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SGR repeal cost estimate drops to $245 billion
Reduced projected Medicare spending for the next decade has lowered the estimated cost of repealing Medicare’s sustainable growth rate formula that helps determine physician pay. Eliminating the SGR and freezing Medicare doctor pay rates over 10 years would cost $245 billion, according to new projections from the Congressional Budget Office. Officials previously had estimated that nearly $300 billion would be needed for a pay freeze. But with slower expected growth in program spending, the SGR formula — which decreases doctor pay when predetermined spending limits are exceeded — would not lower doctor rates as much and thus would be less costly to reverse. Lawmakers said they will work to prevent a scheduled 27% SGR reduction to Medicare pay before it takes effect in 2013. Congress also faces other significant year-end fiscal challenges, including expiring tax cuts and automatic reductions of federal defense and non-defense spending. Determining ways to pay for an SGR re [Read more]
Patient safety law protects some documents in court case
A New Jersey appellate court has upheld as constitutional a state law that protects the confidentiality of documents related to medical errors in order to improve patient safety. The court clarified how broadly such protection extends, saying investigative and analytical material created in compliance with the New Jersey Patient Safety Act is “absolutely protected.” However, documents generated for other purposes are subject to existing discovery rules. For doctors and hospitals, the ruling is an educational guideline for how best to structure Patient Safety Act processes within health facilities, said Melinda Martinson, assistant general counsel for the Medical Society of New Jersey, which was not involved in the case. “The bottom line is physicians need to know whether they’re strictly within the confines of the [Patient Safety Act] procedures,” she said. “It is possible that those involved in a PSA evaluation could believe that their discussions are confidential [Read more]
NQF draws on AMA toolkit to gauge patient-friendly communication
The National Quality Forum in August endorsed a dozen measures of physician group and hospital performance in improving communication with patients who have poor health literacy or limited English proficiency. Seven of the metrics were developed by the American Medical Association’s Ethical Force Program and are used as part of its Communication Climate Assessment Toolkit. The toolkit, publicly launched in 2008, features surveys to be used with patients, executive leaders, physicians, nurses and nonclinical staff. Patients grade their experiences in understanding elements such as signage, forms, receptions and their communications with doctors and other health professionals. The survey of staff asks for their assessment of how well the health system or clinic does in providing interpreter services and training. “Effective, patient-centered communication is critical in delivering quality health care, but illness, fear, low literacy and diverse languages and cultures can mak [Read more]
State medical society reports improvements in access to care
In Massachusetts, it may be more challenging to get care from a primary care physician than a specialist. Health care access in the state is improving, but about half of internists and family physicians still are not accepting new patients, according to a study released Aug. 8 by the Massachusetts Medical Society. In 2012, 50% of family physicians said they were taking new patients, a slight increase from 47% in 2011 and 46% in 2010. Acceptance of new patients among internists was 51% in 2012, compared with 49% in 2011. Four surveyed specialties reported much higher acceptance rates of new patients: 84% for cardiologists; 86% for obstetricians-gynecologists; 92% for gastro-enterologists; and 98% for orthopedic surgeons. The medical society’s study examined physician acceptance of new patients and Medicare and Medicaid coverage, as well as wait times for new patient appointments. The results were based on 830 telephone interviews with physician offices representing seven s [Read more]
Blood type could help identify heart disease risk
Educating patients about their blood type and the health risks associated with it could help prevent cardiovascular disease, a study says. People with blood type AB (7% of the U.S. population) have a 23% increased risk of developing coronary heart disease compared with those who have type O blood, said a study published online Aug. 14 in Arteriosclerosis, Thrombosis and Vascular Biology. Researchers didn’t examine the biological processes behind blood type and heart disease risk. But they said type AB is linked to inflammation, which might affect the function of blood vessels. Blood type A is associated with higher levels of low-density lipo-protein cholesterol. “While people cannot change their blood type, our findings may help physicians better understand who is at risk for developing heart disease,” said study senior author Lu Qi, MD, PhD, assistant professor in the Dept. of Nutrition at Harvard School of Public Health in Boston. A patient’s blood type also can b [Read more]
Uninsured Medicaid eligibles will vary in age and race
A diverse group of uninsured adults will enter the Medicaid rolls in 2014, but many probably will be male, white and young, according to a new study. About 15 million uninsured non-elderly adults are expected to gain Medicaid coverage under the Affordable Care Act’s expansion provision, helping their access to care while seeing their financial situations improve, according to an analysis issued Aug. 10 by the Robert Wood Johnson Foundation and the Urban Institute. The study found that 55% of this population is white, 19% is black and 19% is Hispanic. The rest are in multiple or other ethnic or racial categories. The fact that the majority of eligibles are white is due to the broadening of Medicaid’s eligibility criteria under the health system reform law and the fact that whites continue to represent a large share of the U.S. population, said Stephen Zuckerman, a senior fellow at the Urban Institute and a co-author of the analysis. “It’s not that any one group — y [Read more]
Charity helps medical practices donate unused drug samples
Nearly 800 physician practices around the country are participating in a program that gives soon-to-expire pharmaceutical sample medications to low-income, uninsured patients at safety-net clinics. The Nashville, Tenn.-based service, Dispensary of Hope, has brought in more than $9 million worth of samples in the last year from practices in 30 states. In turn, the drugs have been dispensed to 80 community health centers and charitable pharmacies in 15 states. Participating practices are asked to donate sample medicines six months before they are set to expire so needy patients who are prescribed the drugs can benefit from them. Donor practices place the drugs in a secured box provided by the service, which covers shipping costs. The service’s staffers, volunteers and interns go through the box, log the medications and send back a receipt with the information for the practice to have for record-keeping and regulatory compliance purposes. Disposing of sample medications can [Read more]
More doctors sought to meet hospice and palliative care demands
The U.S. physician work force is failing to keep pace with increasing demands for hospice and palliative care services as more people live longer with chronic diseases, said the American Academy of Hospice and Palliative Medicine. From 8,000 to 10,000 physician specialists are needed to meet demands in hospice and palliative care programs nationwide, according to the AAHPM, a professional organization for hospice and palliative medicine physicians. But only 4,500 doctors specialize in the field, and training programs are expected to produce only an additional 4,600 specialists in the next 20 years, the academy said. Physician shortages will worsen with the aging of the population, said AAHPM President Timothy Quill, MD, director of the palliative care program at the University of Rochester Medical Center in New York. “Demand has grown faster than our ability to produce and train specialists,” Dr. Quill said. The number of Americans 65 and older is projected to increase [Read more]
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