payers & providers california edition – issue of february 9, 2012

8/3/2019 Payers & Providers California Edition Issue of February 9, 2012

1/7

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http://www.calhospital.org/2012-view-of-the-futurehttp://www.calhospital.org/2012-view-of-the-futurehttp://www.calhospital.org/2012-view-of-the-futurehttp://www.calhospital.org/2012-view-of-the-futurehttp://www.hasc.org/2012PalliativeCareConferencehttp://www.hasc.org/2012PalliativeCareConferencehttp://www.hasc.org/2012PalliativeCareConferencehttp://www.hasc.org/2012PalliativeCareConferencehttp://www.hasc.org/2012PalliativeCareConferencehttp://www.hasc.org/2012PalliativeCareConferencehttp://www.hasc.org/2012PalliativeCareConferencehttp://www.hasc.org/2012PalliativeCareConferencehttp://www.hasc.org/2012PalliativeCareConferencehttp://www.healthwebsummit.com/pp021612.htmhttp://www.healthwebsummit.com/pp021612.htmhttp://www.calhospital.org/2012-view-of-the-futurehttp://www.healthwebsummit.com/pp021612.htmhttp://www.hasc.org/2012PalliativeCareConference


2/7

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https://www.managedcarestore.com/pandp/p&pwhitepapers.htmhttps://www.managedcarestore.com/pandp/p&pwhitepapers.htmhttps://www.managedcarestore.com/pandp/p&pwhitepapers.htm


3/7

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Thm hmglth ylgb zmy`ztmd bmt cbkèm o`zthm o`}zth w}gztmz mbdcbf Dmk" ;7 ò $?7"8ecllc`b `b zmvmb}m{ ò $:"8 jcllc`b, kèygzmdt` bmt cbkèm ò $89"4 ecllc`b `b zmvmb}m{ ò$:"= jcllc`b o`z thm o`}zth w}gztmz ò :979"

O`z kglmbdgz :977, Hmglth Bmt zmy`ztmdbmt cbkèm ò $6:"7 ecllc`b `b zmvmb}m{ ò$77"3 jcllc`b" Cb :979, ct{ bmt cbkèm g{$:94": ecllc`b `b zmvmb}m{ ò $7;"? jcllc`b"

Kèygbs òkcgl{ gttzcj}tmd e}kh ò thml`mz ymzo`zegbkm t` zctmòo{ gbd l`{{m{

g{{`kcgtmd cth ct{ cbdcbf d`b o ct{`ymzgtc`b{ cb thm B`zthmg{t, hckh ct {gcdk`bkl}dmd cb thm o`}zth w}gztmz"

@}z o`}zth w}gztmz ymzo`zegbkmk`bkl}dmd g {}kkm{{o}l smgz o`z thm kèygbsgbd y`{ctc`b{ }{ mll f`cbf cbt` :97:, {gcdHmglth Bmt Khcmo Mxmk}tcvm @okmz Ags Fmllmz

Cb f}cdgbkm òomzmd js thm kèygbs,zmvmb}m g{ yzàmktmd t` zmegcb gt, gtjmtmmb $77"= jcllc`b gbd $7: jcllc`b"Glth`}fh ct yzàmktmd fgcb{ cb EmdckgzmGdvgbtgfm mbz`llembt ò }y t` 79-, mxymktmdz`yòo{ cb kèemzkcgl mbz`llembt lmd HmglthBmt t` yzàmkt thgt ct{ `vmzgll mbz`llembt

`}ld fz` js b` e`zm thgb 7-"
http://payersandproviders.com/advertise.phphttp://payersandproviders.com/advertise.php


4/7

'*+$-/$&'(#'!.,!'%'!.,!'+&'"/&*$'9'"$7:;4*$'"-+=;?;68#'331

Ygsmz{ / Yz`vcdmz{ Ygfm@YCBC@B

Yg}lg Dmmb{ E`zjcdcts O`z D`llgz{Mxyl`ctcbf Hmz Dcgjmtm{ H}zt{ Hmglthkgzm Dmlcvmzs

Z`b [hcbnegb c{ thm y}jlc{hmz `o Ygsmz{ /

Yz`vcdmz{"

>7=-


5/7

'*+$-/$&'(#'!.,!'%'!.,!'+&'"/&*$'9'"$7:;4*$'"-+=;?;68#'331

EGZNMTYLGKM/MEYL@SEMBTYgsmz{ Yz`vcdmz{ Ygfm =

H@[YCTGLC[T(L`{ Gbfmlm{, KG / Hcfh Dm{mzt, KG / E`dm{t`, KG /

Yh`mbcx, GQ / Lg{ _mfg{, B_#

Thm H`{yctglc{t yz`vcdm{ Cbtmzbgl Emdckcbm [mzvckm{ t` ygtcmbt{" Zm{y`b{cjclctcm{ cbkl}dm1Z`}bd cb thm h`{yctgl cb thm e`zbcbf{ gbd{mm{ gb gvmzgfm ò ? t` 79 ygtcmbt{" K`bomzmbkm kgll{ cth Kg{mEgbgfmz{ t` zmvcm ygtcmbt{, gbd dc{k}{{ thm dc{khgzfm bmmd{ gbdylgb{" Gdect thm ygtcmbt{ ozè thm MZ cb thm gotmzb``b (}{}glls :t` 4 ygtcmbt{#, co thms gzm g{{cfbmd ol`gt y`{ctc`b o`z thm fcvmb dgs"V`zn cth Kg{m Egbgfmz{ cb tzgb{omzzcbf thm ygtcmbt{ ozè `}t ò

gzmg h`{yctgl{ cbt bmt`zn h`{yctgl{" [mm ygtcmbt{ cb thm KgzmE`zmKgzm Kmbtmz (KKK#" Gll ygtcmbt{ dc{khgzfmd ozè thm h`{yctgl gzm{mmb js thm H`{yctglc{t{ cb thm klcbck }btcl thms gzm {tgjclcqmd" Ygtcmbt{cth ogll{ gzm g{{m{{md" Yzm `ymzgtcvm klmgzgbkm c{ d`bm `b ygtcmbt{}bdmzf`cbf {}zfmzcm{ zmw}czcbf fmbmzgl gbd {ycbgl gbm{thm{cg" G{{c{tB}z{m Yzgktctc`bmz{ js zmvcmcbf thm kg{m{ cth thme" [mm thm{ncllmd ygtcmbt{ cb thm [BO{" Thm{m ygtcmbt{ gzm {mmb `bkm g mmn}btcl thms zmegcb {ncllmd, hckh c{ b`zeglls ozè 7 t` : mmn{" Gttmbdthm [BO emmtcbf{ `bkm g mmn t` zmvcm thm kg{m{"Md}kgtc`b gbd/`z Mxymzcmbkm1Cbtmzbgl Emdckcbm Zm{cdmbks, Emdckgl D`kt`zgtm, gbdecbce}e ò :%; smgz{ ò H {yctglc{t mxymzcmbkm yzmomzzmd" Jclcbf}gl[ygbc{h yzmomzzmd" Kmztcockgtm{, Lckmb{m{, Zmfc{tzgtc`b{1 EmdckglLckmb{m cb thm {tgtm cb hckh s`} gzm gyylscbf, DMG lckmb{m" E}{t jmj`gzd%kmztcocmd z j`gzd mlcfcjlm cb {ymkcglts"

YZCEGZS KGZM YHS[CKCGB(Gbghmce, KG#

Thm Yzcegzs Kgzm Yhs{ckcgb yz`vcdm{ Cbtmzbgl Emdckcbm OgeclsYzgktckm [mzvckm{ t` ygtcmbt{" Zm{y`b{cjclctcm{ cbkl}dm1Yz`vcdm{emdckgl ygtcmbt kgzm js cbtmzvcmcbf, mxgecbcbf gbd tzmgtcbf òklcbckgl ygtcmbt{ cb `zdmz t` emmt thmcz emdckgl bmmd{" Md}kgtm{ygtcmbt{ `b mllbm{{, yzmvmbtc`b gbd mgzls dmtmktc`b js yz`vcdcbfegtmzcgl{ gbd zm{`}zkm{ t` thm ygtcmbt{ gbd ogeclcm{" Dmtmzecbm{hckh zmomzzgl{ gzm zmw}czmd jg{md `b mxgecbgtc`b gbd ygtcmbtbmmd{" Ygztckcygtm{ cb w}glcts ceyz`vmembt, egbgfmembt, k`b%tcb}cbf md}kgtc`b, gbd `thmz ygtcmbt kgzm yz`fzge{ m{tgjlc{hmdjs thm emdckgl fz`}y" G{{c{t{ cb thm zm{`l}tc`b ò kèylgcbt{,zmw}m{t{ gbd cbw}czcm{ ozè ygtcmbt{" Egcbtgcb{ k`bocdmbtcglcts ògll ygtcmbt cbo`zegtc`b gkk`zdcbf t` omdmzgl f}cdmlcbm{ gbd zmf}lg%tc`b{" Kèylmtm{ emdckgl zmk`zd{ (MEZ# d`k}embtgtc`b dgcls"Bcfht kgll{" Kmztcockgtm{, Lckmb{m{, Zmfc{tzgtc`b{1 Emdckgl Lckmb{mcb Kglco`zbcg, DMG, Cbtmzbgl Emd z OY, J`gzd Mlcfcjlm z Kmztcocmd"

[BO B]Z[M YZGKTCTC@BMZ/YHS[CKCGB G[[C[TGBT(L`bf Jmgkh, KG#

Thm B}z{m Yzgktctc`bmzYhs{ckcgb G{{c{tgbt c{ zm{y`b{cjlm o`z mvgl}gt%cbf gbd tzmgtcbf yhs{ckgl gbd y{skh`{`kcgl hmglth bmmd{ ò thm gd}ltgbd fmzcgtzck ygtcmbt cb thm [ncllmd B}z{cbf Ogkclctcm{" Thm [BO BYYG c{ zm{y`b{cjlm o`z {mmcbf gll ygtcmbt{ gt lmg{t `bkm ymz mmn gbdcthcb 6: h`}z{ ò gdect" Md}kgtc`b gbd/`z Mxymzcmbkm1B}z{mYzgktctc`bmz1 Kèylmtc`b ò Ogecls `z Fmzcgtzck B}z{m Yzgktctc`bmzyz`fzge ozè gb gkkzmdctmd {kh``l, J`gzd ò K`b{}emz Googcz{,Eg{tmz{ Dmfzmm cb B}z{cbf, Zmfc{tmzmd B}z{cbf Lckmb{m, O}zbc{hcbfLckmb{m / JL[" Yhs{ckcgb G{{c{tgbt1 Hg{ g k}zzmbt Kglco`zbcg lckmb{mc{{}md js thm Yhs{ckcgb G{{c{tgbt Kèecttmm (YGK#" : smgz{ ò mxym%zcmbkm yzmomzzmd" Vcllcbf t` tzgcb bm fzgd}gtm h` emmt{ thm {ncll{gbd a`j zmw}czmembt"

T@]KH B]Z[M YZGKTCTC@BMZ(T}k{`b, GQ / Lg{ _mfg{, B_#

Thm B}z{m Yzgktctc`bmz o`z `}z T`}kh yz`fzge (cb{tct}tc`bgl {ymkcglbmmd{ ylgb#, mb{}zm{ moomktcvm gbd moockcmbt tzmgtembt ò `}z T`}khemejmz{" Thc{ cbdcvcd}gl cll jm zm{y`b{cjlm o`z egbgfcbf ygtcmbt kgzmgt e}ltcylm ogkclctcm{ thz`}fh thm ceylmembtgtc`b ò k`hm{cvm gbd mooc%kcmbt yz`km{{m{, cth meyhg{c{ t` cbkl}dm ygtcmbt gbd ogecls {gtc{ogk%tc`b gbd yhs{ckcgb gbd ogkclcts {}yy`zt" Thc{ cbdcvcd}gl yz`vcdm{ fmbmzglemdckgl kgzm gbd tzmgtembt t` emejmz{ cb cb{tct}tc`bglcqmd {mttcbf{{}kh g{ b}z{cbf hèm{, g{{c{tmd lcvcbf{, z j`gzd / kgzm ogkclctcm{, }bdmzthm dczmktc`b o thm Yhs{ckcgb"Md}kgtc`b gbd/`z Mxymzcmbkm1Eg{tmz{dmfzmm cb B}z{cbf cth meyhg{c{ cb Ogecls, Gd}lt, `z Fmz`bt`l`fckglyzgktckm" Kmztcockgtm{, Lckmb{m{, Zmfc{tzgtc`b{1 K}zzmbt zmfc{tmzmdb}z{cbf lckmb{m gbd B}z{m Yzgktctc`bmz lckmb{m cb f``d {tgbdcbf cththm {tgtm cb hckh s`} gzm gyylscbf"

MEYL@SMM ZMLGTC@B[ EGBGFMZ(Kmzzct`{, KG#

Thm Meyl`smm Zmlgtc`b{ Egbgfmz ygztbmz{ cth [mbc`zEgbgfmembt gbd thm H}egb Zm{`}zkm{ Egbgfmembt tmge zmfgzd%cbf y`lckcm{, yz`fzge{ gbd yzgktckm{" Yz`vcdm{ f}cdgbkm, gdvckm,k`}b{ml, gbd lmgdmz{hcy `b vgzc`}{ g{ymkt{ ò thm meyl`sembtzmlgtc`b{hcy t` gll lmvml{ ò meyl`smm{" ]tclcqm{ thm dc{kcylcbm{ òH}egb Zm{`}zkm egbgfmembt, meyl`sembt lg, cbtmzbgl yz`km%d}zm{, y`lckcm{, yzgktckm{, gbd yz`fzge{ t` {}yy`zt thm gkhcmvm%embt ò thm `zfgbcqgtc`b{ {tzgtmfck `jamktcvm{ gbd {hgym g k}lt}zmthgt emmt{ thm kèygbs _gl}m{, _c{c`b, Ec{{c`b, gbd J}{cbm{{[tzgtmfs" Md}kgtc`b gbd/`z Mxymzcmbkm1Jgkhml`z{ dmfzmm cbJ}{cbm{{, H}egb Zm{`}zkm{, `z mw}cvglmbt kèjcbgtc`b ò md}kg%tc`b gbd mxymzcmbkm zmw}czmd" Ecbce}e ò =%6 smgz{ ò mxymzcmbkmcb meyl`smm zmlgtc`b{ gbd :%= smgz{ ò mxymzcmbkm cb egbgfmembt" Jgknfz`}bd cb meyl`sembt lg gbd `thmz f`vmzbembt kèylcgbkmzmf}lgtc`b{ c{ yzmomzzmd" Kmztcockgtm{, Lckmb{m{, Zmfc{tzgtc`b{1Kmztcockgtc`b cb H}egb Zm{`}zkm{ yzmomzzmd, j}t b`t zmw}czmd"

T` {}ject s`}z K_/Zm{}em o`z k`b{cdmzgtc`b, vc{ct htty1//"kgzme`zm"kè/mb/Gj`}t/Kgzmmz{"g{yx t` gyyls `blcbm"


6/7

'*+$-/$&'(#'!.,!'%'!.,!'+&'"/&*$'9'"$7:;4*$'"-+=;?;68#'331

Ygsmz{ / Yz`vcdmz{ EGZNMTYLGKMMEYL@SEMBT Ygfm ?

Ct k`{t{ }y t` $:6,999 t` ocll g hmglthkgzm a`j!

vcll d` ct o`z g l`t lm{{"

Meyl`sembt lc{tcbf{ jmfcb gt a}{t $7"?= g v`zd

Kgll (866# :48%:;?9, mxt" :@z m%egcl1 gdmztc{mIygsmz{gbdyz`cdmz{"kè

@z c{ct1 vvv"ygsmz{gbdyz`cdmz{"kè

!Bmv Mbflgbd A`}zbgl ò Emdckcbm, :994"

K`g{tgl Kèe}bctcm{ H`{yctgl cb [gbtg Gbg, KG c{ {mmncbf g dsbgeck

K@@/KB@

W}glcocmd kgbdcdgtm{ ylmg{m gyyls thz`}fh `}z vmj{ctm gt vvv"k`g{tglkèeh`{yctgl"kè/Kgzmmz{

Thc{ y`{ctc`b c{ g lckmb{md yzòm{{c`bgl zmfc{tmzmd b}z{m w}glcocmd js gdvgbkmd md}kgtc`b gbd egbgfmembtmxymzcmbkm thgt cll `vmz{mm gbd jm gkk`}btgjlm o`z thm B}z{cbf, Gbkcllgzs, Ygtcmbt Kgzm [mzvckm{, W}glcts/Zc{n Egbgfmembt, Cbomktc`b K`btz`l gbd Klcbckgl Md}kgtc`b Dmygztembt{" Kgbdcdgtm cll dmvml`y, dczmkt gbdceylmembt h`{yctgl cdm ylgb{ t` yz`vcdm ygtcmbt kgzm, tzmgtembt gbd {mzvckm{, y`lcks gbd yz`kmd}zm{ thgtgddzm{{ h` kgzm bmmd{ ò thm ygtcmbt y`y}lgtc`b{ gzm g{{m{{md, mvgl}gtmd gbd emt" Mb{}zm{ gkkm{{ t` gllygtcmbt kgzm y`lckcm{, yz`kmd}zm{, gbd {tgbdgzd{ c{ gvgclgjlm t` thm h`{yctgl {tgoo" Yz`vcdm{ moomktcvm lmgdmz%{hcy, c{ zm{y`b{cjlm o`z thm yz`vc{c`b ò b}z{cbf {mzvckm{ :4/6"

W]GLCOCKGTC@B[1 KG ZB lckmb{m gbd Eg{tmz{ Dmfzmm cb B}z{cbf `z mw}cvglmbt zmw}czmd" Ecbce}e ò =

smgz{ yz`fzm{{cvmls zm{y`b{cjlm mxymzcmbkm cb }yymz b}z{cbf egbgfmembt cb gb gk}tm kgzm ogkclcts zmw}czmd"J`gzd Kmztcocmd Gdvgbkmd B}z{m Mxmk}tcvm yzmomzzmd"

K`g{tgl Kèe}bctcm{H`{yctgl


7/7

Ygfm 6Ygsmz{ / Yz`vcdmz{ EGZNMTYLGKMMEYL@SEMBT

[MMNCBF G BMV Y@[CTC@B0

KGB HMLY"

Vm y}jlc{h gdvmztc{membt{ o`z th`{m {mmncbfbm kgzmmz

`yy`zt}bctcm{ o`z a}{t $7":= g `zd"

Co s`} yzmomz dc{kzmtc`b, mll hgbdlm gllzm{y`b{m{ t` s`}z gd"

Kgll (866# :48%:;?9, mxt" :, `z m%egclgdvmztc{mIygsmz{gbdyz`vcdmz{"kè"

DCZMKT@Z @O @YMZGTC@B[

Gkk`}btgjlm Hmglth Kgzm CYG, jg{md cb [cfbgl Hcll, cth g hc{t`zs o fz`th{cbkm 733; gbd cth gb mxkmllmbt zmy}tgtc`b, {mmn{ yz`{ymkt{ o`z thm bmls%kzmgtmd y`{ctc`b ò Dczmkt`z ò @ymzgtc`b{1 gb mxymzcmbkmd hgbd t` tmge%`zn cth }{ cb gddcbf t` `}z vc{c`b ò g jzcfht o}t}zm ò {mzvckm" Fz`thc{ k`b{tgbt, cth vmz 749,999 lcvm{ g{ o thc{ zctcbf"

K}zzmbt mxymzcmbkm cb egbgfmd kgzm c{ zmw}czmd" Thm zcfht kgbdcdgtm cllhgvm zm{y`b{cjclcts o`z gll `ymzgtc`bgl dmygztembt{, zmy`ztcbf dczmktls t`thm Khcmo @ymzgtcbf @oockmz, thm Yzm{cdmbt gbd KM@ gbd thm _ckm Yzm{cdmbt"Thc{ c{ gb `yy`zt}bcts o`z g yzòm{{c`bgl h` mba`s{ gb mxtmb{cvm nb`l%mdfm ò Klgce{ gbd ò ]tclcqgtc`b%, Kg{m% gbd W}glcts%Egbgfmembt o}bk%tc`b{ t` {tmy }y cb thmcz kgzmmz" Thm {}kkm{{o}l gyylckgbt cll zmgkh gbmbvcgjlm ylgtmg}, zmkmcvcbf thm zmgzd{ ò g yz`d}ktcvm kgzmmz cb egbgfmdkgzm" @}z bm Dczmkt`z ò @ymzgtc`b{ e}{t jm yzmygzmd t` jzcbf g ozm{hgbd cbo`zemd dcemb{c`b t` GHKCYG{ {}kkm{{o}l tzgkn"

ZMW]CZMEMBT[1 JG, J[, J[B `z mw}cvglmbt, EHG yzmomzzmd" =%79 smgz{egbgfmd kgzm, CYG `z mw}cvglmbt mxymzcmbkm" Mxkmllmbt egbgfmembt gbdkèe}bckgtc`b {ncll{" Mxkmllmbt zmomzmbkm{ zmolmktcbf g kgzmmz mll {ymbt"

Fmbmz`}{ kèymb{gtc`b, jmbmoct{, vgkgtc`b, {ckn ygs, kg{}gl Ozcdgs{ gbde`bthls meyl`smm l}bkhm`b{ kzmgtm thc{ kèygbs{ cbtmzbgl k`hm{cvmbm{{cth g {tgoo o gktcvm, {mlo%e`tcvgtmd k`llmgf}m{"

Co cbtmzm{tmd, ylmg{m megcl s`}z k`vmz lmttmz gbd zm{}em t 1 {{gjgbglIghkcyg"kè

'[MBC@Z KLGCE[ ZMY@ZTCBF GBGLS[T

Y`{ctc`b [}eegzs1 Kzmgtm gbd egcbtgcb zmy`zt{ {}yy`ztcbf o}bktc`bgl gzmg{ ò klgce{ yz`d}ktc`b, gda}{tembt{, zmk`vmzg}dctcbf, kèylcgbkm gbd NYC" Gjclcts t` `zn kl`{mls cth gll lmvò egbgfmembt t` dmtmzecbm j}{cbm{{ zmw}czmembt{" Yz`gktcvymzo`ze gbgls{c{ ò dgtg gbd yz`vcdm egbgfmembt cth k`bk{}eegzs gbd zmkèembdgtc`b{ co gyyz`yzcgtm" Ogeclcgz cth {`gzm lcom ksklm gbd `zncbf cb g tmge mbvcz`bembt" Embt`z tmemejmz{ cb j`th tmkhbckgl gbd o}bktc`bgl {}jamkt{" Lmgd thm tmcb cbb`vgtc`b cth bm tmkhb`l`fs gbd yz`km{{m{" Hmly dmvml`y gmbo`zkm tmge {tgbdgzd{" Thc{ y`{ctc`b zmw}czm{ {tz`bf Mxkml, [gbd Eckz`{òt J}{cbm{{ Cbtmllcfmbkm {ncll{"W}glcockgtc`b{1 Zmw}czmd1Jgkhml`z{ Dmfzmm cb `bm ò thm o`ll``z mw}cvglmbt smgz{ ò `zn mxymzcmbkm1 J}{cbm{{ Gdecbc{tzgtCbo`zegtc`b [s{tme{, Kèy}tmz [kcmbkm, = smgz{ [WL mxymzcmb{tz`bf {ncll{ cth Eckz`{òt Mxkml, Gkkm{{, gbd J}{cbm{{ Cbtmllcfm

([[C[, [[Z[, [[G[#" Dme`b{tzgtmd mxymztc{m cb tmkhb`l`fsklgo}bktc`bgl {}jamkt gzmg{" Yzmomzzmd1 ; smgz{ cb hmglthkgzm cb{gbkm"Mxymzcmbkm cth Eckz`{òt [hgzmY`cbt" Mxymzcmbkm cth WBEckz`{òt kmztcockgtc`b"E`lcbg òomz{ g kèymtctcvm jmbmoct{ gbd kèymb{gtc`b ygkngfm" Ylm{mbd zm{}em gbd {glgzs hc{t`zs t` emlc{{g"{bsdmzIe`lcbghmglthkgzm"k`

(M@M# EOD_"

payers & providers california edition – issue of february 9, 2012

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