Archive for April of 2008

Health Policy Notes

April 30, 2008
The American Medical Association’s Relative Value Scale Update Committee (RUC) has submitted recommendations to Congress supporting the patient-centered medical home model of care and providing payment structures for it, according to an AMA press release on 4/29/08, which is available online. David Hitzeman, DO, of Oklahoma, Chair of the AOA Bureau of Socioeconomic Affairs, chaired this RUC Committee as well.

Presidential Candidate John McCain recently deemed that health care is "too expensive,” stating that America must move away from our current system “toward one where a family has a medical home, providers coordinate their efforts and… where the focus is on affordable quality outcomes,” Reuters reported on 4/28/08.

Illinois Governor Rod Blagojevich announced in a 4/29/08 press release that the state has saved approximately $34 million this year through the Primary Care Case Management and Disease Management pilot programs, which create medical homes for Medicaid patients.

Health Policy Notes

April 29, 2008
This week is “Cover the Uninsured Week 2008,” a campaign organized by the Robert Wood Johnson Foundation, which has become the largest nonpartisan mobilization in history seeking solutions for the 47 million uninsured Americans.

The American Diabetes Association reported that diabetes cost the nation $174 billion in 2007, up from $132 billion in 2002; the disease affects 17.5 million people in the US, and 1 million people are diagnosed with it each year.

America’s Health Insurance Plans (AHIP) has joined with other stakeholders in supporting the “Patient Charter,” a standard set of guiding principles on physician performance measurement and reporting.

Health Policy Notes

April 28, 2008
Former US Surgeon General William H. Steward, MD, has passed away. Dr. Stewart was one of the first to recognize the link between smoking and lung cancer, and became a medical activist to prevent smoking, end racial disparities in health care, and increase health care access for the elderly, according to the 4/27/08 Washington Post.

The 4/20/08 Health Affairs reported that few uninsured households can afford to participate in consumer-driven, cost-sharing health plans, such as health savings accounts, as the deductibles are usually too high to be covered.

A recent analysis by PricewaterhouseCoopers found that over half of the $2.2 trillion the American health care system spends each year is “wasted” paying for medical errors, insufficient use of information technology, and poorly managed chronic diseases, the 4/23/08 USA Today reported.

Health Policy Notes

April 26, 2008
The Agency for Healthcare Research and Quality has undertaken a new campaign called “Real Men Wear Gowns” to educate the public and encourage middle-aged men to learn about the preventive and screening tests they need to take.

The 4/22/08 HealthDay News reported that the number of general surgeons in the US per 100,000 residents fell by over 25% between 1981 and 2005, based on data from the American Medical Association’s Physician Master files.

The 4/25/08 CQ HealthBeat reported that the average individual’s health insurance premium rose 17.8% between 2002 and 2005; about 12 million Americans in 2005 had individual health insurance, the most popular health insurance option for those not covered by employers.

Health Policy Notes

April 25, 2008
Today is World Malaria Day, sponsored by the Global Health Council to reduce the burden that malaria imposes on the health of people worldwide; the Malaria Roundtable has written a community statement calling on the US to continue to provide more investment in malaria initiatives, available online.

The CQ HealthBeat reports that the US Senate on 4/24/08 passed a bill that would prohibit discrimination based on genetic tests, opening the door for disease screening without fear of discrimination; the bill now goes to the House of Representatives.

The AHRQ has launched a new online tool that allows users to learn, share, and adopt innovations in the delivery of health services. The Web site, the Health Care Innovations Exchange, is available at www.innovations.ahrq.gov.

Health Policy Notes

April 24, 2008
The 4/24/08 USA Today reported on an Agency for Healthcare Research and Quality analysis, showing that the number of cases of Clostridium difficile, a common but sometimes deadly infection, has soared 200% from 2000 to 2005.

The USA Today also reported on 4/24/08 that Michale DeBakey, MD, has been awarded the Congressional Gold Medal for his pioneering surgical work, including such procedures as the heart bypass.

The US House of Representatives has voted to block the Bush Administration’s proposed $13 billion in cuts to Medicare spending over the next 5 years, imposing a one-year moratorium on the cuts with enough support to override a veto, according to the 4/24/08 Washington Post.

Health Policy Notes

April 23, 2008
Today’s three policy notes on Alzheimer’s disease are taken from the 4/17/08 USA Today:

A new study presented on 4/16/08 at the American Academy of Neurology meeting suggested that heavy drinkers and smokers tend to develop Alzheimer’s years before people who don’t drink or smoke as much.

Researchers found that people who have elevated blood cholesterol were at least 1.25 times more likely to develop Alzheimer’s than those with low cholesterol.

Autopsies have shown that people who have larger brains tend to be less vulnerable to the plaques and tangles that characterize Alzheimer’s, suggesting that those with larger brains can compensate for some loss without developing the disease.

Health Policy Notes

April 22, 2008
The Minnesota House of Representatives passed a health system reform package on 4/10/08, as the State Senate did earlier this year; both reform bills include provisions that would provide new payments to support patient-centered medical homes.

The Centers for Medicare and Medicaid Services announced via press release on 4/16/08 that $50 million in grants will be given to 20 states to help improve access to primary medical care so that Medicaid beneficiaries could avoid costly hospital emergency room visits.

At its meeting earlier this month, the Agency for Healthcare Research and Quality advised that there will be a “tsunami in the future workforce in primary care,” as more and more students are choosing subspecialties and primary care is less attractive.

Health Policy Notes

April 21, 2008
The 4/18/08 Chicago Tribune reported that this year’s severe flu season has caused more doctor visits and deaths from flu and pneumonia, peaking in February, when flulike illnesses accounted for 5.9% of all doctor visits nationwide.

Raising the price of a gallon of gas by $1 has the potential to lower American obesity rates by 9% by leading people to walk or bike rather than drive, according to Washington University of St. Louis (my alma mater) research published in the 4/10/08 New York Times Magazine.

A recent survey published by Managed Care magazine showed that pulmonologists had the biggest percentage increase in compensation between 2003 and 2006, experiencing a 23.7% payment increase, followed by dermatologists (22.6%) and internists (22.5%).

Health Policy Notes

April 18, 2008
The Centers for Medicare and Medicaid Services are awarding about $50 million in grants to 20 states, with the grants aimed at controlling health care costs by reducing unnecessary emergency room visits, a 4/17/08 Associated Press story reported.

The House’s New Democrat Coalition (NDC ) appeared with New York City Mayor Michael R. Bloomberg and Thomas R. Frieden, Commissioner of the City’s Department of Health and Mental Hygiene, at a 4/15/08 press conference to introduce an initiative that would nationalize interoperable health IT — and have 75 percent of providers adopt it — by 2018.

The health insurer CIGNA, joining with a growing number of other insurers, announced that it will no longer reimburse hospitals for medical errors such as operations on the wrong organ and leaving surgical instruments inside patients, according to the 4/17/08 Yahoo/AP.

Health Policy Notes

April 17, 2008
The 4/15/08 Washington Post reported on the top five federal lobbying entities, which are the US Chamber at $52.75 million; General Electric at $23.62 million; PHARMA at $22.73 million; the AMA at $22.13 million; and the American Hospital Association at $19.73 million.

The Wall Street Journal reported on 4/7/08 that New Jersey, California, and New York, along with several other states, are the costliest states in terms of spending for the care of chronically ill Medicare patients, outspending the national average of $46,412 per patient by 20% or more.

An American Medical Group Association survey of primary care compensation in 2006 found that primary care physicians saw a 4% increase in compensation that year, lower than the 6% increase enjoyed by aggregate medical and surgical specialties, according to Managed Care magazine.

Health Policy Notes

April 16, 2008
The 4/15/08 Chicago Tribune reported on the following three “Fit for Life” policy notes:

Patients with heart failure who exercised 14-22 minutes on a stationary bike 6 times per week and who walked briskly for 45 minutes every day for four weeks experienced significantly improved cardiac performance and breathing capacity, Texas A&M researchers found.

Women who follow the government-recommended diet, which favors fruits, vegetables, whole grains, and low-fat milk, are 24% less likely to have a heart attack and 18% less likely to have a stroke than those women following more typical diets.

Adults who regularly eat apples, applesauce, and apple juice have a 27% lower risk of metabolic syndrome, the cluster of health problems that is commonly associated with numerous chronic diseases like diabetes and cardiovascular disorder.

Health Policy Notes

April 15, 2008
The AP/San Francisco Chronicle reported on 4/11/08 that about 12 of the nation’s largest pharmaceutical companies will begin publicly disclosing information about continuing medical education grants they award to physicians.

The 4/7/08 Wall Street Journal reported that total US health care spending reached $2.1 trillion in 2006, with hospital care comprising the largest portion of this spending at $648 billion, or 31% of the total spending.

Going without health insurance kills almost 1,000 people per year in Illinois alone, according to the 4/9/08 Chicago Sun-Times, as the uninsured are more likely to skip tests, wait until illnesses are severe to seek treatment, and waiting to fill prescriptions to manage chronic diseases.

Health Policy Notes

April 14, 2008
The New York Times reported on 4/14/08 that many health insurance companies are adopting new pricing systems whereby patients’ co-pays are derived as percentages of the drugs’ actual price, rather than flat, fixed-rates.

A new study on a breast cancer vaccine found that the vaccine reduced mortality by 50% in patients with the deadliest form of the disease, and by 100% in patients with low or intermediate levels of the protein HER2/neu, the 3/13/08 Washington Post reported.

The Conference Board has released a new report on obesity, finding that the US rate of obesity has doubled over the last 30 years, with 34% of Americans now considered obese; obese employees cost private employers an estimated $45 billion annually.

Health Policy Notes

April 11, 2008
An America’s Health Insurance Plans survey on members’ use of quality measures found that 61% found access to essential data storage to be a barrier to using such measures; other barriers included feasibility of collecting measures (49%) and cost-efficiency of measure implementation (37%).

Twenty percent of college students between the ages of 18 and 23, or 1.7 million all told, did not have health insurance in 2006, with older students and those from ethnic minority groups more likely to be uninsured, the 3/31/08 CQ HealthBeat reported.

The Chicago Tribune reported on 4/8/08 that infants and toddlers who get fewer than 12 hours of sleep each day are much more likely to become overweight by the time they reach pre-school age, with TV viewing amplifying this effect.

Health Policy Notes

April 10, 2008
An America’s Health Insurance Plans survey on members’ use of quality measures found that 83% provide reports to physician groups for quality improvement and 76% use measurement in incentive programs for physicians.

On 4/2/08, the House Energy and Commerce Committee approved, by a vote of 38-12, the “Family Smoking Prevention and Tobacco Control Act” (HR 1108), which would give the Food and Drug Administration (FDA) the authority to regulate tobacco products.

The New York Times reported today that the increased use and understanding of digital mammograms has led to an increase in the number of second tests being requested; 32% of mammography clinics now have digital machines, up from 10% two years ago.

Health Policy Notes

April 09, 2008
The 4/8/08 Washington Post reported that, between 2004 and 2006, patient safety errors caused 238,337 preventable deaths and cost the Medicare program $8.8 billion, according to the fifth annual Patient Safety in American Hospitals Study.

US spending on pharmaceutical drug and biotechnology research rose $3 billion in 2006 to $58.8 billion overall that year; there are currently more that 2,700 drugs in development in the US, up from 2,000 drugs five years ago, , the 3/31/08 CQ HealthBeat reported.

A 4/1/08 press release from the National Institutes of Health (NIH) stated that treating children with stimulants for Attention-Deficit Hyperactivity Disorder (ADHD) is not likely to increase risk of substance abuse as adults, according to two new NIH studies.

Health Policy Notes

April 08, 2008
The 4/7/08 Chicago Tribune reported that a two-year project by five schools in Pennsylvania to replace soda with fruit juice, scaling back snacks, and eliminate candy resulted in the schools’ percentage of children who became overweight being half that of other schools.

The amount Medicare pays to treat chronically ill seniors and the disabled at our nation’s teaching hospitals varies widely, up to four times higher at some institutions than others, due to differences in patient stays, number of doctor visits, and other factors, the 4/7/08 USA Today reported.

The Internal Medicine News reported on 3/15/08 that many physicians have started using financial incentives to encourage patients to lose weight, including giving discounts on services for pounds lost and additional charges for pounds gained.

Health Policy Notes

April 07, 2008
A new study reported by Health Day News on 4/2/08 found that obesity during pregnancy not only increases the risk of medical complications, but also financially strains the health care system, as obese patients require longer hospital stays and more medications than normal weight women.

The 3/24-31/08 American Medical News reported that medical students begin to lose empathy for patients within one year of entering medical school, and their compassion continues to erode throughout their careers.

Scientists have identified a genetic variation that they say makes people more likely to become addicted to cigarettes, a discovery that both strengthens evidence for biological causes of nicotine addiction and sheds light on how genetics and behavior together cause cancer, the Washington Post reported on 4/3/08.

Health Policy Notes

April 04, 2008
A growing number of states have introduced laws to battle the obesity epidemic: 27 states have laws regarding school nutrition; 24 have laws regarding physical activity at schools; and at least 17 have added taxes to soda and junk food, the 3/24-31/08 American Medical News reported.

The location in which a child is born and raised has a large impact on his or her chances of getting and staying healthy, according to a report ranking states on how well they take care of their children that was reported in today’s Health Day News.

A new report from HHS’s Administration for Children and Families (ACF) found that, of the 1,530 reported child deaths caused by abuse or neglect in the US in 2006, 78% were in children under the age of four and over 44% of those were infants, the 4/3/08 CQ HealthBeat reported.

Health Policy Notes

April 03, 2008
The Department of Health and Human Services has named 4/4/08 as the fourth annual “National Walk to Work Day,” urging all Americans to save gas money, burn calories, and reduce carbon emissions by walking, instead of driving, to work.

The New York Times reported on 3/29/08 that many patients are dissatisfied with aspects of the medical care they receive at hospitals, although 67% of those surveyed nationwide would recommend the institution where they received treatment to a friend or relative.

Americans with health insurance are facing higher out-of-pocket costs for their prescription drugs, with 31% of those surveyed last year by the National Patient Advocate Foundation ranking co-pays as their top medical-debt problem, the 4/3/08 USA Today reported.

Health Policy Notes

April 02, 2008
Reuters reported on 3/31/08 that over 50% of American physicians support switching to a national health insurance system, while about 30% oppose the idea, according to a survey of 2,000 physicians published in the Annals of Internal Medicine.

The 4/1/08 New York Times reported that physicians and health insurers have reached a tentative agreement on creating a fair, uniform set of standards to rank doctors’ performance in taking care of patients.

USA Today reported on 3/27/08 that the number of people who received angioplasties to open clogged heart arteries has leveled off since 2005 and may be declining.

Health Policy Notes

April 01, 2008
Democratic Presidential Candidate Hillary Clinton stated last week that she intends to push for a universal health care plan that would cap Americans’ health insurance premiums at 5% to 10% of their annual income, the 3/28/08 New York Times reported.

A panel convened by the American College of Cardiology urged consumers to use the drugs Vytorin and Zetia only as a “last resort” and after other cholesterol-lowering drugs fail, until research shows that the drugs work, according to the 3/31/08 USA Today.

The Chicago Tribune reported on 3/28/08 that India is becoming the destination of choice for “medical tourists” who travel to obtain cheaper surgeries – 150,000 tourists from many countries traveled to India last year, and employers and insurers are investigating how they too can take advantage of these lower rates.