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Health Care Reform

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Blog: Lott on Health Care
Health Care Reform

April 5, 2011

Expanding coverage while containing costs is a concern for many in the health care industry. Read about the challenging path to health care reform in these blog entries from Jim Lott. 

Jim Lott is the executive vice president of the Hospital Association of Southern California where he is responsible for health care policy development, advocacy, and association communications for hospitals serving Los Angeles, Orange, San Bernardino, Riverside, Santa Barbara and Ventura counties.

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Blog entry

Lott has left the building!

April 26, 2013

Dear readers:

This will be my last post, as I am leaving HASC at the end of next month.  Health is fine, work is great, just moving on to the next chapter of my life, which will be in health care…what else would I do?

I have enjoyed writing this blog, and I thank all of you who have told me that you like reading what I write.  I will truly miss doing this.

Again, I’m still at HASC until May 31, so drop me a line or call.  After I leave, you may reach me on my cell at 213-324-3262 or by email at JLottSr@me.com.

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Blog entry

Health Care Reform Stumbles

April 25, 2013

The  Society of Actuaries (SOA) recently predicted health insurance costs in the individual market would increase 32% by 2017.  Not good news, especially considering that the blame for this increase was placed at the doorstep of the Accountable Care Act (ACA).  Contrary to the expectations of those who developed the new reform laws, the SOA asserts that this increase is in part due to the poor health status of the new enrollees now eligible under the ACA.

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Blog entry

Are you addressing your patients’ CRFs?

April 18, 2013

Most would agree that cutting health care costs requires more active participation of the consumer in medical decision making.

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Blog entry

Retail Clinics: The Next Generation

April 9, 2013

Six years ago, I wrote about the emergence of retail clinics as “…The Next New Thing” in the delivery of health care.  Even then, for almost 10 years these enterprises had been offering basic medical care in drug stores in nearly half the states in the country at about 12 percent of the cost of an emergency room visit and a third of the cost of a visit to an urgent care center.At the time, the California Health Care Foundation opined that, “If successful, this could change the way many people receive routine, non-urgent medical care, with significant implication

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Blog entry

A Yellow Flag for Dual-Eligibles Conversion

April 4, 2013

In my last blog, I summarized the plan to move Medicare/Medi-Cal-covered patients residing in eight California counties into a system of coordinated care.  The move would make California the fifth dual-eligibles coordinated care project in the nation. In no particular order, the following demographics about plan enrollees worry me:

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Blog entry

Plan to Change Dual Eligibles Program Advances

April 2, 2013

Last week, federal and state officials released their long-anticipated Memorandum of Understanding (MOU) implementing a three-year effort to lower costs and improve the coordination of medical care provided to nearly half a million California seniors who are enrolled in both Medicare and Medi-Cal.  If approved by the feds, passive enrollment of program beneficiaries over a 12-to-18-month period will start in seven counties (Orange, Riverside, San Bernardino, San Diego, San Mateo, Alameda and Santa Clara) in October.  What this means is that the dual-eligible program beneficiaries

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Blog entry

Covered California Gets Creative

March 28, 2013

Starting in January, the federal Affordable Care Act (ACA) will require all residents to secure health insurance or pay a $95 tax penalty, assessed only if the filer qualifies for a federal tax return.  

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Blog entry

The Obfuscation Plan

March 26, 2013

A physician specialist that I see regularly ordered a diagnostic test to check on my medical condition.  He explained to me that two tests were available and he disclosed which of the two he preferred.  Of course, I did what most patients do—I chose his preference.  Later I would learn that his preference cost almost twice as much as the other test and that I would have to pay more than $500 for the part of the bill not paid by my health plan.  I hasten to add that I am not upset with my doctor.  Rather, I am ticked off at myself and my health plan for how this play

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Blog entry

To govern or not to govern …

March 21, 2013

… That is the question. 

A belief I regard highly is, “That government is best which governs least,” a quote historians have attributed equally to Henry David Thoreau and Thomas Jefferson.  Mind you, the operative meaning or the verb infinitive in the quote is “to govern.” Few who have been paying attention to the gridlock in our nation’s capital give high marks to our elected representatives for meeting this core job requirement.  In fact, one credible poll gives Congress an approval rating of only 14 percent, with the Obama Administration receiving only slightly higher marks.

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Blog entry

Do Consumers Care About Cutting Health Care Costs?

March 14, 2013

We’ve all heard this one.  When asked about Congress or our state legislature, voters give low performance ratings to both followed by, “but my representative is a good guy.”  It would seem that the same holds true about constraining the growth of health care costs.

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Blog entry

Reflections of a Hospital Lobbyist

March 12, 2013

“Expect more!” 

I learned what that meant when as a third grader my mother moved me to a private Catholic school from an economically depressed inner-city public school where 70 percent of the students never made it to high school graduation and where the majority of those who did were sub-literate. 

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Blog entry

Are Freestanding Emergency Rooms Good for California?

March 7, 2013

Demand for emergency room care in California has increased by 26 percent over the last decade while capacity has remained flat or declined in most service areas. Accordingly, some health care analysts recommend that hospitals be allowed to operate freestanding emergency departments (FEDs) to help meet a growing need in the state. FED supporters also believe that the enactment of health care reform will put greater stress on existing hospital emergency departments because as many as 40 hospitals in California, most with emergency rooms, will close in the coming years.

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Blog entry

Health Care Lost in Translation

March 5, 2013

Almost one person in five in the U.S.

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Blog entry

“A billion here, a billion there …”

February 28, 2013

“… and pretty soon you’re talking real money.” The late Senator Everett Dirksen (R-IL), a politician who often spoke passionately about the debt ceiling, federal spending and the growth of government, is rumored to have made this statement to reporters about the way Congress thinks about the federal budget.  Well, the Rand Corporation may have found a billion dollars that can be taken off our nation’s yearly health care tab.

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Blog entry

“Mr. Jones, the nurse practitioner will see you now.”

February 15, 2013

Substitute “physician assistant” or “pharmacist” in this phrase, and this may become a commonplace introduction patients seeking medical care will hear in the future.  Why?  Legislatures throughout our nation are looking for ways to bridge a looming shortage of doctors caused by the approaching exodus of aging physicians and the increased demand for access to physician-led care by millions of newly-insured Americans, courtesy of the federal Patient Protection and Affordable Care Act (PPACA) enacted in 2010. 

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Blog entry

Illegal Immigrants Denied Health Coverage Aid Again

February 14, 2013

The federal health care reform law enacted in 2010 – the Patient Protection and Affordable Care Act (PPACA) – excluded illegal immigrants from eligibility for inclusion under its expanded health insurance coverage provisions. Now it would appear that health coverage for these immigrants will not be in the immigration reform plan the White House and Congress will likely hammer out later this year.

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Blog entry

Pace to Government-Sponsored Health Insurance for All Hastens

February 11, 2013

In California, 54 percent of health care coverage provided to residents under 65 is sponsored by our state’s employers, down from 61 percent prior to enactment of the federal law in 2010. Last week, the nonpartisan Congressional Budget Office (CBO) advised Congress that seven million fewer Americans were forecast to have employer-sponsored health insurance in 2022 due to the federal Patient Protection and Affordable Care Act (PPACA). The estimate is up from August, when the CBO predicted a drop of four million people with employer-sponsored plans.

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Blog entry

Individual Mandate: Not So Much a Mandate Anymore

February 7, 2013

Last week, the Internal Revenue Service (IRS) and the Health and Human Services Agency (HHS) published rules governing the individual mandate that, according to HealthLeaders Media, “include such extensive exemptions that only 2% of the population would owe a penalty, or ‘shared responsibility payment’ for not having coverage under a health plan.”

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Blog entry

Health Care Reform’s Impact on Employers: Myths, Misconceptions and Consequences

February 5, 2013

There is no employer mandate to provide health insurance coverage under the Patient Protection and Affordable Care Act (PPACA) passed in 2010, but there is a stick in the form of a $2,000-per-year/per-worker penalty hovering over the heads of a minority of California businesses with more than 50 company employees.  The penalty will be assessed starting with the 31st worker and beyond.What this means is that the requirement to either provide health insurance or pay a penalty does not apply to 5.7 million out of 6 million (96 percent) of the registered businesses in California.Specifical

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Blog entry

A Back-To-Basics Health Care Cost Containment Strategy Whose Time Has Come…Again

January 31, 2013

The December 31st Ventura County Star news report that Community Memorial Health System (CMHS)  will no longer hire people who use tobacco gets my vote for the best New Year’s resolution made by a health care organization.By taking this bold action, CMHS, which runs two hospitals and a network of clinics in west Ventura County, joins but a handful of providers of hospital care in California, if not the nation, to move beyond on-campus smoking bans with this more restrictive

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Blog entry

Taming Medicare’s Budget Appetite, Part 2

January 28, 2013

A prominent retirement investment planning firm cites two lifespan statistics in its advertising campaign that, if true, will stun to death any efforts to rein in the aggregate growth of what we spend as a nation on health care.  “One in three people born today will live to be 100 years old,” says one billboard.  “The first person who will live to be 150 years old is alive today,” says another.  Thought-provoking ads, both, and the health care cost implications of such a trend are breathtaking.

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Blog entry

Taming Medicare’s Budget Appetite

January 24, 2013

Medicare cost the federal government $528 billion in 2010.  Current projections place that funding level above $1 trillion in 2020, and that’s after deducting $45 billion in payment cuts per year to providers and Medicare Advantage plans during that period, as ordered by the federal Patient Protection and Affordable Care Act (PPACA).

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Blog entry

Covered California Considers Bold Plan to Extend Coverage to Uninsured Low-Income Residents

January 22, 2013

With some exceptions, the federal Patient Protection and Affordable Care Act (PPACA) enacted in 2010 requires everyone to get health insurance or pay a fine.  The individual mandate contained in the act takes effect in 2014 and levies fines for failure to document coverage at the greater of $95 or 1 percent of annual income capped at $285 (triple the flat rate) for that year.  After that, the penalty will grow until it reaches a ceiling in 2016 of the greater of $695 or 2.5 percent of annual income capped at $2,085.The IRS will be the compliance authority, and the agency is empowe

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Blog entry

Our Hospital Heroes for 2012

November 12, 2012 James Lott

Once a year for the past seven years, our community of hospitals in Southern California comes together to honor the most giving of themselves, the laborers of the planet.  Okay, so we are a little biased about the people working in our hospitals. Here are but five of the extraordinary people we honored last week along with their stories.

Our first award went to a nurse and social worker on the front lines of a busy hospital who teamed up to fix a problem that plagues emergency rooms everywhere … frequent fliers. 

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Blog entry

EMTALA Needs a Makeover

October 15, 2012

One of my most vivid childhood memories was when, as a teenager, I broke my arm playing softball at school. The pain was excruciating, but it was the quest to get medical treatment for my fractured appendage that is most memorable. The private hospital closest to my school in South Central Los Angeles turned my mother and me away because I had no medical insurance.  As a consequence, with my arm resting on a clipboard, we had to take a very long bus ride to the county hospital in East Los Angeles where I finally received treatment after enduring many hours of extreme pain.

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