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January 9, 2017 | VOLUME 24 | NUMBER 2

T O P S T O R I E S

Report: California Could Lose 209,000 Jobs with ACA RepealState lawmakers hire Eric Holder as outside counselAs the GOP begins efforts to dismantle the Affordable Care Act (ACA), a new study predicts the state could lose more than 200,000 jobs if the ACA is repealed.

The study, published in December by researchers at the UC Berkeley Cen-ter for Labor Research and Education, estimates repeal of federal healthcare reform could eliminate nearly 209,000 jobs and cost the state economy $20.5 billion a year. The $20.5 billion in lost revenue would result from the elimination of approximately $5 billion in federal subsidies for people who buy health plans on Covered California and the loss of more than $15 billion in funding for Med-icaid expansion.

The job-loss estimates are based on the jobs that were created when the ACA went into effect, said Laurel Lucia, a healthcare program manager at UC Berkeley and co-author of the study.

“Hospitals, clinics, and other providers staffed up to meet increased demand as a result of the ACA and our economic modeling software estimates that many of those jobs would be lost if the ACA is repealed,” said Lucia.

The majority of the job losses would be in hospitals, doctors offices, labs, outpatient and ambulatory care centers, nursing homes, dentist offices, and other healthcare settings, the report notes. The loss of healthcare jobs would also result in job losses in other industries through a ripple effect.

“Our analysis takes into account the multiplier effect,” said Lucia. “When healthcare workers found new jobs, their income was circulated through the community multiple times.” Additional jobs would also be lost in industries including food service, janitorial, and accounting firms.

Some counties would lose more jobs than others, particularly poorer coun-ties in rural parts of the state such as Merced County and Tulare County, accord-ing to the report. These areas have a higher-than-average share of their population enrolled in Medi-Cal due to Medicaid expansion, the largest single source of federal

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PAGE 2 January 9, 2017

� California Hospital Association (CHA) President C. Duane Dauner will retire when his current employment agreement ends on December 31, 2018. Dauner has served as president and CEO of the CHA since 1985 and previ-ously served as CEO of the Missouri Hospital Association from 1975 to 1985. Prior to that, he served with the Kansas Hospital Association from 1965 to 1975. “CHA and all California hospitals have benefitted from Duane Dauner’s leadership, public policy acu-men, and advocacy skills for more than three decades,” said Jim Holmes, chair of the CHA board of directors. The CHA will start a search for Dauner’s succes-sor later this year.

� Covered California appointed Karen Johnson as chief deputy execu-tive director of operations. In her new role, Johnson will manage the adminis-trative services, financial management, and information technology divisions for Covered California. Johnson most recently served as chief deputy direc-tor of the California Department of Health Care Services. “Throughout her 20-year career with the state of California, Karen has successfully im-plemented a broad range of complex programs with major impacts on the lives of Californians,” said California Health and Human Services Secre-tary Diana Dooley. “In these uncertain times, having Karen’s leadership will serve Covered California well.”

I N B R I E F T O P S T O R I E S CONTINUED FROM PAGE 1

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State to Lose Jobs cont.

spending in this analysis. A related study released in November found that more than 50% of residents in four California counties receive their healthcare coverage through Medi-Cal. Tulare County has the highest percentage of Medi-Cal enrollees at 55% followed by Merced County with 51.5% and Imperial County with 50.6%.

The UC Berkeley study also noted that repeal of the ACA could include some benefits to offset the estimated loss of $20.5 billion in revenue. “The economic losses … would be partially offset by limited economic gains from other provi-sions that may be included as part of a repeal of the ACA, which could yield $6.3 billion in tax cuts to California insurers and high-income households and $1.3 bil-lion in eliminated penalties for uninsured individuals and employers not offering affordable coverage.”

In a related matter, California lawmakers hired former U.S. Attorney Gen-eral Eric Holder as an outside counsel to advise state officials on how to combat changes to the ACA and other policies proposed by the administration of presi-dent-elect Donald Trump. Holder served as U.S. attorney general from 2009 to 2015 and is currently a partner at Covington & Burling, a Washington D.C. law firm that specializes in representing states and companies in lawsuits against the federal government.

“Having the former attorney general of the United States brings us a lot of fire-power in order to prepare to safeguard the values of the people in California,” said state Sen. Kevin de Leon (D-Los Angeles). “This means we are very, very serious.”

Republicans leaders are expected to launch an effort to repeal key provi-sions of the ACA through budget reconciliation shortly after Trump takes office on Jan. 20. —DOUG DESJARDINS

Measles Outbreak Hits Los Angeles, Santa Barbara CountiesNearly a dozen cases confirmed in late DecemberHealth officials in Southern California have confirmed at least 10 cases of measles since mid-December in the second outbreak in the region since December 2014.

The Los Angeles County Department of Public Health announced on December 22 that it was investigating 10 confirmed cases of measles in the county and one suspected case but did not release details on the age, gender, or location of the patients. Health officials said only one person diagnosed with measles in the outbreak has provided evidence of vaccination for the disease, but

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Measles Outbreak cont. T O P S T O R I E S CONTINUED FROM PAGE 2I N B R I E F Continued from page 2

� Good Samaritan Hospital in Los Angeles opened the first phase of its new $80 million Good Samaritan Medical Pavilion. The first physician offices in the 190,000-square-foot expansion opened in December, hospital officials said. The Medical Pavilion will be anchored by the Frank R. Seaver Ambulatory Surgery Center, which will include eight operating rooms, a pharmacy, and outpatient clinics, and is due to open in the third quarter of 2017. The pavilion will also include imaging and oncology services.

� Anthem Blue Cross has introduced a new online educational program called Moving Toward Equity in Asthma Care. The program is designed to improve care for asthma patients and address disparities in care for ethnic patients, including African American and Hispanic patients, who are more likely than white patients to visit emer-gency departments or be hospital-ized for asthma-related complications. Studies also show that Asian-American asthma patients are more likely to die from asthma-related complications than white patients. “The reasons health dis-parities exist are varied and complex, but creating a collaborative environ-ment where we can better understand these gaps and deliver culturally appro-priate asthma care is necessary if we want to improve the quality of life for patients,” said Jacob Asher, MD, medi-cal director for Anthem Blue Cross.

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all healthcare workers who came into contact with infected individuals have been vaccinated.

Santa Barbara County health officials reported one case of measles that was likely related to the Los Angeles County outbreak. The Santa Barbara County Public Health Department reported that a case of measles was confirmed at Goleta Valley Cottage Hospital on December 27, but hospital officials were able to “quickly verify that all exposed healthcare workers were fully vaccinated against the measles virus” and that no new cases have been confirmed since then.

“We followed up with a number of additional contacts and are monitoring the situation closely but have not identified any additional cases so far,” said Susan Klein-Rothschild, MSW, deputy director for the Santa Barbara County Public Health Department.

As of January 4, the California Department of Public Health (CDPH) said it has not received reports on any new measles cases related to the outbreak aside from the 10 cases from December. The CDPH is “providing statewide coor-dination and supporting the Los Angeles Public Health Department in its investi-gation,” a spokesperson for the CDPH said. The CDPH said the 10 cases of mea-sles confirmed in Los Angeles County brings the total number of cases reported in California last year to 17.

The last outbreak of measles in California started at Disneyland in Anaheim in December 2014 and eventually infected 131 people. An investigation conduct-ed by the CDPH found that 57 of the patients who contracted measles in the out-break were never vaccinated for the disease and that 25 patients did not receive their full round of measles vaccinations.

The 2014-2015 Disneyland measles outbreak focused renewed attention on outbreaks of diseases that are preventable with vaccines. California experienced a whooping cough outbreak in 2014 that affected 11,203 state residents and a 2010 outbreak that affected 9,120 residents.

The whooping cough outbreaks and the 2015 measles outbreak helped spur legislation that eliminated the state’s personal belief exemption and requires parents to have their children vaccinated for childhood diseases before they can enroll in school. Senate Bill 277, authored by state Sen. Richard Pan, went into effect in June 2016.

In drafting SB 277, Pan said an increasing number of parents opting out of childhood vaccines for their children was lowering “herd immunity” in some regions. —DOUG DESJARDINS

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T O P S T O R I E S I N B R I E F Continued from page 3

� Kindred Hospital Rehabilitation Services has taken over administra-tion of outpatient physical, speech, and occupational services at Dominican Hospital ’s rehabilitation campus in Santa Cruz. According to a January 2 report in the Santa Cruz Sentinel, patients will not be affected by the change that began on January 1 and the partnership between Kindred and Dominican may result in expanded ser-vices at the rehabilitation facility. “In the changing landscape of healthcare, it makes sense for hospitals to make partnerships in the community that can sustain and even grow their outpatient programs,” said Nanette Mickiewicz, president of Dominican Hospital.

� The California Department of Public Health (CDPH) said that influ-enza activity in California is “wide-spread” and that there have been three influenza-related deaths in the state as of December 31, and 29 cases of severe influenza resulting in patients age 64 or younger being admitted to a hospital intensive care unit. CDPH Director Karen Smith, MD, said holi-day gatherings typically help spur influ-enza activity and California residents should receive a flu shot as a preventive measure against the flu.

� Scripps Health is testing a new system that treats heart attack pa-tients with supersaturated oxygen (SSO2) in an effort to reduce perma-nent damage to heart muscles. The Scripps Prebys Cardiovascular In-

Rate of Hospital Employees Vaccinated for Flu Climbs SlightlyStudy finds 85.4% received vaccines in 2015-2016The percentage of healthcare workers vaccinated for influenza increased slightly last year with more than 85% of employees receiving vaccinations.

A December report from the California Department of Public Health (CDPH) shows that 85.4% of hospital employees received flu vaccines during the 2015-2016 flu season, a slight increase from 85% during the 2014-2015 season. Vaccination rates for non-employee healthcare personnel were much lower, down slightly at 66.1% compared to 66.4% in 2014-2015. The rate for volunteers and workers at hospitals was 78%, up from 77.2% in 2014-2015.

The report also found that 154 hospitals—or about 40% of hospitals in the state—reported employee vaccination rates that were higher than 90%. State health officials have established a 2020 Healthy People goal of having 90% of all hospital workers receive flu vaccines.

The rate of hospital employees receiving flu shots has started to flatten after rising sharply for several years. CDPH data shows the percentage of hospi-tal workers receiving flu shots jumped from 67.8% of employees in 2011-2012 to 74% in 2012-2013 and to 81% in 2013-2014. During that time, dozens of coun-ties adopted mask policies that require employees who choose to not be vacci-nated to wear a surgical mask at work during flu season.

The CDPH report found that 34 counties now have mask policies in place in hospitals, an increase from 31 counties during the 2014-2015 flu season. The report found that vaccination rates in counties with mask policies was 3 percentage points higher than in counties without mask policies and suggested that “local pub-lic health policy may be influencing vaccination coverage in California hospitals.”

A CDPH survey that included responses from 316 hospitals in the state found that 92% of hospitals surveyed offer flu shots during all work shifts, including nights and weekends, and that 79% provide flu vaccines using mobile carts that bring the vaccine to workers. It also found that 96% of hospitals sur-veyed have mask policies for employees who choose to not be vaccinated.

A separate survey conducted by the Centers for Disease Control and Prevention asked hospital workers who chose not to be vaccinated for the flu to explain their decision. The survey found that the No. 1 reason given was that workers did not believe the flu vaccine is effective. The No. 2 reason given was that employees thought they don’t need to receive a vaccine to avoid catching the flu.—DOUG DESJARDINS

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T O P S T O R I E SBlue Shield to Appeal State Decision

to Revoke Not-for-Profit Status

Insurer says appeals process could take two years

Blue Shield of California plans to appeal a state decision to rescind its tax-

exempt status in California as a not-for-profit insurer.

The ruling by the California Franchise Tax Board

Shield to pay millions of dollars in retroactive state taxes. Blue Shield vice president

of corporate communications Steve Shivinsky

decision. “We have filed a protest against the FTB ruling and this will take up to

two years to decide,” said Shivinsky. “Blue Shield as a company and a management

team firm believes it is fulfilling its not-for-profit mission and commitment to the

community. We are, and will remain, a not-for-profit company…”

Shivinsky noted that the decision only pertains to Blue Shield’s status in the

state. “Blue Shield has paid federal taxes since 1986,” said Shivinsky. “Blue Shield

of California’s e�ective tax rate on pre-tax profits exceeds 45% annually …” Blue

Shield of California and other Blue Cross and Blue Shield plans in the U.S. lost their

federal tax-exempt status under reforms to the federal tax code approved in 1986.

O¢cials for the Franchise Tax Board declined to comment on the ruling or

what prompted the state audit that led to its decision issued in August 2014. The

FTB added Blue Shield to a list of companies that had their tax-exempt status

revoked and posted the information on its website but did not comment on it at

the time. The decision will also require Blue Shield to file tax returns dating back

to 2013. While state and federal laws regarding not-for-profits have changed over

the years, the action taken against Blue Shield is unusual. “I am not aware of any

nonprofit health insurer that has been stripped of its tax-exempt status prior

to Blue Shield,” said Gerald Kominski, a professor of health policy at the

Fielding School of Public Health and director of the

Policy Research.

Kominski said Blue Shield has the option of converting to a for-profit insurer

but that it’s more likely to negotiate a settlement with state o¢cials if its appeal of

the Franchise Tax Board decision fails. “I imagine that Blue Shield will try to reach

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January 9, 2017

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E V E N T SI N B R I E F Continued from page 4

Jan. 23–25. Personalized Medicine World Conference. Computer History Museum, Mountain View. An annual educational conference for person-alized medicine that brings togeth-er leaders in government, business and research. To register, please visit http://www.pmwcintl.com/2017sv/location/

Feb. 14–15. CPCA Quality Care Conference. Hyatt Regency Newport Beach. An educational conference for primary care providers focused on inno-vation in healthcare information technol-ogy, quality care improvement, and prac-tice transformation. To register, please visit http://www.cpca.org/index.cfm/training-and-events/conferences/2017-quality-care-conference

Feb. 18–21. Scripps’ 37th Annual Conference: Clinical Hematology and Oncology. Omni San Diego Hotel. A conference for oncologists and hema-tologists focused on the latest advances in the treatment of cancer and blood-based diseases. To register, please visit http://www.scripps.org/events/scripps-37th-annual-conference-clini-cal-hematology-oncology-2017-Febru-ary-18-2017

Feb. 23–24. 26th Annual Health Care Forecast Conference. The Beckman Center, Irvine. A conference that ex-amines healthcare trends and how they affect patient care and payment models. To register, please visit http://merage.uci.edu/events/merage/2017HCFC/

stitute in La Jolla is testing the SSO2 system as part of a clinical trial that com-bines the therapy with stenting, angioplasty, and medication. “A heart attack is like a house fire and the longer it takes to put it out, the more structural damage is done,” said John C. Harrington, MD, an interventional cardiologist at Scripps Health who is leading the study. “By infusing higher concentrations of oxygen into the artery responsible for the heart attack, we can decrease the size of the area of heart mus-cle that is damaged because it is deprived of oxygen.” Harrington is hoping to enroll 100 patients in the study by February.

� The Alameda County Local Agency Formation Commission (LAFCO) released a study in December that determined the Eden Health District “still provides a ser-vice of value” for the community but did not discount the possibility of dissolving the district. According to a report in the East Bay Times, LAFCO will hold a public hear-ing on January 31 to solicit comments from the public on the report and the future of the Eden Health District, which operated Eden Hospital until it was sold to Sutter Health in 2014. The report noted that the district distributed nearly $11.6 million in grants from 1999 to 2015 but that the local community could be better served if Eden Health District’s assets are dissolved and transferred to a non-profit group or Alameda County. Some critics have called for the Eden Health District to be dissolved since it no longer has a hospital to operate.

� Damage from flooding at a new wing of Ventura County Medical Center will not delay its planned opening in May. According to a December 31 report in the Ventura County Star, the flood did not cause significant damage and the opening date is on track. “We’re still tracking for May 7,” said Joan Araujo, chief deputy director of the Ventura County Health Care Agency. The flood occurred on December 7 when a plugged pipe flooded about 8,000-square feet of the new $350 million hospital wing that will house 122 patient beds and an emergency depart-ment. Following an inspection, state health officials approved a plan to replace dry-wall and linoleum damaged in the flood.

� Covered California said an internal study of enrollment data shows that consum-ers who switched to the lowest-priced plan in their tier of coverage during the current open enrollment period will save an average of $38 per month, or $458 per year, in premiums. “Covered California has built a competitive market where the consumer is in the driver’s seat and our health plans are fighting for their business,” said Peter V. Lee, executive director for Covered California. “Consumers who are shopping and switching to the lowest-cost plan in their tier are saving more than $450 per year.” Covered California estimates that 78% of current enrollees would pay lower premiums if they switched to the lowest-priced plan in their coverage category.

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F E A T U R E D C A R E E R O P P O R T U N I T I E S

A county organized health system, CalOptima provides publicly funded health care coverage for low-income children, adults, seniors and people with disabilities in Orange County, California. CalOptima’s mission is to provide members with access to quality health care services delivered in a cost-effective and compassionate manner. In total, CalOptima serves more than 780,000 members with a network of more than 7,000

primary care doctors and specialists, as well as 30 hospitals.

CalOptima is accepting applications for candidates with public agency and managed care experience:

Executive Director, Clinical Operations - Code #14107-080416

Executive Director, Network Operations - Code #13114-052716

Medical Director - Code #96264-031516

Director, Long Term Support Services - Code #02586-091616

Manager, Contracting – Code #02576-090216

Staff Attorney - Code #17024-072216

For a complete job description and to apply online, please go to www.caloptima.org. Questions can be directed to

Debbie Neal, Senior Recruiter for CalOptima at 657-235-6981 or dneal@caloptima.org.

APPLY HERE

Community Health Group, a locally based non-profit health plan, we are committed to serving the under-served populations in our market. We have consistently been recognized for our outstanding customer service from staff, community, providers, member and employ-ers. We were recently recognized as one of the Top Workplaces in San Diego. We are accredited by NCQA and have been recognized for our quality initiatives espe-cially as it relates to HEDIS scores. We are currently recruiting for:

High Risk Case ManagerSuccessful candidate will promote optimal quality and cost effective health care services to members by:

Conducting telephonic and onsite clinical reviews

Inpatient hospital reviews for targeted high risk members

Providing case management for targeted high risk members

Reviewing and processing referrals for high risk members

Providing proactive case management in collabora-tion and coordination with primary care providers, specialty, ancillary providers, other key health plan staff and key community based resource agencies.

Case management experience in a managed care orga-nization, or other health care setting. Engaged in the following actions: case management, disease manage-ment, or authorization referrals processing according to standard clinical (such as Milliman USA). Knowledge of Medicare/Medi-Cal HMO benefits, CPT and ICD-10 codes and principles of case management. Current CA RN license required. Intermediate computer skills. Bilingual preferred.

For consideration, please mail your resume to COMMUNITY HEALTH GROUP, Human Resources Department, 2420 Fenton Street, Suite 100, Chula Vista, CA 91914, fax to:(619) 476-3819, e-mail: hr@chgsd.com. EOE

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F E A T U R E D C A R E E R O P P O R T U N I T I E S

To apply, visit our website at: http://www.scanhealthplan.com/careers/

Search for Job # Req. above

Ventura Career Fair Friday 1/27/2017

9:00am – 2:00pm SCAN Health & Wellness Center

6633 Telephone Road, Ventura, CA 93003

Please Apply Online at www.scanhealthplan.com and RSVP to Kim Brooks, Recruiter at kbrookscanhealthplan.com or call 562-989-5299

Open Positions

• Manager, Health & Wellness Center Req. #17-0006

• Volunteer Coordinator Req. #16-0436

• Health & Wellness Representative Req. #17-0012

Don’t miss this opportunity - Hiring Managers and Recruiter on site day of Career Fair to interview qualified applicants

It’s all about doing your life’s best workSM

 

Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions, and treatments; helping them to navigate the system, finance their Healthcare needs, and stay on track with their Health goals. No other business touches so many lives in such a positive way.

Provider Relations AdvocateThe Provider Relations Advocate is responsible for the full range of provider relations within UnitedHealth Group-Optum Health Behavioral Solutions, including working on end-to-end, claim remediation and the training and development of provider education programs. Provider Relations Advocates design and implement programs to build and nurture positive relationships between the health plan and providers (physician, hospital, etc.). Responsibilities also include implementing strategies relating to network contracting, provider recruitment and management of a behavioral health provider network, identifying gaps in network composition, and active involvement in identifying and remediating network deficiencies. Experience with Medicare is preferred but not required.

To apply for this position please visit https://careers.unitedhealthgroup.com

and enter 688284 in the search bar.