Category: health care

UCLA Med Center Rated #1 in California; 5 in U.S.

From the LA Times: Ronald Reagan UCLA Medical Center nabbed top honors among California hospitals in the latest U.S. News & World Report annual rankings.  The Los Angeles medical center ranked No. 5 nationally in the publisher’s annual honor roll of best hospitals. Only one other hospital in the state, UC San Francisco Medical Center, made the national honor roll of 17 hospitals. It ranked No. 13.  


The online magazine said it analyzed patient survival rates, infection rates, safety measures, staffing ratios and other data…
Full story at
http://www.latimes.com/business/money/la-fi-mo-hospital-rankings-20120717,0,4972814.story
The listing is at
http://health.usnews.com/health-news/best-hospitals/articles/2012/07/16/best-hospitals-2012-13-the-honor-roll

Follow the Leader? Will UC Follow CalPERS on Health Costs?

From the Sacramento Bee: The California Public Employees’ Retirement System plans to raise health care premiums to its members by an average of nearly 10 percent next year, one of the biggest increases in recent years. The increase of 9.6 percent would be more than twice as big as the rate hike that took effect for this year. It would have significant implications for health care affordability in California and beyond. CalPERS is a major purchaser of health insurance; it covers nearly 1.3 million public employees, retirees and their family members…


“Wow – that’s pretty high,” said Joanne Spetz, an expert on health care finance at the University of California, San Francisco. She said CalPERS has substantial influence on the health care marketplace, and a 9.6 percent increase suggests price inflation is taking off again. CalPERS raised rates just 4.1 percent for this year, less than half as much. “They tend to push back (on insurers), so if they accepted it, that kind of sets the tone for what the rest of us can expect…”

Full story at: http://www.sacbee.com/2012/06/12/4557662/calpers-to-raise-health-care-premiums.html
Best advice: Don’t get sick:

LA Times Editorial on UCLA Hospital/Blue Shield Dispute Has a Buried Lede*

In yesterday’s LA Times – if you missed it – there was an editorial about a dispute between Blue Shield and the UCLA Hospital.  Yet beyond saying that controlling costs and being efficient are Good Things, the editorial seemed to miss the point – even though the point is it the text of the editorial.  Excerpt below:

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Blue Shield of California has suspended its relationship with UCLA Medical Center, one of the state’s top hospitals, in a dispute over the cost of treating patients there. It’s a disturbing sign of things to come in the healthcare industry, as insurers become increasingly resistant to the cost increases that they routinely passed along in previous years. Although the standoff is hard on the patients who’ve lost access to UCLA, Blue Shield is right about one thing: The healthcare industry is on an unsustainable path, and every segment must start focusing on cost control.
…Hospitals costs have risen particularly rapidly, with the average daily fee for a bed in an acute-care ward more than tripling since 2000. UCLA’s reimbursements from Blue Shield have almost doubled in the last five years alone, the insurer says. That’s partly because the university has been shifting onto Blue Shield some of the expense of treating patients with Medicare, Medi-Cal or no insurance. But it’s a trend that even University of California officials acknowledge cannot continue.

…UC health officials say they’ve gotten the message; that’s why they created the Center for Healthcare Quality and Innovation in October 2010 to find ways to deliver more effective healthcare services and to control costs. The university system and Blue Shield also have agreed on a new approach at UC San Francisco Medical Center that shares the financial risk of providing care for certain policyholders, holding cost increases at or below the rate of inflation. The question is how to bring that focus on efficiency and value to UCLA and the rest of the UC system. Here’s hoping the two sides find an answer soon.
Full editorial at http://www.latimes.com/news/opinion/opinionla/la-ed-blueshield-20120213,0,3668965.story
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In short, a key problem – according to the editorial itself – is an external one reflecting the cost shifting that goes on in the current system of national health which requires providers to care for the non-insured and to make up for government programs that provide less than full reimbursement.
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*“Burying the lede” is a common stylistic error in journalism. To bury a lede (rhymes with “bead”) is to hide the most important information within a news story instead of putting it up front where readers can find it immediately.  Source: http://www.avwrites.com/?p=15
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Meanwhile, our best advice is not to get sick:

LAOmission

Our previous post deals with the Legislative Analyst’s Office (LAO) report on the state budget. Quote from page 41 of the report:

“…because the state is not required under current law to contribute additional funds to UC to address its unfunded pension and retiree health liabilities, the forecast assumes no General Fund resources to assist UC for these purposes.”

No Smoking Better Than No Scoping

In case you haven’t noticed the signs near the Westwood Blvd. entrance to UCLA, the health center is going entirely no smoking on Nov. 17.

It’s good to have no smoking. But as yesterday’s post pointed out, no scoping is not so good. We are still awaiting the scoping report on the new hotel/conference center plan which is supposed to be discussed at a public meeting next week.

Stolen Data

UCLA Health System warns patients personal information was stolen

Anna Gorman, Los Angeles Times. 11/5/11

The UCLA Health System is warning thousands of patients that their personal information was stolen and they are at risk of possible identity theft, officials said in a statement released Friday. Officials don’t believe the information has been accessed or misused but are referring patients to a data security company if their name and credit are affected. Information from 16,288 patients was taken from the home of a physician whose house was burglarized Sept. 6, according to the UCLA Health System…

The theft is not the first breach at UCLA. Between 2005 and 2009, hospital officials were repeatedly caught and fired for reviewing, without authorization, the medical records of dozens of celebrities, including Britney Spears and Farrah Fawcett. That prompted a state law imposing escalating fines on hospitals for patient privacy lapses. State regulators later fined Ronald Reagan UCLA Medical Center in connection with privacy breaches involving the records of Michael Jackson.

In the statement, UCLA officials said they would review the hospital’s policies and make any fixes necessary. They have contracted with a data security firm to work with patients and notified the U.S. Department of Health and Human Services Office for Civil Rights, which has previously investigated privacy violations at the hospitals. “UCLA’s concern for its patients is absolute, and we deeply regret any breach of confidentiality and the stress and concern it might cause our patients,” the statement said.

Full article at http://www.latimes.com/news/la-me-ucla-medical-data-20111105,0,4225234.story

Buried Lede on Retiree Health?


From Wiktionary

“bury the lede”

(idiomatic, US, journalism) To begin a story with details of secondary importance to the reader while postponing more essential points or facts.

http://en.wiktionary.org/wiki/bury_the_lede

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An article in today’s calpensions.com indicates that both CalPERS and CalSTRS have asked GASB – the Governental Accounting Standards Board – for a delay in its proposed new rules on public pension accounting. The rule would allow public pensions such as UCRP to continue with their projections of earnings on their assets (7.5% for UCRP) but would require a much lower discount rate for unfunded liabilities. The net effect of the proposed change would boost the accounting value of unfunded liability.

Buried at the end of the report is an indication that GASB is moving towards doing the same for retiree health care. Note that at UC, as in most public systems, there essentially is no trust fund with assets for retiree health – the system is pay-as-you-go. Hence, everything is unfunded liability. The impact on reported unfunded liability for retiree health would be much bigger than for pensions.

There is also a final sentence that indicates GASB is looking at “financial projections.” It is not clear to what that phrase refers, but it sure sounds like GASB is looking at whether assumed future earnings rates on assets, e.g., 7.5% for UCRP (and higher at CalPERS and CalSTRS), are too high.

Here are the last few sentences of the article:

Other speakers at the hearing said the new accounting rules should require government employers to report their retiree health debt. The state, for example, owes an estimated $60 billion over the next 30 years for retiree health care. Like most government employers, the state has not set aside money to invest and help pay for retiree health care promised current state workers. The state is paying about $1.5 billion for retiree health care this year, a rapidly growing cost.

“I think I can offer you some hope,” …the GASB chairman, told a speaker. “Dealing with OPEB (other post-employment benefits), primarily retiree health benefits, is something that’s on our agenda. We will be looking at that going forward.”

(He) told another speaker that GASB has “another project that is looking at financial projections.”

Full article at http://calpensions.com/2011/10/17/calpers-calstrs-delay-new-accounting-rules/

UPDATE: Academic Council chair Robert Anderson adds the following note re UCRP via email (in italics below):

The actual GASB proposal for pensions is to project the liabilities year by year; then project the assets forward, including future contributions according to your actuarial plan (which you must be actually following, not just planning to do at some indefinite point in the future) and your assumed rate of return on assets and see if you ever run out of money. If you do, all liabilities beyond that point are discounted back at a lower rate, most likely a corporate bond or a taxable municipal bond rate. If not, all liabilities are discounted back at the assumed rate of return. We have an actuarial plan that restores us to full funding in 30 years, and we are currently following it, so the new GASB rule on pensions should make no difference to us.

It would make sense for (GASB) to apply that to retiree health. But note we are already discounting retiree health at (if I recall correctly) 6%, precisely because we are not prefunding it. Thus, I think there would be little change in our retiree health liability. I presume CalPERS and CalSTRS are also currently required to use the lower rate also. Thus, I am not sure it would make much difference.

In short, the impact on retiree health accounting would depend on whether GASB insisted on a rate below 6%.

Mumps

Arthur Ashe Center releases mumps health alert after outbreak at UC Berkeley

By KAVITHA SUBRAMANIAN, October 6, 2011, Daily Bruin Off the Press blog

UCLA Arthur Ashe Student Health and Wellness Center has released a mumps health alert following an outbreak at UC Berkeley this past week. At least 20 Berkeley students have reported potential mumps infections as of this evening, and hundreds of students have been waiting in line at UC Berkeley’s student health center for free vaccinations, according to the Daily Californian. No cases have been reported at UCLA…


Full article at: http://www.dailybruin.com/index.php/blog/off_the_press/2011/10/arthur_ashe_center_releases_mumps_health_alert_after_outbreak_at_uc_berkeley

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One suspects that the “I-don’t-believe-in-vaccines” crowd had a role in the Berkeley outbreak. Let’s hope there will prove to be less of that effect here.


Update: http://www.sacbee.com/2011/10/08/3968593/vaccination-refusal-endangers.html