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"content": "\u003cp>By Alvin Tran and Sarah Barr,\u003ca href=\"http://www.kaiserhealthnews.org/Stories/2012/December/20/bodaken-q-and-a.aspx\" target=\"_blank\"> Kaiser Health News\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_4301\" class=\"wp-caption alignleft\" style=\"max-width: 272px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/BruceBodakenHeadShot_03262012_COurtesy_BlueShield.jpg\">\u003cimg class=\"size-medium wp-image-4301\" title=\"Bruce Bodaken is CEO of Blue Shield of California. (Photo Courtesy of Blue Shield)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/BruceBodakenHeadShot_03262012_COurtesy_BlueShield-300x330.jpg\" alt=\"Bruce Bodaken is CEO of Blue Shield of California. (Photo Courtesy of Blue Shield)\" width=\"272\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Bruce Bodaken is CEO of Blue Shield of California. (Photo Courtesy of Blue Shield)\u003c/figcaption>\u003c/figure>\n\u003cp>As chairman and CEO, Bruce Bodaken led Blue Shield of California to become one of the fastest growing health plans in the state -- it currently has more than three million members. But after 12 years of service, the 61-year-old recently announced his plans to retire at the end of 2012.\u003c/p>\n\u003cp>Bodaken's successor, Paul Markovich (the chief operating officer), may not have an easy time of it. He’ll have to implement provisions of the federal health law while trying to keep costs as low as possible. \"That will be the biggest challenge that I think any health plan CEO will face over the next several years,\" Bodaken said.\u003c/p>\n\u003cp>Bodaken's views on the health law and the current state of the insurance industry were among the many topics during a recent interview with Kaiser Health News. Here are edited excerpts:\u003c/p>\n\u003cp>\u003cstrong>Q. \u003c/strong>\u003cstrong>Why retire now?\u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>A. One thing I told my board when I first came on, after a decade or so, you need to think about changing your CEO as a policy matter. There is a time for these things for any corporation, for any person. I’ve been doing this for 12 years. I don’t see this retirement as me dropping out of sight.\u003c/p>\n\u003cp>\u003cstrong>Q. \u003c/strong>\u003cstrong>What do you think insurers will have to contend with as they head to 2014, when the federal health law will fully kick in?\u003c!--more-->\u003c/strong>\u003c/p>\n\u003cp>A. One of the biggest challenges will just be incorporating all of the new regulations in such a short period of time -- and putting those into effect in complex organizations with multiple products with different geographies. Those regulations impact eligibility, they impact how we interact with providers, they impact how we interact with the [health insurance] exchange.\u003c/p>\n\u003cp>And, of course, we're not just talking about federal regulations; we're talking about regulations in California that are peculiar to our state. If you look at all of that, I think one of the biggest challenges will be all of the health plans, providers, everyone in the industry being able to get this right with such complex, in some cases, not-clear regulation.\u003c/p>\n\u003cp>Early on, I gave (the federal) HHS great credit in that they issued regulations very quickly. Of course it closed down over the election and I think that was expected. But it was a bad time for us to be slowing down because we only have really a few months left before we have to submit to the federal government the outline of our plan.\u003c/p>\n\u003cp>\u003cstrong>Q. \u003c/strong>\u003cstrong>But Blue Shield of California won’t have to worry because you’re only in California, right?\u003c/strong>\u003c/p>\n\u003cp>A. We think we would worry if other competitors are gaining ground as part of a large association of [multi-state] plans. We want it to be sustainable.\u003c/p>\n\u003cp>\u003cstrong>Q. \u003c/strong>\u003cstrong>Are there challenges that are specific to California's exchange?\u003c/strong>\u003c/p>\n\u003cp>A. A small employer should make a choice about which plans are available to the employees. If each employee is able to make a choice between carriers, it’s going to be very complex and difficult from both a ratings standpoint and for making sure that we have a cohesive group that we can rate against. [If] each member of the group can have a different choice, it’s not clear to us how that works.\u003c/p>\n\u003cp>\u003cstrong>Q. \u003c/strong>\u003cstrong>There’s been some talk about whether the premium subsides for low income-people offered through the health insurance exchanges could be changed as part of a deal to solve the national \"fiscal cliff\" predicament. Would that be problematic?\u003c/strong>\u003c/p>\n\u003cp>A. Changing the subsidies would be problematic in that this is a bill about expanding coverage for the people who have been least able to afford it. And the impact that the subsidies have on a group that will not be eligible for Medi-Cal or Medicaid is profound. So, in general we would not want to see those subsidies cut back.\u003c/p>\n\u003cp>I’m a realist and understand that there’s going to be a lot of different issues that are going to be part of any grand deal, any grand bargain, if this is one that has to be modified to address that, I hope it is not too significant. And I hope that it’s clear so that we can get it into place immediately because right now we’re dealing with the current expectations of the current law. If that were to change, it needs to change quickly.\u003c/p>\n\u003cp>\u003cstrong>Q. \u003c/strong>\u003cstrong>The health law calls for the establishment of ACOs -- accountable care organizations -- so that providers will coordinate care for patients. Do you have any suggestions about what should happen at the federal level to encourage their success?\u003c/strong>\u003c/p>\n\u003cp>A. At the federal level, what would be helpful again would be to not be too prescriptive in the area of accountable care organizations. There are principles that we’re using to organize and I think we’ve developed the greatest number in California of any of the plans there at this point. We have led the field on actual signed contracts that are organized with global reimbursement arrangements.\u003c/p>\n\u003cp>Watching a thousand flowers bloom I think is a good thing across the states -- and even across products, commercial products and Medicare products. We think (ACOs) are going to make a real difference in cost. They’re going to make a real difference in quality and the biggest challenge that we will face are having enough seasoned and experienced medical directors and physician leaders. Physician leadership on the ground makes the difference.\u003c/p>\n\u003cp>\u003cstrong>Q. \u003c/strong>\u003cstrong>Why do you think the public is still split on the federal health law?\u003c/strong>\u003c/p>\n\u003cp>A. The health care law has many pieces to it. The consumer protections that have been put in early on, I think, are well regarded. I think everyone agrees that it is time to get away from a system of determining a person’s health insurance by virtue of their health status. And so, doing away with preexisting conditions was overdue.\u003c/p>\n\u003cp>Any change is scary until you put it in place and then it seems like it was the natural thing to do two years later.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>This law will continue to go through some changes, I’m sure. There’s a lot we’re going to have to experiment with and I hope we’ll be encouraging HHS and the government to allow states to experiment. If we get only the people that need care in the system, it’s obvious that premiums will go up beyond what anyone can pay and that won’t be a success or sustainable. So, while we think it is something that over time people could accept, we need to do this in stages.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By Alvin Tran and Sarah Barr,\u003ca href=\"http://www.kaiserhealthnews.org/Stories/2012/December/20/bodaken-q-and-a.aspx\" target=\"_blank\"> Kaiser Health News\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_4301\" class=\"wp-caption alignleft\" style=\"max-width: 272px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/BruceBodakenHeadShot_03262012_COurtesy_BlueShield.jpg\">\u003cimg class=\"size-medium wp-image-4301\" title=\"Bruce Bodaken is CEO of Blue Shield of California. (Photo Courtesy of Blue Shield)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/BruceBodakenHeadShot_03262012_COurtesy_BlueShield-300x330.jpg\" alt=\"Bruce Bodaken is CEO of Blue Shield of California. (Photo Courtesy of Blue Shield)\" width=\"272\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Bruce Bodaken is CEO of Blue Shield of California. (Photo Courtesy of Blue Shield)\u003c/figcaption>\u003c/figure>\n\u003cp>As chairman and CEO, Bruce Bodaken led Blue Shield of California to become one of the fastest growing health plans in the state -- it currently has more than three million members. But after 12 years of service, the 61-year-old recently announced his plans to retire at the end of 2012.\u003c/p>\n\u003cp>Bodaken's successor, Paul Markovich (the chief operating officer), may not have an easy time of it. He’ll have to implement provisions of the federal health law while trying to keep costs as low as possible. \"That will be the biggest challenge that I think any health plan CEO will face over the next several years,\" Bodaken said.\u003c/p>\n\u003cp>Bodaken's views on the health law and the current state of the insurance industry were among the many topics during a recent interview with Kaiser Health News. Here are edited excerpts:\u003c/p>\n\u003cp>\u003cstrong>Q. \u003c/strong>\u003cstrong>Why retire now?\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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But it was a bad time for us to be slowing down because we only have really a few months left before we have to submit to the federal government the outline of our plan.\u003c/p>\n\u003cp>\u003cstrong>Q. \u003c/strong>\u003cstrong>But Blue Shield of California won’t have to worry because you’re only in California, right?\u003c/strong>\u003c/p>\n\u003cp>A. We think we would worry if other competitors are gaining ground as part of a large association of [multi-state] plans. We want it to be sustainable.\u003c/p>\n\u003cp>\u003cstrong>Q. \u003c/strong>\u003cstrong>Are there challenges that are specific to California's exchange?\u003c/strong>\u003c/p>\n\u003cp>A. A small employer should make a choice about which plans are available to the employees. If each employee is able to make a choice between carriers, it’s going to be very complex and difficult from both a ratings standpoint and for making sure that we have a cohesive group that we can rate against. 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"content": "\u003cp>The \u003ca href=\"http://www.pewhealth.org/reports-analysis/data-visualizations/multistate-foodborne-outbreaks-a-timeline-85899404811\" target=\"_blank\" rel=\"noopener\">Pew Health Group\u003c/a> (as in “Pew Charitable Trusts”) has put together this interactive timeline of 14 widespread foodborne outbreaks that have happened since the\u003ca href=\"http://www.fda.gov/food/foodsafety/fsma/default.htm\" target=\"_blank\" rel=\"noopener\"> FDA Food Safety Modernization Act \u003c/a>was passed in 2011. It’s the first major update to the country’s food safety infrastructure more than 70 years. But the Obama Administration has yet to issue proposed rules required to begin implementing the law. This timeline represents just a fraction of all the foodborne illnesses that have occurred since the Act’s passage.\u003c/p>\n\u003cp>Remember that most cases are never reported, as journalist Maryn McKenna experienced for herself as she described in her blog, \u003cem>\u003ca href=\"http://www.wired.com/wiredscience/2012/10/salmo-peanut-butter/\" target=\"_blank\" rel=\"noopener\">Superbug\u003c/a>\u003c/em>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The \u003ca href=\"http://www.pewhealth.org/reports-analysis/data-visualizations/multistate-foodborne-outbreaks-a-timeline-85899404811\" target=\"_blank\" rel=\"noopener\">Pew Health Group\u003c/a> (as in “Pew Charitable Trusts”) has put together this interactive timeline of 14 widespread foodborne outbreaks that have happened since the\u003ca href=\"http://www.fda.gov/food/foodsafety/fsma/default.htm\" target=\"_blank\" rel=\"noopener\"> FDA Food Safety Modernization Act \u003c/a>was passed in 2011. It’s the first major update to the country’s food safety infrastructure more than 70 years. But the Obama Administration has yet to issue proposed rules required to begin implementing the law. This timeline represents just a fraction of all the foodborne illnesses that have occurred since the Act’s passage.\u003c/p>\n\u003cp>Remember that most cases are never reported, as journalist Maryn McKenna experienced for herself as she described in her blog, \u003cem>\u003ca href=\"http://www.wired.com/wiredscience/2012/10/salmo-peanut-butter/\" target=\"_blank\" rel=\"noopener\">Superbug\u003c/a>\u003c/em>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "After Newtown Shootings: Questions about Mental Health Insurance Coverage",
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"content": "\u003cp>By Jenny Gold, \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2012/December/18/Mental-Health-Insurance-Coverage-Questions-After-Shooting.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_9564\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/PresObamaNewtownOlivier-DoulieryGetty-Images.1.jpg\">\u003cimg class=\"size-full wp-image-9564\" title=\"President Obama Visits Newtown, CT, Consoles Families Of Shooting Victims\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/PresObamaNewtownOlivier-DoulieryGetty-Images.1.jpg\" alt=\"President Obama speaks at an interfaith vigil for the shooting victims at Sandy Hook Elementary School (Olivier Douliery-Pool/Getty Images).\" width=\"300\" height=\"199\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">President Obama speaks at an interfaith vigil for the shooting victims at Sandy Hook Elementary School (Olivier Douliery-Pool/Getty Images).\u003c/figcaption>\u003c/figure>\n\u003cp>On Monday White House spokesman Jay Carney pointed to the federal health law as evidence that the administration has already started to tackle the issue. Mental health issues are \"clearly a factor that needs to be addressed in some of these cases of horrific violence,\" Carney said. \"Obamacare, if you will, has ensured that mental health services are a part of the services\" provided under the health law.\u003c/p>\n\u003cp>While the Affordable Care Act, along with the Mental Health Parity Act of 2008, go a long way toward assuring coverage for most Americans, some gaps remain.\u003c/p>\n\u003cp>Here are some answers to frequently asked questions about mental health coverage:\u003c/p>\n\u003cp>\u003cstrong>Didn't the Mental Health Parity Act already guarantee coverage for Americans with insurance?\u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The \u003ca href=\"http://www.kaiserhealthnews.org/features/insuring-your-health/mental-health-coverage.aspx\" target=\"_self\">Mental Health Parity and Addiction Equity Act\u003c/a>, signed into law in 2008, \u003ca href=\"http://archpsyc.jamanetwork.com/article.aspx?articleid=208673\" target=\"_blank\">made a big dent\u003c/a> in the problem of mental health coverage. But it depends on how you get your insurance\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Large Employers (more than 50 workers): \u003c/strong>If large companies include mental health services in their insurance plans, they must cover those services at same or higher level as other medical conditions. That means that the plans could not provide fewer inpatient hospital days or require higher out-of-pocket costs, more cost sharing or separate deductibles for mental health conditions. But Paul N. Samuels, director and president of the Legal Action Center, says that some people still aren't receiving equal coverage, and the law is not always enforced. \"That's a problem we're really concerned about,\" he says. Note that large employers are not \u003cem>required \u003c/em>to offer mental health insurance, but most do.\u003c/li>\n\u003cli>\u003cstrong>Small Business/Individual Plans: \u003c/strong>Not included in the Parity Act.\u003c/li>\n\u003c/ul>\n\u003cp>In short, whether you have mental health coverage in an employer-sponsored insurance plan depends on where you work.\u003c/p>\n\u003cp>\u003cstrong>What if I don't have mental health coverage in my employer’s insurance plan? Will the ACA change that?\u003c/strong>\u003c/p>\n\u003cp>Small group and individual plans will be required to offer the coverage in 2014 through health exchanges created under the law. But employers with 50 or more workers can continue to not offer the benefits.\u003c/p>\n\u003cp>\u003cstrong>I'm planning to buy an insurance plan through one of the new exchanges. What kind of mental health coverage will I have?\u003c/strong>\u003c/p>\n\u003cp>Again, as noted above, all plans sold in the exchanges \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2012/December/18/www.ncsl.org/documents/health/MHparity&mandates.pdf%20\">will be required\u003c/a> to provide coverage for mental health and substance abuse. The exchanges will be open to individuals and small businesses.\u003c/p>\n\u003cp>The same rules will apply to small group and individual plans purchased outside of the exchange.\u003c/p>\n\u003cp>In other words, beginning in 2014, if you (or your small employer) are purchasing any new insurance plan, coverage will include mental health benefits on par with any other medical condition.\u003c/p>\n\u003cp>\u003cstrong>I'll be covered under the Medicaid expansion authorized by the law. What kind of mental health coverage will I get?\u003c/strong>\u003c/p>\n\u003cp>If you earn less than 138 percent of the federal poverty level (about $32,809 for a family of four), you may be newly eligible for Medicaid coverage in 2014. Like people who purchase coverage through the exchange, new Medicaid beneficiaries will receive mental health benefits on par with other medical or surgical needs.\u003c/p>\n\u003cp>\u003cstrong>What problems might arise?\u003c/strong>\u003c/p>\n\u003cp>While the ACA \"provides enormous potential and opportunity to make sure than many millions more Americans obtain the services they need,\" says Samuels, \"that will only happen if the implementation of those reforms is effective.\" Samuels worries that the rules from HHS will not be clear or strong enough to make the parity laws meaningful. He also worries about getting everyone who is eligible for coverage enrolled, particularly those with severe mental health disorders who be may homeless or living on the fringes of society.\u003c/p>\n\u003cp>Access to treatment will likely also remain a serious stumbling block. As many as 30 million people are expected to gain insurance coverage beginning in 2014. Of those, the U.S. Substance Abuse and Mental Health Services Administration \u003ca href=\"http://www.samhsa.gov/samhsanewsletter/Volume_18_Number_5/HealthReform.aspx\">estimates that 6 to 10 million will have untreated mental illnesses\u003c/a> or addiction, adding additional demands to a system that is already overwhelmed. Patients may experience long wait times to see a psychiatrist, for example, and may require additional investments to expand the mental health workforce.\u003c/p>\n\u003cp>\u003cstrong>Learn More: KQED Forum \u003ca href=\"http://www.kqed.org/a/forum/R201212171000\" target=\"_blank\">Shooting Puts Spotlight on Mental Health\u003c/a>\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cobject width=\"335\" height=\"85\" classid=\"d27cdb6e-ae6d-11cf-96b8-444553540000\" codebase=\"http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201212171000.xml\">\u003cparam name=\"src\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cembed width=\"335\" height=\"85\" type=\"application/x-shockwave-flash\" src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" flashvars=\"file=http://www.kqed.org/radio/archives/R201212171000.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n",
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"excerpt": "In his speech at the memorial service for the Newtown victims, President Obama included mental health in calling for a national response to the massacre, a conversation that so far has focused on gun control. \"I will use whatever power this office holds to engage my fellow citizens -- from law enforcement to mental health professionals to parents and educators -- in an effort aimed at preventing more tragedies like this,\" the president said.\r\n\r\nOn Monday White House spokesman Jay Carney pointed to the federal health law as evidence that the administration has already started to tackle the issue. Mental health issues are \"clearly a factor that needs to be addressed in some of these cases of horrific violence,\" Carney said. \"Obamacare, if you will, has ensured that mental health services are a part of the services\" provided under the health law.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By Jenny Gold, \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2012/December/18/Mental-Health-Insurance-Coverage-Questions-After-Shooting.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_9564\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/PresObamaNewtownOlivier-DoulieryGetty-Images.1.jpg\">\u003cimg class=\"size-full wp-image-9564\" title=\"President Obama Visits Newtown, CT, Consoles Families Of Shooting Victims\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/PresObamaNewtownOlivier-DoulieryGetty-Images.1.jpg\" alt=\"President Obama speaks at an interfaith vigil for the shooting victims at Sandy Hook Elementary School (Olivier Douliery-Pool/Getty Images).\" width=\"300\" height=\"199\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">President Obama speaks at an interfaith vigil for the shooting victims at Sandy Hook Elementary School (Olivier Douliery-Pool/Getty Images).\u003c/figcaption>\u003c/figure>\n\u003cp>On Monday White House spokesman Jay Carney pointed to the federal health law as evidence that the administration has already started to tackle the issue. Mental health issues are \"clearly a factor that needs to be addressed in some of these cases of horrific violence,\" Carney said. \"Obamacare, if you will, has ensured that mental health services are a part of the services\" provided under the health law.\u003c/p>\n\u003cp>While the Affordable Care Act, along with the Mental Health Parity Act of 2008, go a long way toward assuring coverage for most Americans, some gaps remain.\u003c/p>\n\u003cp>Here are some answers to frequently asked questions about mental health coverage:\u003c/p>\n\u003cp>\u003cstrong>Didn't the Mental Health Parity Act already guarantee coverage for Americans with insurance?\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The \u003ca href=\"http://www.kaiserhealthnews.org/features/insuring-your-health/mental-health-coverage.aspx\" target=\"_self\">Mental Health Parity and Addiction Equity Act\u003c/a>, signed into law in 2008, \u003ca href=\"http://archpsyc.jamanetwork.com/article.aspx?articleid=208673\" target=\"_blank\">made a big dent\u003c/a> in the problem of mental health coverage. But it depends on how you get your insurance\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Large Employers (more than 50 workers): \u003c/strong>If large companies include mental health services in their insurance plans, they must cover those services at same or higher level as other medical conditions. That means that the plans could not provide fewer inpatient hospital days or require higher out-of-pocket costs, more cost sharing or separate deductibles for mental health conditions. But Paul N. Samuels, director and president of the Legal Action Center, says that some people still aren't receiving equal coverage, and the law is not always enforced. \"That's a problem we're really concerned about,\" he says. Note that large employers are not \u003cem>required \u003c/em>to offer mental health insurance, but most do.\u003c/li>\n\u003cli>\u003cstrong>Small Business/Individual Plans: \u003c/strong>Not included in the Parity Act.\u003c/li>\n\u003c/ul>\n\u003cp>In short, whether you have mental health coverage in an employer-sponsored insurance plan depends on where you work.\u003c/p>\n\u003cp>\u003cstrong>What if I don't have mental health coverage in my employer’s insurance plan? Will the ACA change that?\u003c/strong>\u003c/p>\n\u003cp>Small group and individual plans will be required to offer the coverage in 2014 through health exchanges created under the law. But employers with 50 or more workers can continue to not offer the benefits.\u003c/p>\n\u003cp>\u003cstrong>I'm planning to buy an insurance plan through one of the new exchanges. What kind of mental health coverage will I have?\u003c/strong>\u003c/p>\n\u003cp>Again, as noted above, all plans sold in the exchanges \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2012/December/18/www.ncsl.org/documents/health/MHparity&mandates.pdf%20\">will be required\u003c/a> to provide coverage for mental health and substance abuse. The exchanges will be open to individuals and small businesses.\u003c/p>\n\u003cp>The same rules will apply to small group and individual plans purchased outside of the exchange.\u003c/p>\n\u003cp>In other words, beginning in 2014, if you (or your small employer) are purchasing any new insurance plan, coverage will include mental health benefits on par with any other medical condition.\u003c/p>\n\u003cp>\u003cstrong>I'll be covered under the Medicaid expansion authorized by the law. What kind of mental health coverage will I get?\u003c/strong>\u003c/p>\n\u003cp>If you earn less than 138 percent of the federal poverty level (about $32,809 for a family of four), you may be newly eligible for Medicaid coverage in 2014. Like people who purchase coverage through the exchange, new Medicaid beneficiaries will receive mental health benefits on par with other medical or surgical needs.\u003c/p>\n\u003cp>\u003cstrong>What problems might arise?\u003c/strong>\u003c/p>\n\u003cp>While the ACA \"provides enormous potential and opportunity to make sure than many millions more Americans obtain the services they need,\" says Samuels, \"that will only happen if the implementation of those reforms is effective.\" Samuels worries that the rules from HHS will not be clear or strong enough to make the parity laws meaningful. He also worries about getting everyone who is eligible for coverage enrolled, particularly those with severe mental health disorders who be may homeless or living on the fringes of society.\u003c/p>\n\u003cp>Access to treatment will likely also remain a serious stumbling block. As many as 30 million people are expected to gain insurance coverage beginning in 2014. Of those, the U.S. Substance Abuse and Mental Health Services Administration \u003ca href=\"http://www.samhsa.gov/samhsanewsletter/Volume_18_Number_5/HealthReform.aspx\">estimates that 6 to 10 million will have untreated mental illnesses\u003c/a> or addiction, adding additional demands to a system that is already overwhelmed. Patients may experience long wait times to see a psychiatrist, for example, and may require additional investments to expand the mental health workforce.\u003c/p>\n\u003cp>\u003cstrong>Learn More: KQED Forum \u003ca href=\"http://www.kqed.org/a/forum/R201212171000\" target=\"_blank\">Shooting Puts Spotlight on Mental Health\u003c/a>\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cobject width=\"335\" height=\"85\" classid=\"d27cdb6e-ae6d-11cf-96b8-444553540000\" codebase=\"http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201212171000.xml\">\u003cparam name=\"src\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cembed width=\"335\" height=\"85\" type=\"application/x-shockwave-flash\" src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" flashvars=\"file=http://www.kqed.org/radio/archives/R201212171000.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Fiscal Cliffnotes: Is That Tax Break on Your Job-Based Health Insurance on the Table?",
"title": "Fiscal Cliffnotes: Is That Tax Break on Your Job-Based Health Insurance on the Table?",
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"content": "\u003cfigure id=\"attachment_9517\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Capitol_KarlEisenhower_KHN.jpg\">\u003cimg class=\"size-full wp-image-9517\" title=\"(Karl Eisenhower/Kaiser Health News)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Capitol_KarlEisenhower_KHN.jpg\" alt=\"(Karl Eisenhower/Kaiser Health News)\" width=\"300\" height=\"205\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Karl Eisenhower/Kaiser Health News)\u003c/figcaption>\u003c/figure>\n\u003cp>Then-presidential candidate Mitt Romney made headlines when he asserted that \u003ca href=\"http://www.kqed.org/a/forum/R201209190900\" target=\"_blank\">47 percent of Americans \u003c/a>were \"victims\" dependent upon government assistance. I'm guessing he wasn't thinking of people who receive employer-based health insurance as being the beneficiary of government largess. But, the government loses a lot of money in the benefit.\u003c/p>\n\u003cp>Here's how: First, people who receive employer-based health insurance do not pay taxes on its cost. Second, employers deduct the cost of the policies as a business expense.\u003c/p>\n\u003cp>As the fiscal cliff approaches, some policy wonks are saying the U.S. can't afford that tax break any more.\u003c/p>\n\u003cp>As Julie Appleby reports for \u003ca href=\"http://capsules.kaiserhealthnews.org/index.php/2012/12/tax-exclusion-for-health-benefits-could-become-part-of-fiscal-cliff-talks/\" target=\"_blank\">Kaiser Health News\u003c/a>, it's the largest cost to the U.S. Treasury, \"\u003ca href=\"http://www.cbo.gov/sites/default/files/cbofiles/ftpdocs/99xx/doc9924/12-18-keyissues.pdf\">an estimated $246 billion annually\u003c/a>, according to Congress’ Joint Committee on Taxation, dwarfing the second-largest break, the mortgage interest deduction, which costs an estimated $98 billion.\"\u003c/p>\n\u003cp>That is a lot of money.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Appleby quotes G. William Hoagland of the Bipartisan Policy Center. He spoke Thursday at a conference sponsored by the Employee Benefit Research Institute. “There’s no way on God’s green earth,\" he said \"that we will not see that exclusion on the table.\"\u003c/p>\n\u003cp>Of course, ditching the exclusion would be \"wildly unpopular\" among voters.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The calculus of ending the tax exclusion has changed since passage of the Affordable Care Act, as Appleby explains:\u003c/p>\n\u003cblockquote>\u003cp>Even if employers were still be able to deduct the cost of paying for health insurance as a business expense, some might drop health coverage if they thought workers valued the benefit less because now had to pay taxes on it.\u003c/p>\n\u003cp>“In the past, before the federal Affordable Care Act, it was assumed that (changing) the tax exclusion would increase the number of uninsured,” said Hoagland, a former staff director of the Senate Budget Committee and senior vice president at insurer CIGNA. “I would argue that (concern) now goes away,” because the health law provides subsidies to help lower income Americans buy coverage.\u003c/p>\n\u003cp>At least a few lawmakers might regard changing the tax exclusion as politically easier than reducing payments to hospitals and other medical providers, said Steve Wojcik, a vice president of public policy at the National Business Group on Health, who was also on the panel.\u003c/p>\n\u003cp>Some economists think that \u003ca href=\"http://www.thefiscaltimes.com/Articles/2012/10/01/End-the-Health-Care-Tax-Break-Reduce-Coverage.aspx#page1\">reducing or eliminating the tax exclusion would slow spending on health care\u003c/a> because it would prompt employers to choose less generous insurance plans that cost less. Others say the savings would be small. Several attempts to revise or cap the exclusion have failed in the past two decades.\u003c/p>\u003c/blockquote>\n\n",
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"excerpt": "Then-presidential candidate Mitt Romney made headlines when he asserted that 47 percent of Americans were \"victims\" dependent upon government assistance. I'm guessing a lot of people don't know that people who receive employer-based health insurance are getting a little government assistance in that expensive benefit.\r\n\r\nFirst, people who receive employer-based health insurance do not pay taxes on the benefit. Second, employers deduct the cost of the policies as a business expense.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_9517\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Capitol_KarlEisenhower_KHN.jpg\">\u003cimg class=\"size-full wp-image-9517\" title=\"(Karl Eisenhower/Kaiser Health News)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Capitol_KarlEisenhower_KHN.jpg\" alt=\"(Karl Eisenhower/Kaiser Health News)\" width=\"300\" height=\"205\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Karl Eisenhower/Kaiser Health News)\u003c/figcaption>\u003c/figure>\n\u003cp>Then-presidential candidate Mitt Romney made headlines when he asserted that \u003ca href=\"http://www.kqed.org/a/forum/R201209190900\" target=\"_blank\">47 percent of Americans \u003c/a>were \"victims\" dependent upon government assistance. I'm guessing he wasn't thinking of people who receive employer-based health insurance as being the beneficiary of government largess. But, the government loses a lot of money in the benefit.\u003c/p>\n\u003cp>Here's how: First, people who receive employer-based health insurance do not pay taxes on its cost. Second, employers deduct the cost of the policies as a business expense.\u003c/p>\n\u003cp>As the fiscal cliff approaches, some policy wonks are saying the U.S. can't afford that tax break any more.\u003c/p>\n\u003cp>As Julie Appleby reports for \u003ca href=\"http://capsules.kaiserhealthnews.org/index.php/2012/12/tax-exclusion-for-health-benefits-could-become-part-of-fiscal-cliff-talks/\" target=\"_blank\">Kaiser Health News\u003c/a>, it's the largest cost to the U.S. Treasury, \"\u003ca href=\"http://www.cbo.gov/sites/default/files/cbofiles/ftpdocs/99xx/doc9924/12-18-keyissues.pdf\">an estimated $246 billion annually\u003c/a>, according to Congress’ Joint Committee on Taxation, dwarfing the second-largest break, the mortgage interest deduction, which costs an estimated $98 billion.\"\u003c/p>\n\u003cp>That is a lot of money.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Appleby quotes G. William Hoagland of the Bipartisan Policy Center. He spoke Thursday at a conference sponsored by the Employee Benefit Research Institute. “There’s no way on God’s green earth,\" he said \"that we will not see that exclusion on the table.\"\u003c/p>\n\u003cp>Of course, ditching the exclusion would be \"wildly unpopular\" among voters.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The calculus of ending the tax exclusion has changed since passage of the Affordable Care Act, as Appleby explains:\u003c/p>\n\u003cblockquote>\u003cp>Even if employers were still be able to deduct the cost of paying for health insurance as a business expense, some might drop health coverage if they thought workers valued the benefit less because now had to pay taxes on it.\u003c/p>\n\u003cp>“In the past, before the federal Affordable Care Act, it was assumed that (changing) the tax exclusion would increase the number of uninsured,” said Hoagland, a former staff director of the Senate Budget Committee and senior vice president at insurer CIGNA. “I would argue that (concern) now goes away,” because the health law provides subsidies to help lower income Americans buy coverage.\u003c/p>\n\u003cp>At least a few lawmakers might regard changing the tax exclusion as politically easier than reducing payments to hospitals and other medical providers, said Steve Wojcik, a vice president of public policy at the National Business Group on Health, who was also on the panel.\u003c/p>\n\u003cp>Some economists think that \u003ca href=\"http://www.thefiscaltimes.com/Articles/2012/10/01/End-the-Health-Care-Tax-Break-Reduce-Coverage.aspx#page1\">reducing or eliminating the tax exclusion would slow spending on health care\u003c/a> because it would prompt employers to choose less generous insurance plans that cost less. Others say the savings would be small. Several attempts to revise or cap the exclusion have failed in the past two decades.\u003c/p>\u003c/blockquote>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "California Prepares for Children's Dental Insurance Mandate",
"title": "California Prepares for Children's Dental Insurance Mandate",
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"content": "\u003cp>\u003cem>By Laird Harrison\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_6734\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/Child-at-dentist.jpg\">\u003cimg class=\"size-medium wp-image-6734 \" title=\"More people may get dental care in Calfornia when the Affordable Care Act is implemented. (heraldpost/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/Child-at-dentist-300x271.jpg\" alt=\"More people may get dental care in Calfornia when the Affordable Care Act is implemented. (heraldpost/Flickr)\" width=\"300\" height=\"271\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">More people may get dental care in Calfornia when the Affordable Care Act is implemented. (heraldpost/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>If you know anything about the Affordable Care Act -- otherwise known as Obamacare -- you know that it will require everyone to get medical coverage by January 1, 2014.\u003c/p>\n\u003cp>But did you know that the act could also require millions of families to buy dental benefits for their children?\u003c/p>\n\u003cp>The dental mandate, if you want to call it that, is indirect and incomplete. Parents who are determined to avoid it can find loopholes. And much depends on regulations that state and federal authorities are still hashing out.\u003c/p>\n\u003cp>But preliminary estimates show that some five million children nationwide and as many as 1.5 million Californians could gain extensive new dental benefits.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Starting in 2014, the Affordable Care Act says, all medical plans sold to small groups (100 people or fewer) or individuals must include a set of “essential benefits,” and these benefits must include “pediatric services, including oral and vision care.”\u003c/p>\n\u003cp>In California, the benefits will be pretty extensive. The state has decided to base them on its \u003ca href=\"http://www.healthyfamilies.ca.gov/HFProgram/Summary_of_Benefits.aspx#dental\">Healthy Families dental program\u003c/a>.\u003c!--more-->\u003c/p>\n\u003cp>Here is where the law gets tricky. The law says that dental plans and medical plans can be sold separately. While the Affordable Care Act imposes a penalty on people who don’t have medical insurance, it does \u003cem>not\u003c/em> say what happens if someone doesn’t get dental coverage for their kids.\u003c/p>\n\u003cp>I called the U.S. Health and Human Services Department, which has so far remained silent on that question. A spokesperson said told me no one would be available for an interview, and instead issued this statement: \"The department will issue further guidance on essential health benefits through the rulemaking process.\" (They've been issuing \u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/12/10/feds-to-states-on-medicaid-expand-fully-or-no-new-funding/\" target=\"_blank\">a lot of guidance\u003c/a> lately, just not on this issue.)\u003c/p>\n\u003cp>Evelyn Ireland, executive director of the National Association of Dental Plans says that federal regulators have told her the question may be left up to individual states. I then called the California Health Benefit Exchange, but was told that no one would be available to comment until next week.\u003c/p>\n\u003cp>Even if most parents do sign up for the coverage, the NADP is warning of another potential problem. It says new fees charged to insurers -- along with the cost of expanding the benefits -- will make children’s dental plans more expensive than what is currently on the market for small groups and individuals. Instead of about $21 per child per month, the cost could go up to $28 or even $36, depending on copayments, the organization says.\u003c/p>\n\u003cp>If you’re below 400 percent of the federal poverty level ($92,000 for a family of four) and spend more than 9.5 percent of your income on health insurance, the Affordable Care Act provides a \u003ca href=\"http://www.kff.org/healthreform/upload/7962-02.pdf\">subsidy\u003c/a> to help you pay for these benefits. But even so, the NADP estimates that nationwide as many as 11 million adults who have dental benefits will decide they can’t afford benefits for both themselves and their kids, and will drop their own benefits. “The entire landscape is changing,” says Jeff Album, vice president of public and government affairs for Delta California.\u003c/p>\n\u003cp>Not everyone agrees with that prediction. The California Dental Association is confident that the new exchange will keep dental benefit costs under control. CDA President Lindsey Robinson praised California's choice to use the extensive dental benefits in the Healthy Families program. “It has a proven track record of meeting the oral health needs of California standards and meets the professional standards of dentists who are taking care of children,” she said.\u003c/p>\n\u003cp>Robinson is also hopeful that the state has enough dentists to cover all the children who might gain benefits under the new law.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>All that remains to be seen is how many parents will sign up.\u003c/p>\n\n",
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"excerpt": "If you know anything about the Affordable Care Act -- otherwise known as Obamacare -- you know that it will require everyone to get medical coverage by January 1, 2014.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>By Laird Harrison\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_6734\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/Child-at-dentist.jpg\">\u003cimg class=\"size-medium wp-image-6734 \" title=\"More people may get dental care in Calfornia when the Affordable Care Act is implemented. (heraldpost/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/Child-at-dentist-300x271.jpg\" alt=\"More people may get dental care in Calfornia when the Affordable Care Act is implemented. (heraldpost/Flickr)\" width=\"300\" height=\"271\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">More people may get dental care in Calfornia when the Affordable Care Act is implemented. (heraldpost/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>If you know anything about the Affordable Care Act -- otherwise known as Obamacare -- you know that it will require everyone to get medical coverage by January 1, 2014.\u003c/p>\n\u003cp>But did you know that the act could also require millions of families to buy dental benefits for their children?\u003c/p>\n\u003cp>The dental mandate, if you want to call it that, is indirect and incomplete. Parents who are determined to avoid it can find loopholes. And much depends on regulations that state and federal authorities are still hashing out.\u003c/p>\n\u003cp>But preliminary estimates show that some five million children nationwide and as many as 1.5 million Californians could gain extensive new dental benefits.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Starting in 2014, the Affordable Care Act says, all medical plans sold to small groups (100 people or fewer) or individuals must include a set of “essential benefits,” and these benefits must include “pediatric services, including oral and vision care.”\u003c/p>\n\u003cp>In California, the benefits will be pretty extensive. The state has decided to base them on its \u003ca href=\"http://www.healthyfamilies.ca.gov/HFProgram/Summary_of_Benefits.aspx#dental\">Healthy Families dental program\u003c/a>.\u003c!--more-->\u003c/p>\n\u003cp>Here is where the law gets tricky. The law says that dental plans and medical plans can be sold separately. While the Affordable Care Act imposes a penalty on people who don’t have medical insurance, it does \u003cem>not\u003c/em> say what happens if someone doesn’t get dental coverage for their kids.\u003c/p>\n\u003cp>I called the U.S. Health and Human Services Department, which has so far remained silent on that question. A spokesperson said told me no one would be available for an interview, and instead issued this statement: \"The department will issue further guidance on essential health benefits through the rulemaking process.\" (They've been issuing \u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/12/10/feds-to-states-on-medicaid-expand-fully-or-no-new-funding/\" target=\"_blank\">a lot of guidance\u003c/a> lately, just not on this issue.)\u003c/p>\n\u003cp>Evelyn Ireland, executive director of the National Association of Dental Plans says that federal regulators have told her the question may be left up to individual states. I then called the California Health Benefit Exchange, but was told that no one would be available to comment until next week.\u003c/p>\n\u003cp>Even if most parents do sign up for the coverage, the NADP is warning of another potential problem. It says new fees charged to insurers -- along with the cost of expanding the benefits -- will make children’s dental plans more expensive than what is currently on the market for small groups and individuals. Instead of about $21 per child per month, the cost could go up to $28 or even $36, depending on copayments, the organization says.\u003c/p>\n\u003cp>If you’re below 400 percent of the federal poverty level ($92,000 for a family of four) and spend more than 9.5 percent of your income on health insurance, the Affordable Care Act provides a \u003ca href=\"http://www.kff.org/healthreform/upload/7962-02.pdf\">subsidy\u003c/a> to help you pay for these benefits. But even so, the NADP estimates that nationwide as many as 11 million adults who have dental benefits will decide they can’t afford benefits for both themselves and their kids, and will drop their own benefits. “The entire landscape is changing,” says Jeff Album, vice president of public and government affairs for Delta California.\u003c/p>\n\u003cp>Not everyone agrees with that prediction. The California Dental Association is confident that the new exchange will keep dental benefit costs under control. CDA President Lindsey Robinson praised California's choice to use the extensive dental benefits in the Healthy Families program. “It has a proven track record of meeting the oral health needs of California standards and meets the professional standards of dentists who are taking care of children,” she said.\u003c/p>\n\u003cp>Robinson is also hopeful that the state has enough dentists to cover all the children who might gain benefits under the new law.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>All that remains to be seen is how many parents will sign up.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Federal Appeals Court Approves Cuts to Medi-Cal Providers",
"title": "Federal Appeals Court Approves Cuts to Medi-Cal Providers",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_9480\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Child_Doctor_DavidMason_Flickr_07092012.jpg\">\u003cimg class=\"size-medium wp-image-9480\" title=\"(David Mason/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Child_Doctor_DavidMason_Flickr_07092012-300x199.jpg\" alt=\"(David Mason/Flickr)\" width=\"300\" height=\"199\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(David Mason/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>A three-judge panel of the Ninth Circuit Court has upheld payment reductions to Medi-Cal doctors, pharmacists and other providers. The cuts have been tied up in courts for more than a year -- and they're not settled yet. Advocates say they expect to ask for a review of the decision by the full court.\u003c/p>\n\u003cp>Some history:\u003c/p>\n\u003cul>\n\u003cli>Medi-Cal cuts must be approved by the federal government.\u003c/li>\n\u003cli>The current reductions, proposed by the Brown Administration, \u003ca href=\"http://www.dhcs.ca.gov/formsandpubs/publications/opa/Documents/11-06%20SPA%20Approvals.pdf\" target=\"_blank\">were approved\u003c/a> by the Centers for Medicare & Medicaid Services in October, 2011.\u003c/li>\n\u003cli>That approval was promptly challenged by the California Medical Association (and others) in federal court.\u003c/li>\n\u003cli>In January, a federal judge \u003ca href=\"http://www.californiahealthline.org/articles/2012/1/31/judge-tentatively-blocks-10-cut-to-medi-cal-reimbursement-rates.aspx\" target=\"_blank\">blocked the cuts\u003c/a>.\u003c!--more-->\u003c/li>\n\u003cli>The state appealed to the Ninth Circuit Court of Appeals -- and that's where we are today.\u003c/li>\n\u003c/ul>\n\u003cp>The Sacramento Bee quotes Lynn S. Carman, counsel for the Medicaid Defense Fund, saying that his side would take the case to the Supreme Court, if the Ninth Circuit's full bench either does not take up the care or does not block the cuts.\u003c/p>\n\u003cp>Also from \u003ca href=\"http://blogs.sacbee.com/capitolalertlatest/2012/12/federal-appeals-court-allows-lower-payments-to-medi-cal-providers.html\" target=\"_blank\">The Bee\u003c/a>:\u003c/p>\n\u003cdiv>\n\u003cdiv id=\"more\">\n\u003cblockquote>\u003cp>Circumstances have changed significantly since Gov. \u003cstrong>Jerry Brown\u003c/strong> and Democratic lawmakers agreed last year to cut Medi-Cal rates. Voters in November approved two statewide tax initiatives, generating several billion dollars annually for the budget, and President \u003cstrong>Barack Obama\u003c/strong>'s health care overhaul has survived political and legal hurdles en route to wide implementation in 2014.\u003c/p>\n\u003cp>The Obama plan calls for increasing rates paid to Medi-Cal primary care physicians starting in January 2013 to the higher Medicare rate, presumably sparing them from state rate cuts.\u003c/p>\n\u003cp>But it also expands Medi-Cal to a new group of uninsured low-income residents, largely able-bodied adults without children, starting in 2014. Meanwhile, Brown officials are pushing hard to move 860,000 lower-middle-class children to Medi-Cal next year.\u003c/p>\n\u003cp>Providers and advocates for the poor, who have repeatedly filed suits blocking state Medi-Cal cuts, argue that lower payments will discourage health care professionals from serving Medi-Cal patients. They say that will hurt access to doctors, particularly from specialty fields, leaving Medi-Cal patients without care.\u003c/p>\n\u003cp>\"Our hope is the state will reconsider,\" said California Medical Association spokeswoman \u003cstrong>Molly Weedn\u003c/strong>. \"The state implemented these cuts when it was in much more dire straits than it is now. This is going to hugely impact care, especially now that the Healthy Families transition is going to happen.\"\u003c/p>\n\u003cp>Brown spokesman Gareth Lacy responded to the ruling in a statement: \"The Court of Appeals ruled that trial courts cannot block California from making Medi-Cal cuts that were approved by the federal government. Today's decision allows California to continue providing quality care for people on Medi-Cal while saving the state millions of dollars in unnecessary costs.\"\u003c/p>\u003c/blockquote>\n\u003c/div>\n\u003c/div>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"excerpt": "A three-judge panel of the Ninth Circuit Court has upheld payment reductions to Medi-Cal providers. The cuts have been tied up in courts for more than a year -- and they're not settled yet. Advocates say they expect to ask for a review of the decision by the full court.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_9480\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Child_Doctor_DavidMason_Flickr_07092012.jpg\">\u003cimg class=\"size-medium wp-image-9480\" title=\"(David Mason/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Child_Doctor_DavidMason_Flickr_07092012-300x199.jpg\" alt=\"(David Mason/Flickr)\" width=\"300\" height=\"199\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(David Mason/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>A three-judge panel of the Ninth Circuit Court has upheld payment reductions to Medi-Cal doctors, pharmacists and other providers. The cuts have been tied up in courts for more than a year -- and they're not settled yet. Advocates say they expect to ask for a review of the decision by the full court.\u003c/p>\n\u003cp>Some history:\u003c/p>\n\u003cul>\n\u003cli>Medi-Cal cuts must be approved by the federal government.\u003c/li>\n\u003cli>The current reductions, proposed by the Brown Administration, \u003ca href=\"http://www.dhcs.ca.gov/formsandpubs/publications/opa/Documents/11-06%20SPA%20Approvals.pdf\" target=\"_blank\">were approved\u003c/a> by the Centers for Medicare & Medicaid Services in October, 2011.\u003c/li>\n\u003cli>That approval was promptly challenged by the California Medical Association (and others) in federal court.\u003c/li>\n\u003cli>In January, a federal judge \u003ca href=\"http://www.californiahealthline.org/articles/2012/1/31/judge-tentatively-blocks-10-cut-to-medi-cal-reimbursement-rates.aspx\" target=\"_blank\">blocked the cuts\u003c/a>.\u003c!--more-->\u003c/li>\n\u003cli>The state appealed to the Ninth Circuit Court of Appeals -- and that's where we are today.\u003c/li>\n\u003c/ul>\n\u003cp>The Sacramento Bee quotes Lynn S. Carman, counsel for the Medicaid Defense Fund, saying that his side would take the case to the Supreme Court, if the Ninth Circuit's full bench either does not take up the care or does not block the cuts.\u003c/p>\n\u003cp>Also from \u003ca href=\"http://blogs.sacbee.com/capitolalertlatest/2012/12/federal-appeals-court-allows-lower-payments-to-medi-cal-providers.html\" target=\"_blank\">The Bee\u003c/a>:\u003c/p>\n\u003cdiv>\n\u003cdiv id=\"more\">\n\u003cblockquote>\u003cp>Circumstances have changed significantly since Gov. \u003cstrong>Jerry Brown\u003c/strong> and Democratic lawmakers agreed last year to cut Medi-Cal rates. Voters in November approved two statewide tax initiatives, generating several billion dollars annually for the budget, and President \u003cstrong>Barack Obama\u003c/strong>'s health care overhaul has survived political and legal hurdles en route to wide implementation in 2014.\u003c/p>\n\u003cp>The Obama plan calls for increasing rates paid to Medi-Cal primary care physicians starting in January 2013 to the higher Medicare rate, presumably sparing them from state rate cuts.\u003c/p>\n\u003cp>But it also expands Medi-Cal to a new group of uninsured low-income residents, largely able-bodied adults without children, starting in 2014. Meanwhile, Brown officials are pushing hard to move 860,000 lower-middle-class children to Medi-Cal next year.\u003c/p>\n\u003cp>Providers and advocates for the poor, who have repeatedly filed suits blocking state Medi-Cal cuts, argue that lower payments will discourage health care professionals from serving Medi-Cal patients. They say that will hurt access to doctors, particularly from specialty fields, leaving Medi-Cal patients without care.\u003c/p>\n\u003cp>\"Our hope is the state will reconsider,\" said California Medical Association spokeswoman \u003cstrong>Molly Weedn\u003c/strong>. \"The state implemented these cuts when it was in much more dire straits than it is now. This is going to hugely impact care, especially now that the Healthy Families transition is going to happen.\"\u003c/p>\n\u003cp>Brown spokesman Gareth Lacy responded to the ruling in a statement: \"The Court of Appeals ruled that trial courts cannot block California from making Medi-Cal cuts that were approved by the federal government. Today's decision allows California to continue providing quality care for people on Medi-Cal while saving the state millions of dollars in unnecessary costs.\"\u003c/p>\u003c/blockquote>\n\u003c/div>\n\u003c/div>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Some Counties Requiring Health Workers to Get Flu Vaccine",
"title": "Some Counties Requiring Health Workers to Get Flu Vaccine",
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"content": "\u003cp>\u003cstrong>Goal is patient protection; unvaccinated workers may have to wear masks around patients\u003c/strong>\u003c/p>\n\u003cp>\u003cem>By Katharine Mieszkowski, \u003ca href=\"http://www.baycitizen.org/health/story/counties-require-health-workers-get-flu/\" target=\"_blank\">The Bay Citizen\u003c/a>\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_9430\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/flu_USACE-Europe-DistrictFlickr.jpg\">\u003cimg class=\"size-medium wp-image-9430\" title=\"(USACE Europe District/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/flu_USACE-Europe-DistrictFlickr-300x248.jpg\" alt=\"(USACE Europe District/Flickr)\" width=\"300\" height=\"248\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(USACE Europe District/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>In an effort to prevent health care workers from spreading the flu to patients this winter, county health officials are mandating that medical staff around the Bay Area receive vaccinations or wear a surgical mask on the job.\u003c/p>\n\u003cp>Health officials say flu vaccination rates among health care workers are dangerously low – \u003ca href=\"http://www.cdph.ca.gov/programs/hai/Documents/CDPH2010-11HCPInfluenzaVaccinationReport.pdf\" target=\"_blank\">60 percent [PDF]\u003c/a> of those working in California hospitals received the vaccine in the 2010-11 flu season, according to the most recent data available from the California Department of Public Health.\u003c/p>\n\u003cp>Officials hope the requirements will help prevent the spread of the virus to patients most vulnerable to its life-threatening complications, particularly the elderly, whose weakening immune systems may render the flu vaccine less effective.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/BayCitizenLogo1.png\">\u003cimg class=\"alignright size-full wp-image-9433\" title=\"BayCitizenLogo1\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/BayCitizenLogo1.png\" alt=\"\" width=\"218\" height=\"74\">\u003c/a>However, county health officers say they have few resources to enforce the new orders, leaving it up to the discretion of hospitals, nursing homes, dialysis centers and other health care facilities to make sure their staffs are vaccinated.\u003c/p>\n\u003cp>Nationally, this year’s flu season has started early and may be shaping up to be a bad one, according to the Centers for Disease Control and Prevention. Among those locally requiring vaccination or masks this year are health officials in San Francisco, Alameda, Contra Costa, Santa Clara and Sonoma counties. Scattered counties \u003ca href=\"http://www.cdph.ca.gov/programs/cclho/Pages/MandatoryofRecommendedInfluenzaVaccinationofHealthcareWorkers.aspx\" target=\"_blank\">around the state\u003c/a> are doing the same.\u003c!--more-->\u003c/p>\n\u003cp>“This is a way that health care workers can prevent transmitting a possibly deadly disease to their patients,” said Erika Jenssen, communicable disease programs manager for Contra Costa Health Services.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.cdc.gov/flu/protect/keyfacts.htm\" target=\"_blank\">CDC recommends\u003c/a> that everyone at least 6 months old get an annual flu shot; because flu viruses are constantly changing, a new vaccine is needed every year. But it is a recommendation that even some health care workers don’t follow.\u003c/p>\n\u003cp>Vaccinating patients is, unfortunately, no substitute for their caregivers receiving the shot. Some patients who are most at risk from flu complications don’t receive as much immunity from the vaccination as healthier people do.\u003c/p>\n\u003cp>All hospitals in California are required to offer free flu shots to their workers. Personnel must either get vaccinated or sign a statement declining to do so. Some people may not get the shots for medical reasons, such as those who have a severe allergy to chicken eggs, according to the CDC.\u003c/p>\n\u003cp>\u003cstrong>Deadly Outbreak\u003c/strong>\u003cbr>\nJenssen, the Contra Costa program manager, noted that it’s possible to spread the flu to others before exhibiting symptoms.\u003c/p>\n\u003cp>“You, as a health care worker, could be spreading the flu to patients you’re caring for, even if you’re vigilant about staying home when you’re sick,” she said.\u003c/p>\n\u003cp>Case in point: A deadly outbreak at a long-term care facility in Santa Clara County in the late 1990s. Only 17 percent of staff at the facility, which the county’s health officer declined to name, had been vaccinated against the flu. Sick staff introduced the virus to the facility, spreading it to patients.\u003c/p>\n\u003cp>“They vaccinated all these very frail people and assumed that they would be protected, yet the staff had such low rates that they got infected and passed it on to the people who had been vaccinated,” said Dr. Marty Fenstersheib, health officer for the county.\u003c/p>\n\u003cp>The outbreak caused two deaths and four hospitalizations, even though the vaccination rate among patients at the facility was nearly 100 percent. As people age, their immune systems begin to weaken, making the vaccination less effective, Fenstersheib said.\u003c/p>\n\u003cp>“Just because we give them the shot doesn’t mean that they will necessarily be protected,” he said.\u003c/p>\n\u003cp>In September, Gov. Jerry Brown \u003ca href=\"http://gov.ca.gov/docs/SB_1318_Veto_Message.pdf\" target=\"_blank\">vetoed a bill [PDF]\u003c/a> that would have required California clinics and health facilities to achieve a 90 percent or higher flu vaccination rate by mid-2015. In his veto message, Brown professed confidence that local governments and health facilities could raise the rates without a new state law.\u003c/p>\n\u003cp>Some employers, such as \u003ca href=\"https://healthy.kaiserpermanente.org/html/kaiser/index.shtml\" target=\"_blank\">Kaiser Permanente\u003c/a>, have taken a strict approach in enforcing the requirements.\u003c/p>\n\u003cp>“As with other job requirements, especially those related to patient safety, failure to fulfill this job requirement can result in discipline up to and including termination,” Nathaniel Oubre, senior vice president and East Bay manager for Kaiser in Northern California, said in an email.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.nationalnursesunited.org/pages/cna/\" target=\"_blank\">California Nurses Association\u003c/a> recommends that its members get the vaccine, but objects to mandating masks for those who refuse to do so or firing those who refuse to comply. Some nursing homes also oppose the mask requirement for unvaccinated staff.\u003c/p>\n\u003cp>“We’re trying to create a homelike environment, and then you’ve got someone with a mask coming to take care of you,” said Deborah Pacyna, spokeswoman for the \u003ca href=\"http://www.cahf.org/\" target=\"_blank\">California Association of Health Facilities\u003c/a>, which represents most nursing homes in the state. “That could be disconcerting to a vulnerable elder.”\u003c/p>\n\u003cp>Some hospitals say the new requirements are boosting vaccination rates. At \u003ca href=\"http://www.sutterdelta.org/\" target=\"_blank\">Sutter Delta Medical Center\u003c/a> in Antioch, 67 percent of employees received the vaccine two years ago, the state Department of Public Health found. This year, 96 percent of the staff had been vaccinated by Nov. 28, said Dr. Brion Pearson, the hospital’s vice president of medical affairs.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“The mandate is helping,” he said. “We just want to encourage people to do the right thing.”\u003c/p>\n\n",
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"excerpt": "In an effort to prevent health care workers from spreading the flu to patients this winter, county health officials are mandating that medical staff around the Bay Area receive vaccinations or wear a surgical mask on the job.\r\n\r\nHealth officials say flu vaccination rates among health care workers are dangerously low – 60 percent [PDF] of those working in California hospitals received the vaccine in the 2010-11 flu season, according to the most recent data available from the California Department of Public Health.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>Goal is patient protection; unvaccinated workers may have to wear masks around patients\u003c/strong>\u003c/p>\n\u003cp>\u003cem>By Katharine Mieszkowski, \u003ca href=\"http://www.baycitizen.org/health/story/counties-require-health-workers-get-flu/\" target=\"_blank\">The Bay Citizen\u003c/a>\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_9430\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/flu_USACE-Europe-DistrictFlickr.jpg\">\u003cimg class=\"size-medium wp-image-9430\" title=\"(USACE Europe District/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/flu_USACE-Europe-DistrictFlickr-300x248.jpg\" alt=\"(USACE Europe District/Flickr)\" width=\"300\" height=\"248\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(USACE Europe District/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>In an effort to prevent health care workers from spreading the flu to patients this winter, county health officials are mandating that medical staff around the Bay Area receive vaccinations or wear a surgical mask on the job.\u003c/p>\n\u003cp>Health officials say flu vaccination rates among health care workers are dangerously low – \u003ca href=\"http://www.cdph.ca.gov/programs/hai/Documents/CDPH2010-11HCPInfluenzaVaccinationReport.pdf\" target=\"_blank\">60 percent [PDF]\u003c/a> of those working in California hospitals received the vaccine in the 2010-11 flu season, according to the most recent data available from the California Department of Public Health.\u003c/p>\n\u003cp>Officials hope the requirements will help prevent the spread of the virus to patients most vulnerable to its life-threatening complications, particularly the elderly, whose weakening immune systems may render the flu vaccine less effective.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/BayCitizenLogo1.png\">\u003cimg class=\"alignright size-full wp-image-9433\" title=\"BayCitizenLogo1\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/BayCitizenLogo1.png\" alt=\"\" width=\"218\" height=\"74\">\u003c/a>However, county health officers say they have few resources to enforce the new orders, leaving it up to the discretion of hospitals, nursing homes, dialysis centers and other health care facilities to make sure their staffs are vaccinated.\u003c/p>\n\u003cp>Nationally, this year’s flu season has started early and may be shaping up to be a bad one, according to the Centers for Disease Control and Prevention. Among those locally requiring vaccination or masks this year are health officials in San Francisco, Alameda, Contra Costa, Santa Clara and Sonoma counties. Scattered counties \u003ca href=\"http://www.cdph.ca.gov/programs/cclho/Pages/MandatoryofRecommendedInfluenzaVaccinationofHealthcareWorkers.aspx\" target=\"_blank\">around the state\u003c/a> are doing the same.\u003c!--more-->\u003c/p>\n\u003cp>“This is a way that health care workers can prevent transmitting a possibly deadly disease to their patients,” said Erika Jenssen, communicable disease programs manager for Contra Costa Health Services.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.cdc.gov/flu/protect/keyfacts.htm\" target=\"_blank\">CDC recommends\u003c/a> that everyone at least 6 months old get an annual flu shot; because flu viruses are constantly changing, a new vaccine is needed every year. But it is a recommendation that even some health care workers don’t follow.\u003c/p>\n\u003cp>Vaccinating patients is, unfortunately, no substitute for their caregivers receiving the shot. Some patients who are most at risk from flu complications don’t receive as much immunity from the vaccination as healthier people do.\u003c/p>\n\u003cp>All hospitals in California are required to offer free flu shots to their workers. Personnel must either get vaccinated or sign a statement declining to do so. Some people may not get the shots for medical reasons, such as those who have a severe allergy to chicken eggs, according to the CDC.\u003c/p>\n\u003cp>\u003cstrong>Deadly Outbreak\u003c/strong>\u003cbr>\nJenssen, the Contra Costa program manager, noted that it’s possible to spread the flu to others before exhibiting symptoms.\u003c/p>\n\u003cp>“You, as a health care worker, could be spreading the flu to patients you’re caring for, even if you’re vigilant about staying home when you’re sick,” she said.\u003c/p>\n\u003cp>Case in point: A deadly outbreak at a long-term care facility in Santa Clara County in the late 1990s. Only 17 percent of staff at the facility, which the county’s health officer declined to name, had been vaccinated against the flu. Sick staff introduced the virus to the facility, spreading it to patients.\u003c/p>\n\u003cp>“They vaccinated all these very frail people and assumed that they would be protected, yet the staff had such low rates that they got infected and passed it on to the people who had been vaccinated,” said Dr. Marty Fenstersheib, health officer for the county.\u003c/p>\n\u003cp>The outbreak caused two deaths and four hospitalizations, even though the vaccination rate among patients at the facility was nearly 100 percent. As people age, their immune systems begin to weaken, making the vaccination less effective, Fenstersheib said.\u003c/p>\n\u003cp>“Just because we give them the shot doesn’t mean that they will necessarily be protected,” he said.\u003c/p>\n\u003cp>In September, Gov. Jerry Brown \u003ca href=\"http://gov.ca.gov/docs/SB_1318_Veto_Message.pdf\" target=\"_blank\">vetoed a bill [PDF]\u003c/a> that would have required California clinics and health facilities to achieve a 90 percent or higher flu vaccination rate by mid-2015. In his veto message, Brown professed confidence that local governments and health facilities could raise the rates without a new state law.\u003c/p>\n\u003cp>Some employers, such as \u003ca href=\"https://healthy.kaiserpermanente.org/html/kaiser/index.shtml\" target=\"_blank\">Kaiser Permanente\u003c/a>, have taken a strict approach in enforcing the requirements.\u003c/p>\n\u003cp>“As with other job requirements, especially those related to patient safety, failure to fulfill this job requirement can result in discipline up to and including termination,” Nathaniel Oubre, senior vice president and East Bay manager for Kaiser in Northern California, said in an email.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.nationalnursesunited.org/pages/cna/\" target=\"_blank\">California Nurses Association\u003c/a> recommends that its members get the vaccine, but objects to mandating masks for those who refuse to do so or firing those who refuse to comply. Some nursing homes also oppose the mask requirement for unvaccinated staff.\u003c/p>\n\u003cp>“We’re trying to create a homelike environment, and then you’ve got someone with a mask coming to take care of you,” said Deborah Pacyna, spokeswoman for the \u003ca href=\"http://www.cahf.org/\" target=\"_blank\">California Association of Health Facilities\u003c/a>, which represents most nursing homes in the state. “That could be disconcerting to a vulnerable elder.”\u003c/p>\n\u003cp>Some hospitals say the new requirements are boosting vaccination rates. At \u003ca href=\"http://www.sutterdelta.org/\" target=\"_blank\">Sutter Delta Medical Center\u003c/a> in Antioch, 67 percent of employees received the vaccine two years ago, the state Department of Public Health found. This year, 96 percent of the staff had been vaccinated by Nov. 28, said Dr. Brion Pearson, the hospital’s vice president of medical affairs.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“The mandate is helping,” he said. “We just want to encourage people to do the right thing.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Children and the Health Care Overhaul: Where is Coverage Best?",
"title": "Children and the Health Care Overhaul: Where is Coverage Best?",
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"content": "\u003cp>\u003cem>Editor's note: this post was updated to clarify benefits available to children who receive Medi-Cal and benefits available in the new Health Insurance Exchange.\u003c/em>\u003c/p>\n\u003cp>\u003cem>By Elaine Korry\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_9421\" class=\"wp-caption alignleft\" style=\"max-width: 287px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/PediatricianPorshiaMack_SaniaBettancourt_ElaineKorry_KQED.jpg\">\u003cimg class=\"size-medium wp-image-9421\" title=\"Pediatrician Porshia Mack examines 3-year-old Sania Bettancourt at Richmond LifeLong community health clinic. (Photo:Elaine Korry)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/PediatricianPorshiaMack_SaniaBettancourt_ElaineKorry_KQED-300x313.jpg\" alt=\"Pediatrician Porshia Mack examines 3-year-old Sania Bettancourt at Richmond LifeLong community health clinic. (Photo:Elaine Korry)\" width=\"287\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Pediatrician Porshia Mack examines 3-year-old Sania Bettancourt at Richmond LifeLong community health clinic. (Photo:Elaine Korry)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003ca href=\"http://keck.usc.edu/About/Administrative_Offices/Office_of_Public_Relations_and_Marketing/News/Detail/2012__pr_and_marketing__fall__cousineau_chcf_111412\" target=\"_blank\">More than a million California children\u003c/a> who currently lack health insurance will qualify for coverage under the Affordable Care Act. When the health care overhaul goes into effect in 2014, more children from poor families will qualify for Medi-Cal, and other children will get subsidies for private low-cost insurance through the new state Exchange, Covered California. But children’s advocates are concerned that some kids won’t get the best coverage.\u003c/p>\n\u003cp>The nation’s pediatricians devised a gold standard of care. The name is a mouthful -- the \u003ca href=\"EARLY%20AND%20PERIODIC%20SCREENING,%20DIAGNOSTIC,%20AND%20TREATMENT%20SERVICES\" target=\"_blank\">Early and Periodic Screening, Diagnostic and Treatment Services\u003c/a>, or EPSDT for short. It's a standard to meet kids' medical needs -- and it's the standard of care at the Richmond LifeLong Medical Care, a community clinic in San Francisco's East Bay that serves low-income families.\u003c/p>\n\u003cp>On a recent visit, Dr. Porshia Mack, head of pediatrics at the clinic, treated 3-year-old Sania Bettancourt. Dr. Mack listened to Sania's lungs, checked her heartbeat, and peered into her throat and ears. Mack told Sania’s mother that all seemed well except for one recurring problem. Sania’s mild anemia was back, so Mack prescribed a multi-vitamin.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Dr. Mack has treated Sania since she was a baby and knew her well enough to realize that this bout of anemia was not serious. But she said that wouldn’t necessarily be the case for kids who aren’t covered for early pediatric care. “It could be a sign of something more ominous than it is, and we wouldn’t know that unless I saw her on a regular interval,” says Mack. “The AAP, the American Academy of Pediatrics, recommends certain lab tests drawn at certain intervals so we can catch these things.”\u003c/p>\n\u003cp>Under the Affordable Care Act, children who are on Medi-Cal, like Sania, will continue to have the full range of coverage recommended by the AAP. Children whose families have slightly more income and qualify for coverage under the new insurance Exchange will likely get significantly better benefits than they have now, but those benefits may not be equal to those under Medi-Cal.\u003c/p>\n\u003cp>The federal law outlines the so-called \u003ca href=\"http://www.healthcare.gov/glossary/e/essential.html\" target=\"_blank\">essential health benefits\u003c/a> that insurers in the state Exchanges must cover. Each state must pick an existing insurance plan as a model -- a plan that has \u003ca href=\"http://aspe.hhs.gov/health/reports/2011/MarketComparison/rb.shtml\" target=\"_blank\">equivalent benefits to a \"typical\" employer plan\u003c/a>. California was among the first states to pick its model benchmark.\u003c/p>\n\u003cp>“It’s a huge step forward for children’s health,” says Kelly Hardy, director of health policy at Children Now, a statewide advocacy group. California chose as its benchmark a Kaiser Small Group plan. That is the baseline plan, and there will be more expensive plans to trade up to, if people want to pay for more benefits. Although Kelly rejects the idea of one-size-fits-all insurance, she says state lawmakers did expand on the Kaiser plan to meet some of children’s needs.\u003c/p>\n\u003cp>“We’re really pleased that the legislature chose to add strong vision and comprehensive dental benefits for children,” says Kelly. “Those are two additions that are really important.\" (By comparison, people with employer-based health insurance often have separate insurance plans for dental and vision coverage.)\u003c/p>\n\u003cp>Yet children’s advocates like Hardy did not get everything they hoped for. Most importantly, she says, they did not convince state lawmakers to adopt the EPSDT for children insured through the state's Exchange. Hardy says that wasn’t practical to include for all kids because it’s simply too expensive. She also noted that many private plans, employer-based health insurance plans included, may not meet that standard.\u003c/p>\n\u003cp>Many pediatricians say that in reality, even the AAP standard is minimal coverage, especially for children with special needs such as asthma, Down syndrome or heart disease. As east bay physician Dr. Thomas Long puts it, “Is it the floor or is it the ceiling? We think it’s the floor, and the least we can do for all children.”\u003c/p>\n\u003cp>Dr. Long is an expert on child health financing with the American Academy of Pediatrics. He says the new Exchange’s standard of care falls short on things like mental health benefits, access to pediatric specialists and other needed coverage.\u003c/p>\n\u003cp>Insurers respond that the Exchange benefits package is broad enough -- and is certainly an improvement for children who have no or very limited insurance now. Charles Bacci, with the California Association of Health Plans, says there’s always a tradeoff between coverage and cost. “The more broad the benefit package, the more expensive your healthcare premiums are,” says Bacci. “The more narrow the benefit, the more affordable your premiums are.”\u003c/p>\n\u003cp>So the irony is that children on Medi-Cal, including half a million new enrollees under the Affordable Care Act, may have the broadest coverage, while children from slightly higher income families in the Exchange, may have at least somewhat narrower benefits. But, says Bacci, if the half-million new kids in the Exchange were also guaranteed the best coverage, healthcare costs would explode.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Support for this report came from the\u003ca href=\"http://www.reportingonhealth.org/fellowships/seminars/lucile-packard-foundation-childrens-health-journalism-fund\" target=\"_blank\"> Lucile Packard Foundation for Children’s Health Journalism Fund\u003c/a>, a program of the USC Annenberg School of Journalism’s California Endowment Health Journalism Fellowships.\u003c/em>\u003c/p>\n\n",
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"excerpt": "More than a million California children who currently lack health insurance will qualify for coverage under the Affordable Care Act. When Obamacare takes effect in 2014, more children from poor families will qualify for Medi-Cal, and others will get subsidies for private low-cost insurance through the new state exchange, Covered California. But children’s advocates are concerned that some kids won’t get the best coverage.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Editor's note: this post was updated to clarify benefits available to children who receive Medi-Cal and benefits available in the new Health Insurance Exchange.\u003c/em>\u003c/p>\n\u003cp>\u003cem>By Elaine Korry\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_9421\" class=\"wp-caption alignleft\" style=\"max-width: 287px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/PediatricianPorshiaMack_SaniaBettancourt_ElaineKorry_KQED.jpg\">\u003cimg class=\"size-medium wp-image-9421\" title=\"Pediatrician Porshia Mack examines 3-year-old Sania Bettancourt at Richmond LifeLong community health clinic. (Photo:Elaine Korry)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/PediatricianPorshiaMack_SaniaBettancourt_ElaineKorry_KQED-300x313.jpg\" alt=\"Pediatrician Porshia Mack examines 3-year-old Sania Bettancourt at Richmond LifeLong community health clinic. (Photo:Elaine Korry)\" width=\"287\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Pediatrician Porshia Mack examines 3-year-old Sania Bettancourt at Richmond LifeLong community health clinic. (Photo:Elaine Korry)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003ca href=\"http://keck.usc.edu/About/Administrative_Offices/Office_of_Public_Relations_and_Marketing/News/Detail/2012__pr_and_marketing__fall__cousineau_chcf_111412\" target=\"_blank\">More than a million California children\u003c/a> who currently lack health insurance will qualify for coverage under the Affordable Care Act. When the health care overhaul goes into effect in 2014, more children from poor families will qualify for Medi-Cal, and other children will get subsidies for private low-cost insurance through the new state Exchange, Covered California. But children’s advocates are concerned that some kids won’t get the best coverage.\u003c/p>\n\u003cp>The nation’s pediatricians devised a gold standard of care. The name is a mouthful -- the \u003ca href=\"EARLY%20AND%20PERIODIC%20SCREENING,%20DIAGNOSTIC,%20AND%20TREATMENT%20SERVICES\" target=\"_blank\">Early and Periodic Screening, Diagnostic and Treatment Services\u003c/a>, or EPSDT for short. It's a standard to meet kids' medical needs -- and it's the standard of care at the Richmond LifeLong Medical Care, a community clinic in San Francisco's East Bay that serves low-income families.\u003c/p>\n\u003cp>On a recent visit, Dr. Porshia Mack, head of pediatrics at the clinic, treated 3-year-old Sania Bettancourt. Dr. Mack listened to Sania's lungs, checked her heartbeat, and peered into her throat and ears. Mack told Sania’s mother that all seemed well except for one recurring problem. Sania’s mild anemia was back, so Mack prescribed a multi-vitamin.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Dr. Mack has treated Sania since she was a baby and knew her well enough to realize that this bout of anemia was not serious. But she said that wouldn’t necessarily be the case for kids who aren’t covered for early pediatric care. “It could be a sign of something more ominous than it is, and we wouldn’t know that unless I saw her on a regular interval,” says Mack. “The AAP, the American Academy of Pediatrics, recommends certain lab tests drawn at certain intervals so we can catch these things.”\u003c/p>\n\u003cp>Under the Affordable Care Act, children who are on Medi-Cal, like Sania, will continue to have the full range of coverage recommended by the AAP. Children whose families have slightly more income and qualify for coverage under the new insurance Exchange will likely get significantly better benefits than they have now, but those benefits may not be equal to those under Medi-Cal.\u003c/p>\n\u003cp>The federal law outlines the so-called \u003ca href=\"http://www.healthcare.gov/glossary/e/essential.html\" target=\"_blank\">essential health benefits\u003c/a> that insurers in the state Exchanges must cover. Each state must pick an existing insurance plan as a model -- a plan that has \u003ca href=\"http://aspe.hhs.gov/health/reports/2011/MarketComparison/rb.shtml\" target=\"_blank\">equivalent benefits to a \"typical\" employer plan\u003c/a>. California was among the first states to pick its model benchmark.\u003c/p>\n\u003cp>“It’s a huge step forward for children’s health,” says Kelly Hardy, director of health policy at Children Now, a statewide advocacy group. California chose as its benchmark a Kaiser Small Group plan. That is the baseline plan, and there will be more expensive plans to trade up to, if people want to pay for more benefits. Although Kelly rejects the idea of one-size-fits-all insurance, she says state lawmakers did expand on the Kaiser plan to meet some of children’s needs.\u003c/p>\n\u003cp>“We’re really pleased that the legislature chose to add strong vision and comprehensive dental benefits for children,” says Kelly. “Those are two additions that are really important.\" (By comparison, people with employer-based health insurance often have separate insurance plans for dental and vision coverage.)\u003c/p>\n\u003cp>Yet children’s advocates like Hardy did not get everything they hoped for. Most importantly, she says, they did not convince state lawmakers to adopt the EPSDT for children insured through the state's Exchange. Hardy says that wasn’t practical to include for all kids because it’s simply too expensive. She also noted that many private plans, employer-based health insurance plans included, may not meet that standard.\u003c/p>\n\u003cp>Many pediatricians say that in reality, even the AAP standard is minimal coverage, especially for children with special needs such as asthma, Down syndrome or heart disease. As east bay physician Dr. Thomas Long puts it, “Is it the floor or is it the ceiling? We think it’s the floor, and the least we can do for all children.”\u003c/p>\n\u003cp>Dr. Long is an expert on child health financing with the American Academy of Pediatrics. He says the new Exchange’s standard of care falls short on things like mental health benefits, access to pediatric specialists and other needed coverage.\u003c/p>\n\u003cp>Insurers respond that the Exchange benefits package is broad enough -- and is certainly an improvement for children who have no or very limited insurance now. Charles Bacci, with the California Association of Health Plans, says there’s always a tradeoff between coverage and cost. “The more broad the benefit package, the more expensive your healthcare premiums are,” says Bacci. “The more narrow the benefit, the more affordable your premiums are.”\u003c/p>\n\u003cp>So the irony is that children on Medi-Cal, including half a million new enrollees under the Affordable Care Act, may have the broadest coverage, while children from slightly higher income families in the Exchange, may have at least somewhat narrower benefits. But, says Bacci, if the half-million new kids in the Exchange were also guaranteed the best coverage, healthcare costs would explode.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Support for this report came from the\u003ca href=\"http://www.reportingonhealth.org/fellowships/seminars/lucile-packard-foundation-childrens-health-journalism-fund\" target=\"_blank\"> Lucile Packard Foundation for Children’s Health Journalism Fund\u003c/a>, a program of the USC Annenberg School of Journalism’s California Endowment Health Journalism Fellowships.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Should Aging Doctors Be Routinely Evaluated?",
"title": "Should Aging Doctors Be Routinely Evaluated?",
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"content": "\u003cp>\u003cem>By Sandra G. Boodman\u003c/em>, \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2012/December/11/aging-doctors-face-greater-scrutiny.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_9400\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/AgingDoctor_83years_Laura4Smit_2009_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-9400\" title=\"This 2009 photo shows the 83-year-old doctor examining the photographers's son. (Laura4Smith:Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/AgingDoctor_83years_Laura4Smit_2009_Flickr-300x239.jpg\" alt=\"This 2009 photo shows the 83-year-old doctor examining the photographers's son. (Laura4Smith:Flickr)\" width=\"300\" height=\"239\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">This 2009 photo shows the 83-year-old doctor examining the photographers's son. (Laura4Smith:Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>A distinguished vascular specialist in his 80s performs surgery, then goes on vacation, forgetting he has patients in the hospital; one subsequently dies because no doctor was overseeing his care. An internist who suffered a stroke gets lost going from one exam room to another in his own office. A beloved general surgeon with Alzheimer's disease continues to assist in operations because hospital officials don't have the heart to tell him to retire.\u003c/p>\n\u003cp>These are real-life examples, provided by an expert who evaluates impaired physicians. They exemplify an emotionally charged issue that is attracting the attention of patient safety experts and hospital administrators: how to ensure that older doctors are competent to treat patients.\u003c/p>\n\u003caside class=\"pullquote alignright\">Norcross estimates that about 8,000 doctors with full-blown dementia are practicing medicine.\u003c/aside>\n\u003cp>About 42 percent of the nation's one million physicians are older than 55 -- and 21 percent are older than 65, according to the American Medical Association, up from 35 percent and 18 percent, respectively, in 2006. Their ranks are expected to increase as many work past the traditional retirement age of 65.\u003c!--more-->\u003c/p>\n\u003cp>Unlike commercial airline pilots, who by law must undergo regular health screenings starting at age 40 and must retire at 65, there is no such rule for doctors. Nor are any formal evaluations required to ensure the continued competence of physicians, many of whom trained decades ago. Most states require continuing education credits to retain a medical license. But, as Stanford Hospital and Clinics chief of medical staff Ann Weinacker observed, \"You can sleep through a session, and if you sign your name, you'll get credit.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"The public thinks that physicians' health and competence is being vigorously monitored and assessed. It isn't,\" said geriatrician William Norcross. He's the founding director of a UC San Diego program that performs competency evaluations of doctors referred by state medical boards or hospitals. The program -- \u003ca href=\"http://www.paceprogram.ucsd.edu/\">known as PACE\u003c/a>, for Physician Assessment and Clinical Education -- is one of about 10 around the country.\u003c/p>\n\u003cp>Norcross evaluates 100 to 150 physicians annually and estimates that about 8,000 doctors with full-blown dementia are practicing medicine. (Between 3 and 11 percent of Americans older than 65 \u003ca href=\"http://www.uspreventiveservicestaskforce.org/3rduspstf/dementia/dementsum.htm\">have dementia\u003c/a>.)\u003c/p>\n\u003cp>\u003cstrong>The Effects Of Aging\u003c/strong>\u003c/p>\n\u003cp>\"Doctors are not immune to the effects of aging,\" Norcross says, adding that the onset of dementia is often insidious and gradual. Too often, he said, health problems become impossible to ignore after a catastrophic event, such as the death of a patient. \"Doctors with cognitive and neurological problems almost never have insight into their problems,\" he said, and many deny that anything is wrong.\u003c/p>\n\u003cp>While few experts would argue that age alone should control who can continue to practice, some studies suggest that doctors' skills tend to deteriorate over time. A \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1856535/\">2006 report\u003c/a> found that patient mortality in complex operations was higher among surgeons older than 60 than among their younger colleagues.\u003c/p>\n\u003cp>To address the problem in a systematic way, a small but growing number of hospitals -- including those at Stanford and the University of Virginia -- have recently adopted policies requiring doctors over a certain age (70 at U-Va., 75 at Stanford) to undergo periodic physical and cognitive exams as a condition of renewing their privileges.\u003c/p>\n\u003cp>Diane Pinakiewicz, former president of the \u003ca href=\"http://www.npsf.org/about-us/mission-and-vision/\">National Patient Safety Foundation\u003c/a>, a Boston-based information and advocacy group, calls the policies \"a fabulous idea\" that is long overdue. \"Without a rule, it's left to someone's personal decision\" to self-monitor.\u003c/p>\n\u003cp>\u003cstrong>'Fred Flintstone' Care\u003c/strong>\u003c/p>\n\u003cp>Still, some hospital administrators dispute the need for such testing. \"In medicine, I think you need to look at people individually,\" said David Mayer, 59, vice president of quality and safety at \u003ca href=\"http://www.nrhrehab.org/About+NRH/Press+Releases/1179.aspx\">MedStarHealth\u003c/a>, the largest hospital network in the District and Maryland. \"To just put a number there and say, 'You need to be looked at more closely' because of age is not justified.\"\u003c/p>\n\u003cp>But Marty Makary, a Johns Hopkins surgeon and author of \"\u003ca href=\"http://www.amazon.com/dp/1608198367\">Unaccountable: What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care\u003c/a>,\" says that screening can weed out those who should no longer be practicing while giving \"those who are fully functional the freedom to practice without the stigma of ageism.\"\u003c/p>\n\u003cp>Although an older doctor can be a font of wisdom and experience, Makary warns that too often patients receive what he calls \"Fred Flintstone care\" from doctors whose skills have not kept pace. \"Some older surgeons are all over minimally invasive surgery,\" he said, \"but many have just ignored minimally invasive techniques.\" Their patients, he said, may receive state-of-the-art care -- for 1976.\u003c/p>\n\u003cp>Orthopedic surgeon Ralph Blasier agrees. In a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2628499/\">2009 review article\u003c/a> entitled \"The Problem of the Aging Surgeon,\" Blasier wrote that \"essentially every treatment technique taught 25 years ago has been abandoned and replaced,\" including the treatment of traumatic fractures and joint diseases. \"All surgical specialties,\" he continued, \"have had similar turnover of treatment methods.\"\u003c/p>\n\u003cp>At Stanford, Weinacker, chief of the 1,800-member medical staff, said that reaction to the policy, which affects about 25 doctors, has been mixed. Several doctors, she said, have decided to retire instead of undergoing testing. \"I think the main thing I stressed with people was that this policy is intended to be supportive,\" not punitive. Anyone found to have problems will be referred to the PACE program for a more complete evaluation.\u003c/p>\n\u003cp>\u003cstrong>Still Practicing At 101\u003c/strong>\u003c/p>\n\u003cp>In the San Francisco Bay Area, rheumatologist \u003ca href=\"http://health.universityofcalifornia.edu/2011/04/05/governor-salutes-centenarian-for-strong-work-ethic/\">Ephraim Engleman\u003c/a> will turn 102 in March and said he plans to never quit.\u003c/p>\n\u003cp>One of the nation's oldest practicing physicians, Engleman drives from his San Mateo home to the UCSF medical campus three days a week. He sees about eight longtime patients per week and spends most of his time directing the Rosalind Russell Medical Research Center for Arthritis, an administrative post he has held since it was created in 1979.\u003c/p>\n\u003cp>\"I'm very much opposed to retirement,\" said Engleman, an accomplished violinist who plays once a week with a chamber music group. \"As long as I'm able intellectually and physically, I'm going to continue.\" Engleman, who graduated from medical school in 1937, loves being a doctor and said, \"I can do everything I ever did.\" His only impediment, he said, is severe spinal stenosis, which has left him stooped and dependent on a cane. \"I walk like an old man,\" he said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Upon learning that Stanford, his undergraduate alma mater, has recently begun requiring doctors older than 75 to be tested, he quipped, \"I'm glad they don't do it here.\" But Engleman said that he is not opposed to such evaluations and that he has asked his colleagues to tell him if they believe he is slipping. \"By all means, let me know -- and I'll get the hell out of here,\" he said he told them.\u003c/p>\n\n",
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"excerpt": "A distinguished vascular specialist in his 80s performs surgery, then goes on vacation, forgetting he has patients in the hospital; one subsequently dies because no doctor was overseeing his care. An internist who suffered a stroke gets lost going from one exam room to another in his own office. A beloved general surgeon with Alzheimer's disease continues to assist in operations because hospital officials don't have the heart to tell him to retire.\r\n\r\nThese are real-life examples, provided by an expert who evaluates impaired physicians. They exemplify an emotionally charged issue that is attracting the attention of patient safety experts and hospital administrators: how to ensure that older doctors are competent to treat patients.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>By Sandra G. Boodman\u003c/em>, \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2012/December/11/aging-doctors-face-greater-scrutiny.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_9400\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/AgingDoctor_83years_Laura4Smit_2009_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-9400\" title=\"This 2009 photo shows the 83-year-old doctor examining the photographers's son. (Laura4Smith:Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/AgingDoctor_83years_Laura4Smit_2009_Flickr-300x239.jpg\" alt=\"This 2009 photo shows the 83-year-old doctor examining the photographers's son. (Laura4Smith:Flickr)\" width=\"300\" height=\"239\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">This 2009 photo shows the 83-year-old doctor examining the photographers's son. (Laura4Smith:Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>A distinguished vascular specialist in his 80s performs surgery, then goes on vacation, forgetting he has patients in the hospital; one subsequently dies because no doctor was overseeing his care. An internist who suffered a stroke gets lost going from one exam room to another in his own office. A beloved general surgeon with Alzheimer's disease continues to assist in operations because hospital officials don't have the heart to tell him to retire.\u003c/p>\n\u003cp>These are real-life examples, provided by an expert who evaluates impaired physicians. They exemplify an emotionally charged issue that is attracting the attention of patient safety experts and hospital administrators: how to ensure that older doctors are competent to treat patients.\u003c/p>\n\u003caside class=\"pullquote alignright\">Norcross estimates that about 8,000 doctors with full-blown dementia are practicing medicine.\u003c/aside>\n\u003cp>About 42 percent of the nation's one million physicians are older than 55 -- and 21 percent are older than 65, according to the American Medical Association, up from 35 percent and 18 percent, respectively, in 2006. Their ranks are expected to increase as many work past the traditional retirement age of 65.\u003c!--more-->\u003c/p>\n\u003cp>Unlike commercial airline pilots, who by law must undergo regular health screenings starting at age 40 and must retire at 65, there is no such rule for doctors. Nor are any formal evaluations required to ensure the continued competence of physicians, many of whom trained decades ago. Most states require continuing education credits to retain a medical license. But, as Stanford Hospital and Clinics chief of medical staff Ann Weinacker observed, \"You can sleep through a session, and if you sign your name, you'll get credit.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"The public thinks that physicians' health and competence is being vigorously monitored and assessed. It isn't,\" said geriatrician William Norcross. He's the founding director of a UC San Diego program that performs competency evaluations of doctors referred by state medical boards or hospitals. The program -- \u003ca href=\"http://www.paceprogram.ucsd.edu/\">known as PACE\u003c/a>, for Physician Assessment and Clinical Education -- is one of about 10 around the country.\u003c/p>\n\u003cp>Norcross evaluates 100 to 150 physicians annually and estimates that about 8,000 doctors with full-blown dementia are practicing medicine. (Between 3 and 11 percent of Americans older than 65 \u003ca href=\"http://www.uspreventiveservicestaskforce.org/3rduspstf/dementia/dementsum.htm\">have dementia\u003c/a>.)\u003c/p>\n\u003cp>\u003cstrong>The Effects Of Aging\u003c/strong>\u003c/p>\n\u003cp>\"Doctors are not immune to the effects of aging,\" Norcross says, adding that the onset of dementia is often insidious and gradual. Too often, he said, health problems become impossible to ignore after a catastrophic event, such as the death of a patient. \"Doctors with cognitive and neurological problems almost never have insight into their problems,\" he said, and many deny that anything is wrong.\u003c/p>\n\u003cp>While few experts would argue that age alone should control who can continue to practice, some studies suggest that doctors' skills tend to deteriorate over time. A \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1856535/\">2006 report\u003c/a> found that patient mortality in complex operations was higher among surgeons older than 60 than among their younger colleagues.\u003c/p>\n\u003cp>To address the problem in a systematic way, a small but growing number of hospitals -- including those at Stanford and the University of Virginia -- have recently adopted policies requiring doctors over a certain age (70 at U-Va., 75 at Stanford) to undergo periodic physical and cognitive exams as a condition of renewing their privileges.\u003c/p>\n\u003cp>Diane Pinakiewicz, former president of the \u003ca href=\"http://www.npsf.org/about-us/mission-and-vision/\">National Patient Safety Foundation\u003c/a>, a Boston-based information and advocacy group, calls the policies \"a fabulous idea\" that is long overdue. \"Without a rule, it's left to someone's personal decision\" to self-monitor.\u003c/p>\n\u003cp>\u003cstrong>'Fred Flintstone' Care\u003c/strong>\u003c/p>\n\u003cp>Still, some hospital administrators dispute the need for such testing. \"In medicine, I think you need to look at people individually,\" said David Mayer, 59, vice president of quality and safety at \u003ca href=\"http://www.nrhrehab.org/About+NRH/Press+Releases/1179.aspx\">MedStarHealth\u003c/a>, the largest hospital network in the District and Maryland. \"To just put a number there and say, 'You need to be looked at more closely' because of age is not justified.\"\u003c/p>\n\u003cp>But Marty Makary, a Johns Hopkins surgeon and author of \"\u003ca href=\"http://www.amazon.com/dp/1608198367\">Unaccountable: What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care\u003c/a>,\" says that screening can weed out those who should no longer be practicing while giving \"those who are fully functional the freedom to practice without the stigma of ageism.\"\u003c/p>\n\u003cp>Although an older doctor can be a font of wisdom and experience, Makary warns that too often patients receive what he calls \"Fred Flintstone care\" from doctors whose skills have not kept pace. \"Some older surgeons are all over minimally invasive surgery,\" he said, \"but many have just ignored minimally invasive techniques.\" Their patients, he said, may receive state-of-the-art care -- for 1976.\u003c/p>\n\u003cp>Orthopedic surgeon Ralph Blasier agrees. In a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2628499/\">2009 review article\u003c/a> entitled \"The Problem of the Aging Surgeon,\" Blasier wrote that \"essentially every treatment technique taught 25 years ago has been abandoned and replaced,\" including the treatment of traumatic fractures and joint diseases. \"All surgical specialties,\" he continued, \"have had similar turnover of treatment methods.\"\u003c/p>\n\u003cp>At Stanford, Weinacker, chief of the 1,800-member medical staff, said that reaction to the policy, which affects about 25 doctors, has been mixed. Several doctors, she said, have decided to retire instead of undergoing testing. \"I think the main thing I stressed with people was that this policy is intended to be supportive,\" not punitive. Anyone found to have problems will be referred to the PACE program for a more complete evaluation.\u003c/p>\n\u003cp>\u003cstrong>Still Practicing At 101\u003c/strong>\u003c/p>\n\u003cp>In the San Francisco Bay Area, rheumatologist \u003ca href=\"http://health.universityofcalifornia.edu/2011/04/05/governor-salutes-centenarian-for-strong-work-ethic/\">Ephraim Engleman\u003c/a> will turn 102 in March and said he plans to never quit.\u003c/p>\n\u003cp>One of the nation's oldest practicing physicians, Engleman drives from his San Mateo home to the UCSF medical campus three days a week. He sees about eight longtime patients per week and spends most of his time directing the Rosalind Russell Medical Research Center for Arthritis, an administrative post he has held since it was created in 1979.\u003c/p>\n\u003cp>\"I'm very much opposed to retirement,\" said Engleman, an accomplished violinist who plays once a week with a chamber music group. \"As long as I'm able intellectually and physically, I'm going to continue.\" Engleman, who graduated from medical school in 1937, loves being a doctor and said, \"I can do everything I ever did.\" His only impediment, he said, is severe spinal stenosis, which has left him stooped and dependent on a cane. \"I walk like an old man,\" he said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Upon learning that Stanford, his undergraduate alma mater, has recently begun requiring doctors older than 75 to be tested, he quipped, \"I'm glad they don't do it here.\" But Engleman said that he is not opposed to such evaluations and that he has asked his colleagues to tell him if they believe he is slipping. \"By all means, let me know -- and I'll get the hell out of here,\" he said he told them.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Fiscal Cliffnotes: If Medicare Eligibility Age Goes Up, People of Color Hit Hardest",
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"content": "\u003cp>While we all wait to see if President Obama and House Speaker John Boehner will \u003ca href=\"http://www.npr.org/blogs/thetwo-way/2012/12/10/166860670/can-a-fiscal-cliff-deal-be-both-in-and-out-of-reach-yes\" target=\"_blank\">hash out a deal \u003c/a>on the fiscal cliff, one item getting a lot of discussion is \u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/12/07/fiscal-cliffnotes-what-are-the-trade-offs-in-raising-medicares-eligibility-age/\" target=\"_blank\">raising the Medicare eligibility age\u003c/a>, as I wrote about on Friday. Today, I was checking out \u003ca href=\"https://twitter.com/sarahkliff\" target=\"_blank\">Sarah Kliff's twitter feed\u003c/a>, and she pointed to UC Berkeley grad student \u003ca href=\"http://owenzidar.wordpress.com/2012/12/09/the-medicare-eligibility-age-impacts-on-health-behavior-and-outcomes/\" target=\"_blank\">Owen Zidar's blog\u003c/a>. Zidar's post includes some eye-opening charts from economists David Card, Carlos Dobkin and Nicole Maestas writing in the \u003ca href=\"http://www.aeaweb.org/articles.php?doi=10.1257/aer.98.5.2242\" target=\"_blank\">American Economic Review\u003c/a>.\u003c/p>\n\u003cp>Embedded in these wonky charts is an illustration of disparity:\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Screen-Shot-2012-12-10-at-11.31.44-AM.png\">\u003cimg class=\"aligncenter size-large wp-image-9352\" title=\"Screen Shot 2012-12-10 at 11.31.44 AM\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Screen-Shot-2012-12-10-at-11.31.44-AM-620x396.png\" alt=\"\" width=\"620\" height=\"396\">\u003c/a>\u003c/p>\n\u003cp>And that disparity plays out in people not getting health care because of cost. Another snapshot of disparity:\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Screen-Shot-2012-12-10-at-11.39.44-AM.png\">\u003cimg class=\"aligncenter size-large wp-image-9355\" title=\"Screen Shot 2012-12-10 at 11.39.44 AM\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Screen-Shot-2012-12-10-at-11.39.44-AM-620x424.png\" alt=\"\" width=\"620\" height=\"424\">\u003c/a>This data was compiled before the Affordable Care Act was passed. We'll have to wait and see how coverage and access change once the ACA is fully implemented in 2014.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"excerpt": "While we all wait to see if President Obama and House Speaker John Boehner will hash out a deal on the fiscal cliff, one item getting a lot of discussion is raising the Medicare eligibility age, as I wrote about on Friday. Today, UC Berkeley grad student Owen Zidar points to some very eye-opening charts from economists David Card, Carlos Dobkin and Nicole Maestas writing in the American Economic Review.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>While we all wait to see if President Obama and House Speaker John Boehner will \u003ca href=\"http://www.npr.org/blogs/thetwo-way/2012/12/10/166860670/can-a-fiscal-cliff-deal-be-both-in-and-out-of-reach-yes\" target=\"_blank\">hash out a deal \u003c/a>on the fiscal cliff, one item getting a lot of discussion is \u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/12/07/fiscal-cliffnotes-what-are-the-trade-offs-in-raising-medicares-eligibility-age/\" target=\"_blank\">raising the Medicare eligibility age\u003c/a>, as I wrote about on Friday. Today, I was checking out \u003ca href=\"https://twitter.com/sarahkliff\" target=\"_blank\">Sarah Kliff's twitter feed\u003c/a>, and she pointed to UC Berkeley grad student \u003ca href=\"http://owenzidar.wordpress.com/2012/12/09/the-medicare-eligibility-age-impacts-on-health-behavior-and-outcomes/\" target=\"_blank\">Owen Zidar's blog\u003c/a>. Zidar's post includes some eye-opening charts from economists David Card, Carlos Dobkin and Nicole Maestas writing in the \u003ca href=\"http://www.aeaweb.org/articles.php?doi=10.1257/aer.98.5.2242\" target=\"_blank\">American Economic Review\u003c/a>.\u003c/p>\n\u003cp>Embedded in these wonky charts is an illustration of disparity:\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Screen-Shot-2012-12-10-at-11.31.44-AM.png\">\u003cimg class=\"aligncenter size-large wp-image-9352\" title=\"Screen Shot 2012-12-10 at 11.31.44 AM\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Screen-Shot-2012-12-10-at-11.31.44-AM-620x396.png\" alt=\"\" width=\"620\" height=\"396\">\u003c/a>\u003c/p>\n\u003cp>And that disparity plays out in people not getting health care because of cost. Another snapshot of disparity:\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Screen-Shot-2012-12-10-at-11.39.44-AM.png\">\u003cimg class=\"aligncenter size-large wp-image-9355\" title=\"Screen Shot 2012-12-10 at 11.39.44 AM\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Screen-Shot-2012-12-10-at-11.39.44-AM-620x424.png\" alt=\"\" width=\"620\" height=\"424\">\u003c/a>This data was compiled before the Affordable Care Act was passed. We'll have to wait and see how coverage and access change once the ACA is fully implemented in 2014.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Fiscal Cliffnotes: What Are the Trade-offs in Raising Medicare's Eligibility Age?",
"title": "Fiscal Cliffnotes: What Are the Trade-offs in Raising Medicare's Eligibility Age?",
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"content": "\u003cfigure id=\"attachment_9340\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Aging_Healthy_Patrick_Flickr_02212012.jpg\">\u003cimg class=\"size-medium wp-image-9340\" title=\"(Patrick/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Aging_Healthy_Patrick_Flickr_02212012-300x240.jpg\" alt=\"(Patrick/Flickr)\" width=\"300\" height=\"240\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Patrick/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>It seems seductively easy: people are living longer, so why not raise the Medicare eligibility age from 65 to 67? This kind of entitlement reform is key to Republican strategies to pull the federal government back from the so-called Fiscal Cliff.\u003c/p>\n\u003cp>The problem is that while raising the Medicare eligibility age looks great in the short run, longterm it could actually cost money.\u003c/p>\n\u003cp>First, the short run: the non-partisan Kaiser Family Foundation says the federal government would save an \u003ca href=\"http://www.kff.org/medicare/8169.cfm\" target=\"_blank\">estimated $5.7 billion\u003c/a> in 2014 if the eligibility age were raised. Using a slightly different analysis, the nonpartisan Congressional Budget Office says savings could total \u003ca href=\"http://www.cbo.gov/sites/default/files/cbofiles/attachments/01-10-2012-Medicare_SS_EligibilityAgesBrief.pdf\" target=\"_blank\">$113 billion over the next decade\u003c/a>.\u003c/p>\n\u003cp>But, those 65 and 66-year-olds are the youngest and presumably healthiest people in the Medicare program --- meaning that if they leave Medicare, they would then be the oldest and presumably sickest people in any other insurance pool.\u003c/p>\n\u003cp>What would happen to those people?\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Some or many might stay in the workforce, and their presence would likely drive up costs to their employers or the new health insurance exchanges.\u003c/p>\n\u003cp>Some might find themselves eligible for Medicaid, the government sponsored health plan for the poor.\u003c/p>\n\u003cp>In its analysis, the Kaiser Family Foundation estimates that two-thirds of the five million affected 65 and 66-year-olds \"would pay an average of $2,200 more for their health care in 2014 than they would have paid if covered under Medicare.\"\u003c/p>\n\u003cp>And what about those still in Medicare? Without those younger, healthier 65 and 66-year-olds, Medicare premiums for the people left would rise by 3 percent, according to the Kaiser Family Foundation analysis.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>A recent Associated Press-GfK poll found that many Americans -- 40 percent -- are willing to consider raising Medicare's eligibility age, but 48 percent are opposed. The poll showed a pretty big division by age, as \u003ca href=\"http://www.google.com/hostednews/ap/article/ALeqM5gtzIcX1ShjCgocK2J3-AjpqdbOGQ?docId=c39d6b640cbd414589744774ba7b98fd\" target=\"_blank\">the AP indicated in its report:\u003c/a>\u003c/p>\n\u003cblockquote>\u003cp>Those under age 30 were most supportive, while a clear majority of those between the ages of 30 and 64 were opposed. Seniors were split. Surprisingly, there were no significant differences by political party. Overall, foes of the idea were more adamant, with strong opponents outnumbering strong supporters by 2-1.\u003c/p>\n\u003cp>U.S. life expectancy has risen by about eight years since Medicare was created in 1965. During the 1980s, Republican President Ronald Reagan and Democratic congressional leaders agreed to gradually increase the age for receiving full Social Security benefits from 65 to 67. But they didn't touch Medicare eligibility.\u003c/p>\n\u003cp>Since then, some policy experts have advocated aligning the Medicare and Social Security eligibility ages through a gradual phase-in that would spare those close to retirement.\u003c/p>\u003c/blockquote>\n\n",
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"excerpt": "It seems seductively easy: people are living longer, so why not raise the Medicare eligibility age from 65 to 67? This kind of entitlement reform is key to Republican strategies to pull the federal government back from the so-called Fiscal Cliff.\r\n\r\nThe problem is that while raising the Medicare eligibility age looks great in the short run, longterm it could actually cost money.",
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"description": "It seems seductively easy: people are living longer, so why not raise the Medicare eligibility age from 65 to 67? This kind of entitlement reform is key to Republican strategies to pull the federal government back from the so-called Fiscal Cliff.\r\n\r\nThe problem is that while raising the Medicare eligibility age looks great in the short run, longterm it could actually cost money.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_9340\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Aging_Healthy_Patrick_Flickr_02212012.jpg\">\u003cimg class=\"size-medium wp-image-9340\" title=\"(Patrick/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Aging_Healthy_Patrick_Flickr_02212012-300x240.jpg\" alt=\"(Patrick/Flickr)\" width=\"300\" height=\"240\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Patrick/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>It seems seductively easy: people are living longer, so why not raise the Medicare eligibility age from 65 to 67? This kind of entitlement reform is key to Republican strategies to pull the federal government back from the so-called Fiscal Cliff.\u003c/p>\n\u003cp>The problem is that while raising the Medicare eligibility age looks great in the short run, longterm it could actually cost money.\u003c/p>\n\u003cp>First, the short run: the non-partisan Kaiser Family Foundation says the federal government would save an \u003ca href=\"http://www.kff.org/medicare/8169.cfm\" target=\"_blank\">estimated $5.7 billion\u003c/a> in 2014 if the eligibility age were raised. Using a slightly different analysis, the nonpartisan Congressional Budget Office says savings could total \u003ca href=\"http://www.cbo.gov/sites/default/files/cbofiles/attachments/01-10-2012-Medicare_SS_EligibilityAgesBrief.pdf\" target=\"_blank\">$113 billion over the next decade\u003c/a>.\u003c/p>\n\u003cp>But, those 65 and 66-year-olds are the youngest and presumably healthiest people in the Medicare program --- meaning that if they leave Medicare, they would then be the oldest and presumably sickest people in any other insurance pool.\u003c/p>\n\u003cp>What would happen to those people?\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Some or many might stay in the workforce, and their presence would likely drive up costs to their employers or the new health insurance exchanges.\u003c/p>\n\u003cp>Some might find themselves eligible for Medicaid, the government sponsored health plan for the poor.\u003c/p>\n\u003cp>In its analysis, the Kaiser Family Foundation estimates that two-thirds of the five million affected 65 and 66-year-olds \"would pay an average of $2,200 more for their health care in 2014 than they would have paid if covered under Medicare.\"\u003c/p>\n\u003cp>And what about those still in Medicare? Without those younger, healthier 65 and 66-year-olds, Medicare premiums for the people left would rise by 3 percent, according to the Kaiser Family Foundation analysis.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>A recent Associated Press-GfK poll found that many Americans -- 40 percent -- are willing to consider raising Medicare's eligibility age, but 48 percent are opposed. The poll showed a pretty big division by age, as \u003ca href=\"http://www.google.com/hostednews/ap/article/ALeqM5gtzIcX1ShjCgocK2J3-AjpqdbOGQ?docId=c39d6b640cbd414589744774ba7b98fd\" target=\"_blank\">the AP indicated in its report:\u003c/a>\u003c/p>\n\u003cblockquote>\u003cp>Those under age 30 were most supportive, while a clear majority of those between the ages of 30 and 64 were opposed. Seniors were split. Surprisingly, there were no significant differences by political party. Overall, foes of the idea were more adamant, with strong opponents outnumbering strong supporters by 2-1.\u003c/p>\n\u003cp>U.S. life expectancy has risen by about eight years since Medicare was created in 1965. During the 1980s, Republican President Ronald Reagan and Democratic congressional leaders agreed to gradually increase the age for receiving full Social Security benefits from 65 to 67. But they didn't touch Medicare eligibility.\u003c/p>\n\u003cp>Since then, some policy experts have advocated aligning the Medicare and Social Security eligibility ages through a gradual phase-in that would spare those close to retirement.\u003c/p>\u003c/blockquote>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "How Many Dentists Accept Children on Medi-Cal? Depends on Who You Ask",
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"content": "\u003cp>\u003cstrong>New report says one in four dentists accept state's Denti-Cal insurance; older reports say closer to two-thirds\u003c/strong>\u003c/p>\n\u003cp>By Emily Bazar, \u003ca href=\"http://centerforhealthreporting.org/blog/how-many-california-dentists-accept-poor-kids-medi-cal-new-report-says-one-four1026\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_9308\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/KidAtDentist_PaulGoyette_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-9308\" title=\"(Paul Goyette/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/KidAtDentist_PaulGoyette_Flickr-300x200.jpg\" alt=\"(Paul Goyette/Flickr)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Paul Goyette/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>I’ve spent many months reporting on dental care for poor California children, looking into what kind of access they have to treatment.\u003c/p>\n\u003cp>(About half of kids in the Medi-Cal dental program see a dentist annually, although figures vary wildly by county.)\u003c/p>\n\u003cp>But I haven’t focused as much on the dentists who participate in the program, called Denti-Cal.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003ca href=\"http://centerforhealthreporting.org/sites/default/files/denti-cal_final_report_nov_2_2012.pdf\" target=\"_blank\">A new report\u003c/a> by \u003ca href=\"http://www.barbaraavedassociates.com/\" target=\"_blank\">health care consultant Barbara Aved\u003c/a> does just that. Based on her research, Aved concludes that 25 percent of California’s general dentists participate in the program.\u003c/p>\n\u003cp>Why not more? Here are some of Aved’s primary conclusions, based in part on a survey of dentists in five counties that she says reflect California as a whole. Out of about 2,000 general and pediatric dentists invited to participate, 322 responded.\u003c/p>\n\u003cul>\n\u003cul>\n\u003cli>Of dentists who do not participate, 97 percent cited the state’s low reimbursement rates as the No. 1 reason. California’s rates, Aved said, are among the lowest in the nation.\u003c/li>\n\u003c/ul>\n\u003c/ul>\n\u003cp>“Unlike physician practices, dental practices are in large part solo or two-person practices,” she said. “It’s really like a small business. Economically, it just doesn’t make sense to do business where you’re not going to be fully reimbursed.”\u003c!--more-->\u003c/p>\n\u003cul>\n\u003cli>Many dentists also blamed their non-participation on the bureaucratic requirements associated with enrolling and billing.\u003c/li>\n\u003c/ul>\n\u003cp>“Make the claim process simple and straightforward; quit denying claims for stupid, little reasons and obscure criteria,” wrote one dentist who responded to the survey.\u003c/p>\n\u003cp>“I would rather treat some people for nothing than jump through all the hoops Denti-Cal makes you go through,” wrote another.\u003c/p>\n\u003cul>\n\u003cli>Some dentists complained about patients breaking appointments and other compliance issues.\u003c/li>\n\u003c/ul>\n\u003cp>Aved’s study, which also analyzed 2011 Denti-Cal claims data, was commissioned by dental plans LIBERTY Dental and HealthNet.\u003c/p>\n\u003cp>The Department of Health Care Services (DHCS), which administers Denti-Cal, has a very different take on the percentage of California dentists who participate: Two thirds of dentists, or 66 percent.\u003c/p>\n\u003cp>“What we’ve done with our numbers is take a look at verifiable data, data that was collected and that represents the actual figures that are kept by the state of California,” said spokesman Norman Williams. “It wasn’t a survey. … It’s actual data and that’s what we base our numbers on.”\u003c/p>\n\u003cp>But Aved pointed to a \u003ca href=\"http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/D/PDF%20DentiCalFactsAndFigures2010.pdf\" target=\"_blank\">California HealthCare Foundation report\u003c/a> on Denti-Cal from 2010 that also concluded that 25 percent of California dentists accept Medi-Cal patients.\u003c/p>\n\u003cp>Williams said current dentist participation in Denti-Cal already “ensures sufficient access,” but the department is taking several steps to boost participation. They include:\u003c/p>\n\u003cul>\n\u003cli>Developing a survey for Denti-Cal beneficiaries to determine their satisfaction with the program;\u003c/li>\n\u003cli>Offering a new customer service line to help children and their families locate participating dentists; and\u003c/li>\n\u003cli>Reaching out to dentists to urge them to join the program or take more Denti-Cal patients.\u003c/li>\n\u003c/ul>\n\u003cp>The department is addressing complaints about bureaucratic obstacles by developing a webinar series, video tutorials and other materials for dentists to help them with enrollment and billing, Williams said.\u003c/p>\n\u003cp>But raising rates isn’t on the table.\u003c/p>\n\u003cp>“Because of our current economic situation, the state is not in a financial position to increase Medi-Cal payments to dentists,” Williams said.\u003c/p>\n\u003cp>Gayle Mathe, director of policy development for the \u003ca href=\"http://www.cda.org/\" target=\"_blank\">California Dental Association\u003c/a>, applauded the department for its recent moves to boost dentist ranks in the program. In many cases, she said, her association is partnering on these initiatives.\u003c/p>\n\u003cp>“We’re starting to see movement and changes in a positive direction,” she said. “And the department is really engaged in doing that.”\u003c/p>\n\u003cp>But the association questions the department’s conclusion that two-thirds of dentists participate Denti-Cal, saying that Aved’s figure is closer.\u003c/p>\n\u003cp>“We don’t have access to data, but the 25 percent is consistent with what we’ve heard anecdotally over the years,” Mathe said.\u003c/p>\n\u003cp>Aved said she’s concerned that not enough dentists participate as it is and worries that Denti-Cal isn’t prepared for the hundreds of thousands of new children coming into the program in the next few years. This will be primarily as a result of the transition of children \u003ca href=\"http://www.dhcs.ca.gov/services/Pages/HealthyFamiliesTransition.aspx\" target=\"_blank\">from the publicly-funded Healthy Families program into Medi-Cal\u003c/a> and the expansion of Medi-Cal under the Affordable Care Act.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“If it’s this way now, we should be worried about the future for sure,” she said.\u003c/p>\n\n",
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"excerpt": "I’ve spent many months reporting on dental care for poor California children, looking into what kind of access they have to treatment.\r\n\r\n(About half of kids in the Medi-Cal dental program see a dentist annually, although figures vary wildly by county.)\r\n\r\nBut I haven’t focused as much on the dentists who participate in the program, called Denti-Cal.\r\n\r\nA new report by health care consultant Barbara Aved does just that. Based on her research, Aved concludes that 25 percent of California’s general dentists participate in the program.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>New report says one in four dentists accept state's Denti-Cal insurance; older reports say closer to two-thirds\u003c/strong>\u003c/p>\n\u003cp>By Emily Bazar, \u003ca href=\"http://centerforhealthreporting.org/blog/how-many-california-dentists-accept-poor-kids-medi-cal-new-report-says-one-four1026\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_9308\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/KidAtDentist_PaulGoyette_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-9308\" title=\"(Paul Goyette/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/KidAtDentist_PaulGoyette_Flickr-300x200.jpg\" alt=\"(Paul Goyette/Flickr)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Paul Goyette/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>I’ve spent many months reporting on dental care for poor California children, looking into what kind of access they have to treatment.\u003c/p>\n\u003cp>(About half of kids in the Medi-Cal dental program see a dentist annually, although figures vary wildly by county.)\u003c/p>\n\u003cp>But I haven’t focused as much on the dentists who participate in the program, called Denti-Cal.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://centerforhealthreporting.org/sites/default/files/denti-cal_final_report_nov_2_2012.pdf\" target=\"_blank\">A new report\u003c/a> by \u003ca href=\"http://www.barbaraavedassociates.com/\" target=\"_blank\">health care consultant Barbara Aved\u003c/a> does just that. Based on her research, Aved concludes that 25 percent of California’s general dentists participate in the program.\u003c/p>\n\u003cp>Why not more? Here are some of Aved’s primary conclusions, based in part on a survey of dentists in five counties that she says reflect California as a whole. Out of about 2,000 general and pediatric dentists invited to participate, 322 responded.\u003c/p>\n\u003cul>\n\u003cul>\n\u003cli>Of dentists who do not participate, 97 percent cited the state’s low reimbursement rates as the No. 1 reason. California’s rates, Aved said, are among the lowest in the nation.\u003c/li>\n\u003c/ul>\n\u003c/ul>\n\u003cp>“Unlike physician practices, dental practices are in large part solo or two-person practices,” she said. “It’s really like a small business. Economically, it just doesn’t make sense to do business where you’re not going to be fully reimbursed.”\u003c!--more-->\u003c/p>\n\u003cul>\n\u003cli>Many dentists also blamed their non-participation on the bureaucratic requirements associated with enrolling and billing.\u003c/li>\n\u003c/ul>\n\u003cp>“Make the claim process simple and straightforward; quit denying claims for stupid, little reasons and obscure criteria,” wrote one dentist who responded to the survey.\u003c/p>\n\u003cp>“I would rather treat some people for nothing than jump through all the hoops Denti-Cal makes you go through,” wrote another.\u003c/p>\n\u003cul>\n\u003cli>Some dentists complained about patients breaking appointments and other compliance issues.\u003c/li>\n\u003c/ul>\n\u003cp>Aved’s study, which also analyzed 2011 Denti-Cal claims data, was commissioned by dental plans LIBERTY Dental and HealthNet.\u003c/p>\n\u003cp>The Department of Health Care Services (DHCS), which administers Denti-Cal, has a very different take on the percentage of California dentists who participate: Two thirds of dentists, or 66 percent.\u003c/p>\n\u003cp>“What we’ve done with our numbers is take a look at verifiable data, data that was collected and that represents the actual figures that are kept by the state of California,” said spokesman Norman Williams. “It wasn’t a survey. … It’s actual data and that’s what we base our numbers on.”\u003c/p>\n\u003cp>But Aved pointed to a \u003ca href=\"http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/D/PDF%20DentiCalFactsAndFigures2010.pdf\" target=\"_blank\">California HealthCare Foundation report\u003c/a> on Denti-Cal from 2010 that also concluded that 25 percent of California dentists accept Medi-Cal patients.\u003c/p>\n\u003cp>Williams said current dentist participation in Denti-Cal already “ensures sufficient access,” but the department is taking several steps to boost participation. They include:\u003c/p>\n\u003cul>\n\u003cli>Developing a survey for Denti-Cal beneficiaries to determine their satisfaction with the program;\u003c/li>\n\u003cli>Offering a new customer service line to help children and their families locate participating dentists; and\u003c/li>\n\u003cli>Reaching out to dentists to urge them to join the program or take more Denti-Cal patients.\u003c/li>\n\u003c/ul>\n\u003cp>The department is addressing complaints about bureaucratic obstacles by developing a webinar series, video tutorials and other materials for dentists to help them with enrollment and billing, Williams said.\u003c/p>\n\u003cp>But raising rates isn’t on the table.\u003c/p>\n\u003cp>“Because of our current economic situation, the state is not in a financial position to increase Medi-Cal payments to dentists,” Williams said.\u003c/p>\n\u003cp>Gayle Mathe, director of policy development for the \u003ca href=\"http://www.cda.org/\" target=\"_blank\">California Dental Association\u003c/a>, applauded the department for its recent moves to boost dentist ranks in the program. In many cases, she said, her association is partnering on these initiatives.\u003c/p>\n\u003cp>“We’re starting to see movement and changes in a positive direction,” she said. “And the department is really engaged in doing that.”\u003c/p>\n\u003cp>But the association questions the department’s conclusion that two-thirds of dentists participate Denti-Cal, saying that Aved’s figure is closer.\u003c/p>\n\u003cp>“We don’t have access to data, but the 25 percent is consistent with what we’ve heard anecdotally over the years,” Mathe said.\u003c/p>\n\u003cp>Aved said she’s concerned that not enough dentists participate as it is and worries that Denti-Cal isn’t prepared for the hundreds of thousands of new children coming into the program in the next few years. This will be primarily as a result of the transition of children \u003ca href=\"http://www.dhcs.ca.gov/services/Pages/HealthyFamiliesTransition.aspx\" target=\"_blank\">from the publicly-funded Healthy Families program into Medi-Cal\u003c/a> and the expansion of Medi-Cal under the Affordable Care Act.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“If it’s this way now, we should be worried about the future for sure,” she said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"info": "KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Bay-Curious-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/news/series/baycurious",
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"source": "kqed",
"order": 3
},
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}
},
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"id": "bbc-world-service",
"title": "BBC World Service",
"info": "The day's top stories from BBC News compiled twice daily in the week, once at weekends.",
"airtime": "MON-FRI 9pm-10pm, TUE-FRI 1am-2am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/BBC-World-Service-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.bbc.co.uk/sounds/play/live:bbc_world_service",
"meta": {
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"source": "BBC World Service"
},
"link": "/radio/program/bbc-world-service",
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"rss": "https://podcasts.files.bbci.co.uk/p02nq0gn.rss"
}
},
"californiareport": {
"id": "californiareport",
"title": "The California Report",
"tagline": "California, day by day",
"info": "KQED’s statewide radio news program providing daily coverage of issues, trends and public policy decisions.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-California-Report-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/californiareport",
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"source": "kqed",
"order": 8
},
"link": "/californiareport",
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}
},
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"title": "The California Report Magazine",
"tagline": "Your state, your stories",
"info": "Every week, The California Report Magazine takes you on a road trip for the ears: to visit the places and meet the people who make California unique. The in-depth storytelling podcast from the California Report.",
"airtime": "FRI 4:30pm-5pm, 6:30pm-7pm, 11pm-11:30pm",
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"officialWebsiteLink": "/californiareportmagazine",
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"order": 10
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM3NjkwNjk1OTAz",
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},
"city-arts": {
"id": "city-arts",
"title": "City Arts & Lectures",
"info": "A one-hour radio program to hear celebrated writers, artists and thinkers address contemporary ideas and values, often discussing the creative process. Please note: tapes or transcripts are not available",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/05/cityartsandlecture-300x300.jpg",
"officialWebsiteLink": "https://www.cityarts.net/",
"airtime": "SUN 1pm-2pm, TUE 10pm, WED 1am",
"meta": {
"site": "news",
"source": "City Arts & Lectures"
},
"link": "https://www.cityarts.net",
"subscribe": {
"tuneIn": "https://tunein.com/radio/City-Arts-and-Lectures-p692/",
"rss": "https://www.cityarts.net/feed/"
}
},
"closealltabs": {
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"info": "Close All Tabs breaks down how digital culture shapes our world through thoughtful insights and irreverent humor.",
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"officialWebsiteLink": "/podcasts/closealltabs",
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"source": "kqed",
"order": 1
},
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"id": "code-switch-life-kit",
"title": "Code Switch / Life Kit",
"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"meta": {
"site": "radio",
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},
"link": "/radio/program/code-switch-life-kit",
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},
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"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.",
"airtime": "THU 10pm, FRI 1am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
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"meta": {
"site": "news",
"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/commonwealth-club-of-california-podcast/id976334034?mt=2",
"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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},
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"id": "forum",
"title": "Forum",
"tagline": "The conversation starts here",
"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
"airtime": "MON-FRI 9am-11am, 10pm-11pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Forum with Mina Kim and Alexis Madrigal",
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"meta": {
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"source": "kqed",
"order": 9
},
"link": "/forum",
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz",
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"freakonomics-radio": {
"id": "freakonomics-radio",
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"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/freakonomicsRadio.png",
"officialWebsiteLink": "http://freakonomics.com/",
"airtime": "SUN 1am-2am, SAT 3pm-4pm",
"meta": {
"site": "radio",
"source": "WNYC"
},
"link": "/radio/program/freakonomics-radio",
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"apple": "https://itunes.apple.com/us/podcast/freakonomics-radio/id354668519",
"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/",
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},
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"id": "fresh-air",
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"link": "/radio/program/fresh-air",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory",
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"info": "A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.",
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},
"hidden-brain": {
"id": "hidden-brain",
"title": "Hidden Brain",
"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
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"airtime": "SUN 7pm-8pm",
"meta": {
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"source": "NPR"
},
"link": "/radio/program/hidden-brain",
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},
"how-i-built-this": {
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"title": "How I Built This with Guy Raz",
"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/howIBuiltThis.png",
"officialWebsiteLink": "https://www.npr.org/podcasts/510313/how-i-built-this",
"airtime": "SUN 7:30pm-8pm",
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"source": "npr"
},
"link": "/radio/program/how-i-built-this",
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"apple": "https://itunes.apple.com/us/podcast/how-i-built-this-with-guy-raz/id1150510297?mt=2",
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},
"hyphenacion": {
"id": "hyphenacion",
"title": "Hyphenación",
"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. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/03/Hyphenacion_FinalAssets_PodcastTile.png",
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"officialWebsiteLink": "/podcasts/hyphenacion",
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"order": 15
},
"link": "/podcasts/hyphenacion",
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},
"jerrybrown": {
"id": "jerrybrown",
"title": "The Political Mind of Jerry Brown",
"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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"officialWebsiteLink": "/podcasts/jerrybrown",
"meta": {
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"source": "kqed",
"order": 18
},
"link": "/podcasts/jerrybrown",
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}
},
"latino-usa": {
"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/latino-usa",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
}
},
"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",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
"site": "news",
"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
}
},
"masters-of-scale": {
"id": "masters-of-scale",
"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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"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
"site": "radio",
"source": "WaitWhat"
},
"link": "/radio/program/masters-of-scale",
"subscribe": {
"apple": "http://mastersofscale.app.link/",
"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"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>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
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"source": "kqed",
"order": 12
},
"link": "/podcasts/mindshift",
"subscribe": {
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
"npr": "https://www.npr.org/podcasts/464615685/mind-shift-podcast",
"stitcher": "https://www.stitcher.com/podcast/kqed/stories-teachers-share",
"spotify": "https://open.spotify.com/show/0MxSpNYZKNprFLCl7eEtyx"
}
},
"morning-edition": {
"id": "morning-edition",
"title": "Morning Edition",
"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.",
"airtime": "MON-FRI 3am-9am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/morning-edition/",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/morning-edition"
},
"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
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