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States maintain or ease access to Medicaid and CHIP
Despite continued budget pressures on states, far more states eased than tightened access to Medicaid and the Children's Health Insurance Program in 2011. Twenty-nine states increased Medicaid or CHIP eligibility, lowered beneficiary cost-sharing or improved their enrollment procedures in 2011. That's according to a 50-state survey of state Medicaid programs released Jan. 18 by the Kaiser Commission on Medicaid and the Uninsured and the Center for Children and Families at Georgetown University. In contrast, only two states restricted Medicaid or CHIP eligibility last year, and only seven increased enrollee cost-sharing. State Medicaid actions were influenced by federal incentives and requirements in the national health system reform law, according to the survey. For example, the Dept. of Health and Human Services announced in April 2011 that it would pay 90% of the costs of developing new or upgrading existing Medicaid eligibility and enrollment systems until 2015. Eighteen state [Read more]
American Lung Assn. gives mixed reception to tobacco control efforts
The federal government took important steps to combat tobacco use in 2011, including extending quit-smoking benefits to federal employees, providing partial payment for states that offer tobacco counseling for Medicaid recipients and pushing graphic warning labels for cigarettes. States, however, did a poor job of tackling tobacco-related issues, said the American Lung Assn.'s 10th annual report on tobacco-control initiatives. No states enacted strong smoke-free-air laws in 2011, and some cut funding to smoking prevention and cessation programs. "We're talking about a vast, ongoing health crisis," said American Lung Assn. President and CEO Charles D. Connor. In addition to its impact on individual lives, tobacco use costs the country nearly $193 billion annually in health care costs and lost productivity, he said. In June 2011, the Food and Drug Administration released images of nine graphic warning labels, including a man smoking through a tracheotomy hole and a small chil [Read more]
Stop giving PSA test to elderly, study urges
Adding to the debate about when to screen men for prostate cancer is a study that shows testing annually for the disease does not reduce deaths. The research, published Jan. 6 in the Journal of the National Cancer Institute, updates findings from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial that began in November 1993. Authors of the most recent study urge physicians to stop screening for the disease in elderly men and those with a limited life expectancy. "We need to take a more targeted approach and selectively screen men who are young and healthy, particularly those at high risk for prostate cancer, including African-Americans and those with a family history of the disease," said lead study author Gerald Andriole, MD. "A large majority of the cancers we found [in the study] are slow-growing tumors that are unlikely to be deadly," said Dr. Andriole, chief urologic surgeon at the Siteman Cancer Center at Barnes-Jewish Hospital and Washington University [Read more]
Med students to get training to treat PTSD, combat head injuries
Academic institutions are partnering with a military support initiative led by the Obama administration to improve care for post-traumatic stress disorder, depression and traumatic brain injury. First lady Michelle Obama announced that 130 medical education programs have agreed to participate in a program ensuring that physicians are trained to recognize and treat combat PTSD and TBI. Obama spoke about the initiative Jan. 11 at Virginia Commonwealth University School of Medicine in Richmond, one of the participating schools. "By directing some of our brightest minds, our most cutting-edge research and our finest teaching institutions toward our military families, they're ensuring that those who have served our country receive the first-rate care that they have earned," she said. The effort is part of the administration's Joining Forces initiative, which coordinates support from different sectors of the economy for service members. Joining Forces Executive Director Brad Cooper [Read more]
Doctors should weigh costs in treatment, ACP says
Physicians should consider data on cost-effectiveness when making treatment recommendations and ought to behave professionally when using social media. Those are among the recommendations in the sixth edition of the American College of Physicians' ethics manual, updated for the first time since 2005 to include guidance on topics such as genetic testing, catastrophic care and pay-for-performance. Doctors have a responsibility to deliver "parsimonious care that utilizes the most efficient means to effectively diagnose a condition and treat a patient," says the college's policy on cost containment. Whether treating individual patients or serving on panels that write formularies and guidelines, doctors should make decisions based on "the best available evidence in the biomedical literature, including data on the cost-effectiveness of different clinical approaches," the guidance says. "Physicians have to start to personally think about how they use resources in the care of individu [Read more]
Volunteering can boost physical and mental health
At a time when financial hardships and unemployment are causing stress among many Americans, primary care physicians should discuss with patients the physical and mental health benefits of volunteering, says the author of a recent report. The report, which was published in the December 2011 issue of The International Journal of Person Centered Medicine, found that people who give back to others lead more happy and healthy lives than those who do not volunteer. "People in general are happier and healthier, and may even live a little longer, when they're contributing" to their community or an organization they are passionate about, said study author Stephen G. Post, PhD. He is director of the Center for Medical Humanities, Compassionate Care and Bioethics at Stony Brook University School of Medicine in New York. "The research on the benefits of giving is extremely powerful, to the point that suggests health care professionals should consider recommending such activities to patients [Read more]
Barred physicians prescribed millions in Medicare drugs
The Centers for Medicare & Medicaid Services allowed physicians barred from prescribing under Medicare Part D to order more than $15 million in drugs from 2006 to 2008, an investigation by the Dept. of Health and Human Services Office of Inspector General has found. In addition to allowing the prohibited physicians to prescribe, CMS approved nearly an additional $2 million for prescriptions that may have come from excluded doctors, said the Dec. 23, 2011, report. In response to the audit, CMS said it has taken significant actions in recent months to ensure that payments are not made to physicians who have been barred from prescribing, according to a response letter sent to the OIG. The agency also is keeping more up to date on its list of excluded physicians and paying closer attention to physician-identifier data. An identifier is the unique number assigned to each physician and required on all pharmacy claims submitted under the Part D program. As part of its audit, the OIG [Read more]
Larger role sought for advanced practice nurses
Efforts to increase the primary care work force, such as expanding medical school classes and offering incentives to those who go into primary care, aren't enough to meet growing demands for care, said a report from the National Institute for Health Care Reform. Though such initiatives are important, it will be several years before the benefits are seen, said the nonprofit institute, which conducts research and analysis of health care organization, financing and delivery. The institute was established by the International Union, United Automobile, Aerospace and Agricultural Implement Workers of America; Chrysler Group LLC; Ford Motor Co.; and General Motors Co. The December 2011 report proposes quicker action by expanding advanced practice nurses' scope of practice and implementing payment policies that encourage team-based care. "Examining scope-of-practice laws and payment reforms to increase productivity of primary care practices may have a greater near-term impact on prima [Read more]
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