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Updated guidelines urge routine bone density tests

More women should undergo routine bone density tests, according to updated U.S. Preventive Services Task Force recommendations for osteoporosis screening published online Jan. 17 in the Annals of Internal Medicine. The revision expands recommended screening to women younger than 65 whose fracture risk is deemed equal to or greater than that of an average 65-year-old white woman, since white women are more prone to the disease than those of other ethnic groups. The task force has recommended routine screening for women 65 and older and high-risk patients 60 and older since 2002. But research showed that there are some post-menopausal women younger than 60 at similar risk for osteoporosis as their older peers, said Ned Calonge, MD, MPH, task force chair and president and chief executive officer of the Colorado Trust, a foundation aimed at improving health care access in Colorado. "That expansion is one thing we thought would be really important," said Dr. Calonge, a family and p ...

Medicare Advantage bonuses could go to low-performing private plans

Washington -- An Obama administration plan to test rewarding Medicare private plans that achieve higher scores on outcome-based measures will pay bonuses to plans that otherwise would be considered poor performers, according to a Jan. 6 letter to the agency from the Medicare Payment Advisory Commission. MedPAC, which advises lawmakers and other federal officials on how to set Medicare pay rates, sent the letter to the Centers for Medicare & Medicaid Services in response to a November 2010 CMS rule outlining changes to the Medicare Advantage program. Although CMS did not invite comments on the quality bonus payment demonstration proposed in the rule, MedPAC members said they were sufficiently concerned about the initiative to bring it to the attention of the agency. Under the national health reform law, Medicare Advantage plans starting in 2012 will receive higher benchmark payments if they are rated at least four stars on a five-star scale based on the quality of the coverage the ...

Unequal distribution of doctors hurts children's medical care

The nation's pediatricians and family physicians who care for young patients are clustered primarily in large cities, leaving many small communities devoid of doctors to care for their children, a new study says. In an analysis of where such physicians practice nationwide, researchers determined that there are enough doctors to care for U.S. children, if only they were more evenly distributed. "The evidence is very strong that we have an adequate physician work force for children," said pediatrician Scott A. Shipman, MD, MPH, lead study author and assistant professor at the Dartmouth Institute for Health Policy and Clinical Practice. "The [child] population isn't growing that much. The problem there really is maldistribution." The number of general pediatricians grew 51% to 38,981 between 1996 and 2006, and the number of family physicians increased 35% to 83,081. Meanwhile, the number of U.S. children grew by just 9% to 73.7 million, according to the study published in the Jan ...