Around the nation: California may drop low-performing hospitals from its exchange plans

Bite-sized hospital and health industry news

  • California: The state's insurance exchange has proposed removing low-quality and high-cost hospitals from its network. Under the proposal, insurers that are part of Covered California—the state's exchange—would be required starting in 2018 to identify hospital "outliers" based on cost and quality. Ratings for medical groups and physicians would follow. According to Peter Lee, executive director of Covered California, the proposal aims to boost quality of care and make health coverage more affordable for consumers (Terhune, "Shots," Kaiser Health News/NPR, 3/18).

  • Vermont: The state has filed a waiver under the Affordable Care Act's (ACA) state innovation provision, which allows states to seek exemptions from various ACA requirements starting in 2017. Vermont hopes to allow businesses to directly enroll with insurers. The so-called 1332 state innovation waiver is the first to be filed by a state to avoid ACA regulations. According to Modern Healthcare, "Vermont's waiver could serve as a national model for the 19 other state-based exchanges, as well as the remaining 30 states with a federally facilitated marketplace." A CMS spokesperson declined to comment on the waiver (Dickson, Modern Healthcare, 3/17).

  • Washington, D.C.: The city will soon have a trendy new rooftop hangout—but this one is just for kids. Children's National Health System plans to begin construction next month on a "healing garden" on top of its hospital building in Washington, D.C. The project is expected to cost $3 million. The garden will be called the "Bunny Mellon Healing Garden Dedicated to the First Ladies of the United States" (Reed, Washington Business Journal, 3/17).

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