Policy Update

Bush's Medicare Budget Plan Draws Opposition in California

According to the California Hospital Association, President Bush's fiscal year 2009 budget proposal would reduce Medicare funding for California hospitals by $8.8 billion over five years. Additionally, doctors could see a 10.1% cut in Medicare payments beginning in July. Hospital industry insiders have expressed concerns that the reductions could push more physicians to stop seeing Medicare patients.

Scott Seamons, regional vice president of the Hospital Council of Northern and Central California, criticized the plan, saying that the cuts will hurt the patients that hospitals are there to serve. "It's unconscionable and a travesty. It's a last-ditch effort by a lame-duck president to throw things against the wall and see what will stick," said Seamons, according to the Sacramento Business Journal. Read More

CMS: Many of California's Nursing Homes Fall Below Federal Standards

Nearly half of California's nursing homes fall short of federal standards in rates of using patient restraints or preventing bedsores, according to the Centers for Medicare and Medicaid Studies (CMS). For the first time ever, CMS released lists last week of nursing homes and hospitals nationwide that have fallen below federal standard-of-care benchmarks set for patient restraints, surgical infections, and bedsores. According to CMS, 674 of California's estimated 1,400 nursing homes are in need of improvement.

It's not as if the state's nursing homes haven't been monitored before now. Medicare and Medicaid contract with privately owned quality-improvement companies such as Lumetra (based in San Francisco) to monitor the facilities. But according to CMS spokesman Peter Ashkenaz, previous contracts did not specify how contractors were to choose facilities for quality improvement. The next round of contracts will require companies like Lumetra to spend 80% of oversight on the facilities identified in the lists. Still, some remain skeptical that the release of the list and the change in the way contracts are handled will really make a difference. According the Press Enterprise, Pat McGinnis, executive director of California Advocates for Nursing Home Reform, expressed doubt that things would change, since facilities themselves are seldom held responsible for bad care. "I'd be surprised if 100 nursing homes participate," she said. Read More

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