Report: Extreme heat events created $7.7 billion in hidden costs in California
New study analyzed seven extreme heat events from past decade
How much do heatwaves cost?
The hidden costs of extreme heat — from lost productivity to healthcare for heat-related illnesses — totaled more than $7.7 billion over the last decade, a new report from the California Department of Insurance found.
The report was released amid a persistent heat wave across Northern California, where temperatures soared into the 100s in the East Bay and cities across the Bay Area faced excessive heat warnings.
“Extreme heat is a silent, escalating disaster that threatens our health, economy, and way of life in California,” state Insurance Commissioner Ricardo Lara said in a statement. “We must prioritize resilience-building efforts and innovative insurance solutions to safeguard our state against the growing impacts and financial risks of extreme heat.”
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Sutter names 3 hospital CEOs
Sutter Health Names New CEOs for Sutter Delta Medical Center and Alta Bates Summit Medical Center
Northern California-based not-for-profit Sutter Health has named new executive leaders for two of its East Bay medical centers. Trevor D. Brand will be CEO of Sutter Delta Medical Center in Antioch, Calif. and Bradley (Brad) R. Goodson, will be CEO of Sutter’s Alta Bates Summit Medical Center in Oakland.
Brand comes to Sutter Health from City of Hope Atlanta, where he was chief operating officer, managing operations across six states and overseeing $2 billion in annual revenue. Under his leadership, service line performance improved, increasing hospital revenue by 13%. At City of Hope Atlanta, Brand also focused on fostering a culture of trust, implementing “people plans” that enhanced employee retention and engagement and reduced turnover rates by 5% annually. He also initiated a capital planning process resulting in a $10 million equipment and facilities improvement plan.
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Premiums for Covered California insurance will go up in 2025. Here’s how much
Premiums for health insurance sold through the state’s marketplace will increase by nearly 8% in 2025, Covered California officials announced Wednesday.
That’s a smaller increase than this year’s 10% hike, which was the biggest jump in Covered California insurance costs since 2018.
Covered California Executive Director Jessica Altman in a media call attributed the upcoming increase to factors such as rising pharmacy costs, labor shortages and wage increases in the health care industry.
So what does this mean for consumers?
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UnitedHealth institutes gold card program to address prior authorization concerns
UnitedHealthcare will launch a national program Oct. 1 for physicians to override traditional prior authorization requirements.
The gold card program, which applies to commercial, individual exchange and Medicare Advantage plans, allows certain physician practices to not submit prior authorization requests for “certain medical, behavioral and mental health services,” according to a fact sheet released by the company.
Instead, practices that earn gold card status must fill out a simple advance notification to confirm member eligibility and coverage for services.
To be eligible for gold card status, practices must show a prior authorization approval rate of 92% or higher for two consecutive years.
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California Delayed A Minimum Wage Bump For Health Workers. Some Are Getting Raises Anyway
Despite delays and confusion surrounding a new minimum wage law for California’s lowest-paid health workers, some employers have begun raising pay ahead of the state’s deadline.
Health care workers at San Bernardino County clinics will get a raise this month even though Newsom and lawmakers delayed the mandated wage increase until at least October. So will workers at University of California health systems, which announced in May that it would comply with the law on its original timeline.
Chas Kelley, a clinical nursing assistant at a clinic operated by San Bernardino County, will see his new wage hike reflected in his next paycheck. His pay is increasing almost $2 to about $23 an hour.
The county didn’t have to grant the raise this month. His union contract does not expire until 2027, and the deadline for the new law is still several months out. But Kelley’s union, Teamsters Local 1932, pressed the county of San Bernardino to implement the raises ahead of the state’s deadline.
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MEDICARE
Medicare Advantage in 2024: Enrollment Update and Key Trends
Medicare Advantage enrollment has been on a steady climb for the past two decades following changes in policy designed to encourage a robust role for private plan options in Medicare. After a period of some instability in terms of plan participation and enrollment, The Medicare Modernization Act of 2003 created stronger financial incentives for plans to participate in the program throughout the country and renamed private Medicare plans Medicare Advantage. In 2024, 32.8 million people are enrolled in a Medicare Advantage plan, accounting for more than half, or 54 percent, of the eligible Medicare population, and $462 billion (or 54%) of total federal Medicare spending (net of offsetting receipts, such as premiums). Medicare Advantage enrolls a disproportionate share of people of color in Medicare as well as an increasing number of dual eligible beneficiaries. The average Medicare beneficiary in 2024 has access to 43 Medicare Advantage plans, the same as in 2023, but more than double the number of plans offered in 2018.
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How Little Denmark Got Homegrown Giant Novo Nordisk To Lower Ozempic Prices
On May 13, Sen. Bernie Sanders (I-Vt.) published an open letter to Novo Nordisk on the front page of a leading Danish newspaper, urging the hometown company to live up to its altruistic standards by lowering U.S. prices for its blockbuster diabetes and weight loss drugs.
What Sanders didn’t realize was that Denmark, a country of 6 million, was enduring its own crisis over how to pay for the Novo Nordisk drugs Ozempic and Wegovy.
Most other developed countries, including Denmark, negotiate down drug costs for their citizens, paying prices that are a fraction of those in the United States. But when a drug is effective and expensive, pharmaceutical companies can play hardball on pricing. And Novo Nordisk did, at least initially, pushing the Danish health system to its limits.
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Part D national average bid amount to increase to $179.45 in 2025
The government subsidy to Part D plans is shifting from being reconciled on the backend to a larger risk-adjusted payment upfront.
The national average bid amount for Part D plans will increase from $64.28 in 2024 to $179.45 in 2025, according to information released Monday by the Centers for Medicare and Medicaid Services.
The increase is due to government subsidies changing from being reconciled on the backend to a larger risk adjustment up front, according to CMS.
This redesign of the Part D program is meant to encourage better cost management through a larger risk-adjusted government Part D subsidy payment up front, rather than cost reconciliation on the backend based on beneficiary costs, or on reinsurance payments.
The preliminary estimated average government subsidy to plans will be $142.67 in 2025.
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Hospitals that pursue patients for unpaid bills will have to tell L.A. County
Hospitals must promptly report to the Los Angeles County Department of Public Health every time they try to collect medical debt from patients, under an ordinance backed Tuesday by county supervisors.
The ordinance, which requires a second vote to be adopted, requires hospitals to tell the county within a month or two of initiating debt collection, which can include making phone calls or mailing letters to seek payment more than 180 days after the initial billing, selling the debt to a collections agency, garnishing wages, seizing a bank account or informing a consumer reporting agency.
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Inflation, weight loss drugs drive ACA premiums higher
ACA premiums will increase an average of 7% next year across 324 insurers.
Premiums for Affordable Care Act (ACA) health plans will increase 7% on average across 324 insurers next year. This increase is on par with premium increases for 2024, according to Peterson-KFF’s Health System Tracker.
Proposed premium changes for 2025 range from a decrease of 14% to an increase of 51%, although most premium changes fall between 2% and 10% increases for 2025. Fifty of the 324 ACA insurers proposed decreasing premiums, while 85 insurers requested premium increases greater than 10%.
Insurers attributed the increased premiums to growth in health care prices, inflation and the increasing use of weight loss and other specialty drugs.
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