used to come in here and now people are here to take care of us,” says 10-year-old Jose Anaya while taking a break from running around the playground. “[Now] it makes me feel safe.”\u003c/p>\n\u003cp>His sister Dulce chimes in.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“The first time I walked by it, it was so amazing I couldn’t help myself,” she says. “The next day I came and seen all the exciting things that was here at Pogo Park. I got to meet some of my friends. I want to thank whoever made the Pogo Park and the workers who are here to help us.”\u003c/p>\n\u003cp>The siblings make a dash to the ice cream truck stopped in front of the park. They share ice cream before Dulce gives Jose a big push on the zip line.\u003c/p>\n\u003cp>“We have a lot of fun,” he says. \u003c/p>\n\u003cp>The park’s renovation is the brainchild of Toody Maher, a UC Berkeley alumna who previously helped launch the trendy Swatch watches on the West Coast.\u003c/p>\n\u003cp>The Richmond resident is the founder and executive director of \u003ca href=\"http://pogopark.org/\">Pogo Park\u003c/a>, the nonprofit that is renovating parks throughout Richmond. In 2007, she visited each of the city’s 56 parks, and it was the tiny “pocket parks,” like Elm Playlot, that captured her attention.\u003c/p>\n\u003cp>“When I first came to visit, every single house surrounding the park, but one, was boarded up,” Maher says. “You drive up and think, ‘Oh, this is a nice park.’ Then you get in and realize there is nowhere to sit, there’s no water fountains, there’s no bathroom.”\u003c/p>\n\u003cp>Maher used funds from her 401(K) as the initial investment. Since then, she’s managed to raise $8 million dollars from private and public sources.\u003c/p>\n\u003cp>“My whole life I’ve always dreamed, if I had a million dollars and I had all the time in the world, I would go and build like great little children’s parks and playgrounds,” she says, smiling.\u003c/p>\n\u003cp>But Maher knew she needed to gain the community’s trust, which was hard since the neighbors were fed up with broken promises.\u003c/p>\n\u003cp>“This is a neighborhood where, despite millions of dollars of investments and urban renewal projects, nothing works,” she says.\u003c/p>\n\u003cp>Maher decided to hire workers from the community to design, build and now manage their own park.\u003c/p>\n\u003cp>“I knocked on people’s doors that live around the neighborhood, and we worked for years to figure out what we wanted to build,” says Maher. “By empowering local residents to make the change themselves, it’s really been a transformative project for the whole neighborhood. It’s like a mini stimulus plan in the neighborhood because all these folks are getting jobs and training.”\u003c/p>\n\u003cp>One of those employees is Karina Guadalupe. She’s worked for Pogo Park since 2008.\u003c/p>\n\u003cp>“Before the park, people knew they had someone living next to them, but it really wasn’t a sense of community,” says Guadalupe. “Now the neighbors know each other, they look after each other’s kids and it’s a place to come meet each other and feel safe and comfortable.”\u003c/p>\n\u003cp>She’s not the only one who has noticed the change.\u003c/p>\n\u003cp>“We live here and are really invested in this,” says Doris Mason, a longtime Richmond resident who works the afternoon shift at the park. “Every day, I wake up I know I’m making a difference, so I don’t mind coming to work.”\u003c/p>\n\u003cp>She says Elm Playlot has changed the whole atmosphere of the neighborhood.\u003c/p>\n\u003cp>“You can look around and you can see the kids, you know, they’re just happy,” Mason says. “There’s no play structure; they’re creating their own type of play.”\u003c/p>\n\u003cp>Maher is already working on renovating two other Richmond parks and has plans for many more.\u003c/p>\n\u003cp>“There are thousands of inner-city parks all over the country that are just lying there — unused, dormant, uninspired — and all you have to do is transform it into a Pogo Park,” Maher says. She adds, “All I set out to do was just build a far-out, fantastic, great children’s park. It’s such a great feeling; it’s indescribable to see a dream come true.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Elm Playlot, Pogo Park’s first renovation, is at Eighth Street and Elm Avenue in Richmond.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "Governor Signs Bill Giving $3 Million to Doctors Medical Center",
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"headTitle": "Governor Signs Bill Giving $3 Million to Doctors Medical Center | KQED",
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"content": "\u003cfigure id=\"attachment_20126\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/RS1449_saccapitoldome090911-scr.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-20126\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/RS1449_saccapitoldome090911-scr-640x426.jpg\" alt=\"State officials have until Monday to submit plan. (Justin Sullivan/Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Justin Sullivan/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Gov. Jerry Brown has signed a bill giving $3 million to financially troubled Doctors Medical Center in western Contra Costa County. The hospital has been in danger of closing for weeks.\u003c/p>\n\u003cp>\u003ca title=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140SB883\" href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140SB883\" target=\"_blank\" rel=\"noopener\">SB883\u003c/a> appropriates the money from the state’s \u003ca title=\"http://www.mrmib.ca.gov/mrmib/mrmip.shtml\" href=\"http://www.mrmib.ca.gov/mrmib/mrmip.shtml\" target=\"_blank\" rel=\"noopener\">Major Risk Medical Insurance Fund\u003c/a> to the West Contra Costa Healthcare District, which oversees Doctors Medical Center. It is considered “bridge funding,” according to a release from Assemblywoman Nancy Skinner (D-Berkeley), an author of the bill, so that the hospital and health care district have time to identify more secure funding.\u003c/p>\n\u003cp>\u003cspan class=\"Apple-style-span\" style=\"color: #000000\">\u003cspan class=\"Apple-style-span\">“Doctors Medical Center is the safety net hospital for Richmond, San Pablo and other West Contra County communities. Its closure would leave a community in need without emergency care, cardio, dialysis and other critical hospital services,” Skinner said in a statement.\u003cbr>\n\u003c/span>\u003c/span>\u003c!--more-->\u003c/p>\n\u003cp>\u003cspan class=\"Apple-style-span\" style=\"color: #000000\">\u003cspan class=\"Apple-style-span\">“The governor’s support of this $3 million lifeline expands our window for pursuing solutions to continue to meet these critical health care needs.” \u003c/span>\u003c/span>\u003c/p>\n\u003cp>Doctors Medical Center (DMC) has been\u003ca title=\"http://ww2.kqed.org/news/2014/09/05/do-or-die-for-doctors-medical-center-but-not-for-lack-of-trying\" href=\"http://ww2.kqed.org/news/2014/09/05/do-or-die-for-doctors-medical-center-but-not-for-lack-of-trying\" target=\"_blank\" rel=\"noopener\"> struggling financially for more than a decade\u003c/a>. The crisis hit hard in early August when (DMC) stopped accepting \u003ca title=\"http://www.mercurynews.com/my-town/ci_26292817/doctors-medical-center-ends-emergency-ambulance-service\" href=\"http://www.mercurynews.com/my-town/ci_26292817/doctors-medical-center-ends-emergency-ambulance-service\" target=\"_blank\" rel=\"noopener\">emergency ambulance patients\u003c/a> and reduced inpatient beds from 140 to 50. Just days after the ambulance diversion began, a \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/08/28/options-outlined-in-doctors-medical-center-court-hearing/\" href=\"http://ww2.kqed.org/stateofhealth/2014/08/28/options-outlined-in-doctors-medical-center-court-hearing/\" target=\"_blank\" rel=\"noopener\">group of doctors, nurses and advocates sued\u003c/a> Contra Costa County.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cspan class=\"Apple-style-span\" style=\"color: #000000\">\u003cspan class=\"Apple-style-span\">“I am glad the governor joined with us to help ensure health care access for the residents of West Contra Costa County,” Skinner said.\u003c/span>\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cspan class=\"Apple-style-span\" style=\"color: #000000\">\u003cspan class=\"Apple-style-span\">Senator Loni Hancock (D-Berkeley) was a co-author of the bill.\u003c/span>\u003c/span>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_20126\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/RS1449_saccapitoldome090911-scr.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-20126\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/RS1449_saccapitoldome090911-scr-640x426.jpg\" alt=\"State officials have until Monday to submit plan. (Justin Sullivan/Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Justin Sullivan/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Gov. Jerry Brown has signed a bill giving $3 million to financially troubled Doctors Medical Center in western Contra Costa County. The hospital has been in danger of closing for weeks.\u003c/p>\n\u003cp>\u003ca title=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140SB883\" href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140SB883\" target=\"_blank\" rel=\"noopener\">SB883\u003c/a> appropriates the money from the state’s \u003ca title=\"http://www.mrmib.ca.gov/mrmib/mrmip.shtml\" href=\"http://www.mrmib.ca.gov/mrmib/mrmip.shtml\" target=\"_blank\" rel=\"noopener\">Major Risk Medical Insurance Fund\u003c/a> to the West Contra Costa Healthcare District, which oversees Doctors Medical Center. It is considered “bridge funding,” according to a release from Assemblywoman Nancy Skinner (D-Berkeley), an author of the bill, so that the hospital and health care district have time to identify more secure funding.\u003c/p>\n\u003cp>\u003cspan class=\"Apple-style-span\" style=\"color: #000000\">\u003cspan class=\"Apple-style-span\">“Doctors Medical Center is the safety net hospital for Richmond, San Pablo and other West Contra County communities. Its closure would leave a community in need without emergency care, cardio, dialysis and other critical hospital services,” Skinner said in a statement.\u003cbr>\n\u003c/span>\u003c/span>\u003c!--more-->\u003c/p>\n\u003cp>\u003cspan class=\"Apple-style-span\" style=\"color: #000000\">\u003cspan class=\"Apple-style-span\">“The governor’s support of this $3 million lifeline expands our window for pursuing solutions to continue to meet these critical health care needs.” \u003c/span>\u003c/span>\u003c/p>\n\u003cp>Doctors Medical Center (DMC) has been\u003ca title=\"http://ww2.kqed.org/news/2014/09/05/do-or-die-for-doctors-medical-center-but-not-for-lack-of-trying\" href=\"http://ww2.kqed.org/news/2014/09/05/do-or-die-for-doctors-medical-center-but-not-for-lack-of-trying\" target=\"_blank\" rel=\"noopener\"> struggling financially for more than a decade\u003c/a>. The crisis hit hard in early August when (DMC) stopped accepting \u003ca title=\"http://www.mercurynews.com/my-town/ci_26292817/doctors-medical-center-ends-emergency-ambulance-service\" href=\"http://www.mercurynews.com/my-town/ci_26292817/doctors-medical-center-ends-emergency-ambulance-service\" target=\"_blank\" rel=\"noopener\">emergency ambulance patients\u003c/a> and reduced inpatient beds from 140 to 50. Just days after the ambulance diversion began, a \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/08/28/options-outlined-in-doctors-medical-center-court-hearing/\" href=\"http://ww2.kqed.org/stateofhealth/2014/08/28/options-outlined-in-doctors-medical-center-court-hearing/\" target=\"_blank\" rel=\"noopener\">group of doctors, nurses and advocates sued\u003c/a> Contra Costa County.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cspan class=\"Apple-style-span\" style=\"color: #000000\">\u003cspan class=\"Apple-style-span\">“I am glad the governor joined with us to help ensure health care access for the residents of West Contra Costa County,” Skinner said.\u003c/span>\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cspan class=\"Apple-style-span\" style=\"color: #000000\">\u003cspan class=\"Apple-style-span\">Senator Loni Hancock (D-Berkeley) was a co-author of the bill.\u003c/span>\u003c/span>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "Do or Die for Doctors Medical Center But It's Not for Lack of Trying",
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"content": "\u003cp>\u003ciframe loading=\"lazy\" src=\"http://cdn.knightlab.com/libs/timeline/latest/embed/index.html?source=0AnyL_u8iq5ZydExfU3YyaVM0bzUyenE5TVpBMThYRkE&font=PT&maptype=watercolor&lang=en&start_at_slide=11&height=650\" width=\"100%\" height=\"650\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp>Doctors Medical Center in San Pablo has been struggling for more than a decade — hemorrhaging millions of dollars in the face of extraordinary efforts to keep it afloat.\u003c/p>\n\u003cp>Despite emerging from bankruptcy and 10 years of million-dollar grants, loans and parcel taxes, the center recently \u003ca href=\"http://blogs.kqed.org/stateofhealth/2014/08/28/options-outlined-in-doctors-medical-center-court-hearing/\">downsized\u003c/a>, cutting the number of inpatient beds from 140 to 50, closing the unit treating heart attack patients and diverting ambulance traffic to nearby hospitals.\u003c/p>\n\u003cp>Without additional and continuous funding, Doctors Medical Center will have to close its doors entirely or completely reconsider its model very soon.\u003c/p>\n\u003cp>In 2008, 2009 and 2010, the medical center saw a bit of a reprieve when outside funding — a combined $17 million a year from Kaiser, John Muir and the state — filled its financial gap. But when that funding dropped by 93 percent in 2011, DMC’s chances of survival grew more dismal. It just can’t survive on its own.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[googlemaps https://www.google.com/fusiontables/embedviz?containerId=googft-gviz-canvas&q=select+col0%2C+col1%2C+col3%2C+col2+from+11mPIoLrK8mvCfhGj-XDBuuW7rRflzi0cdmF4vA6W+order+by+col2+desc+limit+10&viz=GVIZ&t=COLUMN&uiversion=2&gco_forceIFrame=true&gco_hasLabelsColumn=true&gco_vAxes=%5B%7B%22title%22%3Anull%2C+%22minValue%22%3Anull%2C+%22maxValue%22%3Anull%2C+%22useFormatFromData%22%3Atrue%2C+%22viewWindow%22%3A%7B%22max%22%3Anull%2C+%22min%22%3Anull%7D%2C+%22logScale%22%3Afalse%7D%2C%7B%22useFormatFromData%22%3Atrue%2C+%22viewWindow%22%3A%7B%22max%22%3Anull%2C+%22min%22%3Anull%7D%2C+%22minValue%22%3Anull%2C+%22maxValue%22%3Anull%2C+%22logScale%22%3Afalse%7D%5D&gco_useFirstColumnAsDomain=true&gco_isStacked=false&gco_booleanRole=certainty&gco_hAxis=%7B%22useFormatFromData%22%3Atrue%2C+%22minValue%22%3Anull%2C+%22maxValue%22%3Anull%2C+%22viewWindow%22%3Anull%2C+%22viewWindowMode%22%3Anull%7D&gco_legend=right&gco_domainAxis=%7B%22direction%22%3A1%7D&gco_focusTarget=category&gco_title=Financial+Situation+for+DMC&att=true&width=640&height=285&w=640&h=300]\u003c/p>\n\u003cp>Doctors Medical Center became a stand-alone hospital in 2004, when Tenet Healthcare didn’t renew its contract and the West Contra Costa County Healthcare District took over operations and assumed financial liability.\u003c/p>\n\u003cp>With changes to the national health care system and a shaky economic climate, it has been challenging for many stand-alone hospitals across the country. In 1990, there were 3,562 stand-alone hospitals. But by 2010, there were only 2,044, according to \u003ca href=\"http://www.lovelace.com/content/stand-alone-rural-hospitals-face-major-challenges#.VApIfuL4JgE\" target=\"_blank\" rel=\"noopener\">Lovelace Health System\u003c/a>.\u003c/p>\n\u003cp>“Stand-alone hospitals have challenges,” says Richard Gundling, vice president for the Healthcare Financial Management Association. “They have a lack of market share, geographic coverage and limited access to capital.”\u003c/p>\n\u003cp>While the Affordable Care Act provided coverage to the uninsured, it compounded the challenges of stand-alone hospitals. Hospitals are reimbursed for each patient covered by Medi-Cal, but those reimbursements are only about 70 percent of what the hospital receives for patients covered by commercial insurance.\u003c/p>\n\u003cp>“With the Affordable Care Act, more people got coverage,” says Gundling, “but more people got coverage that pays less than cost. It has accelerated a change to larger systems.”\u003c/p>\n\u003cp>The payer mix at Doctors Medical Center is about 80 percent Medi-Cal and about 10 percent uninsured, leaving only about 10 percent that is commercial insurance — which is not enough to cover the much larger number of Medi-Cal patients with a lower amount of reimbursement.\u003c/p>\n\u003cp>“The hospital has always had a payer mix that is not highly profitable,” says John Gioia, West Contra Costa County supervisor, who has worked alongside the medical center to since 2004.\u003c/p>\n\u003cp>But that is the Catch-22 of DMC. That payer mix might be exactly why people like Gioia are desperately trying to keep the hospital above ground. It is one of two hospitals serving Richmond, a community with many residents living in poverty.\u003c/p>\n\u003cp>In 2013, DMC served 41,903 patients in the emergency room, with many in severe or critical condition. If DMC closes its doors, there will be only 15 emergency room beds to serve a population of about 250,000, according to the \u003ca href=\"http://cchealth.org/dmc/\" target=\"_blank\" rel=\"noopener\">Contra Costa Emergency Medical Services Agency\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“It’s a combination of a bad model and bad payer mix,” Gioia says, “yet you have a very important emergency room.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003ciframe\n src='https://www.google.com/fusiontables/embedviz?containerId=googft-gviz-canvas&q=select+col0%2C+col1%2C+col3%2C+col2+from+11mPIoLrK8mvCfhGj-XDBuuW7rRflzi0cdmF4vA6W+order+by+col2+desc+limit+10&viz=GVIZ&t=COLUMN&uiversion=2&gco_forceIFrame=true&gco_hasLabelsColumn=true&gco_vAxes=%5B%7B%22title%22%3Anull%2C+%22minValue%22%3Anull%2C+%22maxValue%22%3Anull%2C+%22useFormatFromData%22%3Atrue%2C+%22viewWindow%22%3A%7B%22max%22%3Anull%2C+%22min%22%3Anull%7D%2C+%22logScale%22%3Afalse%7D%2C%7B%22useFormatFromData%22%3Atrue%2C+%22viewWindow%22%3A%7B%22max%22%3Anull%2C+%22min%22%3Anull%7D%2C+%22minValue%22%3Anull%2C+%22maxValue%22%3Anull%2C+%22logScale%22%3Afalse%7D%5D&gco_useFirstColumnAsDomain=true&gco_isStacked=false&gco_booleanRole=certainty&gco_hAxis=%7B%22useFormatFromData%22%3Atrue%2C+%22minValue%22%3Anull%2C+%22maxValue%22%3Anull%2C+%22viewWindow%22%3Anull%2C+%22viewWindowMode%22%3Anull%7D&gco_legend=right&gco_domainAxis=%7B%22direction%22%3A1%7D&gco_focusTarget=category&gco_title=Financial+Situation+for+DMC&att=true&width=640&height=285&w=640&h=300'\n title='https://www.google.com/fusiontables/embedviz?containerId=googft-gviz-canvas&q=select+col0%2C+col1%2C+col3%2C+col2+from+11mPIoLrK8mvCfhGj-XDBuuW7rRflzi0cdmF4vA6W+order+by+col2+desc+limit+10&viz=GVIZ&t=COLUMN&uiversion=2&gco_forceIFrame=true&gco_hasLabelsColumn=true&gco_vAxes=%5B%7B%22title%22%3Anull%2C+%22minValue%22%3Anull%2C+%22maxValue%22%3Anull%2C+%22useFormatFromData%22%3Atrue%2C+%22viewWindow%22%3A%7B%22max%22%3Anull%2C+%22min%22%3Anull%7D%2C+%22logScale%22%3Afalse%7D%2C%7B%22useFormatFromData%22%3Atrue%2C+%22viewWindow%22%3A%7B%22max%22%3Anull%2C+%22min%22%3Anull%7D%2C+%22minValue%22%3Anull%2C+%22maxValue%22%3Anull%2C+%22logScale%22%3Afalse%7D%5D&gco_useFirstColumnAsDomain=true&gco_isStacked=false&gco_booleanRole=certainty&gco_hAxis=%7B%22useFormatFromData%22%3Atrue%2C+%22minValue%22%3Anull%2C+%22maxValue%22%3Anull%2C+%22viewWindow%22%3Anull%2C+%22viewWindowMode%22%3Anull%7D&gco_legend=right&gco_domainAxis=%7B%22direction%22%3A1%7D&gco_focusTarget=category&gco_title=Financial+Situation+for+DMC&att=true&width=640&height=285&w=640&h=300'\n width='640'\n height='300'\n scrolling='no'\n frameborder='no'>\u003c/iframe>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Doctors Medical Center became a stand-alone hospital in 2004, when Tenet Healthcare didn’t renew its contract and the West Contra Costa County Healthcare District took over operations and assumed financial liability.\u003c/p>\n\u003cp>With changes to the national health care system and a shaky economic climate, it has been challenging for many stand-alone hospitals across the country. In 1990, there were 3,562 stand-alone hospitals. But by 2010, there were only 2,044, according to \u003ca href=\"http://www.lovelace.com/content/stand-alone-rural-hospitals-face-major-challenges#.VApIfuL4JgE\" target=\"_blank\" rel=\"noopener\">Lovelace Health System\u003c/a>.\u003c/p>\n\u003cp>“Stand-alone hospitals have challenges,” says Richard Gundling, vice president for the Healthcare Financial Management Association. “They have a lack of market share, geographic coverage and limited access to capital.”\u003c/p>\n\u003cp>While the Affordable Care Act provided coverage to the uninsured, it compounded the challenges of stand-alone hospitals. Hospitals are reimbursed for each patient covered by Medi-Cal, but those reimbursements are only about 70 percent of what the hospital receives for patients covered by commercial insurance.\u003c/p>\n\u003cp>“With the Affordable Care Act, more people got coverage,” says Gundling, “but more people got coverage that pays less than cost. It has accelerated a change to larger systems.”\u003c/p>\n\u003cp>The payer mix at Doctors Medical Center is about 80 percent Medi-Cal and about 10 percent uninsured, leaving only about 10 percent that is commercial insurance — which is not enough to cover the much larger number of Medi-Cal patients with a lower amount of reimbursement.\u003c/p>\n\u003cp>“The hospital has always had a payer mix that is not highly profitable,” says John Gioia, West Contra Costa County supervisor, who has worked alongside the medical center to since 2004.\u003c/p>\n\u003cp>But that is the Catch-22 of DMC. That payer mix might be exactly why people like Gioia are desperately trying to keep the hospital above ground. It is one of two hospitals serving Richmond, a community with many residents living in poverty.\u003c/p>\n\u003cp>In 2013, DMC served 41,903 patients in the emergency room, with many in severe or critical condition. If DMC closes its doors, there will be only 15 emergency room beds to serve a population of about 250,000, according to the \u003ca href=\"http://cchealth.org/dmc/\" target=\"_blank\" rel=\"noopener\">Contra Costa Emergency Medical Services Agency\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“It’s a combination of a bad model and bad payer mix,” Gioia says, “yet you have a very important emergency room.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "5 Things You Should Know About Sun Protection",
"title": "5 Things You Should Know About Sun Protection",
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"content": "\u003cfigure id=\"attachment_20630\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/hotsun-e1407519125473.jpg\">\u003cimg class=\"size-large wp-image-20630\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/hotsun-640x442.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"442\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Kathy Shield\u003c/strong>\u003c/p>\n\u003cp>It's almost the end of summer. But not quite. There's still plenty of time left to be outside – and plenty of opportunities to get sunburned if you're not careful. Sun-damaged skin increases your risk of skin cancer down the road.\u003c/p>\n\u003cp>Rates of melanoma have been climbing for the last 30 years. \u003ca href=\"http://www.kqed.org/a/forum/R201407280900\" target=\"_blank\">KQED Forum\u003c/a> recently called together three experts on sun damage and skin cancer, and we've distilled their recommendations here so you can protect yourself.\u003c/p>\n\u003cp>\u003cstrong>1. When Buying Sunscreen, The Right SPF is Everything\u003c/strong>\u003cbr>\nYou've seen all those SPF number: 15, 50, 100. The takeaway here is that you should buy a product with an SPF between 15 and 50.\u003c!--more-->\u003c/p>\n\u003cp>The \u003ca href=\"http://www.cdc.gov/cancer/skin/basic_info/sun-safety.htm#sunscreen\" target=\"_blank\">Centers for Disease Control says SPF 15 is a minimum\u003c/a>. SPF or \"sun protection factor\" refers to protection from UVB rays. Those are the ones that burn your skin. The \u003ca href=\"http://www.ewg.org/sunsafety/tips-how-to-pick-a-good-sunscreen.php\" target=\"_blank\">Environmental Working Group \u003c/a>advises that anything over 50 is not only worthless. (50 blocks 98 percent of the UV rays; 100 blocks 100 percent) but could also be dangerous. That's because products may do little to protect you from UVA rays, which are the ones that damage skin. A high SPF may well prevent you from burning -- but then you're out in the sun longer and cause other damage to your skin.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Save your money and skip the \"waterproof\" types. Sonya Lunder with the Environmental Working Group told Forum's audience that those claims are overblown. Lunder also recommended cream products over sprays because with sprays \"the risk is too great (you'll) be missing patches of your skin.\"\u003c/p>\n\u003cp>Once you’ve got the right type, make sure you reapply frequently and all day long. Lunder recommends applying two layers before leaving the house to give the sunscreen time to soak in. Then, re-apply every 90 minutes to two hours, more often if you’re sweating or swimming.\u003c/p>\n\u003cp>If you’re concerned about the chemicals in the sunscreen, Stanford dermatologist Susan Swetter says not to worry. “The FDA is not questioning the safety of any of the ingredients in marketed sunscreens,\" she said. \"Many of the safety concerns that have been raised are actually based on laboratory investigations … and really don’t have a real-life application in humans.” But if you’re still concerned, she recommended products with bemotrizinol or bisoctrizole.\u003c/p>\n\u003cp>\u003cstrong>2. Wear Protective Clothing\u003c/strong>\u003cbr>\nAll three experts agreed that you shouldn’t rely just on sunscreen. “Sunscreen is one tool, but only one tool, in preventing sunburn,” Lunder said. Long sleeves and long pants will help protect your skin, although you should still wear sunscreen underneath the clothes.\u003c/p>\n\u003cp>UV-blocking clothing can be expensive, but Swetter thinks it is worth it. “You don’t need to wear sunscreen underneath sun protective clothing,\" she says. (It) does a very good job.”\u003c/p>\n\u003cp>If you have small children, consider long sleeve swim shirts if you're going to the beach or a pool.\u003c/p>\n\u003cp>\u003cstrong>3. Avoid the Midday Sun -- and Its Manmade Cousins\u003c/strong>\u003cbr>\nTina Clarke with the Cancer Prevention Institute of California said her top recommendation is to stay out of the harsh sun altogether. The sun’s rays are strongest between 10 am and 4 pm, so she suggests you limit the time spent in the sun during these hours.\u003c/p>\n\u003cp>And skip the tanning salon, too. The World Health Organization has classified tanning beds as a \u003ca href=\"www.who.int/mediacentre/factsheets/fs287/en/\" target=\"_blank\">Class 1 carcinogen\u003c/a>, the highest cancer risk category.\u003c/p>\n\u003cp>Clarke also explained that studies show “intermittent intense exposure seems to be most associated with risk [for melanoma].”\u003c/p>\n\u003cp>\u003cstrong>4. Use UV-Blocking Glass – eyewear, car windows\u003c/strong>\u003cbr>\nIf you drive a lot, make sure you have tinted glass in your car. Even better, says Swetter, is laminated glass. Either type limits the amount of UV rays that hit your skin. And if you live at altitude, these considerations are even more important, because UVB rays increase 4-10 percent for every 1000 feet of elevation.\u003c/p>\n\u003cp>For eyeglasses, the guests all said most will stop some UV rays, but tinted glasses are always better. They recommend wearing sunglasses while outside as often as possible.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>5. Get Checked\u003c/strong>\u003cbr>\nMelanoma can be a fast-growing cancer, so don't delay if you see something unusual. \"It you notice something on your skin that is changing differently than the rest,\" Swetter says, \"it is important to get that looked at early.” She says melanoma is also prevalent in people of color. \"It should not be labeled as a disease of only fair-skinned individuals,” she said. There has been a 20 percent increase in melanoma \u003ca href=\"http://www.skincancer.org/publications/sun-and-skin-news/winter-2013-30-4/soar\" target=\"_blank\">among Hispanics \u003c/a>over the last 20 years. Get your doctor to check for melanomas, regardless of your skin color or your primary reason for visiting.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_20630\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/hotsun-e1407519125473.jpg\">\u003cimg class=\"size-large wp-image-20630\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/hotsun-640x442.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"442\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Kathy Shield\u003c/strong>\u003c/p>\n\u003cp>It's almost the end of summer. But not quite. There's still plenty of time left to be outside – and plenty of opportunities to get sunburned if you're not careful. Sun-damaged skin increases your risk of skin cancer down the road.\u003c/p>\n\u003cp>Rates of melanoma have been climbing for the last 30 years. \u003ca href=\"http://www.kqed.org/a/forum/R201407280900\" target=\"_blank\">KQED Forum\u003c/a> recently called together three experts on sun damage and skin cancer, and we've distilled their recommendations here so you can protect yourself.\u003c/p>\n\u003cp>\u003cstrong>1. When Buying Sunscreen, The Right SPF is Everything\u003c/strong>\u003cbr>\nYou've seen all those SPF number: 15, 50, 100. The takeaway here is that you should buy a product with an SPF between 15 and 50.\u003c!--more-->\u003c/p>\n\u003cp>The \u003ca href=\"http://www.cdc.gov/cancer/skin/basic_info/sun-safety.htm#sunscreen\" target=\"_blank\">Centers for Disease Control says SPF 15 is a minimum\u003c/a>. SPF or \"sun protection factor\" refers to protection from UVB rays. Those are the ones that burn your skin. The \u003ca href=\"http://www.ewg.org/sunsafety/tips-how-to-pick-a-good-sunscreen.php\" target=\"_blank\">Environmental Working Group \u003c/a>advises that anything over 50 is not only worthless. (50 blocks 98 percent of the UV rays; 100 blocks 100 percent) but could also be dangerous. That's because products may do little to protect you from UVA rays, which are the ones that damage skin. A high SPF may well prevent you from burning -- but then you're out in the sun longer and cause other damage to your skin.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Save your money and skip the \"waterproof\" types. Sonya Lunder with the Environmental Working Group told Forum's audience that those claims are overblown. Lunder also recommended cream products over sprays because with sprays \"the risk is too great (you'll) be missing patches of your skin.\"\u003c/p>\n\u003cp>Once you’ve got the right type, make sure you reapply frequently and all day long. Lunder recommends applying two layers before leaving the house to give the sunscreen time to soak in. Then, re-apply every 90 minutes to two hours, more often if you’re sweating or swimming.\u003c/p>\n\u003cp>If you’re concerned about the chemicals in the sunscreen, Stanford dermatologist Susan Swetter says not to worry. “The FDA is not questioning the safety of any of the ingredients in marketed sunscreens,\" she said. \"Many of the safety concerns that have been raised are actually based on laboratory investigations … and really don’t have a real-life application in humans.” But if you’re still concerned, she recommended products with bemotrizinol or bisoctrizole.\u003c/p>\n\u003cp>\u003cstrong>2. Wear Protective Clothing\u003c/strong>\u003cbr>\nAll three experts agreed that you shouldn’t rely just on sunscreen. “Sunscreen is one tool, but only one tool, in preventing sunburn,” Lunder said. Long sleeves and long pants will help protect your skin, although you should still wear sunscreen underneath the clothes.\u003c/p>\n\u003cp>UV-blocking clothing can be expensive, but Swetter thinks it is worth it. “You don’t need to wear sunscreen underneath sun protective clothing,\" she says. (It) does a very good job.”\u003c/p>\n\u003cp>If you have small children, consider long sleeve swim shirts if you're going to the beach or a pool.\u003c/p>\n\u003cp>\u003cstrong>3. Avoid the Midday Sun -- and Its Manmade Cousins\u003c/strong>\u003cbr>\nTina Clarke with the Cancer Prevention Institute of California said her top recommendation is to stay out of the harsh sun altogether. The sun’s rays are strongest between 10 am and 4 pm, so she suggests you limit the time spent in the sun during these hours.\u003c/p>\n\u003cp>And skip the tanning salon, too. The World Health Organization has classified tanning beds as a \u003ca href=\"www.who.int/mediacentre/factsheets/fs287/en/\" target=\"_blank\">Class 1 carcinogen\u003c/a>, the highest cancer risk category.\u003c/p>\n\u003cp>Clarke also explained that studies show “intermittent intense exposure seems to be most associated with risk [for melanoma].”\u003c/p>\n\u003cp>\u003cstrong>4. Use UV-Blocking Glass – eyewear, car windows\u003c/strong>\u003cbr>\nIf you drive a lot, make sure you have tinted glass in your car. Even better, says Swetter, is laminated glass. Either type limits the amount of UV rays that hit your skin. And if you live at altitude, these considerations are even more important, because UVB rays increase 4-10 percent for every 1000 feet of elevation.\u003c/p>\n\u003cp>For eyeglasses, the guests all said most will stop some UV rays, but tinted glasses are always better. They recommend wearing sunglasses while outside as often as possible.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>5. Get Checked\u003c/strong>\u003cbr>\nMelanoma can be a fast-growing cancer, so don't delay if you see something unusual. \"It you notice something on your skin that is changing differently than the rest,\" Swetter says, \"it is important to get that looked at early.” She says melanoma is also prevalent in people of color. \"It should not be labeled as a disease of only fair-skinned individuals,” she said. There has been a 20 percent increase in melanoma \u003ca href=\"http://www.skincancer.org/publications/sun-and-skin-news/winter-2013-30-4/soar\" target=\"_blank\">among Hispanics \u003c/a>over the last 20 years. Get your doctor to check for melanomas, regardless of your skin color or your primary reason for visiting.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_20380\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/139551566.jpg\">\u003cimg class=\"size-large wp-image-20380\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/139551566-640x425.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Right now, drug labels appear only in English in California, yet 44 percent of Californians speak a language other than English at home. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Every Saturday morning, a steady stream of Chinese and Vietnamese patients line up at the Paul Hom Asian Clinic in Sacramento. Most of them speak little to no English.\u003c/p>\n\u003cp>Patient assistance director Danny Tao says people come here to get free medical consultations and drug prescriptions. But, he says that when patients take those prescriptions to be filled, they don’t understand the instructions on the label.\u003c/p>\n\u003cp>\"They go pick them up, and we don’t exactly know if they’re taking it or not -- or if they know how to take it,\" Tao said.\u003c!--more-->\u003c/p>\n\u003cp>Tao says drug labels at most pharmacies in California are printed only in English. That puts patients in danger of taking of any number or errors -- taking too much medication or not enough, taking it at the wrong time of day, and more. Such mistakes can cause serious harm or even death.\u003c/p>\n\u003cp>Tao says that for the drugs his clinic supplies directly, all have a bilingual label.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"It’s going to be English/Chinese or English/Vietnamese,\" he said. \"By the time they get home they know exactly how to take the medication, because it’s in their own language.\"\u003c/p>\n\u003cp>This week California's Board of Pharmacy will discuss new regulations that would require all pharmacies in California to provide translated labels on prescription drug bottles. Statewide, 44 percent of Californians speak a language other than English at home. \u003ca href=\"http://www.rxtran.com/pharmacy-translation-regulations/pharmacy-translation-regulations-new-york-state.html\" target=\"_blank\">New York approved a similar rule \u003c/a>last year to make it easier for non-English speakers to take their medications properly and avoid costly mistakes.\u003c/p>\n\u003cp>But the board’s executive officer Virginia Herold says the move is very controversial. For starters, there is a concern that requiring translated labels would require larger bottles of pills to fit all the text. But she says patients don’t like larger bottles.\u003c/p>\n\u003cp>\u003ciframe width=\"100%\" height=\"166\" scrolling=\"no\" frameborder=\"no\" src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/160863705&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\">\u003c/iframe>\u003c/p>\n\u003cp>\"They decant the drug out of the large container, put it in a baggie or someplace else,\" Herold said. \"There you’ve separated the drug from the container, now the instructions on how to take it have been separated.\"\u003c/p>\n\u003cp>Pharmacists don’t like the proposal because they say it opens them to liability if there’s a mistake in the translation. Brian Warren is with the California Pharmacists Association.\u003c/p>\n\u003cp>\"If the label is translated into Russian and there’s an error, and I’m a pharmacist that does not speak Russian, I cannot verify that that error exists,\" Warren said.\u003c/p>\n\u003cp>At present, the state's board of pharmacy \u003ca href=\"http://www.pharmacy.ca.gov/publications/translations.shtml\" target=\"_blank\">includes on its website\u003c/a> translations of basic instructions such as \"take one pill at bedtime\" in five languages: Chinese, Russian, Spanish, Korean, and Vietnamese.\u003c/p>\n\u003cp>Proponents of translating labels say that concerns about the change are outweighed by the problems patients who speak limited English face under the status quo.\u003c/p>\n\u003cp>\"There’s a risk right now,\" said Sarah de Guia, director of government affairs for the California Pan Ethnic Health Network, an advocacy group. \"They can’t understand anything on their label because the label is not in their language.\"\u003c/p>\n\u003cp>De Guia says the expansion of insurance under the Affordable Care Act places more urgency on the issue.\u003c/p>\n\u003cp>\"You’re going to have 1.5 million more limited-English proficient individuals in the health care system now that the ACA has passed.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The discussions are in the earliest stages, and if new regulations go forward, many details need to be worked out, including how many languages press and who would have responsibility for translation.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"It’s going to be English/Chinese or English/Vietnamese,\" he said. \"By the time they get home they know exactly how to take the medication, because it’s in their own language.\"\u003c/p>\n\u003cp>This week California's Board of Pharmacy will discuss new regulations that would require all pharmacies in California to provide translated labels on prescription drug bottles. Statewide, 44 percent of Californians speak a language other than English at home. \u003ca href=\"http://www.rxtran.com/pharmacy-translation-regulations/pharmacy-translation-regulations-new-york-state.html\" target=\"_blank\">New York approved a similar rule \u003c/a>last year to make it easier for non-English speakers to take their medications properly and avoid costly mistakes.\u003c/p>\n\u003cp>But the board’s executive officer Virginia Herold says the move is very controversial. For starters, there is a concern that requiring translated labels would require larger bottles of pills to fit all the text. But she says patients don’t like larger bottles.\u003c/p>\n\u003cp>\u003ciframe width=\"100%\" height=\"166\" scrolling=\"no\" frameborder=\"no\" src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/160863705&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\">\u003c/iframe>\u003c/p>\n\u003cp>\"They decant the drug out of the large container, put it in a baggie or someplace else,\" Herold said. \"There you’ve separated the drug from the container, now the instructions on how to take it have been separated.\"\u003c/p>\n\u003cp>Pharmacists don’t like the proposal because they say it opens them to liability if there’s a mistake in the translation. Brian Warren is with the California Pharmacists Association.\u003c/p>\n\u003cp>\"If the label is translated into Russian and there’s an error, and I’m a pharmacist that does not speak Russian, I cannot verify that that error exists,\" Warren said.\u003c/p>\n\u003cp>At present, the state's board of pharmacy \u003ca href=\"http://www.pharmacy.ca.gov/publications/translations.shtml\" target=\"_blank\">includes on its website\u003c/a> translations of basic instructions such as \"take one pill at bedtime\" in five languages: Chinese, Russian, Spanish, Korean, and Vietnamese.\u003c/p>\n\u003cp>Proponents of translating labels say that concerns about the change are outweighed by the problems patients who speak limited English face under the status quo.\u003c/p>\n\u003cp>\"There’s a risk right now,\" said Sarah de Guia, director of government affairs for the California Pan Ethnic Health Network, an advocacy group. \"They can’t understand anything on their label because the label is not in their language.\"\u003c/p>\n\u003cp>De Guia says the expansion of insurance under the Affordable Care Act places more urgency on the issue.\u003c/p>\n\u003cp>\"You’re going to have 1.5 million more limited-English proficient individuals in the health care system now that the ACA has passed.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The discussions are in the earliest stages, and if new regulations go forward, many details need to be worked out, including how many languages press and who would have responsibility for translation.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_17341\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/01/96525183-e1390846077644.jpg\">\u003cimg class=\"size-large wp-image-17341\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/01/96525183-640x426.jpg\" alt=\"The Anthem Blue Cross headquarters in Woodland Hills, California. (David McNew/Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Anthem Blue Cross headquarters in Woodland Hills, California. (David McNew/Getty Images) \u003ccite>(David McNew/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Julie Appleby,\u003c/strong> \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2014/July/09/anthem-lawsuit-over-enrollment-practices.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>Statewide insurance giant Anthem Blue Cross misled “millions of enrollees” about whether their doctors and hospitals were participating in its new plans, and failed to disclose that many policies wouldn’t cover care outside its approved network, according to a \u003ca href=\"http://media.khn.webfactional.com/html/anthem-lawsuit/Felser.pdf\" target=\"_blank\">class action lawsuit\u003c/a> filed Tuesday.\u003c/p>\n\u003caside class=\"pullquote alignleft\">As a result, many consumers are on the hook for thousands in medical bills, advocacy group says.\u003c/aside>\n\u003cp>As a result, many consumers have been left on the hook for thousands of dollars in medical bills, and have been unable to see their longtime doctors, alleges the suit by Consumer Watchdog based in Santa Monica.\u003c/p>\n\u003cp>Anthem spokesman Darrel Ng declined to comment directly on the lawsuit. He said Anthem has agreed to pay the claims of those who received treatment from inaccurately listed doctors during the first three months of the year.\u003c/p>\n\u003cp>However, that policy would not be extended for enrollees who discovered after March 31 that their doctors had been incorrectly listed, he said.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The suit says that Anthem, the state’s largest individual health insurer, delayed providing full information to consumers until it was too late for them to change coverage. Anthem also failed to disclose it had stopped offering any plans with out-of-network coverage in four of the state's biggest counties -- Los Angeles, Orange, San Francisco and San Diego, the suit says.\u003c/p>\n\u003cp>Anthem “intentionally misrepresented and concealed the limitations of their plans because it wanted a big market share,” said Jerry Flanagan of the consumer advocacy group. Co-counsel on the case is the Claremont law firm Shernoff Bidart Echeverria Bentley, which specializes in suing health insurers.\u003c/p>\n\u003cp>The suit comes as Consumer Watchdog helped put a measure on the November ballot that would give the state's insurance commissioner greater authority to veto rate increases.\u003c/p>\n\u003cp>Brought on behalf of Anthem enrollees who purchased individual coverage between Oct. 1, 2013 and March 31, 2014, the lawsuit reflects growing consumer pushback against so-called “narrow network” health plans, which are increasingly common, especially in the new online state and federal marketplaces. Anthem was a major player on California’s insurance exchange and the suit includes those who bought coverage online, as well as directly from the insurer.\u003c/p>\n\u003cp>Insurers have defended plans with limited provider networks as \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/11/28/why-narrow-networks-may-not-be-such-a-bad-idea/\" target=\"_blank\">a way of holding down premiums\u003c/a>. Many expected younger and healthier customers might be willing to give up broad access to providers for these lower costs.\u003c/p>\n\u003cp>But consumers are retaliating with lawsuits and complaints to state regulators. As a result of the rising complaints, state managed care regulators are investigating whether Anthem and, separately, Blue Shield of California, provided accurate information about the doctors and hospitals in their plans.\u003c/p>\n\u003cp>\u003cstrong>Six Enrollees' Stories\u003c/strong>\u003c/p>\n\u003cp>The Consumer Watchdog lawsuit names six Californians who purchased Anthem plans. Among them is Betsy Felser of Pasadena, who had coverage with Anthem for 20 years. Like hundreds of thousands of Anthem customers, she received a letter late last year stating that her preferred provider organization (PPO), which allows for in- and out-of-network care, was being cancelled, according to the lawsuit. The letter suggested a replacement Anthem plan “with the benefits you have come to count on.”\u003c/p>\n\u003cp>Before agreeing to switch, Felser, a physician, said she checked with five Anthem telephone representatives, making it clear she wanted to be in a PPO.\u003c/p>\n\u003cp>“I would never have gotten anything that wasn’t a PPO plan,” said Felser, 47, whose insurance also covers her young son. “They said they would give me the same coverage.”\u003c/p>\n\u003cp>She also checked Anthem’s website and the doctors she sees, including her son’s pediatrician, to make sure they were participating in the plans she was considering and was assured that they were, she said.\u003c/p>\n\u003cp>During those calls, none of Anthem’s representatives told Felser that the insurer was no longer offering PPOs in Los Angeles County, the lawsuit alleges. Nor did they tell her that the Anthem plans offered in her area would not cover care provided by out-of-network doctors or hospitals, according to the lawsuit.\u003c/p>\n\u003cp>When she received her identification cards, they were stamped with a PPO symbol. But when she tried to use the coverage, she found out her doctors – and her son’s pediatrician – were not in the network and that the plan was an exclusive provider organization (EPO), an extremely limited type of plan which pays nothing for out-of-network care.\u003c/p>\n\u003cp>“It pays zero, so I essentially have no coverage,” said Felser.\u003c/p>\n\u003cp>Anthem, while declining to comment on the Consumer Watchdog suit, had answered questions last week about an earlier lawsuit that raised similar issues.\u003c/p>\n\u003cp>Spokesman Ng said then that consumers were informed about what kind of plan they purchased, along with details about out-of-network benefits, in packets they received soon after enrolling. “All those materials clearly spelled out type of plan they were receiving,” he said.\u003c/p>\n\u003cp>But consumers would have to dig deep in a brochure on the Anthem website to find a footnote to a page 9 chart indicating that EPO plans have no out-of-network benefits.\u003c/p>\n\u003cp>Ng noted that Anthem’s EPO and PPO networks have the same doctors and hospitals for people with individual policies, although only the PPOs have out-of-network benefits. In recent weeks, Anthem said it has added 3,800 doctors to its networks.\u003c/p>\n\u003cp>\u003cstrong>'A Giant Mess'\u003c/strong>\u003c/p>\n\u003cp>As for the PPO symbol on identification cards, Ng said last week that it had been intended to protect consumers who sought emergency care out-of-state, in keeping with Blue Cross Blue Shield Association rules. Ng said Anthem recently got association approval to reissue the cards without the symbol.\u003c/p>\n\u003cp>But consumers say the damage was done. Josh Worth of Los Angeles said he was unable to get accurate information after receiving notice that his Anthem plan would be cancelled at the end of 2013. He said he called Anthem, as well as all the doctors he used — including his child’s pediatrician and his wife’s obstetrician — to be sure they were participating in the network.\u003c/p>\n\u003cp>“They all said, ‘yes, we’re going to be continuing to accept all Blue Cross PPOs,’ and that’s what I was told I was going to be getting,” said Worth, a 43-year-old graphic artist. In January, he said he enrolled his family in an Anthem plan with an $800 a month premium.\u003c/p>\n\u003cp>Worth received an ID card in late February that called his plan a “Pathway Tiered PPO,” according to the lawsuit. His son was born on March 31. Not long after, he said he began receiving bills from his wife’s obstetrician, who was not in the network. Nor was the baby’s pediatrician, he said.\u003c/p>\n\u003cp>As a result, he said he owes about $1,100 out of pocket for both. And although an Anthem telephone representative told him afterward that the hospital where his son was born was not in network, it actually is – and his bills there are being covered, he said.\u003c/p>\n\u003cp>“It’s a giant mess,” said Worth, who can’t switch plans until open enrollment resumes in the fall. “I was sold something I thought was one product, but when I used it, I found out it wasn’t. I’m not going to be going through Anthem again.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"BmR0WPZq6RSJcEntShDdrDz9FsVmJH8T\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_17341\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/01/96525183-e1390846077644.jpg\">\u003cimg class=\"size-large wp-image-17341\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/01/96525183-640x426.jpg\" alt=\"The Anthem Blue Cross headquarters in Woodland Hills, California. (David McNew/Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Anthem Blue Cross headquarters in Woodland Hills, California. (David McNew/Getty Images) \u003ccite>(David McNew/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Julie Appleby,\u003c/strong> \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2014/July/09/anthem-lawsuit-over-enrollment-practices.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>Statewide insurance giant Anthem Blue Cross misled “millions of enrollees” about whether their doctors and hospitals were participating in its new plans, and failed to disclose that many policies wouldn’t cover care outside its approved network, according to a \u003ca href=\"http://media.khn.webfactional.com/html/anthem-lawsuit/Felser.pdf\" target=\"_blank\">class action lawsuit\u003c/a> filed Tuesday.\u003c/p>\n\u003caside class=\"pullquote alignleft\">As a result, many consumers are on the hook for thousands in medical bills, advocacy group says.\u003c/aside>\n\u003cp>As a result, many consumers have been left on the hook for thousands of dollars in medical bills, and have been unable to see their longtime doctors, alleges the suit by Consumer Watchdog based in Santa Monica.\u003c/p>\n\u003cp>Anthem spokesman Darrel Ng declined to comment directly on the lawsuit. He said Anthem has agreed to pay the claims of those who received treatment from inaccurately listed doctors during the first three months of the year.\u003c/p>\n\u003cp>However, that policy would not be extended for enrollees who discovered after March 31 that their doctors had been incorrectly listed, he said.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The suit says that Anthem, the state’s largest individual health insurer, delayed providing full information to consumers until it was too late for them to change coverage. Anthem also failed to disclose it had stopped offering any plans with out-of-network coverage in four of the state's biggest counties -- Los Angeles, Orange, San Francisco and San Diego, the suit says.\u003c/p>\n\u003cp>Anthem “intentionally misrepresented and concealed the limitations of their plans because it wanted a big market share,” said Jerry Flanagan of the consumer advocacy group. Co-counsel on the case is the Claremont law firm Shernoff Bidart Echeverria Bentley, which specializes in suing health insurers.\u003c/p>\n\u003cp>The suit comes as Consumer Watchdog helped put a measure on the November ballot that would give the state's insurance commissioner greater authority to veto rate increases.\u003c/p>\n\u003cp>Brought on behalf of Anthem enrollees who purchased individual coverage between Oct. 1, 2013 and March 31, 2014, the lawsuit reflects growing consumer pushback against so-called “narrow network” health plans, which are increasingly common, especially in the new online state and federal marketplaces. Anthem was a major player on California’s insurance exchange and the suit includes those who bought coverage online, as well as directly from the insurer.\u003c/p>\n\u003cp>Insurers have defended plans with limited provider networks as \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/11/28/why-narrow-networks-may-not-be-such-a-bad-idea/\" target=\"_blank\">a way of holding down premiums\u003c/a>. Many expected younger and healthier customers might be willing to give up broad access to providers for these lower costs.\u003c/p>\n\u003cp>But consumers are retaliating with lawsuits and complaints to state regulators. As a result of the rising complaints, state managed care regulators are investigating whether Anthem and, separately, Blue Shield of California, provided accurate information about the doctors and hospitals in their plans.\u003c/p>\n\u003cp>\u003cstrong>Six Enrollees' Stories\u003c/strong>\u003c/p>\n\u003cp>The Consumer Watchdog lawsuit names six Californians who purchased Anthem plans. Among them is Betsy Felser of Pasadena, who had coverage with Anthem for 20 years. Like hundreds of thousands of Anthem customers, she received a letter late last year stating that her preferred provider organization (PPO), which allows for in- and out-of-network care, was being cancelled, according to the lawsuit. The letter suggested a replacement Anthem plan “with the benefits you have come to count on.”\u003c/p>\n\u003cp>Before agreeing to switch, Felser, a physician, said she checked with five Anthem telephone representatives, making it clear she wanted to be in a PPO.\u003c/p>\n\u003cp>“I would never have gotten anything that wasn’t a PPO plan,” said Felser, 47, whose insurance also covers her young son. “They said they would give me the same coverage.”\u003c/p>\n\u003cp>She also checked Anthem’s website and the doctors she sees, including her son’s pediatrician, to make sure they were participating in the plans she was considering and was assured that they were, she said.\u003c/p>\n\u003cp>During those calls, none of Anthem’s representatives told Felser that the insurer was no longer offering PPOs in Los Angeles County, the lawsuit alleges. Nor did they tell her that the Anthem plans offered in her area would not cover care provided by out-of-network doctors or hospitals, according to the lawsuit.\u003c/p>\n\u003cp>When she received her identification cards, they were stamped with a PPO symbol. But when she tried to use the coverage, she found out her doctors – and her son’s pediatrician – were not in the network and that the plan was an exclusive provider organization (EPO), an extremely limited type of plan which pays nothing for out-of-network care.\u003c/p>\n\u003cp>“It pays zero, so I essentially have no coverage,” said Felser.\u003c/p>\n\u003cp>Anthem, while declining to comment on the Consumer Watchdog suit, had answered questions last week about an earlier lawsuit that raised similar issues.\u003c/p>\n\u003cp>Spokesman Ng said then that consumers were informed about what kind of plan they purchased, along with details about out-of-network benefits, in packets they received soon after enrolling. “All those materials clearly spelled out type of plan they were receiving,” he said.\u003c/p>\n\u003cp>But consumers would have to dig deep in a brochure on the Anthem website to find a footnote to a page 9 chart indicating that EPO plans have no out-of-network benefits.\u003c/p>\n\u003cp>Ng noted that Anthem’s EPO and PPO networks have the same doctors and hospitals for people with individual policies, although only the PPOs have out-of-network benefits. In recent weeks, Anthem said it has added 3,800 doctors to its networks.\u003c/p>\n\u003cp>\u003cstrong>'A Giant Mess'\u003c/strong>\u003c/p>\n\u003cp>As for the PPO symbol on identification cards, Ng said last week that it had been intended to protect consumers who sought emergency care out-of-state, in keeping with Blue Cross Blue Shield Association rules. Ng said Anthem recently got association approval to reissue the cards without the symbol.\u003c/p>\n\u003cp>But consumers say the damage was done. Josh Worth of Los Angeles said he was unable to get accurate information after receiving notice that his Anthem plan would be cancelled at the end of 2013. He said he called Anthem, as well as all the doctors he used — including his child’s pediatrician and his wife’s obstetrician — to be sure they were participating in the network.\u003c/p>\n\u003cp>“They all said, ‘yes, we’re going to be continuing to accept all Blue Cross PPOs,’ and that’s what I was told I was going to be getting,” said Worth, a 43-year-old graphic artist. In January, he said he enrolled his family in an Anthem plan with an $800 a month premium.\u003c/p>\n\u003cp>Worth received an ID card in late February that called his plan a “Pathway Tiered PPO,” according to the lawsuit. His son was born on March 31. Not long after, he said he began receiving bills from his wife’s obstetrician, who was not in the network. Nor was the baby’s pediatrician, he said.\u003c/p>\n\u003cp>As a result, he said he owes about $1,100 out of pocket for both. And although an Anthem telephone representative told him afterward that the hospital where his son was born was not in network, it actually is – and his bills there are being covered, he said.\u003c/p>\n\u003cp>“It’s a giant mess,” said Worth, who can’t switch plans until open enrollment resumes in the fall. “I was sold something I thought was one product, but when I used it, I found out it wasn’t. I’m not going to be going through Anthem again.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Covered California Needs Better Outreach to Limited-English Speakers, Advocates Say",
"title": "Covered California Needs Better Outreach to Limited-English Speakers, Advocates Say",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_16988\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/01/CoveredCA_Spanish-e1388775098705.jpg\">\u003cimg class=\"size-large wp-image-16988\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/01/CoveredCA_Spanish-640x480.jpg\" alt=\"A report from Berkeley's Greenlining Institute called on Covered California to make its enrollment website available in more languages than English and Spanish. \" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A report from Berkeley's Greenlining Institute called on Covered California to make its enrollment website available in more languages than English and Spanish.\u003c/figcaption>\u003c/figure>\n\u003cp>Covered California may have had strong overall enrollment, but people who do not speak English as a first language are underrepresented in the state's health insurance marketplace, according to an analysis from Berkeley's Greenlining Institute.\u003c/p>\n\u003cp>The\u003ca href=\"http://greenlining.org/wp-content/uploads/2014/06/iHealth-Report-print-friendly.pdf\" target=\"_blank\"> report \u003c/a>relied on Covered California data, which showed that 20 percent of enrollees do not speak English as a primary language. That's compared with\u003ca href=\"http://censusreporter.org/profiles/04000US06-california/\" target=\"_blank\"> 44 percent of Californians\u003c/a> overall.\u003c/p>\n\u003cp>\"We know California is a diverse state ethnically and linguistically,\" said Jordan Medina, a health policy fellow with Greenlining and lead author of the study. \"Moving forward, if the Affordable Care Act is going to work in California, we have to make sure those populations are represented in the health insurance marketplace.\"\u003c!--more-->\u003c/p>\n\u003cp>As part of its analysis, Greenlining interviewed certified enrollment counselors working to help people sign up for insurance through Covered California. While online sign-up was available in English and Spanish, people who spoke other languages had only printed material available. Counselors reported that they ran out of materials in at least some languages.\u003c/p>\n\u003cp>Counselors said they preferred helping people sign up by using the online portal, but since it was available only in English and Spanish, it slowed them down. A counselor with an agency that worked with Japanese-Americans told Greenlining, \"We tried to use the website, because that's what Covered California suggested we do, but the line-by-line translation with elderly Japanese-Americans made the process extremely tedious.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Greenlining called on Covered California to make the online sign-up available in the 13 most common languages spoken in California.\u003c/p>\n\u003cp>Covered California spokeswoman Anne Gonzales said the agency is looking into this, \"\u003cspan class=\"Apple-style-span\" style=\"color: #000000\">\u003cspan class=\"Apple-style-span\">but there is no firm date on when that functionality will be added, or which languages will be added.\"\u003c/span>\u003c/span>\u003c/p>\n\u003cp>Problems with both the Spanish-language marketing campaign and the Spanish-language website were\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/02/17/missteps-in-covered-californias-marketing-campaign-to-latinos/\" target=\"_blank\"> widely reported\u003c/a> earlier this year, and Greenlining mentioned these issues. Gonzales pointed to a Spanish-language working group at Covered California that \"recalibrated and focused resources\" on making improvements in these areas. She said Covered California is currently reviewing its resources for Asian-language translations as well, including Mandarin, Korean, Vietnamese and Hmong.\u003c/p>\n\u003cp>Curiously, one of the major issues Greenlining pointed out has already been addressed by the Covered California board. In the first open enrollment period, certified enrollment counselors were paid $58 for every person they enrolled in a plan. But counselors told Greenlining that the fee did not compensate them for the level of work required.\u003c/p>\n\u003cp>Gonzales said that Covered California is \"moving away from that business model.\" During the first open enrollment, there was a division between outreach/education and enrollment. Covered California grantees doing educational events could not also sign people up for insurance.\u003c/p>\n\u003cp>That's changing now. Covered California is \u003ca href=\"http://board.coveredca.com/meetings/2014/6-19/PDFs/PPT%20-%20Covered%20California%20Policy%20and%20Action%20Items_June%2019,%202014.pdf\" target=\"_blank\">instituting a \"navigator\" mode\u003c/a>l and will award a total of $16.9 million in grants to organizations that will handle \"outreach, education and enrollment.\"\u003c/p>\n\u003cp>Greenlining also called on Covered California to move forward on hiring a diversity officer.\u003c/p>\n\u003cp>\"At the end of the day, this helps with accountability,\" Medina said. \"If you have someone whose sole responsibility it is to make sure that all materials -- whether that be on the Web or printed materials -- if there’s one person in charge of that, it makes it really easy for community groups to partner with Covered California to make sure it’s done in an equitable way.”\u003c/p>\n\u003cp>Greenlining credited Covered California, saying that the state \"led the nation in implementing the Affordable Care Act,\" but Medina also observed that the rollout was always expected to be a multi-year effort. \"As we move farther into implementation, Covered California is going to have to really pay attention to hard-to-reach groups,\" he said. \"That's particularly crucial to outreach to Californians who don't speak English well.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"N6YDe3GBE9KI5r58HlM0Xrvwzvipav7x\"]\u003c/p>\n\n",
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"headline": "Covered California Needs Better Outreach to Limited-English Speakers, Advocates Say",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_16988\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/01/CoveredCA_Spanish-e1388775098705.jpg\">\u003cimg class=\"size-large wp-image-16988\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/01/CoveredCA_Spanish-640x480.jpg\" alt=\"A report from Berkeley's Greenlining Institute called on Covered California to make its enrollment website available in more languages than English and Spanish. \" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A report from Berkeley's Greenlining Institute called on Covered California to make its enrollment website available in more languages than English and Spanish.\u003c/figcaption>\u003c/figure>\n\u003cp>Covered California may have had strong overall enrollment, but people who do not speak English as a first language are underrepresented in the state's health insurance marketplace, according to an analysis from Berkeley's Greenlining Institute.\u003c/p>\n\u003cp>The\u003ca href=\"http://greenlining.org/wp-content/uploads/2014/06/iHealth-Report-print-friendly.pdf\" target=\"_blank\"> report \u003c/a>relied on Covered California data, which showed that 20 percent of enrollees do not speak English as a primary language. That's compared with\u003ca href=\"http://censusreporter.org/profiles/04000US06-california/\" target=\"_blank\"> 44 percent of Californians\u003c/a> overall.\u003c/p>\n\u003cp>\"We know California is a diverse state ethnically and linguistically,\" said Jordan Medina, a health policy fellow with Greenlining and lead author of the study. \"Moving forward, if the Affordable Care Act is going to work in California, we have to make sure those populations are represented in the health insurance marketplace.\"\u003c!--more-->\u003c/p>\n\u003cp>As part of its analysis, Greenlining interviewed certified enrollment counselors working to help people sign up for insurance through Covered California. While online sign-up was available in English and Spanish, people who spoke other languages had only printed material available. Counselors reported that they ran out of materials in at least some languages.\u003c/p>\n\u003cp>Counselors said they preferred helping people sign up by using the online portal, but since it was available only in English and Spanish, it slowed them down. A counselor with an agency that worked with Japanese-Americans told Greenlining, \"We tried to use the website, because that's what Covered California suggested we do, but the line-by-line translation with elderly Japanese-Americans made the process extremely tedious.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Greenlining called on Covered California to make the online sign-up available in the 13 most common languages spoken in California.\u003c/p>\n\u003cp>Covered California spokeswoman Anne Gonzales said the agency is looking into this, \"\u003cspan class=\"Apple-style-span\" style=\"color: #000000\">\u003cspan class=\"Apple-style-span\">but there is no firm date on when that functionality will be added, or which languages will be added.\"\u003c/span>\u003c/span>\u003c/p>\n\u003cp>Problems with both the Spanish-language marketing campaign and the Spanish-language website were\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/02/17/missteps-in-covered-californias-marketing-campaign-to-latinos/\" target=\"_blank\"> widely reported\u003c/a> earlier this year, and Greenlining mentioned these issues. Gonzales pointed to a Spanish-language working group at Covered California that \"recalibrated and focused resources\" on making improvements in these areas. She said Covered California is currently reviewing its resources for Asian-language translations as well, including Mandarin, Korean, Vietnamese and Hmong.\u003c/p>\n\u003cp>Curiously, one of the major issues Greenlining pointed out has already been addressed by the Covered California board. In the first open enrollment period, certified enrollment counselors were paid $58 for every person they enrolled in a plan. But counselors told Greenlining that the fee did not compensate them for the level of work required.\u003c/p>\n\u003cp>Gonzales said that Covered California is \"moving away from that business model.\" During the first open enrollment, there was a division between outreach/education and enrollment. Covered California grantees doing educational events could not also sign people up for insurance.\u003c/p>\n\u003cp>That's changing now. Covered California is \u003ca href=\"http://board.coveredca.com/meetings/2014/6-19/PDFs/PPT%20-%20Covered%20California%20Policy%20and%20Action%20Items_June%2019,%202014.pdf\" target=\"_blank\">instituting a \"navigator\" mode\u003c/a>l and will award a total of $16.9 million in grants to organizations that will handle \"outreach, education and enrollment.\"\u003c/p>\n\u003cp>Greenlining also called on Covered California to move forward on hiring a diversity officer.\u003c/p>\n\u003cp>\"At the end of the day, this helps with accountability,\" Medina said. \"If you have someone whose sole responsibility it is to make sure that all materials -- whether that be on the Web or printed materials -- if there’s one person in charge of that, it makes it really easy for community groups to partner with Covered California to make sure it’s done in an equitable way.”\u003c/p>\n\u003cp>Greenlining credited Covered California, saying that the state \"led the nation in implementing the Affordable Care Act,\" but Medina also observed that the rollout was always expected to be a multi-year effort. \"As we move farther into implementation, Covered California is going to have to really pay attention to hard-to-reach groups,\" he said. \"That's particularly crucial to outreach to Californians who don't speak English well.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"N6YDe3GBE9KI5r58HlM0Xrvwzvipav7x\"]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Coordinated Care for Those Nearing Life's End — But Does It Save Money?",
"title": "Coordinated Care for Those Nearing Life's End — But Does It Save Money?",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_19725\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/Bob_april-e1403652651481.jpg\">\u003cimg class=\"wp-image-19725 size-large\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/Bob_april-e1403652651481-640x480.jpg\" alt=\"Sutter nurse Aileen Capuyan listens to Bob Martinez’s lungs. (April Dembosky/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Sutter nurse Aileen Capuyan listens to Bob Martinez’s lungs. (April Dembosky/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Bob Martinez has been in the hospital so many times, the surgical staff treats him like a regular at a coffee shop.\u003c/p>\n\u003cp>“They all know me!” he says. “If I go in there today, they’d say, ‘How’re ya doing Mr. Martinez?' ”\u003c/p>\n\u003caside class=\"pullquote alignleft\">'I’m so sick and tired of being in hospitals. I don’t want to go back no more. I said, God, no more.'\u003c/aside>\n\u003cp>Martinez is 81, a long-retired life insurance salesman. In the last few years, he's had more than a dozen surgeries on his right leg, including a foot amputation, a casualty of severe diabetes. His heart disease has warranted almost half a dozen heart procedures. After one of his recent operations, he said he'd had enough.\u003c/p>\n\u003cp>“I’m so sick and tired of being in hospitals,” he says shaking his head. “I don’t want to go back no more. I said, God, no more. No more.”\u003c/p>\n\u003cp>That’s when hospital staff told him about a program through Sutter Health that would send people to take care of him at home. It’s called the Advanced Illness Management program, or AIM. It’s designed for people like Martinez who have multiple chronic illnesses.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>It’s not hospice. That’s for people who doctors say have six months or less to live. This program is for the pre-hospice population, people estimated to be in the last 18 months of life. The AIM program assigns a team of doctors, nurses and social workers to help patients transition home after hospital stays, manage medication, and carefully coordinate care, at home and over the phone, to help keep patients out of the hospital.\u003c/p>\n\u003cp>Martinez’ nurse, Aileen Capuyan, and social worker, Ally Chu, come to his home in Oakland once a week.\u003c/p>\n\u003cp>“Are you coughing? Do you have any shortness of breath?” Capuyan asks as she listens to Martinez’s lungs.\u003c/p>\n\u003cp>He sits in the brown leather armchair in his living room while she takes his temperature and checks his blood pressure. Meanwhile, Chu is in the kitchen talking with Martinez's son, Jimmy, who takes care of him. Jimmy is making tamales. Then Capuyan and Chu switch.\u003c/p>\n\u003cp>Most of the visit is spent talking: about the pain in Martinez’s leg, how his dominoes game is going at the senior center, and about more sensitive things, like what happens when his health gets worse — what kind of care he wants at the end of life and what care he doesn’t want.\u003c/p>\n\u003cp>“I don’t want to be resuscitated,” Martinez says. “When my time comes — let it go.”\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/155994604&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>The founders of the AIM program hope that these ongoing visits build the kind of trust where patients can fully explore these questions. Chief program executive Betsy Gornet says this avoids rushed decisions that don’t capture a person’s real values.\u003c/p>\n\u003cp>“Spending fifteen minutes in a doctor's office or in an ICU in a crisis isn’t necessarily the way to do advanced care planning,” she says. “We do know that a dialogue over time does help foster the right kind of information.”\u003c/p>\n\u003cp>She says that means patients get the kind of care they want, and get help before their conditions reach a crisis level.\u003c/p>\n\u003cp>“We’ve been able to track very consistently a 30 percent reduction in emergency room visits by these patients, 70 to 80 percent reduction in ICU days, 50 percent reduction in hospitalizations,” she says.\u003c/p>\n\u003cp>That in turn has saved money.\u003c/p>\n\u003cp>“We’ve seen the total cost of care go down anywhere from $3,600 to $5,000 dollar per patient over the course of 90 days,” she says.\u003c/p>\n\u003cp>This is the kind of talk that has sparked fiery debates in Washington. Back in 2009, the idea of doctors even talking to their patients about their end-of-life wishes spurred fears of “\u003ca href=\"http://www.washingtonpost.com/wp-dyn/content/article/2009/07/31/AR2009073103148.html\" target=\"_blank\">death panels\u003c/a>” rationing care.\u003c/p>\n\u003cp>But today, the tone is shifting, according to health policy lobbyist Andrew MacPherson.\u003c/p>\n\u003cp>“We’re seeing a death of the death panels,” he says. “We’re in a totally new place today.”\u003c/p>\n\u003cp>[contextly_sidebar id=\"392e700af225e5a57a941f70d559db24\"]\u003c/p>\n\u003cp>He says lawmakers are having real bipartisan discussions about overhauling the American way of death, especially now that more and more politicians are shepherding their own parents through the end of life.\u003c/p>\n\u003cp>“It’s personal stories,” MacPherson says. “People's personal stories about their mother, about their father are really what bring folks to table to say, 'Look, we need to have a health care system that is responsive to patients’ values and preferences and wishes when they’re really seriously ill.' ”\u003c/p>\n\u003cp>He says officials in Washington are keeping an eye on the Sutter program as a model that might be replicated across the country. The Medicare program, which pays for health care for people over 65, gave the AIM program a $13 million grant from a fund created under the Affordable Care Act. In return, they want to see the program generate savings for Medicare of at least $29 million.\u003c/p>\n\u003cp>“The big question is whether or not it will pan out,” says Suzanne Delbanco, executive director of the nonprofit group Catalyst for Payment Reform.\u003c/p>\n\u003cp>The Medicare grants are one way the government is trying to move away from paying for health care on a fee-for-service basis, which Delbanco says incentivizes doctors to order more tests and procedures to drive up their revenues. Instead, interest is growing to develop more holistic payment models — things like “care management fees,” “bundled payments” and “shared savings” — that reward doctors based on the overall care they provide and outcomes where their patients ultimately get better.\u003c/p>\n\u003cp>“It’s almost as if we’re going from an a la carte menu to a pre-fixe meal where you pay a set amount for all your courses,” Delbanco says.\u003c/p>\n\u003cp>But there are two big unknowns.\u003c/p>\n\u003cp>First, it's not clear if these new models of care really will cost less in the long run. “We don’t know for sure whether or not financially it will end up being beneficial in an effort to curtail our health care costs,” Delbanco says.\u003c/p>\n\u003cp>Second, Sutter has to find a way to operate the AIM program that works for its own bottom line. When Sutter saves money for Medicare, by reducing hospitalizations and ER visits, it takes a financial hit on its own revenues. Many of the new services it provides to achieve those savings — the telephone coordination, some home care and some social work services — are not reimbursed under Medicare’s current payment system.\u003c/p>\n\u003cp>Sutter declined to reveal operation costs or budget figures for the AIM program, although the federal Agency for Healthcare Research and Quality reports it costs about $900 monthly, for each patient, on average.\u003c/p>\n\u003cp>AIM chief executive Betsy Gornet says the program does operate at a loss in some regions and has stayed afloat so far through foundation grants and investments from Sutter. But its goal this year, as part of the government grant, is to become self-sustaining, and to propose a new payment model for Medicare that balances savings for the government and still keeps its own program in business.\u003c/p>\n\u003cp>“We want to get the right care to the right patient at the right time,” Gornet says. “That will help save everybody’s resources.”\u003c/p>\n\u003cp>Gornet says the ultimate goal is to keep patients like Bob Martinez as comfortable and vibrant as possible until he reaches the end of his life.\u003c/p>\n\u003cp>Martinez says he's been thinking about death a lot lately, especially since his wife, Josie, died two years ago — at home, with her husband at her side.\u003c/p>\n\u003cp>“God’s got a plan for everybody, different plans,\" Martinez says. \"Some die at home. Some die in a hospital. I want to be home like she was. If it comes to that. But anyway, I’ll take it any way. I just want to be with her now.\"\u003c/p>\n\u003cp>Martinez died in May. He was at home, in his living room, surrounded by family.\u003c/p>\n\u003cp>\u003cem>This report was produced with support from \u003c/em>\u003cem>the MetLife Foundation Journalists in Aging Fellowships, a program of New America Media and the Gerontological Society of America.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19725\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/Bob_april-e1403652651481.jpg\">\u003cimg class=\"wp-image-19725 size-large\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/Bob_april-e1403652651481-640x480.jpg\" alt=\"Sutter nurse Aileen Capuyan listens to Bob Martinez’s lungs. (April Dembosky/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Sutter nurse Aileen Capuyan listens to Bob Martinez’s lungs. (April Dembosky/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Bob Martinez has been in the hospital so many times, the surgical staff treats him like a regular at a coffee shop.\u003c/p>\n\u003cp>“They all know me!” he says. “If I go in there today, they’d say, ‘How’re ya doing Mr. Martinez?' ”\u003c/p>\n\u003caside class=\"pullquote alignleft\">'I’m so sick and tired of being in hospitals. I don’t want to go back no more. I said, God, no more.'\u003c/aside>\n\u003cp>Martinez is 81, a long-retired life insurance salesman. In the last few years, he's had more than a dozen surgeries on his right leg, including a foot amputation, a casualty of severe diabetes. His heart disease has warranted almost half a dozen heart procedures. After one of his recent operations, he said he'd had enough.\u003c/p>\n\u003cp>“I’m so sick and tired of being in hospitals,” he says shaking his head. “I don’t want to go back no more. I said, God, no more. No more.”\u003c/p>\n\u003cp>That’s when hospital staff told him about a program through Sutter Health that would send people to take care of him at home. It’s called the Advanced Illness Management program, or AIM. It’s designed for people like Martinez who have multiple chronic illnesses.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>It’s not hospice. That’s for people who doctors say have six months or less to live. This program is for the pre-hospice population, people estimated to be in the last 18 months of life. The AIM program assigns a team of doctors, nurses and social workers to help patients transition home after hospital stays, manage medication, and carefully coordinate care, at home and over the phone, to help keep patients out of the hospital.\u003c/p>\n\u003cp>Martinez’ nurse, Aileen Capuyan, and social worker, Ally Chu, come to his home in Oakland once a week.\u003c/p>\n\u003cp>“Are you coughing? Do you have any shortness of breath?” Capuyan asks as she listens to Martinez’s lungs.\u003c/p>\n\u003cp>He sits in the brown leather armchair in his living room while she takes his temperature and checks his blood pressure. Meanwhile, Chu is in the kitchen talking with Martinez's son, Jimmy, who takes care of him. Jimmy is making tamales. Then Capuyan and Chu switch.\u003c/p>\n\u003cp>Most of the visit is spent talking: about the pain in Martinez’s leg, how his dominoes game is going at the senior center, and about more sensitive things, like what happens when his health gets worse — what kind of care he wants at the end of life and what care he doesn’t want.\u003c/p>\n\u003cp>“I don’t want to be resuscitated,” Martinez says. “When my time comes — let it go.”\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/155994604&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>The founders of the AIM program hope that these ongoing visits build the kind of trust where patients can fully explore these questions. Chief program executive Betsy Gornet says this avoids rushed decisions that don’t capture a person’s real values.\u003c/p>\n\u003cp>“Spending fifteen minutes in a doctor's office or in an ICU in a crisis isn’t necessarily the way to do advanced care planning,” she says. “We do know that a dialogue over time does help foster the right kind of information.”\u003c/p>\n\u003cp>She says that means patients get the kind of care they want, and get help before their conditions reach a crisis level.\u003c/p>\n\u003cp>“We’ve been able to track very consistently a 30 percent reduction in emergency room visits by these patients, 70 to 80 percent reduction in ICU days, 50 percent reduction in hospitalizations,” she says.\u003c/p>\n\u003cp>That in turn has saved money.\u003c/p>\n\u003cp>“We’ve seen the total cost of care go down anywhere from $3,600 to $5,000 dollar per patient over the course of 90 days,” she says.\u003c/p>\n\u003cp>This is the kind of talk that has sparked fiery debates in Washington. Back in 2009, the idea of doctors even talking to their patients about their end-of-life wishes spurred fears of “\u003ca href=\"http://www.washingtonpost.com/wp-dyn/content/article/2009/07/31/AR2009073103148.html\" target=\"_blank\">death panels\u003c/a>” rationing care.\u003c/p>\n\u003cp>But today, the tone is shifting, according to health policy lobbyist Andrew MacPherson.\u003c/p>\n\u003cp>“We’re seeing a death of the death panels,” he says. “We’re in a totally new place today.”\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>He says lawmakers are having real bipartisan discussions about overhauling the American way of death, especially now that more and more politicians are shepherding their own parents through the end of life.\u003c/p>\n\u003cp>“It’s personal stories,” MacPherson says. “People's personal stories about their mother, about their father are really what bring folks to table to say, 'Look, we need to have a health care system that is responsive to patients’ values and preferences and wishes when they’re really seriously ill.' ”\u003c/p>\n\u003cp>He says officials in Washington are keeping an eye on the Sutter program as a model that might be replicated across the country. The Medicare program, which pays for health care for people over 65, gave the AIM program a $13 million grant from a fund created under the Affordable Care Act. In return, they want to see the program generate savings for Medicare of at least $29 million.\u003c/p>\n\u003cp>“The big question is whether or not it will pan out,” says Suzanne Delbanco, executive director of the nonprofit group Catalyst for Payment Reform.\u003c/p>\n\u003cp>The Medicare grants are one way the government is trying to move away from paying for health care on a fee-for-service basis, which Delbanco says incentivizes doctors to order more tests and procedures to drive up their revenues. Instead, interest is growing to develop more holistic payment models — things like “care management fees,” “bundled payments” and “shared savings” — that reward doctors based on the overall care they provide and outcomes where their patients ultimately get better.\u003c/p>\n\u003cp>“It’s almost as if we’re going from an a la carte menu to a pre-fixe meal where you pay a set amount for all your courses,” Delbanco says.\u003c/p>\n\u003cp>But there are two big unknowns.\u003c/p>\n\u003cp>First, it's not clear if these new models of care really will cost less in the long run. “We don’t know for sure whether or not financially it will end up being beneficial in an effort to curtail our health care costs,” Delbanco says.\u003c/p>\n\u003cp>Second, Sutter has to find a way to operate the AIM program that works for its own bottom line. When Sutter saves money for Medicare, by reducing hospitalizations and ER visits, it takes a financial hit on its own revenues. Many of the new services it provides to achieve those savings — the telephone coordination, some home care and some social work services — are not reimbursed under Medicare’s current payment system.\u003c/p>\n\u003cp>Sutter declined to reveal operation costs or budget figures for the AIM program, although the federal Agency for Healthcare Research and Quality reports it costs about $900 monthly, for each patient, on average.\u003c/p>\n\u003cp>AIM chief executive Betsy Gornet says the program does operate at a loss in some regions and has stayed afloat so far through foundation grants and investments from Sutter. But its goal this year, as part of the government grant, is to become self-sustaining, and to propose a new payment model for Medicare that balances savings for the government and still keeps its own program in business.\u003c/p>\n\u003cp>“We want to get the right care to the right patient at the right time,” Gornet says. “That will help save everybody’s resources.”\u003c/p>\n\u003cp>Gornet says the ultimate goal is to keep patients like Bob Martinez as comfortable and vibrant as possible until he reaches the end of his life.\u003c/p>\n\u003cp>Martinez says he's been thinking about death a lot lately, especially since his wife, Josie, died two years ago — at home, with her husband at her side.\u003c/p>\n\u003cp>“God’s got a plan for everybody, different plans,\" Martinez says. \"Some die at home. Some die in a hospital. I want to be home like she was. If it comes to that. But anyway, I’ll take it any way. I just want to be with her now.\"\u003c/p>\n\u003cp>Martinez died in May. He was at home, in his living room, surrounded by family.\u003c/p>\n\u003cp>\u003cem>This report was produced with support from \u003c/em>\u003cem>the MetLife Foundation Journalists in Aging Fellowships, a program of New America Media and the Gerontological Society of America.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cfigure id=\"attachment_19661\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\">\u003cimg class=\"wp-image-19661 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/pricecheck-wname-2.jpg\" alt=\"(Photo: Getty Images)\" width=\"640\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/06/pricecheck-wname-2.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/pricecheck-wname-2-400x225.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/pricecheck-wname-2-320x180.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Photo: Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Update June 30:\u003c/strong> Early PriceCheck data show\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/30/initial-mammogram-cost-comparisons-in-kqeds-pricecheck-project/\" target=\"_blank\"> Bay Area mammogram prices range from $125 to $801\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Original Post:\u003c/strong>\u003c/p>\n\u003cp>Say you're shopping for a new computer or a new car, and you want to get the best price. Within a matter of minutes on Google, you would have a pretty good idea of the price range for the product you want.\u003c/p>\n\u003cp>But in health care? Forget it.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Shining light on a system where the costs of the same procedure might range from $0 to $1,100. That's just one example.\u003c/aside>\n\u003cp>It's well known to health policy types, but less so to consumers, that health care prices are utterly lacking in transparency and wildly variable.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>If you've ever looked at a bill for a health care procedure -- and been astounded by the numbers you see -- or thought that you would like to find the best price on an elective procedure -- and been astounded that there's no easy way to compare prices -- KQED is launching a new project for you.\u003c/p>\n\u003cp>Today we bring you \"\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">Price Check\u003c/a>,\" a community-created guide to health costs. Since no database yet exists where consumers can easily look up costs, we're commencing the work of creating one. But we need your help.\u003c/p>\n\u003cp>This summer and into the fall, we're turning to you, our community, to share -- anonymously -- what you have paid for some common procedures. We're starting with mammograms. (More on \"why mammograms?\" in a moment.)\u003c!--more-->\u003c/p>\n\u003cp>We've created a tool to make it easy to share what you paid. \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">Visit the tool and take a look\u003c/a>. If you don't have insurance and pay out of pocket -- called self-pay -- you can enter that price. If you have insurance, you can submit both what your health insurance paid and your own co-pay charge, if any.\u003c/p>\n\u003cp>Once you've shared your costs, the tool will feed your information into a database so you can see how much mammograms cost elsewhere in the Bay Area and across California. Again, your submitted data are anonymous and confidential.\u003c/p>\n\u003cp>We want this project to have as much impact as possible, so we have teamed up with \u003ca href=\"http://www.scpr.org/blogs/health/2014/06/23/16873/join-pricecheck-help-make-health-care-costs-more-t/\" target=\"_blank\">KPCC\u003c/a>, our public radio friends in Southern California, and \u003ca href=\"http://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts.com\u003c/a>, a New York City startup working to bring transparency to the health care marketplace.\u003c/p>\n\u003cp>We chose to start with mammograms, because it is a screening test that many women have at least every other year. Because it is a test that can be scheduled, women could, in theory, shop around for the best price. Yes, mammograms are covered as a preventive benefit under the Affordable Care Act, and patients are supposed to access them at no co-pay, but that doesn't always happen.\u003c/p>\n\u003caside class=\"pullquote alignright\">Learn more: \u003ca href=\"http://ww2.kqed.org/stateofhealth/series/price-check/\" target=\"_blank\">read all our PriceCheck coverage\u003c/a>. \u003c/aside>\n\u003cp>ClearHealthCosts did a \u003ca href=\"http://clearhealthcosts.com/wnyc/how-much-do-birth-control-mammograms-cost/\" target=\"_blank\">pilot version of this project\u003c/a> with WNYC public radio in New York in 2012. They found that 25-30 percent of the 400 respondents were paying for their mammograms. That's because some of the women chose out-of-network providers, or they weren't insured, or the mammogram simply wasn't covered.\u003c/p>\n\u003cp>We'll be able to compare California data with what ClearHealthCosts learned with WNYC -- where \u003ca href=\"http://clearhealthcosts.com/blog/2013/07/how-much-does-a-mammogram-cost-the-takeaway-on-billing-from-our-wnyc-partnership/\" target=\"_blank\">women paid between $0 and $1,100 or more\u003c/a>.\u003c/p>\n\u003cp>In other sectors of the economy, people often equate higher cost with higher quality, but in health care there's not a correlation between price and quality. We think people want quality care at a fair price. But just as there is little transparency in health costs, there are few good measures of quality. We believe that shining a bright light on health costs helps to drive discussion about quality metrics.\u003c/p>\n\u003cp>We're just at the start of this project. Over the next four months, we'll sample other common procedures. We're grateful to the Knight Foundation for funding this project through a \u003ca href=\"http://www.knightfoundation.org/blogs/knightblog/2014/4/22/17-projects-receive-funding-through-knight-prototype-fund/\" target=\"_blank\">Prototype Fund grant\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Please join us! We'll report what you share with us as soon as we have stories to tell.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19661\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\">\u003cimg class=\"wp-image-19661 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/pricecheck-wname-2.jpg\" alt=\"(Photo: Getty Images)\" width=\"640\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/06/pricecheck-wname-2.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/pricecheck-wname-2-400x225.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/pricecheck-wname-2-320x180.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Photo: Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Update June 30:\u003c/strong> Early PriceCheck data show\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/30/initial-mammogram-cost-comparisons-in-kqeds-pricecheck-project/\" target=\"_blank\"> Bay Area mammogram prices range from $125 to $801\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Original Post:\u003c/strong>\u003c/p>\n\u003cp>Say you're shopping for a new computer or a new car, and you want to get the best price. Within a matter of minutes on Google, you would have a pretty good idea of the price range for the product you want.\u003c/p>\n\u003cp>But in health care? Forget it.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Shining light on a system where the costs of the same procedure might range from $0 to $1,100. That's just one example.\u003c/aside>\n\u003cp>It's well known to health policy types, but less so to consumers, that health care prices are utterly lacking in transparency and wildly variable.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>If you've ever looked at a bill for a health care procedure -- and been astounded by the numbers you see -- or thought that you would like to find the best price on an elective procedure -- and been astounded that there's no easy way to compare prices -- KQED is launching a new project for you.\u003c/p>\n\u003cp>Today we bring you \"\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">Price Check\u003c/a>,\" a community-created guide to health costs. Since no database yet exists where consumers can easily look up costs, we're commencing the work of creating one. But we need your help.\u003c/p>\n\u003cp>This summer and into the fall, we're turning to you, our community, to share -- anonymously -- what you have paid for some common procedures. We're starting with mammograms. (More on \"why mammograms?\" in a moment.)\u003c!--more-->\u003c/p>\n\u003cp>We've created a tool to make it easy to share what you paid. \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">Visit the tool and take a look\u003c/a>. If you don't have insurance and pay out of pocket -- called self-pay -- you can enter that price. If you have insurance, you can submit both what your health insurance paid and your own co-pay charge, if any.\u003c/p>\n\u003cp>Once you've shared your costs, the tool will feed your information into a database so you can see how much mammograms cost elsewhere in the Bay Area and across California. Again, your submitted data are anonymous and confidential.\u003c/p>\n\u003cp>We want this project to have as much impact as possible, so we have teamed up with \u003ca href=\"http://www.scpr.org/blogs/health/2014/06/23/16873/join-pricecheck-help-make-health-care-costs-more-t/\" target=\"_blank\">KPCC\u003c/a>, our public radio friends in Southern California, and \u003ca href=\"http://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts.com\u003c/a>, a New York City startup working to bring transparency to the health care marketplace.\u003c/p>\n\u003cp>We chose to start with mammograms, because it is a screening test that many women have at least every other year. Because it is a test that can be scheduled, women could, in theory, shop around for the best price. Yes, mammograms are covered as a preventive benefit under the Affordable Care Act, and patients are supposed to access them at no co-pay, but that doesn't always happen.\u003c/p>\n\u003caside class=\"pullquote alignright\">Learn more: \u003ca href=\"http://ww2.kqed.org/stateofhealth/series/price-check/\" target=\"_blank\">read all our PriceCheck coverage\u003c/a>. \u003c/aside>\n\u003cp>ClearHealthCosts did a \u003ca href=\"http://clearhealthcosts.com/wnyc/how-much-do-birth-control-mammograms-cost/\" target=\"_blank\">pilot version of this project\u003c/a> with WNYC public radio in New York in 2012. They found that 25-30 percent of the 400 respondents were paying for their mammograms. That's because some of the women chose out-of-network providers, or they weren't insured, or the mammogram simply wasn't covered.\u003c/p>\n\u003cp>We'll be able to compare California data with what ClearHealthCosts learned with WNYC -- where \u003ca href=\"http://clearhealthcosts.com/blog/2013/07/how-much-does-a-mammogram-cost-the-takeaway-on-billing-from-our-wnyc-partnership/\" target=\"_blank\">women paid between $0 and $1,100 or more\u003c/a>.\u003c/p>\n\u003cp>In other sectors of the economy, people often equate higher cost with higher quality, but in health care there's not a correlation between price and quality. We think people want quality care at a fair price. But just as there is little transparency in health costs, there are few good measures of quality. We believe that shining a bright light on health costs helps to drive discussion about quality metrics.\u003c/p>\n\u003cp>We're just at the start of this project. Over the next four months, we'll sample other common procedures. We're grateful to the Knight Foundation for funding this project through a \u003ca href=\"http://www.knightfoundation.org/blogs/knightblog/2014/4/22/17-projects-receive-funding-through-knight-prototype-fund/\" target=\"_blank\">Prototype Fund grant\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Please join us! We'll report what you share with us as soon as we have stories to tell.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "In Alameda County, Leaving Jail Doesn't Have to Mean Losing Health Care",
"title": "In Alameda County, Leaving Jail Doesn't Have to Mean Losing Health Care",
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"content": "\u003cfigure id=\"attachment_19175\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/Screen-Shot-2014-05-19-at-10.24.13-AM.png\">\u003cimg class=\"size-large wp-image-19175\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/Screen-Shot-2014-05-19-at-10.24.13-AM-640x352.png\" alt=\"Rodrigo Salido, recently released from Santa Rita jail in Dublin, Calif., enrolls in Medi-Cal at Healthy Oakland clinic. (Courtesy: PBS NewsHour)\" width=\"640\" height=\"352\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Rodrigo Salido, recently released from Santa Rita jail in Dublin, Calif., enrolls in Medi-Cal at Healthy Oakland clinic. (Courtesy: PBS NewsHour)\u003c/figcaption>\u003c/figure>\n\u003cp style=\"color: #000000\">\u003cstrong>By Sarah Varney,\u003c/strong> \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2014/May/16/inmates-leave-jail-retain-mental-health-care.aspx\" target=\"_blank\">Kaiser Health News and PBS NewsHour\u003c/a>\u003c/p>\n\u003cp style=\"color: #000000\">It's been two months since Rodrigo Salido left the maximum security wing at Santa Rita jail, about 40 miles east of San Francisco in Alameda County. It's also been two months since Salido had medication for his bipolar disorder.\u003c/p>\n\u003cp style=\"color: #000000\">\n\u003caside class=\"pullquote alignleft\">In Alameda County officials estimate 18,000 offenders in its two jails will now qualify for Medi-Cal.\u003c/aside>\n\u003c/p>\u003cp>A drug, Risperdal, prescribed by a jailhouse psychiatrist, had quelled Salido’s angry moods. “It helped me be more relaxed,” he said. “Not as much on the edge and feeling like everybody is out to get me.”\u003c/p>\n\u003cp style=\"color: #000000\">Now Salido, who served two years for burglary, assault and gang involvement, has no health insurance and until recently had few options for refilling his medication.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp style=\"color: #000000\">Many inmates leave county jails and state prisons with mental health problems and chronic physical ailments -- and no health coverage. Because they typically are not custodial parents, ex-offenders have long been ineligible for a public health insurance program aimed at kids, mothers and the disabled.\u003c!--more-->\u003c/p>\n\u003cp style=\"color: #000000\">But earlier this year, California and 25 other states, under a provision of the Affordable Care Act, opened up Medicaid to single and so-called “childless” adults. The change in eligibility criteria will extend Medicaid coverage to vast numbers of ex-offenders with very low incomes.\u003c/p>\n\u003cp style=\"color: #000000\">“Historically, 10 or 11 percent of folks in detention have been eligible for Medicaid,” said Alex Briscoe, health director for Alameda County. “That number is well over 90 percent as of January,” since the ACA took full effect.\u003c/p>\n\u003cp style=\"color: #000000\">[contextly_sidebar id=\"c4bac880693cbdd4b01c435155bec487\"]\u003c/p>\n\u003cp>Indeed, of those newly eligible under the Medicaid expansion, experts predict \u003ca style=\"color: #2262cc\" href=\"http://www.ncbi.nlm.nih.gov/pubmed/22566431\">one out of three\u003c/a> nationally will be former inmates or detainees. Health officials in Alameda County estimate 18,000 offenders in its two jails will now qualify. Recently, Rodrigo Salido began the process of enrolling in Medi-Cal, California's version of Medicaid, at a clinic, Healthy Oakland. He got a preliminary check up there, but once he gets his card will be able to visit a primary care doctor and see specialists.\u003c/p>\n\u003cp style=\"color: #000000\">Men and women involved in the criminal justice system are more likely to be sicker than the general population\u003cstrong>,\u003c/strong> with higher rates of diabetes, hypertension, depression, mood disorders and alcohol and drug addiction. Many have spent years -- perhaps their entire adult livens -- without health insurance and have medical conditions that must be stabilized when they’re incarcerated.\u003c/p>\n\u003cp style=\"color: #000000\">“They come to us in bad shape, and we get them as good as possible,” said Richard Lucia, the undersheriff for Alameda County.\u003c/p>\n\u003cp style=\"color: #000000\">At Santa Rita jail in Dublin, one of the largest detention facilities in the United States, the pharmacy dispenses some 350,000 prescription drugs each month and spends $28 million each year on medical and mental health services. But because recidivism rates are so high in Alameda County -- two out of three inmates re-offend -- the jails’ medical clinics often end up re-stabilizing the same inmates.\u003c/p>\n\u003cp style=\"color: #000000\">“They leave and they get in bad shape again,” said Lucia. “And they come back to us, and we fix them up again.”\u003c/p>\n\u003cdiv>\u003ca class=\"embedly-card\" href=\"https://www.youtube.com/watch?list=UU6ZFN9Tx6xh-skXCuRHCDpQ&v=rpOwkAsXXHM\">Former inmates stand to gain Medicaid under expansion\u003c/a>\u003c/div>\n\u003cp style=\"color: #000000\">The churning of sick offenders costs the county when inmates are in custody -- but it also strains public hospital budgets when they’re released. “When they do need care they come to our emergency department. They cost us between $600 and $800 a visit,” said Briscoe, the county health director. “The cost drivers on our system are intense.”\u003c/p>\n\u003cp style=\"color: #000000\">The Medicaid expansion, county officials contend, offers a rare opportunity to connect men and women with criminal records to ongoing medical and mental health services, and to directly reimburse the county’s general fund for medical care outside of correctional facilities.\u003c/p>\n\u003cp style=\"color: #000000\">While it remains against federal law to use Medicaid to pay for day-to-day medical care for inmates, the program, funded by federal and state dollars, will cover hospital stays longer than 24 hours. Those longer hospital visits often involve costly and complicated surgeries, and the county estimates it could save $3 to $5 million a year in off-site hospital care.\u003c/p>\n\u003cp style=\"color: #000000\">“That would shift the cost, essentially, from the county to the state or to the federal government,” said Undersheriff Lucia.\u003c/p>\n\u003cp style=\"color: #000000\">Over the last few months, a constellation of Alameda County agencies, including the sheriff’s office, public health and social services, have been feverishly working to create new protocols that will automatically enroll all eligible inmates into Medi-Cal. Other enrollment efforts are underway in Contra Costa, San Francisco, Solano and Lassen counties, and in Cook County, Illinois, the state of Washington and elsewhere.\u003c/p>\n\u003cp style=\"color: #000000\">The bureaucratic and technical challenges are immense: archaic information technology platforms must be re-tooled to share data with other county systems; arrested individuals often give false information about their marriage status, number of children, home address and income, foiling Medi-Cal eligibility background checks; and labor union rules permit only certain county workers to approve Medicaid applications.\u003c/p>\n\u003cp style=\"color: #000000\">Overcoming those obstacles is a priority, Alameda county officials said, not only because of the potential cost savings, but also because the Medi-Cal expansion offers a solid chance at reducing the county’s dismal recidivism rate. Several studies have shown that ex-inmates who have access to health care when they leave jail, especially mental health and substance abuse counseling, are less likely to re-offend.\u003c/p>\n\u003cp style=\"color: #000000\">Still, a Medi-Cal card is no panacea for troubled lives. “You can’t treat away the problems that face poor communities,” said Briscoe, the county health director. “It’s about a good job. It’s about a sense of belonging. It’s about a place to sleep, but healthcare can be a tool for social justice if it’s delivered effectively and creatively, and that’s why the Medicaid expansion is such a great opportunity for us.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Kaiser Health News (KHN) is 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>\u003cfigure id=\"attachment_19175\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/Screen-Shot-2014-05-19-at-10.24.13-AM.png\">\u003cimg class=\"size-large wp-image-19175\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/Screen-Shot-2014-05-19-at-10.24.13-AM-640x352.png\" alt=\"Rodrigo Salido, recently released from Santa Rita jail in Dublin, Calif., enrolls in Medi-Cal at Healthy Oakland clinic. (Courtesy: PBS NewsHour)\" width=\"640\" height=\"352\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Rodrigo Salido, recently released from Santa Rita jail in Dublin, Calif., enrolls in Medi-Cal at Healthy Oakland clinic. (Courtesy: PBS NewsHour)\u003c/figcaption>\u003c/figure>\n\u003cp style=\"color: #000000\">\u003cstrong>By Sarah Varney,\u003c/strong> \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2014/May/16/inmates-leave-jail-retain-mental-health-care.aspx\" target=\"_blank\">Kaiser Health News and PBS NewsHour\u003c/a>\u003c/p>\n\u003cp style=\"color: #000000\">It's been two months since Rodrigo Salido left the maximum security wing at Santa Rita jail, about 40 miles east of San Francisco in Alameda County. It's also been two months since Salido had medication for his bipolar disorder.\u003c/p>\n\u003cp style=\"color: #000000\">\n\u003caside class=\"pullquote alignleft\">In Alameda County officials estimate 18,000 offenders in its two jails will now qualify for Medi-Cal.\u003c/aside>\n\u003c/p>\u003cp>A drug, Risperdal, prescribed by a jailhouse psychiatrist, had quelled Salido’s angry moods. “It helped me be more relaxed,” he said. “Not as much on the edge and feeling like everybody is out to get me.”\u003c/p>\n\u003cp style=\"color: #000000\">Now Salido, who served two years for burglary, assault and gang involvement, has no health insurance and until recently had few options for refilling his medication.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp style=\"color: #000000\">Many inmates leave county jails and state prisons with mental health problems and chronic physical ailments -- and no health coverage. Because they typically are not custodial parents, ex-offenders have long been ineligible for a public health insurance program aimed at kids, mothers and the disabled.\u003c!--more-->\u003c/p>\n\u003cp style=\"color: #000000\">But earlier this year, California and 25 other states, under a provision of the Affordable Care Act, opened up Medicaid to single and so-called “childless” adults. The change in eligibility criteria will extend Medicaid coverage to vast numbers of ex-offenders with very low incomes.\u003c/p>\n\u003cp style=\"color: #000000\">“Historically, 10 or 11 percent of folks in detention have been eligible for Medicaid,” said Alex Briscoe, health director for Alameda County. “That number is well over 90 percent as of January,” since the ACA took full effect.\u003c/p>\n\u003cp style=\"color: #000000\">\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Indeed, of those newly eligible under the Medicaid expansion, experts predict \u003ca style=\"color: #2262cc\" href=\"http://www.ncbi.nlm.nih.gov/pubmed/22566431\">one out of three\u003c/a> nationally will be former inmates or detainees. Health officials in Alameda County estimate 18,000 offenders in its two jails will now qualify. Recently, Rodrigo Salido began the process of enrolling in Medi-Cal, California's version of Medicaid, at a clinic, Healthy Oakland. He got a preliminary check up there, but once he gets his card will be able to visit a primary care doctor and see specialists.\u003c/p>\n\u003cp style=\"color: #000000\">Men and women involved in the criminal justice system are more likely to be sicker than the general population\u003cstrong>,\u003c/strong> with higher rates of diabetes, hypertension, depression, mood disorders and alcohol and drug addiction. Many have spent years -- perhaps their entire adult livens -- without health insurance and have medical conditions that must be stabilized when they’re incarcerated.\u003c/p>\n\u003cp style=\"color: #000000\">“They come to us in bad shape, and we get them as good as possible,” said Richard Lucia, the undersheriff for Alameda County.\u003c/p>\n\u003cp style=\"color: #000000\">At Santa Rita jail in Dublin, one of the largest detention facilities in the United States, the pharmacy dispenses some 350,000 prescription drugs each month and spends $28 million each year on medical and mental health services. But because recidivism rates are so high in Alameda County -- two out of three inmates re-offend -- the jails’ medical clinics often end up re-stabilizing the same inmates.\u003c/p>\n\u003cp style=\"color: #000000\">“They leave and they get in bad shape again,” said Lucia. “And they come back to us, and we fix them up again.”\u003c/p>\n\u003cdiv>\u003ca class=\"embedly-card\" href=\"https://www.youtube.com/watch?list=UU6ZFN9Tx6xh-skXCuRHCDpQ&v=rpOwkAsXXHM\">Former inmates stand to gain Medicaid under expansion\u003c/a>\u003c/div>\n\u003cp style=\"color: #000000\">The churning of sick offenders costs the county when inmates are in custody -- but it also strains public hospital budgets when they’re released. “When they do need care they come to our emergency department. They cost us between $600 and $800 a visit,” said Briscoe, the county health director. “The cost drivers on our system are intense.”\u003c/p>\n\u003cp style=\"color: #000000\">The Medicaid expansion, county officials contend, offers a rare opportunity to connect men and women with criminal records to ongoing medical and mental health services, and to directly reimburse the county’s general fund for medical care outside of correctional facilities.\u003c/p>\n\u003cp style=\"color: #000000\">While it remains against federal law to use Medicaid to pay for day-to-day medical care for inmates, the program, funded by federal and state dollars, will cover hospital stays longer than 24 hours. Those longer hospital visits often involve costly and complicated surgeries, and the county estimates it could save $3 to $5 million a year in off-site hospital care.\u003c/p>\n\u003cp style=\"color: #000000\">“That would shift the cost, essentially, from the county to the state or to the federal government,” said Undersheriff Lucia.\u003c/p>\n\u003cp style=\"color: #000000\">Over the last few months, a constellation of Alameda County agencies, including the sheriff’s office, public health and social services, have been feverishly working to create new protocols that will automatically enroll all eligible inmates into Medi-Cal. Other enrollment efforts are underway in Contra Costa, San Francisco, Solano and Lassen counties, and in Cook County, Illinois, the state of Washington and elsewhere.\u003c/p>\n\u003cp style=\"color: #000000\">The bureaucratic and technical challenges are immense: archaic information technology platforms must be re-tooled to share data with other county systems; arrested individuals often give false information about their marriage status, number of children, home address and income, foiling Medi-Cal eligibility background checks; and labor union rules permit only certain county workers to approve Medicaid applications.\u003c/p>\n\u003cp style=\"color: #000000\">Overcoming those obstacles is a priority, Alameda county officials said, not only because of the potential cost savings, but also because the Medi-Cal expansion offers a solid chance at reducing the county’s dismal recidivism rate. Several studies have shown that ex-inmates who have access to health care when they leave jail, especially mental health and substance abuse counseling, are less likely to re-offend.\u003c/p>\n\u003cp style=\"color: #000000\">Still, a Medi-Cal card is no panacea for troubled lives. “You can’t treat away the problems that face poor communities,” said Briscoe, the county health director. “It’s about a good job. It’s about a sense of belonging. It’s about a place to sleep, but healthcare can be a tool for social justice if it’s delivered effectively and creatively, and that’s why the Medicaid expansion is such a great opportunity for us.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Kaiser Health News (KHN) is 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\u003c/div>\u003c/p>",
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"id": "commonwealth-club",
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"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
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"order": 9
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"airtime": "SUN 7:30pm-8pm",
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"tagline": "Where conversation and cultura meet",
"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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"order": 15
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"tagline": "Lessons from a lifetime in politics",
"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. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
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"order": 18
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"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
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"source": "American Public Media"
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"masters-of-scale": {
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"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
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},
"mindshift": {
"id": "mindshift",
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"tagline": "A podcast about the future of learning and how we raise our kids",
"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"order": 12
},
"link": "/podcasts/mindshift",
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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"morning-edition": {
"id": "morning-edition",
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"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
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"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"order": 11
},
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"on-the-media": {
"id": "on-the-media",
"title": "On The Media",
"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
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},
"link": "/radio/program/on-the-media",
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},
"pbs-newshour": {
"id": "pbs-newshour",
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},
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"tuneIn": "https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/",
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},
"perspectives": {
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"order": 14
},
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"planet-money": {
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"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
"airtime": "SUN 3pm-4pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/planetmoney.jpg",
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},
"link": "/radio/program/planet-money",
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"apple": "https://itunes.apple.com/us/podcast/planet-money/id290783428?mt=2",
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},
"politicalbreakdown": {
"id": "politicalbreakdown",
"title": "Political Breakdown",
"tagline": "Politics from a personal perspective",
"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.",
"airtime": "THU 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Political-Breakdown-2024-Podcast-Tile-703x703-1.jpg",
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"order": 5
},
"link": "/podcasts/politicalbreakdown",
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"possible": {
"id": "possible",
"title": "Possible",
"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.",
"airtime": "SUN 2pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.possible.fm/",
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"source": "Possible"
},
"link": "/radio/program/possible",
"subscribe": {
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"spotify": "https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"
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},
"pri-the-world": {
"id": "pri-the-world",
"title": "PRI's The World: Latest Edition",
"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
"airtime": "MON-FRI 2pm-3pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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