California’s largest health system agreed to a $200 million settlement on October 12 following an investigation that found the system has failed to provide timely behavioral health appointments for patients and has canceled more than 100,000 appointments.

Kaiser Permanente, which also runs a health plan, will “undertake a systemic overhaul” of its behavioral health services, Mary Watanabe, director of the Department of Managed Health Care (DMHC), the regulatory body that oversees managed care plans in California, said in a statement.

The DMHC began investigating Kaiser in May 2022 after the Oakland-based health system saw a 20% increase in behavioral health patient complaints in 2021, the DMHC said in a statement.

Keep reading here.—MA

Do you work in healthcare or have information about the industry that we should know? Email Maia at [email protected]. For confidential conversations, ask Maia for her number on Signal.

Healthcare is a complex industry made even more difficult by inefficient technology. With increasing demands from regulators and patients, it’s hard for healthcare organizations to keep delivering high-quality care experiences.

The harsh reality is that both clinicians and patients are feeling negative effects from all this complicated industry technology.

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Patients with Medicare Advantage (MA) coverage are less likely than those with traditional fee-for-service Medicare to be hospitalized, readmitted to hospitals, or use high-risk medications, according to data released Wednesday.

Researchers with Harvard Medical School and health software provider Inovalon looked at Medicare quality measures over a two-year period as enrollees transitioned from commercial insurance to Medicare. They found that people enrolled in MA plans—which are offered by private companies—had better quality and health outcomes compared to those in fee-for-service Medicare.

Specifically, researchers found that MA enrollees—who currently account for more than half of Medicare enrollees (including a large share of disadvantaged patient populations) and $450+ billion in total federal spending—had 70% fewer readmissions within 30 days.

They also had 24% fewer preventable hospitalizations—with 59% fewer acute-related preventable hospitalizations and 9% fewer preventable chronic hospitalizations—and 21% lower rates of improper high-risk medication use than traditional Medicare patients, though overall medication adherence rates were similar between the two groups, according to the study.

Keep reading here.—SY

Do you work in healthcare or have information about the industry that we should know? Email Shannon at [email protected]. For confidential conversations, ask Shannon for her number on Signal.

Nursing shortages are nothing new, but the Adams administration is celebrating a city effort that’s trained 5,000 new registered nurses (RNs) since 2019.

New York City’s Citywide Nurse Residency Program, which is the nation’s first “city-led nurse residency consortium,” offers on-the-job training and support for new hires at 28 hospitals and facilities. The program aims to improve nurse retention rates, which has touted a 96+% retention rate year to date, compared to the 84% national average, City Hall announced on October 24.

“Nurses are often the first people you see and one of the last with whom you interact when visiting the hospital or an outpatient setting,” deputy mayor for Health and Human Services Anne Williams-Isom said in a statement. “This residency program provides an important structure to support, attract, and retain the city’s nurses.”

Keep reading here.—AE

Do you work in healthcare or have information about the industry that we should know? Email Amanda at [email protected]. For confidential conversations, ask Amanda for her number on Signal.

Today’s top healthcare reads.

Stat: Only 7% of adults and 2% of children in the US have received the latest Covid-19 vaccine. (the Associated Press)

Quote: “If you have a male coworker who takes paternity leave, you’re more likely to take paternity leave.”—Maya Rossin-Slater, a Stanford University associate professor of health policy, on more fathers taking paternity leave in California (KFF News)

Read: A top Philips Respironics executive allegedly told distributors to sell defective breathing machines despite potential health risks to patients. (ProPublica)

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