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Health disparities persist despite VA quality improvements

Significant quality improvement initiatives in the Veterans Affairs health care system have failed to eliminate health disparities between white and black patients, says a study in the April issue of Health Affairs. The VA underwent major organizational changes between 1995 and 1999 that led to quality improvements, such as higher cholesterol-screening rates for all patients, said Amal Trivedi, MD, MPH, lead study author and research investigator at the Providence VA Medical Center in Rhode Island. But racial disparities persist in health outcomes with cardiovascular disease, diabetes and hypertension, he said. "Quality improvement is not synonymous with disparity reduction," said Dr. Trivedi, assistant professor at the Warren Alpert Medical School of Brown University in Providence, R.I. "It is possible to still be left with lingering disparities in care." For example, although 96% of whites and 94% of blacks received low-density lipoprotein cholesterol tests in 2009, there ...

Many paid caregivers lack health literacy skills

More than a third of the people paid to care for seniors are not health literate, and 60% wrongly interpret the instructions on prescription labels, a study says. Caregivers often are hired by families to help care for seniors with cognitive loss, dementia or Alzheimer's disease and who have trouble performing daily activities such as toileting, bathing, cooking and shopping. This makes it especially important that caregivers have the ability to understand health-related instructions, said Lee A. Lindquist, MD, MPH, lead author of the study published in May's Journal of General Internal Medicine ( Caregivers' poor health literacy skills can affect patient care, said Dr. Lindquist, a geriatrician at Northwestern Memorial Hospital in Chicago. "Many times, I see patients cared for by caregivers. They come with the senior to the doctor's visit," she said. "You can't really tell the senior information because they have cognitive issues that do ...

Medicare criticized for $4 million drug overpayment

Washington -- The Centers for Medicare & Medicaid Services overpaid for dozens of drugs in 2009 by an estimated $4.4 million, the Dept. of Health and Human Services Office of Inspector General said in an April report. The OIG examined payment levels for drug codes in 2009 and found that 34 of the 493 drugs in the Part B payment system exceeded the average manufacturing price by 5% or more during at least one quarter of that year. For instance, Medicare paid $346.57 in October 2009 for the injection drug Dexrazoxane, exceeding the 105% mark. Payments had surpassed this threshold throughout the year, according to the report. Medicare expenditures for Part B drugs would have been reduced by $4.4 million if CMS had paid 103% of the manufacturer's price, which the Medicare agency has the authority to do when prices exceed the 105% mark. CMS concurred with just one out of four OIG recommendations in the report on drug prices, according to a memo from CMS Administrator Donald M. B ...