24 March 2011
California Edition
Calendar
March 24-25
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April 8-10
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E-Mail
info@payersandproviders.com with
the details of your event, or call
(877) 248-2360, ext. 3. It will be
published in the Calendar section,
space permitting.
Group Takes On Care For Disabled
Consejo Claims Abuse, Neglect is Commonplace
A Los Angeles non-prot group that succeeded
in persuading California’s hospitals to change
their charity care policies nearly a decade ago
has taken on a new cause: adult day care
facilities.
The founder of the Consejo de Latinos
Unidos claimed that broad abuses are
occurring within the adult day care system,
which provides care for many individuals with
disabilities.
Consejo Executive Director K.B. Forbes
declined to provide specic details, but said
that evidence has been submitted to his
organization that both physical abuse and
neglect of clients at adult day care providers
may be signicant.
“We believe it is broad,” said Forbes,
whose organization helped the families of
eight developmentally disabled adults le suit
against the operators of an El Monte day care
center earlier this week.
In that case, a former employee of the
center – now known as New Day but formerly
known as Healthy Start – pleaded guilty in
January to charges of sexually molesting three
female clients.
However, the lawsuit claims that other
clients were physically abused and neglected.
Forbes also charged that in the case of the
sexual molestations, New Day’s operators
conspired to keep charges of abuse secret, and
red an employee in retaliation for notifying
law enforcement.
www.lakesidecommunityhealthcare.com
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In published reports, New Day ofcials
say they have xed operational issues at its
center and called the Consejo’s actions a
“witch hunt.”
The Consejo made national headlines
early last decade when it accused hospitals of
putting undue pressure on patients who were
uninusred or underinsured to pay their bills.
The Consejo’s actions eventually led to
several hospital chains agreeing to provide
charity care to patients with much higher
levels of income than in the past, policies that
have since been adopted by virtually every
hospital in California. Such policies are now
usually posted in hospital emergency rooms
and other parts of the facility.
Forbes said he wants the owners and
operators of the New Day center investigated,
as well as the of the East L.A. and Pomona
Regional Centers, which are operated by the
California Department of Developmental
Services. There are 21 such centers statewide,
and make client referrals to adult day care
operators such as New Day.
Nancy Lungren, a spokesperson for the
California DDS, said that all reports of abuse
at adult day care centers are investigated as a
matter of course and that protections are
provided to whistleblowing employees. She
added that corrective actions had been issued
to New Day to undertake.
Continued on Next Page
 Payers & Providers
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Bottomless Potential
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In Brief
Survey Shows Lack Of
Information Among
Small Business Owners
About Reform
Many small business owners in
California are unaware of general
provisions of the Patient Protection
and Affordable Care Act, according
to a new survey by an Francisco-
based not-for-profit group Pacific
Community Ventures.
Although 43% of the small
businesses surveyed said they
would offer insurance to their
employees after learning of tax
credits offered to do so, 48% said
they had been unaware of such
incentives.
Moreover, nearly two-thirds of
small business owners – 62% –
have not heard of the health
insurance exchanges set to begin
operating in 2014. However, 55%
said they would participate once
provided basic information about
their functions.
Among the survey’s 802
participants, 45% identified
themselves as Republicans, 26% as
Democrats and 21% as politically
independent. Recent national
surveys show more than 80% of
Republican favor the repeal of
federal healthcare reform.
Half of the business owners
surveyed had two to nine
employees, and half had 10 to 19
employees.
"This survey shows the
tremendous opportunity to further
inform small business owners about
the healthcare act's core benefits
available to help them offer
insurance," said Pacific Community
Ventures Executive Director Beth
Sirull. "Armed with this
information, small businesses will
play a vital role in covering great
numbers of uninsured workers.”
Continued on Page 3
NEWS
Consejo (Continued from Page One)
However, Forbes noted the lawsuit
against New Day was a start of what would
be a campaign against alleged abuses at other
Cuts Could Cost Healthcare Jobs
Group Says Budget Puts 42,000 Positions at Risk
A study released today by the Sacramento-
based advocacy group Health Access
estimates that the $6.4 billion in cuts
proposed by Gov. Jerry Brown to the Medi-
Cal, Healthy Families and other healthcare
programs will cost the state’s healthcare
sector a minimum of 42,000 jobs.
In addition to those forecast job losses,
Health Access also estimated that the cuts
would also result in lost economic activity
totaling more than $2.7 billion.
“Combined with the other cuts proposed
by the Governor, this will compound the
economic downturn instead of reversing it,”
the report said. It added that healthcare was
the only job sector that grew in California in
2009.
In trying to close a budget decit
approaching $27 billion, Brown’s budget
proposal calls for cuts in payments to
providers, a cap of 10 physician ofce visits
per enrollee per year, as well as the
imposition of co-payments for ER visits,
hospital admissions and prescription limits.
Brown has also proposed the elimination
of coverage for adult day care in the Medi-Cal
program. Health Access claims would lead to
the loss of at least 7,500 jobs at those
facilities.
Cuts are also proposed to the Healthy
Families program, which provides healthcare
CEO/COO/CFO COMPENSATION
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COMPENSATION ON MORE THAN 300 OF CALIFORNIA’s
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Page 2
organizations.
“You know my M.O. This will eventually
grow,” he said.
coverage to children in lower income
households that do not qualify for Medi-Cal.
Health Access noted that the cuts – and
presumably job losses – will be much deeper
if Brown’s proposals to extend about $12
billion worth of various taxes are not placed
on the ballot as voter initiatives later this year.
Brown so far has been unable to reach an
agreement with Republican lawmakers to
place the tax extensions on the ballot for a
special referndum in June. He is now seeking
a signature campaign by voters to approve the
placement of the referendum directly. Such a
referendum would be scheduled for
November, and would constitute a tax
increase rather than an extension.
In addition to the additional cuts if the
taxes are not green-lighted by voters, the
report noted that “these estimates also do not
attempt to quantify the damage to California’s
long-term economic growth of cuts to
programs that help sick and injured workers
return to work, or the impact of hundreds of
thousands of children going without health
coverage, and the nearly one million children
being denied eye glasses and other vision
services.
“The Governor’s proposed healthcare cuts
are bad for jobs, bad for California’s families,
and bad for California’s economy,” the report
concluded.
Payers & Providers NEWS Page 3

Longer ALOS!* Anthem Dials Back Rate Hikes

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*For our ads, not your hospital
Move Comes Days After Blue Shield Cancellation
Anthem Blue Cross of California on Monday Anthem’s action was not as drastic as Blue
announced a curtailment and delay of double- Shield of California, which last week
digit rate hikes that were to be imposed on its announced the cancellation of a planned

In Brief individual policyholders this spring – just days

Anthem, Sharp
Collaborate On ACO
Pilot Project
Anthem Blue Cross of California is
teaming with Sharp Community
Medical Group and Sharp Rees-
Stealy Medical Centers to launch
an accountable care organization
pilot project.
Enrollees in Anthem’s PPO
products in the San Diego area that
already receive much of their care
from the participating physicians
are candidates for enrollment in
the project. About 17,000 such
enrollees are eligible, officials
said.
“PPO patients will now have
the opportunity to have their
personal doctor help
them navigate the often-confusing
array of health care options and
better coordinate their care,” said
John Jenrette, M.D., CEO of the
Sharp Community Medical Group.
Anthem is involved with a
similar pilot project in
collaboration with medical groups
in Orange County.
after Blue Shield of California cancelled
similar scheduled hikes.
The plan’s original 16.4% average
premium increase for its roughly 600,000
individual policyholders was set to go into
effect on June 1. Instead, it has reduced that
rate hike to an overall average of 9.1% – a
reduction of roughly 45% – and will move
that increase back to July 1. Planned increased
in deductibles and co-payments were also
moved back from next month to January 2012.
Anthem did so at the behest of California
Insurance Commissioner Dave Jones.
Although Jones has no power to cancel such
rate hikes, he has been critical of health plans
putting pressure on individual policyholders
with such steep increases.
Jones said he was pleased by the action,
estimating that the change would save Anthem
policyholders about $40 million. However, he
reiterated that his ofce has received
numerous complaints about rate hikes, and
added that he has no power to regulate rates –
something he would like to change.
"Health insurers still hold all the cards
and consumers remain at their mercy,” Jones
said. He reiterated support for a bill currently
pending in the Legislature that would give his
ofce and the Department of Managed Health
Care power to regulate premium increases.
rate hike this spring and the imposition of
no further increases on its 193,000
policyholders for the remainder of 2011.
Like Blue Shield, Anthem ofcials
blamed rising medical costs for the need to
impost rate hikes, and suggested other
parties need to take some responsibility for
for the trend.
“We are pleased with the resolution of this
matter, but feel all stakeholders in the
healthcare market in the state must do more
to control the unrelenting rise of underlying
health are costs,” said Anthem Blue Cross of
California president Pam Kehaly. “We plan
to be an active participant in helping forge
that dialogue and bringing together the
major healthcare players to nd the best
solutions for California consumers.”
Anthem said it lost $110 million on its
individual policyholders in California last
year, and projected more losses for 2011
even if it had implemented its original
increases.
Consumer advocates remained wary
about Anthem’s actions. Michael Russo, an
attorney for the California Public Interest
Research Group, called the pullback a
“reprieve for consumers,” but noted “an
almost 10 percent hike will still be hard for
many to afford. And Anthem enrollees have
to be worried about what will happen next
year.”

Huntington Memorial
It was reported in the March 17 edition of Payers & Providers that both L.A. Care Health Plan and
Receives Nursing HITECH-LA, its affiliated regional health information organization, were providing $2 million in funds to
Magnet Designation providers for EHR development. Registration with HITECH-LA is required in order to be eligible to
receive the funds, but L.A. Care is the conduit.
Pasadena-based Huntington
Memorial Hospital has received a
“magnet” designation from the

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American Nurses Credentialing
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Huntington is only among 5% ]

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Payers & Providers
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OPINION
The Ever-Evolving Nursing Profession
It Has Had to Change as Rapidly As Healthcare Itself
Just a generation ago there was little science
backing the practice of nursing. Nurses relied,
as they always had, on folklore,!instinct, and
nally trial and error. Thankfully, for the
profession itself and, most importantly for the
patients, that has changed.
Today, the practice of nursing is being
excitingly redened. Critically important
clinical research is taking
place at premier nursing
schools across the country,
and these collective efforts
are helping to transform the
nursing vocation that will
make immeasurable impact
on the nation’s health.!
The timing couldn’t be
better. Society is aging and
consumer expectations have
never been higher. With the
early stages of healthcare
reform beginning to take
hold, ACOs beginning to
emerge and transparency By Courtney H. vital contributions toward this
becoming the new norm,
Lyder
healthcare itself is going through
its own transformation.
!!!!!!One of nursing’s distinct characteristics has pain management, improving quality of life, and
always been found in its focus on caring for
and improving the quality of life of patients
and their family members -- not just in the
hospital but in the home and in the community
as well. This is often done through education
and other behavioral interventions, with an
emphasis on prevention. It is no surprise then
that the vast majority of nursing research being
conducted across the country could be
classied as science aimed at affecting
behaviors that will improve health outcomes.
!!!!!!Such is certainly the case at the UCLA
School of Nursing. Last month, four members
of our faculty presented important ndings at
the annual research conference of the
Oncology Nursing Society. Other members on
our faculty are conducting important research
in the elds of geriatrics, cardiovascular health
and enhancing the health of vulnerable
populations with a focus on such areas as
asthma and childhood obesity. And that’s only
part of the picture.
!!!!!!Among other things, the school’s faculty
includes nearly a dozen basic scientists. Some
are nurses prepared in the biological sciences
!!!"#$$!%&!'(&)*+!,!'*-./0)*+!'1%2/+3/456!778
Page 4
–!neuroscience, physiology or genetics. Others
are non-nurses, from an engineer studying links
between brain changes, depression and
physiology to a physician studying HIV/AIDS.
The school also boasts a group of nurses and
non-nurses who are biobehaviorists. These
faculty members marry the behavioral and the
biological. With ample opportunities to
exchange ideas and forge
collaborations, the school’s
researchers are addressing
important health challenges
and pushing the scientic
frontiers as never before.
!!!!!!While the UCLA School
of Nursing is at the forefront
in these efforts, we are not
alone. From Yale to John
Hopkins and from
Georgetown to the University
of Virginia, nursing schools
across the country are doing
remarkable work and making
effort. These nursing schools and
others like them are focusing on
such areas as disease prevention,
palliative and end-of-life care. They are helping
to build the scientic foundation for clinical
practice and developing knowledge that will
one day lead to disease prevention and the
better management of symptoms caused by
illness.
!!!!!!Nurses have long been among the most
respected and revered of all healthcare
professionals. They are the comforting voice; the
helping hand; the patient ally. This is a position
we hold dearly and a responsibility we cherish.
But today’s nurse researchers are making
contributions in the lab and scientic
community as well, and that makes it time for
healthcare leaders across the country to take a
fresh new look at the nursing profession and of
the contribution these nurses can make.!
Courtney H. Lyder is dean of the UCLA School
of Nursing.
Op-ed submissions of up to 600 words are
welcomed. Please e-mail proposals to
editor@payersandproviders.com,
Payers & Providers MARKETPLACE/EMPLOYMENT Page 5

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Payers & Providers MARKETPLACE/EMPLOYMENT Page 6

It costs up to $27,000 to fill a healthcare job*

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*New England Journal of Medicine, 2004.

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