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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]
AMA details multipronged approach to Medicare pay overhaul
The outdated Medicare payment system needs to offer more options for physicians when lawmakers craft reforms, the American Medical Association stated in an Aug. 30 letter to the Senate Finance Committee. Sen. Max Baucus (D, Mont.), the committee’s chair, had asked the AMA and other physician organizations to offer suggestions on how to transition to a new payment system after a July 11 roundtable discussion with organized medicine and committee members. During that hearing, senators agreed that the current system is broken and that the sustainable growth rate formula used to help calculate Medicare rates in the fee-for-service system needs to be replaced. The SGR is set to reduce rates by about 27% in 2013. A new pay system would need to be a significant departure from the current one-size-fits-all program, wrote AMA President-elect Ardis Dee Hoven, MD. It would need to promote delivery models that reward quality of care instead of simply volume of services provided. “As s [Read more]
Court knocks down requiring graphic warnings on cigarette packs
Physicians and public health advocates say they are disappointed by an appeals court decision that blocks graphic warnings from appearing on cigarette packages. The U.S. Court of Appeals for the District of Columbia Circuit declared unconstitutional a Food and Drug Administration rule requiring the images, which include pictures of a man smoking through his tracheotomy hole and a dead person with a surgery-scarred chest. The ruling ignores strong scientific evidence supporting the effectiveness of larger graphic warning labels in communicating the health dangers of tobacco use, said Robert W. Block, MD, president of the American Academy of Pediatrics. “With 10 million cigarettes sold every minute and almost 3,000 children under the age of 18 starting to smoke each day, this ruling puts children’s lives at risk,” Dr. Block said in a statement. “Warning labels play a critical role in educating children, teens and parents about the negative health impacts of tobacco.” [Read more]
House calls increase satisfaction and cut hospital admissions among elderly
A house call program may not always reduce health care costs in treating older adults with numerous chronic conditions, but there may be other benefits, according to the August American Journal of Managed Care. “The problem is not the model but most likely the way we selected the people,” said Susan Enguidanos, MPH, PhD, one of the authors and an assistant professor at the University of Southern California in Los Angeles. “We need to better select the population based on illness and need.” House calls are one of many possibilities being considered to reduce medical costs within health system reform. The paper looked at 156 elderly patients randomized to a house call program run by HealthCare Partners. These patients were compared with 142 who were not in the program. Enguidanos is a consultant with HealthCare Partners, based in Torrance, Calif., and operates medical groups and physician networks in California, Florida and Nevada. The majority of the other authors are e [Read more]
U.S. performs poorly on preventable death rates
Americans younger than age 65 have higher chances of dying from preventable conditions than those in other industrialized nations, according to a new study. The study, sponsored by the Commonwealth Fund and published online by Health Affairs, concluded that the U.S. ranked behind the United Kingdom, France and Germany on avoidable mortality rates, and that it also was progressing at the slowest pace to improve these statistics. “Despite spending about twice as much per person each year on health care as France, Germany or the U.K. — $8,400 in 2010 — the U.S. is increasingly falling behind these countries in terms of progress in lowering the potentially preventable death rate,” Commonwealth Fund President Karen Davis said in a statement. In conducting their research, Martin McKee, professor of European public health at the London School of Hygiene & Tropical Medicine, and Ellen Nolte, director of the health and health care at RAND Europe, looked at “amenable mortality [Read more]
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