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House votes to repeal long-term-care program

The House on Feb. 1 voted to repeal the long-term-care insurance program created by the health system reform law amid Democratic calls to save the coverage plan. House Republicans have been sharply critical of the Community Living Assistance Services and Supports Act, or CLASS Act. Opponents of the provision have called it a broken component of the Democrats' reform law that created the illusion of saving billions of dollars while providing much-needed care for the elderly and disabled. But independent actuarial analysis had determined that the new voluntary insurance program would not be viable over the long term. The House voted 267-159, with some Democratic support, for legislation to repeal the act. "This unsustainable program would have increased federal expenditures and debt and was deemed to be financially insolvent," said Rep. Larry Bucshon, MD (R, Ind.). "Repealing the CLASS Act is important to ensure it is not implemented at a future time, which would have added to t ...

Almost half of preventive services not offered during checkups

The annual checkup is geared toward doing a physical exam, taking a patient's history and using the opportunity to deliver counseling or other preventive services that might be difficult to squeeze in during other office visits. Yet even during these encounters, patients are nearly as likely to miss out as they are to receive guideline-based prevention, says an American Journal of Preventive Medicine study published in February. Researchers audio-recorded 284 annual-checkup visits to 64 Detroit-area general internists and family physicians from 2007 to 2009. They also examined patient records for the preceding five to 10 years and surveyed patients to determine if they were eligible or due for 19 items recommended by the U.S. Preventive Services Task Force and the Advisory Committee on Immunization Practices. Patients were due for an average of 5.5 preventive services such as cholesterol screening, obesity counseling or pneumococcal vaccination. In all, 54% of the services due ...

Referral rates for physicians nearly double in 10 years

More outpatient visits are ending with the doctor recommending that the patient make an appointment to see another physician. It's a fact that probably is contributing to rising health care costs, says a Jan. 23 study in Archives of Internal Medicine. Between 1999 and 2009, the percentage of ambulatory visits that resulted in a referral nearly doubled from 4.8% to 9.3%, the study said. Researchers evaluated Centers for Disease Control and Prevention data from more than 845,000 patient visits between 1993 and 2009, focusing on the period from 1999 to 2009. They were surprised by the increase in referrals, said Bruce Landon, MD, MSc, study co-author and professor with Harvard Medical School's Dept. of Health Care Policy. "It is not something we would have predicted, particularly given the relative stability up until 10 years ago," he said. Referral rates were high for both specialists and primary care physicians. The number of outpatient visits to specialists that resulted in ...