Stanford Health, Blue Shield of California split
Palo Alto, Calif.-based Stanford Health Care and Blue Shield of California went out of network on June 29 in Santa Clara and Alameda counties.
Hospitals affected include Stanford Health Care Medical Center, Lucile Packard Children’s Hospital in Palo Alto and Stanford Health Care Tri-Valley in Pleasanton.
“While we are disappointed, we have not reached an agreement at this time, both parties continue to engage working toward a resolution to continue our long-standing network relationship,” Patty Gonzalez, vice president of network management at Blue Shield, said in a July 5 news release.
Nonprofit Blue Shield of California has 4.8 million members and is the third-largest health insurer in California, behind Kaiser Permanente and Anthem Blue Cross.
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California Health Care Worker Minimum Wage Delayed Again
California’s health care worker minimum wage gets delayed again — with a few possible start dates depending on certain circumstances.
In 2023, Governor Gavin Newsome signed SB 525, which required certain health care facilities to pay a special minimum wage to their employees starting June 1, 2024. Then, on the certain subsequent June 1, that minimum wage would incrementally increase before eventually following an annual consumer price index adjustment in line with California’s standard minimum wage. As previously reported, on May 31, 2024, Governor Newsom signed SB 828, a budget trailer bill that pushed the effective date back to July 1, 2024, and changes the date of subsequent increases to July 1, as appropriate. No other changes to SB 525’s health care worker minimum wage law were made.
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A UC Merced medical program is slowly taking shape. Why California wants more doctors there
A hospital closure in the heart of the San Joaquin Valley a year and a half ago underscored something that people in the region have long known: They don’t have enough doctors or access to medical care.
Madera County’s lone acute care hospital is expected to reopen later this year. But the issues around medical access that patients in this county and neighboring ones experience will likely continue long after Madera Community Hospital reopens.
People in this 250-mile region that spans eight counties often wait months for appointments or travel hours to the San Francisco Bay Area or Los Angeles for the care they can’t get at home. Attracting, retaining and producing doctors and health workers is among the top needs in the valley because it has one of the lowest physician-to-patient ratios in the state, according to estimates from the California Health Care Foundation.
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California Takes Lead on Regulating Private Equity Health Deals
Bill would give approval authority to state attorney general
State policies face diverging views on private investments
California legislation that would give the attorney general authority to block private equity firms’ moves into the health-care industry is seen as a potential model for other states looking to limit consolidation and protect patient care.
The bill (AB 3129), which the state’s Senate Judiciary Committee approved July 2, would authorize the attorney general to approve or deny an acquisition or change of control between a private equity firm and a health-care entity. The measure, which is supported by the state’s powerful medical trade associations and consumer advocacy groups, is set to go to the Senate Appropriations Committee before heading to the Senate floor. The Senate would have to vote on it in August before the legislative session ends.
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3 Innovative Telehealth Trends Shaping 2024
Telehealth has been a key topic of discussion for a while, especially as the pandemic prompted more individuals to seek remote rather than in-person care. According to CDC data, over 43% of individuals aged 65 and older are regular users of telehealth services. This field is constantly evolving with new advancements.
One notable development is the integration of artificial intelligence to enhance diagnostic accuracy and patient monitoring. Furthermore, there is a growing emphasis on ensuring equitable access to telehealth services across different demographics. These advancements promise to make remote healthcare more efficient and inclusive for all users.
Here is an overview of some significant trends emerging in 2024.
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GROUP BENEFITS
2024 Midyear Employment Law Update
Usually, the busiest time of the year revolves around new laws taking effect on January 1. But over the last few years, a trend has emerged in which several labor and employment law developments occur throughout the year — and 2024 is no exception.
In fact, this year, not only are laws taking effect mid-year, but we also have new regulations, local ordinance updates and court cases — all of which are keeping employers quite busy.
Read on for a summary of employment law developments in 2024 so far, including minimum wage updates, workplace violence prevention requirements, indoor heat regulations, federal pregnancy accommodation regulations and the latest employment law decisions from the courts.
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MEDICARE
CMS revised Medicare Advantage star ratings. Here’s which payers benefited.
More than 60 Medicare Advantage health plans from 40 insurers have received a higher star rating for 2024, according to a Healthcare Dive analysis.
Dive Insight:
Last month, the CMS said it would recalculate MA star ratings after two federal judges ruled the agency had erred in calculating the original ratings for 2024, which were released in October. Regulators only changed plans’ scores if they improved under the new methodology.
Along with serving as an indication of quality, star ratings have a major impact on insurers’ revenue from MA. The CMS uses stars to determine two parts of a plan’s MA outlook: whether a plan receives a bonus, and a plan’s ability to bid against a higher benchmark rate.
Plans that receive four stars or above receive a 5% quality bonus adjustment for the following year and have their benchmark increased, giving them a competitive advantage in their markets.
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