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White House refuses to drop $8 billion Medicare private plan demo
The Obama administration’s top health official will not rescind a Medicare demonstration project that a government watchdog agency concluded is mainly benefiting average health plans instead of just those providing a higher quality of coverage. Health and Human Services Secretary Kathleen Sebelius defended the Medicare Advantage quality bonus program during an April 27 hearing before the House Education and the Workforce Committee. Committee members strongly criticized HHS over findings in a recent Government Accountability Office report, which called for ending an $8 billion project that will offset some of the Medicare Advantage cuts mandated by the 2010 health system reform law. “We have no intention of canceling the project,” Sebelius said. In November 2010, the Centers for Medicare & Medicaid Services announced it would run the three-year demonstration project beginning in 2012. The program would reward private Medicare plans according to a five-star rating system b [Read more]
Promise seen in blood test that diagnoses depression in teens
In a small but significant study, researchers have identified biological markers in the bloodstream that physicians could use to diagnose depression in adolescents. The goal is to develop a blood test that could be used easily and widely to pinpoint early-onset major depressive disorder. Such a test would particularly be of use to primary care physicians, said Eva E. Redei, PhD, senior study author and David Lawrence Stein Professor of Psychiatric Diseases Affecting Children and Adolescents at Northwestern University Feinberg School of Medicine in Chicago. Of all age groups, adolescents see doctors the least. When they do, they most often see a primary care physician. “This is an exciting study,” said Robert Scott Benson, MD, speaker-elect of the American Psychiatric Assn. Assembly and a child and adolescent psychiatrist in Pensacola, Fla. “It is one of many we expect to see that will help us improve our understanding of depression.” Major depression affects about 1 [Read more]
Telemonitored patients show no drop in readmissions and ED visits
Daily remote monitoring of patients with chronic conditions appears to be ineffective in reducing re-hospitalizations and emergency department visits, according to the most recent randomized controlled trial of the technology. Researchers compared two groups of Mayo Clinic patients 60 and older with conditions such as heart disease, diabetes and chronic obstructive pulmonary disease who were at high risk of re-hospitalization. One group of 102 patients received tele-monitoring that had real-time videoconferencing capability and could measure patients’ weight, blood glucose and blood pressure for nurse and physician review, while a group of 103 patients received no tele-health services. Forty-four percent of the usual-care patients were re-hospitalized within the following year, while 52% of the tele-monitoring patients were admitted to the hospital. Meanwhile, 28% of the usual-care patients visited the ED, compared with 35% of the tele-monitored patients. The differences were n [Read more]
Regulatory compliance alone not protecting practices against data breaches
In an effort to meet industry and government patient privacy regulations, many health care organizations, including physician practices, are stuck in a “check-box mentality” that has taken focus away from other vulnerabilities, an organization behind a report on data security concludes. The Healthcare Information and Management Systems Society surveyed 250 senior health information technology and data security officers on behalf of Kroll Advisory Solutions, a risk-management firm whose services include data security and data-breach response. The officers reported that they were prepared to meet compliance regulations. On a scale of one to seven, with one being “not at all compliant” and seven being “compliant with all applicable standards,” respondents reported that they were an average of 6.64 in terms of meeting regulations set by the Centers for Medicare & Medicaid Services, a 6.62 for meeting HIPAA regulations, and a 6.41 for meeting state security laws. However, [Read more]
State abortion laws place unprecedented limits, requirements on doctors
Several states recently continued their push to implement more restrictions on when doctors are allowed to provide abortions, in some cases effectively cutting off access to the procedures, according to opponents. Wisconsin Planned Parenthood announced that it had stopped offering nonsurgical abortion services after Gov. Scott Walker signed into law requirements on the physicians facilitating them. Under the new law, a doctor must have three office visits with a woman before prescribing a drug-induced abortion, determine that the woman is not being coerced into the procedure and not use webcams during the procedure. Physicians who don’t follow the mandate could be subject to jail time or other criminal penalties. The enactment of the law was opposed by the Wisconsin Medical Society, which said that it “directly infringes on the special and private relationship between the patient and physician” by legislating medical protocol. In Mississippi, a new law requires physician [Read more]
House GOP claims health reform taxes would hurt businesses
House Republicans are objecting to taxes earmarked to fund key health system reforms, saying that raising new revenues from businesses would hinder employers from hiring workers. The House Small Business Committee held an April 18 hearing to discuss taxes created by the 2010 reform law. Republicans are pushing to lower taxes on businesses, but a dozen taxes related to the law will be levied on companies and individuals by 2014. They include tax penalties on certain businesses that do not provide health coverage to workers and surtaxes on investment income for individuals with income more than $200,000. “Small businesses are especially sensitive to expected tax policy because they must make important, long-term decisions today on investment, hiring and expansion,” said Rep. Sam Graves (R, Mo.), the committee chair. Starting in 2013, a 3.8% surtax will be levied on investment income of more than $200,000 for individuals and more than $250,000 for couples, according to a comm [Read more]
Higher glucose levels might help heart failure patients with diabetes
Tight control of diabetic patients’ blood glucose levels often helps prevent them from developing complications, such as kidney disease and nerve damage. But for patients who have advanced heart failure and diabetes, significantly decreasing their glucose levels might raise their mortality risk, a study says. Diabetic patients with heart failure who had lower levels of glycosylated hemoglobin were more likely to die or need urgent heart transplantation during two years of follow-up compared with those with higher HbA1c levels, according to the study published online March 29 in The American Journal of Cardiology. One possible explanation for the finding is that patients with lower HbA1c levels might be taking an inappropriate medication to control their diabetes, such as insulin, said senior study author Tamara B. Horwich, MD. Though insulin might decrease glucose levels, it often is linked to poor health prognosis for people with heart failure, she said. “We may find that [Read more]
Med students benefit from following patients long-term
Third-year medical students who participated in a program that allowed them to follow the same patients throughout the year performed as well or better than peers who underwent traditional clerkship training, says a study in Academic Medicine. The program was a pilot of the Harvard Medical School-Cambridge Integrated Clerkship at Cambridge (Mass.) Health Alliance, and it since has been made a full program. Instead of traditional clinical block rotations, integrated clerkship students follow a panel of patients representing a wide spectrum of medical conditions through inpatient and outpatient care. They also work continuously during the year with physicians in each of the core specialties. Students develop relationships with patients and faculty and witness the natural progression of illness and treatment outcomes, said David Hirsh, MD, lead study author and the program’s director and co-creator. “They really get to know patients in context so that they aren’t known just by [Read more]
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