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Med students’ biggest challenges: educational costs, workload
The cost of medical education poses the biggest challenge for medical students, according to a national survey of students released Sept. 13. “They’re really seeing the bills piling up as the costs for medical school go up year after year,” said Erica Sniad Morgenstern, spokeswoman for the health information technology company Epocrates. The company surveyed 1,015 students in August who use its drug reference tool at more than 160 medical schools nationwide. Medical school costs have been an increasing challenge for students in the seven years the company has been conducting the survey, she said. The average student debt is $162,000 for allopathic students and $205,674 for osteopathic medicine students, according to the latest data from the Assn. of American Medical Colleges and the American Assn. of Colleges of Osteopathic Medicine. Eighty-six percent of allopathic medical school graduates and 91% of osteopathic medicine college graduates had educational debt in 2011. [Read more]
Nationwide initiative cuts central-line infections by 40%
Additional evidence emerged in September to document the nation’s patient safety breakthrough in reducing the toll of central line-associated bloodstream infections in hospital intensive care units. More than 1,100 hospitals in 44 states participated in a federally funded initiative using an evidence-based tool kit that incorporates standardized checklists. They slashed central-line infections by 40% over four years. The overall infection rate among hospitals in the project fell from 1.903 infections for every 1,000 days patients have a central line inserted to a rate of 1.137 per 1,000 days. “That 40% is not just a number — it means more than 500 lives saved and more than 2,000 fewer patients suffered an infection. And we avoided $34 million in costs,” said Carolyn M. Clancy, MD, director of the Agency for Healthcare Research and Quality. The agency, part of the Dept. of Health and Human Services, funded the work done by the American Hospital Assn. to spread the preve [Read more]
Stakeholders seek regulatory direction on insurance exchanges
A panel representing state, insurance and employer interests told the House Ways and Means health subcommittee on Sept. 12 that they need more concrete direction from the federal government on how to set up the Affordable Care Act’s health insurance exchanges as implementation dates fast approach on these new coverage marketplaces. The Dept. of Health and Human Services has asked states to select their “benchmark” plans on essential health benefits by the end of September. “But no rule, proposed or final, has been released outlining the details of this process,” said Michael Consedine, Pennsylvania’s insurance commissioner, testifying before the panel. The essential health benefits are the minimum coverage standards that must be followed by the exchanges and some health plans outside of the exchanges starting in 2014. Many unknowns surround the selection of these benefits, including whether HHS could modify or override a state’s choice and replace it with another op [Read more]
Suicide prevention strategy calls for screening those most at risk
An updated national suicide prevention strategy calls on physicians to screen patients at increased risk of taking their own lives and to educate family members about ways to support such individuals. At-risk patients include those with an illness that impairs their physical functions or causes chronic pain, members of the Armed Forces and veterans. Doctors also are encouraged to implement protocols that ensure immediate follow-up with patients after they are discharged from an emergency department or inpatient care facility due to suicidal thoughts or behavior. The recommendations are part of the 2012 National Strategy for Suicide Prevention issued Sept. 10 by the Dept. of Health and Human Services Office of the Surgeon General and the National Action Alliance for Suicide Prevention. The alliance is a public-private partnership focused on advancing the national initiative. “Keeping [Americans] safe from lost hope is as critical a public health issue as keeping them safe [Read more]
Physicians, industry continue to wait for Sunshine Act rules
Senators from both major parties sharply criticized the Centers for Medicare & Medicaid Services for the continued delay in regulations on publicizing the financial ties between physicians and pharmaceutical, medical device and biologics companies during a Sept. 12 hearing. The Senate Special Committee on Aging convened a roundtable discussion on the long-awaited implementation of the Sunshine Act, a bipartisan component to the 2010 health system reform law. Senators took the opportunity to voice their frustration with the agency tasked with running a program that is designed to allow public searches of databases to find information about individual physicians’ financial relationships. CMS published a proposed rule for the Sunshine Act on Dec. 14, 2011, more than two months after the rule was supposed to be finalized. The overdue rule now should be ready following a review and comment period during the past nine months, said Sen. Charles Grassley (R, Iowa). However, the regulat [Read more]
Educational tool helps residents learn value-based care
Amid increasing emphasis on containing health expenditures while providing high-quality care, a new educational tool is intended to teach medical residents how to evaluate the benefits and cost-effectiveness of treatments for patients. The VALUE framework is designed to help guide teaching hospitals and residency programs in educating physicians-in-training about providing value-based care. The program is outlined in the September issue of the Journal of General Internal Medicine. “Our model can be used to train young physicians to assess the benefits of medical interventions, with the goal of selecting those that generate high value and reduce unnecessary costs,” said Mitesh Patel, MD, lead author and Robert Wood Johnson clinical scholar at the Perelman School of Medicine at the University of Pennsylvania. VALUE is an acronym representing the model’s core concepts of validation and variability, affordability and access, long-term benefits and less side effects, utility [Read more]
Dual-eligibles market creates opportunities for physician practices
Physicians have new opportunities to partner with health plans to take advantage of the rapidly growing private market for beneficiaries who are eligible for both Medicare and Medicaid, according to a partner at a global management consulting firm. “There’s been a tremendous interest and appetite around the so-called dual-eligibles population,” said Sanjay Saxena, MD, a partner in the North American health practice at Booz & Co. and co-author of a new Booz report. Several years ago, discussions about changes in the private insurance market were all about health insurance exchanges, then about accountable care organizations, and “now it’s about the duals,” Dr. Saxena said. The Booz report discusses ways in which managed care companies could leverage both the Medicaid and dual-eligibles markets by identifying states that present the best growth opportunities and then defining their operating models or “choosing a way to play” in these markets. Managed care organi [Read more]
Health is improving for U.S. adults with HIV
Significant health improvements have been made among HIV-infected adults in the United States, according to a study in the Sept. 4 issue of Annals of Internal Medicine. Those advancements include an increase in the proportion of people taking highly active anti-retroviral therapy, researchers said. The treatment consists of using at least three drugs to maximally suppress the HIV virus and stop progression of the disease. In 2008, 83% of HIV-infected adults who received care were prescribed the therapy, up from 74% in 2000. “This is good news for the HIV epidemic in the U.S., but there is room for improvement,” said lead author Keri N. Althoff, PhD, MPH. “We need to continue to focus on linking HIV-infected adults into care and effective treatment, not only for the individual’s health, but to reduce the likelihood of transmission to others,” said Althoff, an assistant professor in the Dept. of Epidemiology at Johns Hopkins Bloomberg School of Public Health in Mary [Read more]
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