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*For our ads, not your hospital

In Brief
2009 a drop of nearly 10%. By
contrast, nearly 30% of the states
adults smoked in the mid-1980s.
The data is from the Centers for
Disease Control and Preventions
behavioral risk factor surveillance
system.
The most recent decrease
means that California is only one
of two states to reach the U.S.
Department of Health and
Human Services Healthy 2020
target of reducing the adult
smoking rate below 12%.
The drop in smoking means
that fewer people will see their
lives cut short by tobacco, said
CDPH Director Ron Chapman,
M.D.
Adult men smoke at
significantly higher rates than
women: 14.4% versus 9.4%,
compared to 15.6% of men and
10.7% of womenin 2009.
Smoking rates among
adolescents, although dropping,
remained relatively high. Among
high school students, 13.8%
smoked last year, down from
14.6% in 2008. Among middle
schoolers, 4.8% smoked in 2010,
down from 6% in 2008.

AHA Says Most

Hospitals Suffer Drug
Shortages
Nearly all of 820 community
hospitals 99.5% surveyed by
the American Hospital
Association last month reported at
least one drug shortage in the past
six months, with more than 40%
reporting shortages of more than
20 different drugs.
Among those medications in
particularly short supply:
anesthetics, emergency care,
nutritional and infectious disease
drugs were reported by more than
80% of the hospitals. The AHA
estimates such shortages cost
hospitals up ot $200 million a
year.

NEWS

Page 3

Blue Cross Links ER Usage To Maps

System Allows Users to Find Cheaper Treatments
Anthem Blue Cross of California has unveiled
a Google Maps-based navigation system that
allows its enrollees to select less-expensive
alternatives to hospital emergency rooms to
treat minor ailments.
The application, which can be used on a
laptop or desktop computer and on Webenabled smartphones, allows the user to type
in their zip code via a custom application
known as the California Alternative ER Finder.
A list of nearby urgent care and retail clinics
Anthem contracts with in California about
300 in all are presented, along with their
addresses, phone numbers and websites.
Jammed emergency rooms are an issue
both nationally and in California. According to
a report issued by Press Ganey Associates last
year, the average ER wait statewide was nearly
ve hours, ranking California 40th nationally.
A RAND Corp. study also from 2010
concluded that 17% of all hospital ER visits
could be handled in less-intensive settings.
Anthem ofcials claim that offering
alternatives to ER care for relatively minor
ailments could save enrollees money. For
example, the average contracted hospital in
California charges $641 to treat a strep throat
infection in its emergency room. By
comparison, the same care costs about $70 in
an urgent care clinic and $27 in a retail clinic,
most of which are attached to chain
pharmacies.
Although Anthem covers the treatments,
the patient co-payment for a hospital visit can
be $150 or more, compared with co-payments
of as little as $10 in the other settings.

When your ve-year-old is crying with a

fever at 7 p.m. on a Friday because she has a
sore throat or an ear ache, what do you do?
said Kurt Tamaru, M.D., medical director for
Anthem Blue Cross of California. It's
important people know that they have options
for less serious ailments.
Tamaru added that the largest consumers
of avoidable ER visits are between the ages of
18 and 34 a demographic more likely to not
have a primary care physician than their older
counterparts, but also more likely to have easy
access to computer technology.
The program, which is currently being
rolled out among all Anthem plans in the U.S.,
was the brainchild of Manish Oza, M.D., a
medical director for Anthems parent
company, Indianapolis-based WellPoint, who
has training in Google Maps programming.
The application was developed in conjunction
with Maryland-based Meemo Media Labs.
According to Oza, a yearlong pilot
program Anthem conducted with its health
plan in Virginia cut ER usage among 22,000
enrollees who had access to the application
by 14% All of the reduced visits involved care
that could be sought appropriately outside of
the ER. The Google Maps application was also
supplemented by e-mails and advertising
directed to the specic members.
Oza said it was too early to tell if the
Virginia pilots success is being replicated in
California. He also said that an extension of
the Google Maps program a smartphone
application was in some stages of
development, but would not be available in
the near-term.

HEALTHCARES BEST ADVERTISING VALUE

]

PAYERS & PROVIDERS reaches 5,000 hospital, health plan and nonprot executives statewide. There is no better venue for marketing
your organization or conference, or recruiting new staff.

LEARN MORE HERE

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Payers & Providers

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OPINION

Page 4

Premium Intervention Is A Bad Idea

It Looks Good on Paper, But Disastrous in Reality
Rising health insurance premiums are a
Cars dont need to be rushed to hospitals in a
concern for consumers and their medical care
matter of minutes if they suddenly stop
givers. Both want to preserve access to high
functioning; replacement parts are readily
quality, affordable health care. However,
available and often can be easily installed; and
empowering a government agency to decide
the staffs of auto body shops are not heavily
what health insurance premiums will be, as
unionized as they are in the healthcare sector.
proposed by Assembly Bill 52, is the wrong
For comparisons sake, a single ve-day hospital
solution to this very real problem.
stay (slightly above the average in California)
costs enough to replace a totaled Mercedes.
Health insurance premiums rise, in part, in
Thats the type of claim that would quickly ruin
response to the rising costs of the medical care
an auto insurer if it became routine.
we purchase with our insurance.
Rates would skyrocket for every
And the chief driver of increased
driver in order to keep
medical care costs is the increase
automobile indemnication
in demand for and consumption
viable.
of medical care caused by
Indeed, we only have to look
population growth and aging. The
at how the state manages the
more our population grows, the
Medi!Cal program to see what
more medical care is dispensed.
will happen if we turn over our
Still more medical care is
private health insurance to rate
provided as people get older with
regulation by a government
declining health status. Add to
agency. This program for families
that the higher cost of our direct
on welfare and the disabled pays
care labor force; the cost of
medical care givers so poorly that
acquiring newer life!saving and
nding doctors, especially
life!improving medical
physician specialists, to treat
technologies; and the cost of
them is the single, greatest
newer better and life!extending
access-to-medical-care challenge for
medications, and the reasonable
By
these consumers. The depressed rates
among us readily see that depressing
Jim Lott
paid by the state to our hospitals that
health insurance premiums by
are prevented by law from turning anyone away
arbitrary governmental rate setting does not
is the chief reason for closure cited by 10 of the
begin to address any of the reasons why
11 hospitals that closed in Los Angeles since
premiums are rising.
2002.
We medical care givers are concerned that
There is a better solution already in play.
AB 52 might do more to harm access to
Legislation passed last year, SB 1163,
medical care for our patients because premium
established rate review in California. Health
rate setting by government will drive some
health plans and insurers out of California. That plans now must actuarially justify rate increases
for individuals and small businesses. The federal
will decrease consumer choice of plans, and
government has provided California a $1 million
that, in turn, will decrease the choice of
grant to establish the rate review process and
medical care givers consumers may go to for
hire actuaries. That is the way to go.
their medical care needs because health plans
Accordingly, the Legislature should reject AB 52.
are selective about which medical care givers
they include in their provider networks.
Advocates of the legislation point to the
success of Proposition 103, which was passed
Jim Lott is the executive vice president of the
by California voters in the 1980s to regulate
Hospital Association of Southern California.
automobile insurance premiums. Although it
has succeeded in keeping premiums in check
for good drivers and resulted in very few
Op-ed submissions of up to 600 words are
insurers leaving the state, repairing a car and
welcomed. Please e-mail proposals to
indemnifying its operator is far less complex
editor@payersandproviders.com,
and expensive than repairing someones health.

!!!"#$$!%&!'(&)*+!,!'*-./0)*+!'1%2/+3/456!778

Payers & Providers

MARKETPLACE/EMPLOYMENT

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

will do it for a lot less.

Employment listings begin at just $1.65 a word
Call (877) 248-2360, ext. 2
Or e-mail: advertise@payersandproviders.com
Or visit: www.payersandproviders.com

SEEKING A NEW POSITION?

CAN HELP.
We publish advertisements for those seeking
new career
opportunities for just $1.25 a word.
If you prefer discretion, well handle all
responses to your ad.
Call (877) 248-2360, ext. 2, or e-mail
advertise@payersandproviders.com.

!!!"#$$!%&!'(&)*+!,!'*-./0)*+!'1%2/+3/456!778

Page 5

Payers & Providers

MARKETPLACE/EMPLOYMENT

Page 6

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